Montreal woman whose legs were severed by train has 'strong spirit,' mom says

The family of Sarah Stott is overwhelmed by the outpouring of support for a 22-year-old whose legs were severed by a train in Montreal earlier this month.

An online crowdfunding campaign, started two days ago by Stott's best friend, to help Stott and her family, reached almost $25,000 by early Wednesday morning.

In the early morning hours of Dec. 8, Stott finished a waitressing shift at the Irish Embassy Pub and Grill in downtown Montreal by popping in to visit a friend.

She took a taxi to her friend's place, but when she realized no one was there, she headed home to Verdun on foot, across CN Rail tracks that have become a popular but unauthorized rail crossing.

She saw a stopped train on one set of tracks. But it wasn't until it was too late that she saw the second one.

The trains were near the CN rail yard at Bridge and Wellington streets, near the Victoria Bridge. It is not known how fast the train was travelling or whether it made any sounds as it approached.

"She saw the train coming and she ran as fast as she could. She thought she could make it across," said mom Shelley Stott.

Conscious during entire ordeal

The woman told her mom she remembers seeing her severed legs, and then trying to sit up and crawl towards them.

'She saw the train coming and she ran as fast as she could. She thought she could make it across.'- Shelley Stott, mother of Sarah Stott

She lost her entire right leg, and her left leg was severed below the knee.

She was lying on the ground in the cold for three to four hours before another train began approaching.

She sat up and waved the train down, and was transported to hospital shortly thereafter.

That's where she has been ever since.

Stott is in a Montreal hospital trauma unit, where she was given a tracheotomy and has undergone more than 15 surgeries.

"It's a miracle that she's alive," Shelley Stott said. "Every day with her is an absolute blessing. She has an extremely strong spirit and will to live. She was left there for three, four hours with her legs severed, in the cold. She was still conscious. She was hypothermic."

Stott has a long road ahead of her.

Her mother said she may still lose her fingertips or parts of her hands, and is facing at least a year of rehabilitation after she gets out of hospital.

Her mom will move her back to Ottawa to take care of her.

Mom 'speechless' over support

Despite experiencing a double amputation in such a horrific way, she said her daughter has maintained her sense of humour.

"I walked into the room one day and she was awake, and she lifted her leg and said, 'Look Mom, I have no legs!' And I said, 'Yes sweetheart, you're going to get a brand new one.' She said, 'Yes I am! It'll be firm forever — and I want it tanned,'" Shelley recounted.

She said she has been blown away by the support her daughter has received from friends, co-workers and even strangers, including the money raised so far through crowdfunding.

"It's very overwhelming … I always believed people have a good heart, but for the amount that was raised in such little time … I'm speechless. I'm overwhelmed. I'm full of gratitude," Shelley Stott said.

Outpouring of support

Emily Whyte, Stott's best friend, decided to start the fundraising campaign after hearing about the accident.

"I just wanted to help Sarah however I could," she said. 

"I was so devastated when I heard about the accident. It's so shocking and such a rare thing to happen, and I knew there would be a lot of medical bills.

"I didn't expect that turnout, and I think that's going to help her heal, just to see how many people care about her and how many people are rooting for her," Whyte said. 

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Flu shot no match for H3N2 strain reported across Canada

Flu season is coming in early and strong this winter, with hospitals across Canada getting flooded with infected patients.

Most flu cases are being reported in Alberta, Ontario and Quebec, according to Canada's Public Health Agency, but there is increasing activity in Saskatchewan, Manitoba, and Newfoundland and Labrador. 

"We're at or close to peak, certainly in southern Ontario, for influenza activity," said Dr. Doug Sider, medical director of communicable disease prevention and control at Public Health Ontario.

It's the same situation in Montreal, where the city's two pediatric hospitals are asking parents to keep their children at home if they have mild cold or flu symptoms. Over the past two weeks, the hospitals have received several hundred children with a cold or flu, per day.

"These are record numbers for this time of year," said Dr. Antonio D'Angelo, head of Ste-Justine's ER department.

In Manitoba, the Winnipeg Regional Health Authority (WRHA) said emergency rooms are very busy. According to WRHA, the number of people with the flu who are reporting to ERs and could not be sent home is almost double the normal rate for this time of year.

The reason for the high numbers of hospitalizations and activity could be this year's H3N2 flu strain, which is being seen in the majority of cases.

Public health officials said the flu vaccine this year is not as effective in protecting against the H3N2 strain, which tends to cause more deaths and hospitalizations, especially in the elderly.

According to FluWatch, Canada's national surveillance system that monitors the spread of flu, the majority of H3N2 cases have been among individuals 65 and older.

In Ontario, among the 1,169 confirmed flu cases, nearly half were H3N2.

So far, the flu has caused 369 hospitalizations in the province. Nineteen people — all 65 or older — have also died, according to a public health bulletin released on Tuesday.

Despite the reduced effectiveness of the vaccine against H3N2, "the vaccine can still provide some protection against H3N2 influenza illness and can offer protection against other influenza strains such as A (H1N1) and B," according to the federal public health agency's website.

Winnipeg's health authority said that while it is hard to determine how effective this year's vaccine has been, it is still encouraging people who haven't yet been vaccinated to get the flu shot.

"Whether we're seeing the illness in those that were vaccinated, or whether it was people who were unvaccinated ... we won't know that probably for several weeks," said chief nursing officer Lori Lamont.

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Ebola outbreak: Canadian volunteers to West Africa doubles since call to action

The number of Canadians who have volunteered to take part in the government's efforts to stop the deadly spread of Ebola in West Africa has doubled since Health Minister Rona Ambrose put out a call to action last month.

Ambrose called on health-care workers to join the fight against Ebola in Sierra Leone, Liberia and Guinea during a press conference on Nov. 27.

​​Nick Ayre, a recruitment officer with the Red Cross's Ebola response team, said 670 Canadians have applied to help contain the deadly virus in West Africa — 350 since the government's call for more volunteers. Of the 350 who have applied, 100 of those are government workers.​

In an interview with CBC News, Ayre did not sugarcoat the risks and challenges faced by volunteers on this mission.

"The environmental conditions are harsh to deal with and they're coming face-to-face on a daily basis with death."

Patrice Gordon, a B.C. nurse practitioner and Red Cross delegate, is currently working at the Red Cross Ebola treatment centre in Kenema, Sierra Leone. She is seen here caring for a one-month-old baby with Ebola. (Handout/Canadian Red Cross)

Ayre said while the majority of the applicants are nurses, there is still a need for more volunteers, specifically doctors as well as water sanitation engineers.

The Red Cross will open a new treatment centre in Kono, Sierra Leone, in the next few days. The new centre will open as Canadian troops have begun working on the ground.

The federal government confirmed today that 37 Canadian Armed Forces doctors, nurses, medics and support staff have started working at a British-operated treatment unit in Kerry Town, Sierra Leone.

National Defence Minister Rob Nicholson, following an event in Halifax earlier today, welcomed their efforts in preparing for the mission.

"The feedback that I have received at this point in time is that it's positive and they're working well and putting this together."

In a written statement, Lieutenant-General Jonathan Vance, commander of Canadian Joint Operations Command, said he was proud of the work Canadian troops were doing on the ground.

"Their efforts will help alleviate human suffering, save lives, and serve as a reminder of the Canadian Armed Forces' important and enduring role in helping people around the world."

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The new fix for weight-loss woes? 'Eau de potato'

Potatoes have long been thought of as a starch-filled food that pack a big punch on your plates — but that could also pack on pounds.

But recent lab testing being undertaken by researchers at Montreal's McGill University indicates the humble potato could actually provide a key to weight control.

Their research indicates potato extract has been shown to prevent obesity in mice.

Stan Kubow and fellow researchers at McGill University have discovered that potato extract may hold to a key to blocking fat absorption. (CBC)

At a lab on McGill's MacDonald campus in Ste-Anne-de-Bellevue, researchers have been scrubbing, boiling and extracting samples from potatoes.

"[We chose] mice that were genetically prone to develop obesity when they were fed a high-fat diet, and to our astonishment there was an inhibition of 50 per cent of the weight gain," said McGill professor and researcher Stan Kubow.

Researchers and nutrition experts believe potatoes are undervalued sources of nutrients. They contain antioxidants called polyphenols, which are also found in blueberries and red wine. Polyphenols act as an anti-inflammatory, and work to block the absorption of fat from food.

"We maybe are overlooking these nice, starchy vegetables as a good, healthy source too, not just of polyphenols, but vitamin C, which is also an antioxidant, and great potassium, B vitamins. It's pretty nutrient-packed," said dietitian Robin Glance.

However, researchers caution that simply piling a stack of french fries or even boiled potatoes onto your plate won't have nearly the same effect as using a potato extract.

"The one dose of the potato extract is equivalent to eating 30 potatoes. Thirty regular-sized table potatoes," said Lou Agellon a professor with McGill's School of Dietetics and Human Nutrition.

"What we envisage is that this extract could be used as a supplement, so you make a drink out of it, or even as an ingredient that one can use in cooking," he added.

If potato extract does turn out to help keep weight off, researchers say you're better off sprinkling it onto a salad and not a rich food like poutine.

The McGill study was funded by the Natural Sciences and Engineering Research Council of Canada, the Canadian Institutes of Health Research and the Canada Foundation for Innovation.

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Ebola patient in Scotland transferred to London

A health worker who was the first person diagnosed with Ebola in Britain arrived at a London hospital from Scotland early on Tuesday for treatment after contracting the disease in West Africa.

The woman arrived at the capital's Royal Free hospital, Britain's designated Ebola treatment centre, in an ambulance accompanied by several police vehicles, a Reuters witness said.

"We think so far certainly the clinical care for her is going as expected," said Paul Cosford, Director for Health Protection at Public Health England, the government body handling Britain's response to Ebola, on BBC radio.

"The agreement we have across the country is that the right place for treatment for people with Ebola is at the Royal Free in their specialist facilities... it's a clinical decision."

The hospital's 'High-level isolation unit' will allow doctors to treat the patient while she lies inside a plastic tent, limiting the scope for the disease, which is transmitted by contact with bodily fluids, to be passed to medical staff.

The World Health Organization said on Monday that the number of people infected by Ebola in the three West African countries worst affected by the outbreak - Sierra Leone, Liberia and Guinea - had passed 20,000, with more than 7,842 deaths so far.

The National Health Service worker, who had been working in West Africa with the charity Save the Children, flew from Sierra Leone to Glasgow late on Sunday on a British Airways flight via Casablanca in Morocco and London's Heathrow.

She was diagnosed with the deadly virus on Monday after developing symptoms overnight and was initially treated at Scotland's Gartnavel Hospital.

"I'm satisfied... that the procedures, the protocols, the things that we've been practising now for months and months have now kicked in," Health Minister Jeremy Hunt said. Hunt led a meeting of the government's emergency response committee late on Monday.

Scottish authorities have said the illness was diagnosed at an early stage, meaning the risk to others was considered extremely low, but they were investigating all possible contacts with the patient.

Britain began screening passengers arriving from West Africa for symptoms of Ebola in October as part of its preparations for a case of the disease on British soil. Hunt said at the time that he expected to see "a handful" of cases arriving in Britain.

Earlier this year the Royal Free hospital successfully treated another British aid worker, William Pooley, who was flown home for treatment after being diagnosed with the virus in Sierra Leone.

Scottish First Minister Nicola Sturgeon said a second patient in Scotland was being tested for the virus after returning from West Africa, but had a low probability of having the virus, having had no known contact with infected people.

A third person was undergoing tests for the Ebola in Cornwall, England and was being treated in an isolation unit, a statement from Public Health England said. The results of that test would take at least 24 hours, the statement said.

Public Health England's Cosford said that around 200 people had been assessed or tested for the virus in recent months.

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Dozens of new Ebola cases in Liberia mark setback amid recent improvements

Dozens of new Ebola cases have erupted in Liberia, near the border with Sierra Leone, Liberian health officials warned Monday, marking a setback amid recent improvements.

It also threatens the country's goal of recording no new cases of the disease by the end of the year.

The new cases bring the number of people infected by Ebola in the three countries worst affected by the outbreak to 20,081, the World Health Organization said on Monday. Among them, more than 7,842 deaths have been reported.

The flare-up is due to a number of factors including people going in and out of Liberia and traditional practices such as the washing of bodies, said Liberia's Assistant Health Minister Tolbert Nyenswah.

Forty-nine cases were reported in in western Grand Cape Mount County between December 1 and 25, Nyenswah told state radio. This included 27 confirmed cases, nine probable and 13 suspected, said Nyensuwah.

The government had set a Dec. 31 target for recording no new Ebola infections. The Grand Cape Mount outbreak makes hitting that target unlikely.

"In a very small population, an increase in the number of [Ebola] cases raises high level of concerns that we need to take very seriously as people of Liberia and people of Grand Cape Mount in particular," he said.

Grand Cape Mount is one of Liberia's least populous counties, with just over 140,000 people. It borders Sierra Leone, where the deadly hemorrhagic fever is also raging.

Nearly 3,400 people have died from Ebola in Liberia over the past year with nearly 8,000 cases total, though health officials say the situation has improved, especially in the capital, Monrovia.

Sierra Leone, in comparison, has now eclipsed Liberia with more than 9,000 Ebola cases, according to the World Health Organization.

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4 damaging effects of poor posture from technology

Every inch your head moves forward is an extra 10 pounds your neck holds up. (Mike Segar/Reuters)

Health professionals have have seen an uptick in ​headaches, and pain in the neck, back and face they say is increasingly ​linked to poor posture, but there are ways to counteract the damage.

Here are four examples of the damage, why it occurs and one solution, from the Canadian Chiropractic Association and Halifax physiotherapist Janice Moreside:

• Each year, over 11 million Canadians suffer from at least one musculoskeletal condition, many linked to the use of technology.
• Low back pain and other musculoskeletal conditions account for one-third of missed work time in Canada — second only to the common cold.
• Every inch your head moves forward is an extra 10 pounds your neck holds up. Do that for much of the day and the results can be excruciating and costly. 
• When you stare down at a screen, the head is taken off the vertical and bent forward up to 45 degrees.
• The Canadian Chiropractic Association's free Straighten Up Canada app provides 12 short exercises to improve posture. The videos demonstrate stretches and exercises that combat technology-induced poor posture.

Theresa Blackburn, 47, is a writer and a teacher in New Brunswick. She's seeing a massage therapist for back pain.

"She said, 'You know, you have a hump,'" Blackburn said. "She said it's related  to poor posture and we had a conversation about how I spend a lot of time in front of a computer, and you're kind of hunched down."

Moreside of Dalhousie University in Halifax has been a physiotherapist for more than 35 years. In her career, Moreside has seen many campus students with low back and neck pain or arm dysfunction because of sitting and leaning forward on computers.

Sitting with the shoulders forward can lead to tightness and pulling at the opposing muscles in the back, Moreside said. The arteries, veins and nerves that run to the arms and hands can also be compressed, which increases the likelihood of tennis elbow and carpal tunnel syndrome.

To counteract poor posture, Moreside​ ​recommends​ standing straight, and stretching and strengthening muscles.

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Tattoo artist creates booming business concealing scars

Samira Omar pushes back her headscarf to reveal burn scars that swirl along her face and neck. Her hands are also dotted with colourless patches where her skin was scorched.

The 17-year-old says she was the victim of a horrific bullying incident in August. She says four classmates she thought were her friends, beat her and then doused her with boiling water.

Basma Hameed before and after tattooing the burn scars on her own face (Courtesy of Basma Hameed)

"I remember I looked into the mirror when I was calling for help and I could see my skin completely hanging off me," says the soft-spoken girl. "It just felt as if I'd been through hell and back."

She thought she'd be scarred for life. But then Omar heard about para-medical tattoo specialist Basma Hameed. She didn't hold out much hope because she'd been let down before when she consulted specialists.

"It was just like, am I going to go in and just have another plastic surgeon or dermatologist tell me 'oh, you're not going to get colour back?'" she said.

But Hameed told Omar that she could restore her natural skin colour. While inspecting the scars, she said, "We'll make sure we cover all of these areas. But it will take a series of treatments."

One step at a time

Over time, Hameed will camouflage Omar's burns by tattooing them with ink that blends with her natural skin tones.

"When she told me she could actually get my pigments back and find a skin colour that could match my actual skin colour, it's just a big sigh of relief," Omar says.

Patients from around the world seek out Hameed's skills. She started her Toronto clinic in 2011 and recently opened a second location in Chicago. In addition to scar victims, she also treats people with vitiligo — a skin disease that causes loss of pigment — and breast cancer survivors who need redrawing of their nipples or eyebrows that disappeared during chemotherapy.

"I think that I'm good at para-medical scar camouflage because I was able to work on myself, and I was able to see the process of it," she says.

Hameed's painful journey

When Hameed was just two years old, she was badly burned by hot oil in a kitchen accident in her native country, Iraq. She endured more than 100 painful procedures —from plastic surgery to laser treatments. But half her face remained scarred with red discoloration from third degree burns. She was advised nothing more could be done.

'I think that I'm good at para-medical scar camouflage because I was able to work on myself.'- Basma Hameed, para-medical tattoo specialist

"I was told by my plastic surgeon that I needed to take my money and go on a vacation. For me, I felt like that wasn't the end of the road. I truly believed that something else did exist. So I did a lot of research, and of course I went to school. I made sure I knew what I was getting myself into."

What she was getting into was an emerging form of cosmetic tattooing. Hameed discovered the procedure when she got an eyebrow tattooed to replace the one she had lost from the burn. She decided if tattooing could replace eyebrows, then why not her original skin colour?

"When I started working on my face, I was extra careful. I wanted to make sure that I was going to get the right result," she says.

Patient transformation

Hameed not only transformed her own face, but she also started what is now a booming business, helping transform the lives of others.

On this day, she is treating Nafi Nzambe, who burned her hand in a cooking accident. Hameed carefully chooses the right colour to match Nzambe's skin and began tattooing the white marks left by the burn.

When asked what she thinks of Hameed, Nzambe lights up. "She's good! So I can smile now because of her."

Nzambe shows a section of the scar where Hameed has planted pigment as proof. "It's like my normal skin," she says, "So I have hope."

Artistry and empathy

Hameed is also giving hope to Omar, who she is treating for free through her charity, the Basma Hameed Survivors Foundation.

It's a big relief for Omar, who is still trying to cope with what happened to her. She says police are investigating her bullying case, which happened near London, England, her home at the time. She has since retreated back to her birthplace, Canada.

"When I hear her story, I felt like I relate so much," says Hameed. "I wanted to reach out to and help as much as possible."

She has to wait a few more months to treat Omar because the scars are still fresh. But she already has a way to help. She shows the young woman how to apply scar concealer. Hameed developed the product — again by experimenting on herself.

After, Omar stood in the mirror, smiling. "It's a great finish, honestly, thank you so much," she tells Hameed with renewed confidence.

"I am proud of myself for not giving up but what I'm mostly proud of is the reaction [I get] from people," says Hameed.

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4 damaging effects of poor posture from technology

Every inch your head moves forward is an extra 10 pounds your neck holds up. (Mike Segar/Reuters)

Health professionals have have seen an uptick in ​headaches, and pain in the neck, back and face they say is increasingly ​linked to poor posture, but there are ways to counteract the damage.

Here are four examples of the damage, why it occurs and one solution, from the Canadian Chiropractic Association and Halifax physiotherapist Janice Moreside:

• Each year, over 11 million Canadians suffer from at least one musculoskeletal condition, many linked to the use of technology.
• Low back pain and other musculoskeletal conditions account for one-third of missed work time in Canada — second only to the common cold.
• Every inch your head moves forward is an extra 10 pounds your neck holds up. Do that for much of the day and the results can be excruciating and costly. 
• When you stare down at a screen, the head is taken off the vertical and bent forward up to 45 degrees.
• The Canadian Chiropractic Association's free Straighten Up Canada app provides 12 short exercises to improve posture. The videos demonstrate stretches and exercises that combat technology-induced poor posture.

Theresa Blackburn, 47, is a writer and a teacher in New Brunswick. She's seeing a massage therapist for back pain.

"She said, 'You know, you have a hump,'" Blackburn said. "She said it's related  to poor posture and we had a conversation about how I spend a lot of time in front of a computer, and you're kind of hunched down."

Moreside of Dalhousie University in Halifax has been a physiotherapist for more than 35 years. In her career, Moreside has seen many campus students with low back and neck pain or arm dysfunction because of sitting and leaning forward on computers.

Sitting with the shoulders forward can lead to tightness and pulling at the opposing muscles in the back, Moreside said. The arteries, veins and nerves that run to the arms and hands can also be compressed, which increases the likelihood of tennis elbow and carpal tunnel syndrome.

To counteract poor posture, Moreside​ ​recommends​ standing straight, and stretching and strengthening muscles.

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From weight loss to pot, the top 10 health news topics of 2014

Research suggests only about five per cent of people who try to lose weight ultimately succeed, but we cling to their stories as proof that losing weight is possible. (Canadian Obesity Network)

The Ebola virus dominated health news in 2014 but it was our waistlines that clicked most on cbc.ca/news/health.

A story about how our biology taunts us by making short-term weight loss fairly easy but permanent weight loss nearly impossible was the top health news story of the year.

The second-most ready story was an analysis of public health inspection reports from national chain restaurants. It revealed a range of health violations, including temperature and food storage issues, food handling and handwashing problems, pest control, cross-contamination and general kitchen cleanliness.

A food-related story rounded out the top three. Researchers said artificial sweeteners may have directly contributed to enhancing the obesity epidemic that the calorie-free sweeteners were intended to fight.

The next most-viewed story explored how drinking water was contaminated by excreted drugs from people. Trace evidence of acetaminophen, codeine, antibiotics, hormones and steroids passed through most sewage treatment processes and eventually in our drinking water. No one knows whether the cocktail of biologically active compounds, consumed at low levels over a lifetime, is a human health risk. A related story comparing bottle and tap water also made the list.

Ebola cases and deaths in Guinea, Sierra Leone and Liberia quickly exceeded the totals for all previous outbreaks of the disease combined. A look at Ebola by the numbers was the most viewed story on the topic, followed by a story on the  first Ebola case diagnosed in the U.S. Among the top 10 included:

Another virus, enterovirus D68, sent hundreds of children to hospital in the U.S. and Canada. A frequently asked questions and answers story provided eight facts parents should know.

A feature with the headline, "Marijuana was criminalized in 1923, but why?" was the eighth most read.

To complete the list, two stories reconsidered use of prescription drugs for two common conditions, depression and heart disease.

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Malaria treatment suffering in shadow of Ebola fight in Africa

West Africa's fight to contain Ebola has hampered the campaign against malaria, a preventable and treatable disease that is claiming many thousands more lives than the dreaded virus.

In Gueckedou, near the village where Ebola first started killing people in Guinea's tropical southern forests a year ago, doctors say they have had to stop pricking fingers to do blood tests for malaria.

Guinea's drop in reported malaria cases this year by as much as 40 per cent is not good news, said Dr. Bernard Nahlen, deputy director of the U.S. President's Malaria Initiative. He said the decrease is likely because people are too scared to go to health facilities and are not getting treated for malaria.

"It would be a major failure on the part of everybody involved to have a lot of people die from malaria in the midst of the Ebola epidemic," he said in a telephone interview. "I would be surprised if there were not an increase in unnecessary malaria deaths in the midst of all this, and a lot of those will be young children."

Last year, 15,000 people in Guinea died from malaria - 14,000 of them were children. (Schalk van Zuydam/ Associated Press)

Figures are always estimates in Guinea, where half the 12 million people have no access to health centres and die uncounted.

Some 15,000 Guineans died from malaria last year, 14,000 of them children under five, according to Nets for Life Africa, a New York-based charity dedicated to providing insecticide-treated mosquito nets to put over beds. In comparison, about 1,600 people in Guinea have died from Ebola, according to statistics from the World Health Organization.

Malaria is the leading cause of death in children under five in Guinea and, after AIDS, the leading cause of adult deaths, according to Nets for Life.

Ebola and malaria have many of the same symptoms, including fever, dizziness, head and muscle aches. Malaria is caused by bites from infected mosquitoes while Ebola can be contracted only from the body fluids of an infected victim — hence doctors' fears of drawing blood to do malaria tests.

People suffering malaria fear being quarantined in Ebola treatment centres and health centres not equipped to treat Ebola are turning away patients with Ebola-like symptoms, doctors said.

WHO figures from Gueckedou show that of people coming in with fever in October, 24 percent who tested positive for Ebola also tested positive for malaria, and 33 percent of those who did not have Ebola tested positive for malaria — an indication of the great burden of malaria in Guinea.

'Most people turn up at Ebola treatment centres thinking that they have Ebola, when actually they have malaria.'— Patrick Robataille, Doctors Without Borders field manager

Malaria killed one of 38 Cuban doctors sent to Guinea to help fight the Ebola outbreak. One private hospital had a kidney dialysis machine that could have saved his failing organ but the clinic was shut after several people died there of Ebola.

The U.S. President's Malaria Initiative ground to a halt in Guinea months ago and the WHO in November advised health workers against testing for malaria unless they have protective gear.

The malaria initiative is doing a national survey of health facilities and elsewhere to try to find out "what's actually happening here ... where people with malaria are going," said Nahlen, of the U.S. campaign. There was some positive news in Guinea — it had just completed a national mosquito net campaign against malaria when Ebola struck, he said.

Neighbouring Liberia, on the other hand, suspended the planned distribution of 2 million nets, said Nahlen.

The Ebola outbreak that began in West Africa earlier this year has killed more than 7,500 people around the world. (Abbas Dulleh/Associated Press)

In Sierra Leone, the third country hard-hit by Ebola, Doctors Without Borders took unprecedented, pre-emptive action this month, distributing 1.5 million antimalarial drugs that can be used to both prevent and treat, aiming to protect people during the disease's peak season.

"Most people turn up at Ebola treatment centres thinking that they have Ebola, when actually they have malaria," said Patrick Robataille, Doctors Without Borders field coordinator in Freetown. "It's a huge load on the system, as well as being a huge stress on patients and their families."

He said a second distribution is planned in Freetown and western areas most affected by Ebola. Robataille said the huge delivery of antimalarial drugs was "in proportion to the scale of the Ebola epidemic — it's massive."

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U.S lab technician possibly exposed to Ebola shows no signs of infection

 The laboratory technician who may have been exposed to Ebola in a mishap last week at the Centers for Disease Control and Prevention in Atlanta is showing no signs of the disease, the U.S. Ebola co-ordinator said on Sunday.

"Only one technician was exposed. So far she's showing no signs of having the disease. She's being monitored every day," Ron Klain, named by U.S. President Barack Obama in October to lead the American response to Ebola, told CBS's Face the Nation.

The unidentified technician may have been exposed last Monday when working with Ebola specimens that were supposed to have been inactivated but which may instead have contained live virus, CDC has said.

The technician will be monitored for signs of infection for a total of 21 days, the disease's incubation period.

Klain called the mishap "unacceptable" and said CDC Director Dr. Tom Frieden had promised a report in four weeks on the investigation into the incident.

Klain said there had been no risk to the public or the larger CDC campus from the possible exposure.

The error follows two high-profile cases of mishandled samples of anthrax and avian influenza at the CDC earlier this year that called into question safety practices at the highly respected research institute.

Klain, who visited the CDC lab in October, said it has been studying Ebola for 20 years without incident and has processed more than 10,000 samples of the virus during the current outbreak, which has killed more than 7,500 people in West Africa.

"The American people should be very proud of the job that is being done in Atlanta by Dr. Frieden and the team at CDC," he said.

Two nurses in Dallas who treated an Ebola patient from Liberia are the only people known to have become infected with the disease on U.S. soil. They both recovered.

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Ebola death toll rises to 7,588 globally, WHO says

The global death toll from Ebola has risen to 7,588 out of 19,497 confirmed cases recorded in the year-old epidemic raging in West Africa, the World Health Organization (WHO) says.

The virus is still spreading intensely in Sierra Leone, especially in the north and west, with 315 new confirmed cases reported in the former British colony in the week to December 21, it said. These included 115 cases in the capital Freetown.

"The neighbouring district of Port Loko experienced a surge in new cases, reporting 92 confirmed cases compared with 56 the previous week," the WHO said.

In Sierra Leone, information about how to prevent and treat Ebola was provided to more than 5,000 households between 10 and 17 December as part of a major awareness campaign, it said.

In Guinea, 156 confirmed cases were recorded during the same period, "the highest weekly case incidence reported by the country in this outbreak", the WHO said.

"This largely due to a surge in cases in the south-eastern district of Kissidougou, which reported 58 confirmed cases - one-third of cases reported in the country in the past week."

Noting the district had previously reported no more than five cases per week, it said the surge showed the need for continuing vigilance even where the virus was not widespread.

In Liberia, where case incidence has been declining for the past month, 21 cases were reported in the week to December 21.

Montserrado county, including the capital Monrovia, still has the highest rates of the disease nationwide, while along the Côte d'Ivoire border to the east, Nimba county reported 3 confirmed cases, its first in 9 weeks, the WHO said.

Five additional countries - Nigeria, Senegal, Mali, Spain and the United States - have had imported cases and are included in the global toll.

The Ebola crisis, which claimed its first victim in Guinea exactly a year ago, is likely to last until the end of 2015, according to Peter Piot, a scientist who helped to discover the virus in 1976.

Medical detective work will be the next phase in the fight against Ebola. The United Nations will deploy hundreds of health workers to identify chains of infection as the virus passes from person to person, WHO director-general Margaret Chan said in Accra, Ghana earlier on Wednesday.

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From weight loss to pot, the top 10 health news topics of 2014

Research suggests only about five per cent of people who try to lose weight ultimately succeed, but we cling to their stories as proof that losing weight is possible. (Canadian Obesity Network)

The Ebola virus dominated health news in 2014 but it was our waistlines that clicked most on cbc.ca/news/health.

A story about how our biology taunts us by making short-term weight loss fairly easy but permanent weight loss nearly impossible was the top health news story of the year.

The second-most ready story was an analysis of public health inspection reports from national chain restaurants. It revealed a range of health violations, including temperature and food storage issues, food handling and handwashing problems, pest control, cross-contamination and general kitchen cleanliness.

A food-related story rounded out the top three. Researchers said artificial sweeteners may have directly contributed to enhancing the obesity epidemic that the calorie-free sweeteners were intended to fight.

The next most-viewed story explored how drinking water was contaminated by excreted drugs from people. Trace evidence of acetaminophen, codeine, antibiotics, hormones and steroids passed through most sewage treatment processes and eventually in our drinking water. No one knows whether the cocktail of biologically active compounds, consumed at low levels over a lifetime, is a human health risk. A related story comparing bottle and tap water also made the list.

Ebola cases and deaths in Guinea, Sierra Leone and Liberia quickly exceeded the totals for all previous outbreaks of the disease combined. A look at Ebola by the numbers was the most viewed story on the topic, followed by a story on the  first Ebola case diagnosed in the U.S. Among the top 10 included:

Another virus, enterovirus D68, sent hundreds of children to hospital in the U.S. and Canada. A frequently asked questions and answers story provided eight facts parents should know.

A feature with the headline, "Marijuana was criminalized in 1923, but why?" was the eighth most read.

To complete the list, two stories reconsidered use of prescription drugs for two common conditions, depression and heart disease.

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Aging brain helped by having complex job, says new study

Regardless of IQ, people who work at complex jobs have a slightly higher chance of being better thinkers as they age, a recent study suggests.

"When we look at the association between complexity of work with people or data, we see that those in more complex jobs generally do better on a range of cognitive ability measures," said Alan Gow, one of the study authors.

"That's not necessarily surprising . . . but we were able to add an interesting twist," said Gow, an assistant professor of psychology at the School of Life Sciences at Heriot-Watt University in Edinburgh, Scotland.

The researchers knew from earlier work that complex jobs might help protect cognitive ability later in life. So they added the childhood IQs of 1,066 people in Scotland from a 1936 study to their analysis.

They also grouped the people from that study according to profession - for example, architect, engineer and lawyer (higher thinking jobs) or typist and salesperson (requiring less complicated thinking).

The cognitive benefit of a complex job was similar to the benefits of not smoking on later cognition.

The study participants, all age 70 during the new analysis, took cognitive tests that determined general thinking ability, speed and memory. Their educational and criminal backgrounds and access to services were also factored in.

By including data on IQ from the participants when they were 11 years old, "the association between more complex jobs and better cognitive outcomes is reduced, but there remains a small additional benefit for our cognitive abilities from being in more complex jobs," Gow told Reuters Health in an email.

Childhood IQ explained about half of the difference in later thinking ability in the participants. And complex jobs were responsible for about 1 to 2 percent of the cognitive differences betweeen people later in life, according to the results in the journal Neurology.

The researchers said the cognitive benefit of a complex job was similar to the benefits of not smoking on later cognition.

'Being able to do complex thinking and reasoning in our profession is one way to continually flex our cognitive horsepower or brain power.'-  Sian Beilock, psychology professor at the University of Chicago

"It's been proposed, for example, that more complex work with people and data might require the deployment of various cognitive abilities; this may develop these skills, or at least protect them from decline, and people are exploring what those suggested mechanisms might actually look like in terms of changes in the brain," Gow said.

He's been looking at a variety of lifestyle factors that might predict cognitive ability in older people, including leisure and physical activity and social networks and support.

"The reason I focus on factors like these is that many, though not all, of course, are amenable to change. If we can identify the things that protect or harm our cognitive abilities, we will be able to provide clear information or design better interventions," Gow said.

"I think the opportunity to use our thinking and reasoning skills and continually use them throughout our lives likely contributes to our ability to stay sharp," said Sian Beilock, a psychology professor at the University of Chicago.

"So being able to do complex thinking and reasoning in our profession is one way to continually flex our cognitive horsepower or brain power," said Beilock, who was not involved in the study.

Other ways to ward off cognitive decline include exercise, and remembering our strengths, rather than dwelling on what we're forgetting, he said.

"Doing things to get rid of those worries, whether reminding yourself you have lots of experience or jotting down things (like worries) in notes . . . can help ensure you can use all the brain power at your disposal," Beilock said.

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4 damaging effects of poor posture from technology

Every inch your head moves forward is an extra 10 pounds your neck holds up. (Mike Segar/Reuters)

Health professionals have have seen an uptick in ​headaches, and pain in the neck, back and face they say is increasingly ​linked to poor posture, but there are ways to counteract the damage.

Here are four examples of the damage, why it occurs and one solution, from the Canadian Chiropractic Association and Halifax physiotherapist Janice Moreside:

• Each year, over 11 million Canadians suffer from at least one musculoskeletal condition, many linked to the use of technology.
• Low back pain and other musculoskeletal conditions account for one-third of missed work time in Canada — second only to the common cold.
• Every inch your head moves forward is an extra 10 pounds your neck holds up. Do that for much of the day and the results can be excruciating and costly. 
• When you stare down at a screen, the head is taken off the vertical and bent forward up to 45 degrees.
• The Canadian Chiropractic Association's free Straighten Up Canada app provides 12 short exercises to improve posture. The videos demonstrate stretches and exercises that combat technology-induced poor posture.

Theresa Blackburn, 47, is a writer and a teacher in New Brunswick. She's seeing a massage therapist for back pain.

"She said, 'You know, you have a hump,'" Blackburn said. "She said it's related  to poor posture and we had a conversation about how I spend a lot of time in front of a computer, and you're kind of hunched down."

Moreside of Dalhousie University in Halifax has been a physiotherapist for more than 35 years. In her career, Moreside has seen many campus students with low back and neck pain or arm dysfunction because of sitting and leaning forward on computers.

Sitting the shoulders forward can lead to tightness and pulling at the opposing muscles in the back, Moreside said. The arteries, veins and nerves than run to the arms and hands can also be compressed, which increases the likelihood of tennis elbow and carpel tunnel syndrome.

To counteract poor posture, Moreside​ ​recommends​ standing straight, and stretching and strengthening muscles.

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How Skype and email could help seniors avoid loneliness – and an early death

Researchers say that loneliness is not only emotionally taxing but can affect your life expectancy.

This is of particular concern to seniors, but many have found that modern communications technology provides a means of keeping loneliness at bay.

Just ask 94-year-old Bertha Kronenberg, who lives in Revera's Forest Hill retirement home in Toronto.

Kronenberg grew up in an orphanage in Johannesburg, and her early life was devoid of love and human contact – staff in the orphanage called children by numbers rather than their names.

Now just six years shy of 100, Kronenberg's life is full of love and meaningful connections, even though her family lives in South Africa.

That's because more than a decade ago, she taught herself to use her computer to reach out and stay in touch. When she's skyping with her sons and grandchildren, she says she feels they're in the room with her. She says she has made and maintains deep friendships online.

Video: Meet Bertha Kronenberg

On mobile? Watch the video here

These connections might even be helping to keep her alive, because loneliness can be lethal.

"Seniors that experience social isolation and loneliness are more likely to suffer from stress, depression, cognitive and functional decline, morbidity and death," warns Barbara Barbosa Neves, a research associate at the Technologies for Aging Gracefully lab (TAGlab) at the University of Toronto.

Neves stresses that sending an email or skyping with an aging relative is not the same as visiting with them in person, but she says a growing body of research suggests that digital connections play a crucial role in maintaining and improving seniors' quality of life.

The largest study on the impact of loneliness, published in 2012 in the Archives of Internal Medicine, shows that people who are socially isolated are twice as likely to die prematurely.

It found that lonely seniors were nearly 50 per cent more likely to die earlier than seniors who felt meaningfully connected with others, even after results were adjusted for factors such as depression, socioeconomic status and existing health conditions.

To put that in context, that means loneliness is nearly twice as dangerous as obesity, with a mortality rate comparable to smoking.

Ron Baecker is dedicated to changing that, and as the founder and director of the TAGlab, he's trying to do something about it.

His lab has developed technology called InTouch, which is designed to combat social isolation and loneliness. It uses "asynchronous messaging" – that is, platforms that don't require both parties to communicate at the same time, such as email – multimedia and whatever medium the individual recipient prefers.

InTouch allows family members to send video messages to each other and have them appear on televisions, computers or tablets, so that regardless of availability, loved ones can stay in touch.

The technology is designed to be as accessible as possible, leaving no excuse not to keep in contact with family members, regardless of their chosen technology platform or available time.

 "We think that asynchronous multimedia messaging has a great role to play... "Face to face communications and internet communications go hand in hand. One does not take away from the other," says Baecker.

"We're also looking to enable this technology to encourage families to work together, not just from the point of view of communication, but engaging productively around issues of quality of life and health that seniors encounter regularly."

Jesse Hirsh is the host of Next Age. It airs at 7 a.m. (7:30 NT) on Radio One on Dec. 26 and again at 4 p.m. (4:30 NT) on Jan. 1.

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CDC monitoring lab technician for possible Ebola exposure

A laboratory technician for the U.S. Centers for Disease Control and Prevention has been placed under observation for possible exposure to the deadly Ebola virus due to an apparent mix-up in lab specimens, the Atlanta-based agency said on Wednesday.

The technician, who was working on Monday with Ebola specimens that were supposed to have been inactivated but which may instead have contained live virus, will be monitored for signs of infection for 21 days, the disease's incubation period, CDC officials said.

The error follows two high-profile cases of mishandled samples of anthrax and avian influenza at the CDC earlier this year that called into question safety practices at the highly respected research institute and drew criticism from Capitol Hill.

CDC spokeswoman Barbara Reynolds told Reuters the technician's risk of exposure to Ebola, even if the virus were active, was believed to be low and that the worker was not being quarantined while under observation.

She said a small number of other CDC employees who entered the lab where the samples in question were handled also "were assessed and none require monitoring."

"There was no possible exposure outside the secure laboratory at CDC and no exposure or risk to the public," the agency said in a statement. Lab scientists discovered on Tuesday what had transpired, and reported it to superiors within an hour, it said.

The problem occurred when active Ebola virus samples were believed to have been mixed up with specimens that had been rendered inactive for further testing in a lower-security lab down the hall, Reynolds said.

When inactivated specimens turned up the next day in storage, lab personnel realized that they apparently had transferred the wrong samples, ones that had contained active virus material, out of the higher-security lab, Reynolds said.

CDC officials could not be certain because the material in question had by then been destroyed and the lower-security lab decontaminated under routine safety procedures, she said.

The technician who handled the samples had worn protective gloves and a gown but not a face mask, she said. Ebola virus is not airborne. In a lab environment, it could be transmitted from a contaminated surface through physical contact that spreads the virus to the eyes, nose or mouth of an individual.

The mishap resembled the anthrax incident, in which researchers mistakenly believed they had transferred an inactivated sample of bacteria to a lower-security lab where workers wear less-protective gear. No illnesses resulted from that breach.

Then as now, the CDC temporarily halted the transfer of samples at its high-security labs while it reviewed its protocols.

In July an agency scientist, Dr. Michael Bell, was appointed to a new role overseeing lab safety and a panel of independent experts was formed to advise the institute on such issues.

Bell has since returned to his previous post, Reynolds told Reuters, though she did not say whether anyone else had assumed the lead role for lab safety.

"I am troubled by this incident in our Ebola research laboratory in Atlanta," the CDC director, Dr. Tom Frieden, said of the latest error. "Thousands of laboratory scientists in more than 150 labs throughout CDC have taken extraordinary steps in recent months to improve safety."

The CDC also was criticized by some for not doing more to prepare the U.S. medical establishment to deal with Ebola when a Liberian man visiting Dallas in October was diagnosed with the disease after initially being turned away from a hospital emergency room there.

Two nurses who treated that patient before he died ended up contracting the virus but survived. They are the only two people known to have been infected on U.S. soil during the current Ebola epidemic, which has killed more than 7,500 people, most of them in West Africa.

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Brain-dead pregnant woman removed from life support in Ireland

A brain-dead pregnant woman was taken off life support Friday after a court ruled that her 18-week-old fetus was doomed to die — a case that exposed fear and confusion among doctors over how to apply Ireland's strict ban on abortion in an age of medical innovation.

The three-judge Dublin High Court said that all artificial support for the woman should end more than three weeks after she was declared clinically dead. Her relatives gathered at a hospital in the Irish Midlands to bid farewell to the unidentified woman, who was in her late 20s and had two young children.

In their 29-page ruling, the judges accepted testimony from seven doctors who said the fetus couldn't survive for the extra two months of development needed to be delivered safely. The doctors detailed how the woman's body was becoming a lethal environment rife with infections, fungal growths, fever and high blood pressure.

The nation's Supreme Court was put on standby for an appeal, given the constitutional questions at stake. But lawyers representing the rights of the woman and of the fetus said they accepted the ruling from the country's second-highest court.

Ireland has the strictest abortion ban in Europe, a reflection of the country's heavily Roman Catholic population. But Dublin's archbishop had suggested before the decision came down that he would have no objection to removing life support.

Lack of explicit laws

The woman suffered irreversible brain death on Dec. 3, four days after sustaining a severe head injury in a fall. She had already been hospitalized after doctors found a cyst in her brain.

Doctors refused family pleas to turn off a half-dozen machines that regulated oxygen, blood flow, nutrition and waste collection, citing fears they could be sued for negligence or even face murder charges if they cut life-sustaining support for the fetus.

One doctor testified that he and two colleagues couldn't agree on how Ireland's constitutional ban on abortion should be applied, given the lack of explicit laws or guidelines for such cases.

Other doctors described the woman as a corpse unrecognizable from the photo by her bedside. Another noted that the body was being pumped with drugs never authorized for use on a pregnant woman and described what they were doing as experimental and, if it persisted, grotesque.

The judges said the fetus faced "a 'perfect storm' from which it has no realistic prospect of emerging alive. It has nothing but distress and death in prospect."

The woman's life support, they said, was "being maintained at hugely destructive cost to both her remains and to the feelings and sensitivities of her family and loved ones."

'A woman isn't simply an incubator'

The court said it was wrong to continue to deprive the woman "of dignity in death and subject her father, her partner and her young children to unimaginable distress in a futile exercise which commenced only because of fears held by treating medical specialists of potential legal consequences."

The Catholic Church questioned why secular authorities had not established clear guidelines for cases where a woman dies and doctors determine that the fetus can't survive on its own.

"There is no obligation to use extraordinary means to maintain a life. That applies both to the woman and to the child," said Dublin Archbishop Diarmuid Martin, who spoke before Friday's ruling and declined to comment on the specific case.

"A woman isn't simply an incubator. The relation between a woman and a child is a relationship, and it is very clear that one has to examine at what stage is this fetus, what are the possibilities," he said.

The judges did leave open the possibility that future cases might be handled differently if the fetus was significantly closer to delivery age, even if its deteriorating environment meant a higher risk of abnormalities.

They said Ireland's ban on abortion commits authorities to defend equally the right to life of the mother and unborn child. Because the mother is already dead in such cases, the judges found, the rights of the living fetus "must prevail over the feelings of grief and respect for a mother who is no longer living."

Irish women seek procedures abroad

Health Minister Leo Varadkar, who favours creating more medical exceptions to Ireland's blanket ban on abortion, said the government would study the ruling.

Ireland's main anti-abortion group, the Pro Life Campaign, said requiring such cases to go to court "is a sign of a healthy democracy" and demonstrated that Ireland treats matters of life and death seriously.

Irish doctors have appealed for decades for clearer guidelines on when they may terminate a pregnancy. Irish law permits this only when deemed necessary to save the woman's life. Parliament passed the law last year after a 31-year-old woman, suffering a protracted miscarriage, was refused an abortion and died of blood poisoning.

An estimated 4,000 Irishwomen travel each year for abortions in neighbouring England, where the practice was legalized in 1967.

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Ebola death toll rises to 7,588 globally, WHO says

The global death toll from Ebola has risen to 7,588 out of 19,497 confirmed cases recorded in the year-old epidemic raging in West Africa, the World Health Organization (WHO) says.

The virus is still spreading intensely in Sierra Leone, especially in the north and west, with 315 new confirmed cases reported in the former British colony in the week to December 21, it said. These included 115 cases in the capital Freetown.

"The neighbouring district of Port Loko experienced a surge in new cases, reporting 92 confirmed cases compared with 56 the previous week," the WHO said.

In Sierra Leone, information about how to prevent and treat Ebola was provided to more than 5,000 households between 10 and 17 December as part of a major awareness campaign, it said.

In Guinea, 156 confirmed cases were recorded during the same period, "the highest weekly case incidence reported by the country in this outbreak", the WHO said.

"This largely due to a surge in cases in the south-eastern district of Kissidougou, which reported 58 confirmed cases - one-third of cases reported in the country in the past week."

Noting the district had previously reported no more than five cases per week, it said the surge showed the need for continuing vigilance even where the virus was not widespread.

In Liberia, where case incidence has been declining for the past month, 21 cases were reported in the week to December 21.

Montserrado county, including the capital Monrovia, still has the highest rates of the disease nationwide, while along the Côte d'Ivoire border to the east, Nimba county reported 3 confirmed cases, its first in 9 weeks, the WHO said.

Five additional countries - Nigeria, Senegal, Mali, Spain and the United States - have had imported cases and are included in the global toll.

The Ebola crisis, which claimed its first victim in Guinea exactly a year ago, is likely to last until the end of 2015, according to Peter Piot, a scientist who helped to discover the virus in 1976.

Medical detective work will be the next phase in the fight against Ebola. The United Nations will deploy hundreds of health workers to identify chains of infection as the virus passes from person to person, WHO director-general Margaret Chan said in Accra, Ghana earlier on Wednesday.

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How Skype and email could help seniors avoid loneliness – and an early death

Researchers say that loneliness is not only emotionally taxing but can affect your life expectancy.

This is of particular concern to seniors, but many have found that modern communications technology provides a means of keeping loneliness at bay.

Just ask 94-year-old Bertha Kronenberg, who lives in Revera's Forest Hill retirement home in Toronto.

Kronenberg grew up in an orphanage in Johannesburg, and her early life was devoid of love and human contact – staff in the orphanage called children by numbers rather than their names.

Now just six years shy of 100, Kronenberg's life is full of love and meaningful connections, even though her family lives in South Africa.

That's because more than a decade ago, she taught herself to use her computer to reach out and stay in touch. When she's skyping with her sons and grandchildren, she says she feels they're in the room with her. She says she has made and maintains deep friendships online.

Video: Meet Bertha Kronenberg

On mobile? Watch the video here

These connections might even be helping to keep her alive, because loneliness can be lethal.

"Seniors that experience social isolation and loneliness are more likely to suffer from stress, depression, cognitive and functional decline, morbidity and death," warns Barbara Barbosa Neves, a research associate at the Technologies for Aging Gracefully lab (TAGlab) at the University of Toronto.

Neves stresses that sending an email or skyping with an aging relative is not the same as visiting with them in person, but she says a growing body of research suggests that digital connections play a crucial role in maintaining and improving seniors' quality of life.

The largest study on the impact of loneliness, published in 2012 in the Archives of Internal Medicine, shows that people who are socially isolated are twice as likely to die prematurely.

It found that lonely seniors were nearly 50 per cent more likely to die earlier than seniors who felt meaningfully connected with others, even after results were adjusted for factors such as depression, socioeconomic status and existing health conditions.

To put that in context, that means loneliness is nearly twice as dangerous as obesity, with a mortality rate comparable to smoking.

Ron Baecker is dedicated to changing that, and as the founder and director of the TAGlab, he's trying to do something about it.

His lab has developed technology called InTouch, which is designed to combat social isolation and loneliness. It uses "asynchronous messaging" – that is, platforms that don't require both parties to communicate at the same time, such as email – multimedia and whatever medium the individual recipient prefers.

InTouch allows family members to send video messages to each other and have them appear on televisions, computers or tablets, so that regardless of availability, loved ones can stay in touch.

The technology is designed to be as accessible as possible, leaving no excuse not to keep in contact with family members, regardless of their chosen technology platform or available time.

 "We think that asynchronous multimedia messaging has a great role to play... "Face to face communications and internet communications go hand in hand. One does not take away from the other," says Baecker.

"We're also looking to enable this technology to encourage families to work together, not just from the point of view of communication, but engaging productively around issues of quality of life and health that seniors encounter regularly."

Jesse Hirsh is the host of Next Age. It airs at 7 a.m. (7:30 NT) on Radio One on Dec. 26 and again at 4 p.m. (4:30 NT) on Jan. 1.

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Irish court approves taking pregnant woman off life support, fetus faces 'distress and death'

Thousands of Roman Catholics took part in a Rosary procession at Knock Shrine, Ireland, in May 2013. Chooselife held a National Prayer Vigil for the right to life of mothers and babies during a service at Knock Shrine. A lawyer representing an 18-week-old fetus living inside the clinically dead body of its mother says the right to life trumps the woman's right to a dignified death. (Peter Morrison/Associated Press)

Irish judges have ruled that life support should be removed from a brain-dead pregnant woman because her
18-week-old fetus cannot survive to birth.

Friday's ruling was accepted by lawyers representing the rights of the woman and the fetus, which in Ireland has a
constitutionally protected right to life.

Ireland has the strictest anti-abortion laws in Europe.

Doctors treating the woman had refused family requests to remove her from life-support machines after she was declared clinically dead Dec. 3, arguing they couldn't legally afford to withdraw support from the
fetus inside her.

The court accepted testimony from seven doctors that the fetus "has nothing but distress and death in prospect."

The woman was declared clinically dead four days after suffering a severe head injury in a fall.

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CDC monitoring lab technician for possible Ebola exposure

A laboratory technician for the U.S. Centers for Disease Control and Prevention has been placed under observation for possible exposure to the deadly Ebola virus due to an apparent mix-up in lab specimens, the Atlanta-based agency said on Wednesday.

The technician, who was working on Monday with Ebola specimens that were supposed to have been inactivated but which may instead have contained live virus, will be monitored for signs of infection for 21 days, the disease's incubation period, CDC officials said.

The error follows two high-profile cases of mishandled samples of anthrax and avian influenza at the CDC earlier this year that called into question safety practices at the highly respected research institute and drew criticism from Capitol Hill.

CDC spokeswoman Barbara Reynolds told Reuters the technician's risk of exposure to Ebola, even if the virus were active, was believed to be low and that the worker was not being quarantined while under observation.

She said a small number of other CDC employees who entered the lab where the samples in question were handled also "were assessed and none require monitoring."

"There was no possible exposure outside the secure laboratory at CDC and no exposure or risk to the public," the agency said in a statement. Lab scientists discovered on Tuesday what had transpired, and reported it to superiors within an hour, it said.

The problem occurred when active Ebola virus samples were believed to have been mixed up with specimens that had been rendered inactive for further testing in a lower-security lab down the hall, Reynolds said.

When inactivated specimens turned up the next day in storage, lab personnel realized that they apparently had transferred the wrong samples, ones that had contained active virus material, out of the higher-security lab, Reynolds said.

CDC officials could not be certain because the material in question had by then been destroyed and the lower-security lab decontaminated under routine safety procedures, she said.

The technician who handled the samples had worn protective gloves and a gown but not a face mask, she said. Ebola virus is not airborne. In a lab environment, it could be transmitted from a contaminated surface through physical contact that spreads the virus to the eyes, nose or mouth of an individual.

The mishap resembled the anthrax incident, in which researchers mistakenly believed they had transferred an inactivated sample of bacteria to a lower-security lab where workers wear less-protective gear. No illnesses resulted from that breach.

Then as now, the CDC temporarily halted the transfer of samples at its high-security labs while it reviewed its protocols.

In July an agency scientist, Dr. Michael Bell, was appointed to a new role overseeing lab safety and a panel of independent experts was formed to advise the institute on such issues.

Bell has since returned to his previous post, Reynolds told Reuters, though she did not say whether anyone else had assumed the lead role for lab safety.

"I am troubled by this incident in our Ebola research laboratory in Atlanta," the CDC director, Dr. Tom Frieden, said of the latest error. "Thousands of laboratory scientists in more than 150 labs throughout CDC have taken extraordinary steps in recent months to improve safety."

The CDC also was criticized by some for not doing more to prepare the U.S. medical establishment to deal with Ebola when a Liberian man visiting Dallas in October was diagnosed with the disease after initially being turned away from a hospital emergency room there.

Two nurses who treated that patient before he died ended up contracting the virus but survived. They are the only two people known to have been infected on U.S. soil during the current Ebola epidemic, which has killed more than 7,500 people, most of them in West Africa.

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Ebola death toll rises to 7,588 globally, WHO says

The global death toll from Ebola has risen to 7,588 out of 19,497 confirmed cases recorded in the year-old epidemic raging in West Africa, the World Health Organization (WHO) says.

The virus is still spreading intensely in Sierra Leone, especially in the north and west, with 315 new confirmed cases reported in the former British colony in the week to December 21, it said. These included 115 cases in the capital Freetown.

"The neighbouring district of Port Loko experienced a surge in new cases, reporting 92 confirmed cases compared with 56 the previous week," the WHO said.

In Sierra Leone, information about how to prevent and treat Ebola was provided to more than 5,000 households between 10 and 17 December as part of a major awareness campaign, it said.

In Guinea, 156 confirmed cases were recorded during the same period, "the highest weekly case incidence reported by the country in this outbreak", the WHO said.

"This largely due to a surge in cases in the south-eastern district of Kissidougou, which reported 58 confirmed cases - one-third of cases reported in the country in the past week."

Noting the district had previously reported no more than five cases per week, it said the surge showed the need for continuing vigilance even where the virus was not widespread.

In Liberia, where case incidence has been declining for the past month, 21 cases were reported in the week to December 21.

Montserrado county, including the capital Monrovia, still has the highest rates of the disease nationwide, while along the Côte d'Ivoire border to the east, Nimba county reported 3 confirmed cases, its first in 9 weeks, the WHO said.

Five additional countries - Nigeria, Senegal, Mali, Spain and the United States - have had imported cases and are included in the global toll.

The Ebola crisis, which claimed its first victim in Guinea exactly a year ago, is likely to last until the end of 2015, according to Peter Piot, a scientist who helped to discover the virus in 1976.

Medical detective work will be the next phase in the fight against Ebola. The United Nations will deploy hundreds of health workers to identify chains of infection as the virus passes from person to person, WHO director-general Margaret Chan said in Accra, Ghana earlier on Wednesday.

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Caramel apples linked to listeriosis outbreak may have reached Canada

Caramel apples linked to an outbreak of listeria infections in the U.S. may  have been imported into Canada, federal officials say.

There are two cases of listeriosis, one in Ontario and one in Manitoba, with the same genetic fingerprint as seen in the U.S. investigation, the Public Health Agency of Canada (PHAC) said Tuesday.  

As a precaution, Canadians are advised to not eat commercially produced, prepackaged caramel apples imported from the U.S. (Bernard Thomas/The Herald-Sun/Associated Press)

Investigators continue to determine if these individuals ate prepackaged caramel apples imported from the U.S. Their health status is not known.

As a precaution, agency officials advised Canadians to not eat commercially produced, prepackaged caramel apples imported from the U.S. until further notice, although the risk to Canadians is low.

The advice applies to plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings. The products could have a shelf life of one month, the agency said.

In the U.S., the Centers for Disease Control and Prevention said as of Monday, a total of 29 people infected with the outbreak strains have been reported. They were all hospitalized. Five deaths have been reported and the infection contributed to three of the fatalities with one unclear and the fifth unrelated to listeriosis.

Canadian officials recommended if you have a candy apple product and are unsure if it would qualify as a caramel apple, do not consume it.

Instead, put the caramel apple in a plastic bag and throw it out to prevent animals from consuming the product from your garbage. Then wash your hands.

Listeriosis can be treated with antibiotics. Early diagnosis is key, especially for people at high risk, such as pregnant women, older adults and people with weakened immune systems, PHAC said.

Only a few people exposed to listeria will develop listeriosis.  Symptoms include fever, muscle aches, nausea and diarrhea, headache and neck stiffness. Severe symptoms can include convulsions.

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Blood pressure apps 'not quite ready for prime time'

Millions of people could be trying to measure their blood pressure with untested, inaccurate and potentially dangerous smartphone applications, or apps, a new study finds.

Researchers analyzed the top 107 apps for "hypertension" and "high blood pressure" that are available for download on the Google Play store and Apple iTunes and found that nearly three-quarters offered useful tools for tracking medical data.

But they also found seven Android apps that claimed users needed only to press their fingers onto phone screens or cameras to get blood-pressure readings — claims that scientists say are bogus.

A growing number of hypertension patients use mobile health technologies to track and manage their conditions, researchers say.

"This technology is really in its nascent stages, and it's not quite ready for prime time," lead author Dr. Nilay Kumar told Reuters Health.

Kumar, an attending physician at the Cambridge Health Alliance in Cambridge, Massachusetts and a Harvard Medical School instructor, was surprised to learn that apps marketed as turning smartphones into blood pressure measuring devices had been downloaded at least 900,000 times and as many as 2.4 million times.

"That's concerning that such a small number of apps have been downloaded so many times," he said. "We were surprised by the popularity."

He wasn't sure how the technology supposedly works but said the phone camera appears to read a finger pulse.

"It's really in a research-and-development stage. It's not ready for clinical use. For now, we need to be careful that we are not using things that are inaccurate and could be potentially dangerous," he said.

Apps that inaccurately measure blood pressure could lead to false alarms and possibly fatal false assurances, Kumar said.

'The idea that you're going to be able to stick your finger on the camera of your smartphone and get an accurate blood pressure reading is pretty farfetched right now.'- Dr. Karen Margolis

About one in three American adults has high blood pressure, according to the U.S. Centers for Disease Control and Prevention. Also known as hypertension, the condition has been called the silent killer because it often shows no warning symptoms but increases the risk of heart disease and stroke, two leading causes of death.

A growing number of hypertension patients use mobile-health technologies to track and manage their conditions, the authors write in the Journal of the American Society of Hypertension.

The study, conducted earlier this year, in general found good news about blood pressure apps. The majority, or 72 per cent, of the most popular apps allowed consumers to keep track of their medical data. About a quarter could directly export recorded information to physicians' offices. And nearly a quarter included tools to enhance medication adherence.

But healthcare agencies, such as universities, helped develop only a tiny fraction of the apps, 2.8 per cent, the study found.

The U.S. Food and Drug Administration (FDA), which regulates medical devices, has not approved any of the blood pressure apps, the authors write.

The study's findings raise "serious concerns about patient safety" and reveal an "urgent need for greater regulation and oversight in medical app development," the authors say.

Dr. Karen Margolis, an internist and director of clinical research at HealthPartners Institute for Education and Research in Minneapolis, would also like to see more oversight.

"The idea that you're going to be able to stick your finger on the camera of your smartphone and get an accurate blood pressure reading is pretty farfetched right now," she told Reuters Health.

Margolis has studied devices to measure blood pressure but was not involved in the current study.

"There is virtually no information at all about how accurate these apps are," she said. "It doesn't sound to me like it's ready for routine use in any way that medical decisions could be based on."

Regulatory authority over smartphone apps that can be turned into medical devices remains unclear, Kumar said.

Writing earlier this year in The New England Journal of Medicine, a group of three lawyers, led by Nathan G. Cortez of the Southern Methodist University Dedman School of Law in Dallas, Texas, warned that mobile health, or mHealth, poses a challenge for the FDA.

"Many members of Congress and industry believe that regulation will stifle mHealth innovation," the lawyers wrote. "The true challenge, however, is creating a regulatory framework that encourages high-value innovation while also preventing the market from being overcome with products that are ineffective or unsafe."

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Ebola cases in Sierra Leone show signs of slowing

The increase in new cases of Ebola in Sierra Leone seems to be slower, the World Health Organization says, as the country's government restricts travel over the holidays.

As of Dec.  21, the death toll has risen to 7,588 out of 19,497 reported cases in the Ebola outbreak that began a year ago, the United Nations' public health agency said Wednesday.

A Liberian woman washes her hands from a bottle of chlorine water to curb the spread of Ebola. The Ebola death toll has risen to 7,588 out of 19,497 reported cases. (Ahmed Jallanzo/EPA)

"Reported case incidence is fluctuating in Guinea and declining in Liberia," WHO said.

"In Sierra Leone, there are signs that the increase in incidence has slowed, and that incidence may no longer be increasing. The country's west is now experiencing the most intense transmission in the affected countries, and response efforts have been strengthened to curb the spread of disease in the area."

Guinea, Sierra Leone and Liberia have all improved their ability to isolate and treat Ebola patients but there are still shortfalls in some districts because of an uneven distribution of cases and beds, WHO said.

Sierra Leone's capital of Freetown accounts for one-third of the country's 315 new confirmed cases.

Last week, Sierra Leone's government joined UN partners to step up efforts to limit spread of the disease in western parts of the country.

Travel is restricted between districts during the holidays. People may go to church services on Christmas Day but President Ernest Bai Koroma requested they return home immediately after.

Public gatherings at restaurants, nightclubs and beaches are banned and markets have reduced their hours.

Guinea reported its highest weekly case incidence — 156 confirmed cases. The WHO said the number was largely because of a surge of cases in the southeastern district of Kissidougou.

"This emphasizes the need for continuing vigilance in case management, safe burial practices and social mobilization, to prevent outbreaks in areas previously experiencing little or no transmission."

In Liberia, incidence has been declining for a month but transmission remains intense. The country reported 21 cases in the week to Dec. 21. The district of Montserrado, which includes the capital Monrovia, continues to experience the highest activity in the country.

Meanwhile, the UN peacekeeping mission in Liberia says one if its staffers has become infected. It brings the number of UN members who've fallen sick with Ebola to four.

The global toll includes cases imported to Nigeria, Senegal, Mali, Spain and the United States.

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CDC monitoring lab technician for possible Ebola exposure

A laboratory technician for the U.S. Centers for Disease Control and Prevention has been placed under observation for possible exposure to the deadly Ebola virus due to an apparent mix-up in lab specimens, the Atlanta-based agency said on Wednesday.

The technician, who was working on Monday with Ebola specimens that were supposed to have been inactivated but which may instead have contained live virus, will be monitored for signs of infection for 21 days, the disease's incubation period, CDC officials said.

The error follows two high-profile cases of mishandled samples of anthrax and avian influenza at the CDC earlier this year that called into question safety practices at the highly respected research institute and drew criticism from Capitol Hill.

CDC spokeswoman Barbara Reynolds told Reuters the technician's risk of exposure to Ebola, even if the virus were active, was believed to be low and that the worker was not being quarantined while under observation.

She said a small number of other CDC employees who entered the lab where the samples in question were handled also "were assessed and none require monitoring."

"There was no possible exposure outside the secure laboratory at CDC and no exposure or risk to the public," the agency said in a statement. Lab scientists discovered on Tuesday what had transpired, and reported it to superiors within an hour, it said.

The problem occurred when active Ebola virus samples were believed to have been mixed up with specimens that had been rendered inactive for further testing in a lower-security lab down the hall, Reynolds said.

When inactivated specimens turned up the next day in storage, lab personnel realized that they apparently had transferred the wrong samples, ones that had contained active virus material, out of the higher-security lab, Reynolds said.

CDC officials could not be certain because the material in question had by then been destroyed and the lower-security lab decontaminated under routine safety procedures, she said.

The technician who handled the samples had worn protective gloves and a gown but not a face mask, she said. Ebola virus is not airborne. In a lab environment, it could be transmitted from a contaminated surface through physical contact that spreads the virus to the eyes, nose or mouth of an individual.

The mishap resembled the anthrax incident, in which researchers mistakenly believed they had transferred an inactivated sample of bacteria to a lower-security lab where workers wear less-protective gear. No illnesses resulted from that breach.

Then as now, the CDC temporarily halted the transfer of samples at its high-security labs while it reviewed its protocols.

In July an agency scientist, Dr. Michael Bell, was appointed to a new role overseeing lab safety and a panel of independent experts was formed to advise the institute on such issues.

Bell has since returned to his previous post, Reynolds told Reuters, though she did not say whether anyone else had assumed the lead role for lab safety.

"I am troubled by this incident in our Ebola research laboratory in Atlanta," the CDC director, Dr. Tom Frieden, said of the latest error. "Thousands of laboratory scientists in more than 150 labs throughout CDC have taken extraordinary steps in recent months to improve safety."

The CDC also was criticized by some for not doing more to prepare the U.S. medical establishment to deal with Ebola when a Liberian man visiting Dallas in October was diagnosed with the disease after initially being turned away from a hospital emergency room there.

Two nurses who treated that patient before he died ended up contracting the virus but survived. They are the only two people known to have been infected on U.S. soil during the current Ebola epidemic, which has killed more than 7,500 people, most of them in West Africa.

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Top job at national microbiology lab filled

Canada's National Microbiology Laboratory has a new leader.

Matthew Gilmour will start his job as scientific director in February, the Public Health Agency of Canada announced Tuesday.

He will be responsible for the National Microbiology Laboratory in Winnipeg and the Laboratory for Foodborne Zoonoses in Guelph, Ont., which examines diseases that can spread between animals and humans.

As the scientific director of National Microbiology Laboratory in Winnipeg, Matthew Gilmour will manage the delivery of laboratory public health and emergency preparedness programs. (Public Health Agency of Canada)

The job involves managing the delivery of laboratory public health and emergency preparedness programs, providing strategic scientific advice to officials and representing the lab nationally and internationally.

In April,  some scientists and public health leaders expressed concerns that the federal government may not be looking for a top-notch scientist, given how the job was posted on a government jobs website without fanfare, with a short deadline, and without an explicit requirement for candidates to be experienced scientists.

World-renowned HIV scientist Frank Plummer was the lab's previous scientific director.

Gilmour is currently a clinical microbiologist with Diagnostic Services of Manitoba and an assistant professor in the Department of Medical Microbiology at the University of Manitoba.

He previously held the positions of Director of Bacteriology and Enteric Diseases and the Chief of Enteric Diseases at the National Microbiology Laboratory, the public health agency said.

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Gay blood donation lifetime ban could ease in U.S.

An FDA advisory committee discussed the effectiveness of new blood supply tests for HIV infections earlier this month.

The U.S. Food and Drug Administration said on Tuesday that it plans to change its blood donor policy recommendation to allow gay men to donate blood one year after their last sexual contact.

The FDA's proposed policy would replace its current stance, which backs indefinite deferral for this group as part of its policies aimed at protecting blood supplies. It said the move puts the policy in line with that of other men and women who are at increased risk for HIV infection.

The FDA said it will issue draft guidance on the policy, hopefully early in 2015. It would then review the comments and issue final guidance "as quickly as possible," Peter Marks, deputy director of the FDA's Center for Biologics Evaluation and Research, said during a press briefing.

An FDA advisory committee met earlier this month to discuss the issue around changing its policy for donations from men who have sex with men. Those discussions highlighted the effectiveness of new blood supply tests for HIV infections. In November, an advisory committee to the U.S. Department of Health and Human Services had recommended replacing the ban with the one-year deferral that the FDA is now proposing.

Marks said during the briefing that scientific evidence for a ban shorter than a year was not "compelling."

In 2013, Health Canada announced it will allow men to donate blood if they haven't had sex with a man in the last five years. Previously, men who said they had sex with a man, even once, since 1977, were not eligible to donate blood in Canada.

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Caramel apples linked to listeriosis outbreak may have reached Canada

Caramel apples linked to an outbreak of listeria infections in the U.S. may  have been imported into Canada, federal officials say.

There are two cases of listeriosis, one in Ontario and one in Manitoba, with the same genetic fingerprint as seen in the U.S. investigation, the Public Health Agency of Canada (PHAC) said Tuesday.  

As a precaution, Canadians are advised to not eat commercially produced, prepackaged caramel apples imported from the U.S. (Bernard Thomas/The Herald-Sun/Associated Press)

Investigators continue to determine if these individuals ate prepackaged caramel apples imported from the U.S. Their health status is not known.

As a precaution, agency officials advised Canadians to not eat commercially produced, prepackaged caramel apples imported from the U.S. until further notice, although the risk to Canadians is low.

The advice applies to plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings. The products could have a shelf life of one month, the agency said.

In the U.S., the Centers for Disease Control and Prevention said as of Monday, a total of 29 people infected with the outbreak strains have been reported. They were all hospitalized. Five deaths have been reported and the infection contributed to three of the fatalities with one unclear and the fifth unrelated to listeriosis.

Canadian officials recommended if you have a candy apple product and are unsure if it would qualify as a caramel apple, do not consume it.

Instead, put the caramel apple in a plastic bag and throw it out to prevent animals from consuming the product from your garbage. Then wash your hands.

Listeriosis can be treated with antibiotics. Early diagnosis is key, especially for people at high risk, such as pregnant women, older adults and people with weakened immune systems, PHAC said.

Only a few people exposed to listeria will develop listeriosis.  Symptoms include fever, muscle aches, nausea and diarrhea, headache and neck stiffness. Severe symptoms can include convulsions.

22.46 | 0 komentar | Read More

Blood pressure apps 'not quite ready for prime time'

Millions of people could be trying to measure their blood pressure with untested, inaccurate and potentially dangerous smartphone applications, or apps, a new study finds.

Researchers analyzed the top 107 apps for "hypertension" and "high blood pressure" that are available for download on the Google Play store and Apple iTunes and found that nearly three-quarters offered useful tools for tracking medical data.

But they also found seven Android apps that claimed users needed only to press their fingers onto phone screens or cameras to get blood-pressure readings — claims that scientists say are bogus.

A growing number of hypertension patients use mobile health technologies to track and manage their conditions, researchers say.

"This technology is really in its nascent stages, and it's not quite ready for prime time," lead author Dr. Nilay Kumar told Reuters Health.

Kumar, an attending physician at the Cambridge Health Alliance in Cambridge, Massachusetts and a Harvard Medical School instructor, was surprised to learn that apps marketed as turning smartphones into blood pressure measuring devices had been downloaded at least 900,000 times and as many as 2.4 million times.

"That's concerning that such a small number of apps have been downloaded so many times," he said. "We were surprised by the popularity."

He wasn't sure how the technology supposedly works but said the phone camera appears to read a finger pulse.

"It's really in a research-and-development stage. It's not ready for clinical use. For now, we need to be careful that we are not using things that are inaccurate and could be potentially dangerous," he said.

Apps that inaccurately measure blood pressure could lead to false alarms and possibly fatal false assurances, Kumar said.

'The idea that you're going to be able to stick your finger on the camera of your smartphone and get an accurate blood pressure reading is pretty farfetched right now.'- Dr. Karen Margolis

About one in three American adults has high blood pressure, according to the U.S. Centers for Disease Control and Prevention. Also known as hypertension, the condition has been called the silent killer because it often shows no warning symptoms but increases the risk of heart disease and stroke, two leading causes of death.

A growing number of hypertension patients use mobile-health technologies to track and manage their conditions, the authors write in the Journal of the American Society of Hypertension.

The study, conducted earlier this year, in general found good news about blood pressure apps. The majority, or 72 per cent, of the most popular apps allowed consumers to keep track of their medical data. About a quarter could directly export recorded information to physicians' offices. And nearly a quarter included tools to enhance medication adherence.

But healthcare agencies, such as universities, helped develop only a tiny fraction of the apps, 2.8 per cent, the study found.

The U.S. Food and Drug Administration (FDA), which regulates medical devices, has not approved any of the blood pressure apps, the authors write.

The study's findings raise "serious concerns about patient safety" and reveal an "urgent need for greater regulation and oversight in medical app development," the authors say.

Dr. Karen Margolis, an internist and director of clinical research at HealthPartners Institute for Education and Research in Minneapolis, would also like to see more oversight.

"The idea that you're going to be able to stick your finger on the camera of your smartphone and get an accurate blood pressure reading is pretty farfetched right now," she told Reuters Health.

Margolis has studied devices to measure blood pressure but was not involved in the current study.

"There is virtually no information at all about how accurate these apps are," she said. "It doesn't sound to me like it's ready for routine use in any way that medical decisions could be based on."

Regulatory authority over smartphone apps that can be turned into medical devices remains unclear, Kumar said.

Writing earlier this year in The New England Journal of Medicine, a group of three lawyers, led by Nathan G. Cortez of the Southern Methodist University Dedman School of Law in Dallas, Texas, warned that mobile health, or mHealth, poses a challenge for the FDA.

"Many members of Congress and industry believe that regulation will stifle mHealth innovation," the lawyers wrote. "The true challenge, however, is creating a regulatory framework that encourages high-value innovation while also preventing the market from being overcome with products that are ineffective or unsafe."

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