Pot smoked or used by 12% over a year: StatsCan

About 12 per cent of Canadians age 15 or older said they used marijuana in a year, according to Statistics Canada.

Wednesday's issue of the agency's Health Reports looks at marijuana use in 2012 compared with a decade earlier.

Among those aged 18 to 24, 33 per cent said they'd "used or tried" marijuana in the past year  — the highest prevalence by age group and the group that tended to use it more frequently. About eight per cent of 18- to 24-year-olds said they used marijuana at least once a week and nearly five per cent said they smoked or used daily.  

Marijuana is "one of the most common illicit drugs used in Canada. Significant proportions of the population report having used marijuana in the past year," said report author Michelle Rotermann, a senior researcher with Statistics Canada in Ottawa.

"When you extend it to lifetime, you get 43 per cent of the population."

Rotermann called the literature somewhat mixed on if there are negative health implications of marijuana use.

"Perhaps there are risks associated with marijuana use amongst adolescents and young adults and so were able to produce estimates," for those age groups and older.  

Use in the past year declined by nearly one-third among the youngest Canadians surveyed, 15 to 17, from 28.5 per cent in 2002 to 20.0 per cent in 2012.

In contrast, the figures changed as you got older. Past-year use among those aged 25 to 44 increased from 14 per cent to 15.6 per cent. Likewise for those 45 and older, past-year use increased from 3.0 per cent to 4.7 per cent over the decade.

Overall in 2012, about two per cent of respondents said they smoked or used marijuana daily in the previous year and another three per cent did so weekly.  

In 2012, self-reported marijuana use was highest in Nova Scotia at 16 per cent and British Columbia, 14 per cent, both above the estimates for the rest of Canada. Saskatchewan residents reported lower-than-average use at 10 per cent.

The survey did not include questions about the use of medical marijuana or the age people started using pot or other illicit use.

While self-reported marijuana use may be affected by "social desirability" bias, Rotermann said, the findings are consistent with another national survey conducted by Health Canada, the 2012 Canadian Alcohol and Drug Use Monitoring Survey.

The latest cross-sectional survey data was collected from 25,113 respondents participating in the 2012 Canadian Community Health Survey – Mental Health.

In a statement emailed to CBC News on Wednesday, Health Minister Rona Ambrose said the "evidence is clear" that youth smoking marijuana have an increased risk of developing mental health issues — including psychosis and schizophrenia.

"We will continue to discourage Canadians from smoking marijuana at every step," Ambrose's statement said, citing the Conservative government's national anti-drug campaign.

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Herbal laxative, detox kit recalled over lead levels

A herbal laxative and detox kit are under recall for unacceptably high levels of lead or arsenic.

St. Francis Herb Farm Inc. is voluntarily recalling Buklkax V and All Seasons Detox Kit after the company's product tests showed levels of the heavy metals, Health Canada said Wednesday.

St. Francis Herb Farm Inc. is voluntarily recalling its All Seasons Detox Kit over excessive lead levels. (Health Canada)

Buklkax V is promoted as a herbal laxative for children aged six and older and adults. All Seasons Detox Kit is promoted as a herbal detox kit for use by adults.

"Lead and arsenic are heavy metals and can pose serious health risks when too much is ingested, particularly to children, and pregnant and breastfeeding women," Health Canada said.

Tests started by the Combermere, Ont.-based company showed the herbal laxative had lead at over seven times the acceptable limit and arsenic at double the limit. The detox kit showed lead at over twice the acceptable limit.

Health Canada said ingesting excessive amount of the heavy metals poses serious health risks because the metals may accumulate in our vital organs.

The toxic effects of lead include:

• Abdominal pain.
• Anemia.
• Loss of appetite.
• Constipation.
• Fatigue.
• Sleeplessness.
• Irritability and headache.
• Changes in blood pressure.
• Reproductive effects such as miscarriage.
• Weakness.
• Concentration problems.
• Weight loss.
• Dizziness.
• Kidney and brain damage.

For pregnant women, consuming products with higher arsenic levels may increase risk of pre-term birth, stillbirth and miscarriage. Children and adults who are exposed to arsenic may experience side-effects such as stomach pain, vomiting, diarrhea, muscle cramping, weakness, skin rash, numbness or tingling and loss of movement.

The affected lot numbers and expiry dates are available in Health Canada's advisory. 

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Leafy greens may be linked to E. coli cases across country

Cases in Alberta, Saskatchewan, Ontario and Newfoundland and Labrador under investigation

CBC News Posted: Apr 15, 2015 5:11 PM ET Last Updated: Apr 15, 2015 5:11 PM ET

External Links

(Note: CBC does not endorse and is not responsible for the content of external links.)

Recent cases of E. coli across Canada may be linked to leafy green vegetables, according to the Public Health Agency of Canada. 

The agency said Wednesday it is currently aware of 12 similar cases of E.coli in Alberta, Saskatchewan, Ontario and Newfoundland and Labrador, and that exposure to leafy greens such as lettuce, kale and spinach has emerged as a possible cause. 

No specific product has been identified and the risk to the public is low, the agency said in a statement. 

The Canadian Food Inspection Agency is investigating. 

Canadians are reminded to follow safe food handling practices to reduce the risk of illness, including washing fruits and vegetables before eating them, and cleaning counters, hands and cutting boards. 

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Disneyland-linked measles outbreak close to end

A measles outbreak that began at Disneyland and reignited debate about vaccinations is nearing an end.

The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.

Many who fell ill in the Disneyland outbreak were not immunized or only had one dose of the measles-mumps-rubella vaccine. (Jae C. Hong/Associated Press)

Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. In all, 131 people in California were infected.

The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or only had one dose of the measles-mumps-rubella vaccine.

Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.

The Disneyland outbreak "reminds us that we are part of a global medical community" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.

The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.

Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash.

As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.

Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.

Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.

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Canadian physicians group blames coal power for Edmonton's poor air quality

A group of physicians is cautioning that Edmonton's air quality is worse than that of other larger centres such as Toronto, a fact they blame in part on coal-fired electrical generating plants.

The Canadian Association of Physicians for the Environment has examined a decade's worth of air quality data, which group member Dr. Joe Vipond says show a troubling trend in Edmonton.

Although only about one-fifth the size of greater Toronto in terms of population, Edmonton has significantly higher levels of fine particulate matter in the air, the group's findings suggest.

At a time when most Canadian cities are reducing dependence on coal-fired electrical generation, Edmonton's rose 13 per cent last year, Calgary-based Vipond told CBC news.

"This fine particulate matter has been dropping steadily over the last 10 years in Ontario … as their coal phase-out has occurred," he said ."Overall, the trend is going up (in Edmonton)."

Travel deeply down

A coal-burning power plant in Geisenkirchen, Germany, emits steam and smoke in this file photo from 2009. (Martin Meissner/Associated Press)

The particulates, which are significantly smaller than the diameter of a human hair, are invisible, and can remain suspended in the air for days or weeks.

"When we breathe them in, they can travel deeply down into our respiratory tract and when they deposit and come in contact with tissue, generally they lead to inflammation," said Michael Brauer, a professor in School of Population and Public Health at the University of British Columbia.

Brauer said the particulates have been linked to a number of cardiovascular and respiratory health problems in areas that rely on coal-fired electrical plants around the world, including increased heart attacks, abnormal heart rhythms, heart failure, strokes, lung cancer and emphysema. The substance can also affect fetal health, birth weight and lung development in children.

In December, a report released by Alberta's Environment and Sustainable Resource Development showed two Edmonton regions — Edmonton Central and Edmonton East — exceeded the Canada-wide standards for the amount of fine particulate matter in the air.

Under the Clean Air Strategic Alliance, the province was mandated to notify residents, Dr. Vipond said — however, that report was released at 4:30 p.m. on a Friday with little fanfare.

Coal not only problem, say critics

"I didn't find out about if for 10 days afterwards, and as far as I know there was only one media story ever done about this," he said Tuesday.

After reading the province's report, Dr. Vipond began looking into the air quality numbers himself, first examining the smog alerts issued for Toronto by Air Quality Ontario.

"In 2014, for the first time in over 20 years, they had zero smog days," he said. "That happens to be probably not coincidentally the year that they closed their last coal-fired power plant in April."

Next, the team of physicians looked at air quality data produced by CAPE and Air Quality Ontario comparing Edmonton and Toronto.

"We made some graphs and we noticed that one graph was going up and one graph was going down and about four years ago those lines crossed," Dr. Vipond said.

Coal-fired power

"This is a good news story for Ontario. They can be extremely proud of what they've done for their air quality and pretty safe in how they're feeling walking around in the air — but here in Edmonton, this is a pretty bad news story. We've been neglecting the quality of our air."

Now, Vipond says he'd like to see Alberta begin to lessen its reliance on coal-fired power.

Brauer, however, said it is still too early to make any conclusions from the air quality data collected by CAPE. He also noted the presence of particulates in the air can not be pinned on coal alone.

"A portion of that (Ontario's improving air quality) is likely due to the phase-out of the coal burning, but there are many other factors at play," he said.

Those include improvements made to fuel quality and automobile emissions over the measured time period, he said, which could be responsible for at least some of the decrease seen in Ontario.

And there are factors — including forest fires and weather patterns — that can cause a spike in particulate quantities in Edmonton, he said.

Bob Myrick with the Alberta Environmental Monitoring, Evaluation and Reporting Agency agrees.

Troubling fact remains

"Part of it is automobiles, home heating, the domestic sources — and then the industry sources including the power plants, the refineries east of Edmonton and northeast of Edmonton, they all contribute to the air quality issue that we have," he said.

Regardless of the source, one troubling fact remains.

While most Canadian cities have seen a reduction in airborne particulates over the past decade, Edmonton is a rare exception.

"Basically, it looks like over time we've definitely seen an improvement in air quality in Toronto, and over that same time, air quality in Edmonton has certainly not improved," Brauer said.

"And there's some indication that in recent years it may be getting worse."

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Surgery wait times change little in 5 years

About eight in 10 Canadians received priority surgery such as hip and knee replacements in a timely manner, but large regional variations exist, according to a new five-year report.

Tuesday's report from the Canadian Institute for Health Information focuses on the five priority areas set by first ministers in 2004 using timeframes based on clinical evidence:

• Knee replacement — 182 days.
• Hip replacement — 182 days.
• Hip-fracture repair — 48 hours.
• Cataract surgery — 112 days.
• Radiation therapy — 28 days.

"Since 2010, there has been little change in the proportion of people treated within the benchmarks, with the exception of hip-fracture repairs, which increased from 78 per cent in 2010 to 84 per cent in 2014," the report's authors said.

Despite the increase in the number of procedures from more patients needing surgery, wait times remained consistent.

Nationally last year, knee-replacement surgeries were performed within the clinical benchmark 79 per cent of the time on average, down from 80 per cent in 2010.

About 83 per cent of hip-replacement surgeries were done within the benchmark. The median wait time of 87 days with the second lowest among peer countries in the Organization for Economic Co-operation and Development after the United Kingdom at 82 days.

"We spend a lot of time in Canada focusing on whether we've got the appropriate benchmarks, and is eight of 10 patients at the moment good enough," said Tracy Johnson, manager of emerging issues at CIHI in Toronto.

"I think by looking at the countries, we get the perspective that we're in the ballpark and particularly not doing so badly."

British Columbia and Nova Scotia were worse than the OECD average for waits for hip and knee replacements. 

For hip and knee replacements within each province, new data show "considerable variation" in wait times. Quebec, Ontario and British Columbia all had wide ranges, such as a variation of 54 per cent to 98 per cent for hip replacements between the six networks that serve Toronto and its surrounding areas.

Vancouver Island Health Authority and Vancouver Coastal Health also showed variation. For smaller regional health authorities, Johnson noted many are focused on blitzes to clear queues within benchmarks, which could take a year or two to show improvements.

Johnson said information on regional variations could help guide health systems in their decisions about how to organize care. Options include:

• A central intake model in which all patients queue together with the option of waiting for a specific doctor or the first available surgeon.
• Orthopedic assessment centres where multidisciplinary health-care teams ensure the appropriateness of surgery and the right tests are done to free up surgeons' time.
• Removing waste from the system, such as through a lean model common in Saskatchewan and Newfoundland and Labrador.

Cataract surgery patients received their procedure in a timely fashion 80 per cent of the time, compared with 83 per cent in 2010.

Radiation therapy wait times were consistent with 98 per cent of treatments performed within a month.

Demand for specialized care will increase as the population ages and patients with more complex conditions need medical attention, the report's authors concluded.

The institute is working with the provinces to report and compare intravenous chemotherapy wait times.

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Medical marijuana prescription 'gap' challenged

The ability of people to fill medical marijuana prescriptions directly with a government-approved grower, rather than a pharmacist, creates difficulty for physicians trying to keep tabs on a patient, says the registrar of the College of Physicians and Surgeons of New Brunswick.

Dr. Ed Schollenberg, registrar of the College of Physicians and Surgeons of New Brunswick, opposes the medical marijuana dispensing system, approved by the federal government, which gives patients a direct route to the approved drug suppliers. (CBC)

"We end up with a gap in the information that's available to us if there's a problem," said Dr. Ed Schollenberg. "And more specifically, a gap in the information that might be available to a physician if there might be a problem."

A Fredericton family went public on Monday with questions about medical marijuana prescriptions after Steve Saunders, a 53-year-old businessman, husband and father, committed suicide about one year after receiving a prescription for medical marijuana.

The Saunders family challenges a lack of consultation between prescribing physician Dr. Paul Smith and the Saunders family doctor.

They also question the need for a one-year prescription of up to 10 grams of marijuana a day — enough for about 16 joints, as well as the use of marijuana they maintain had a THC concentration of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)

Schollenberg was not prepared to discuss the specifics of the Saunders case, but in general terms he notes the college has always opposed the dispensing system for medical marijuana, which was approved by the federal government, giving the patients a direct route to the approved drug suppliers.

"Unlike going down to the local pharmacy, which the physician will have a long-standing relationship with, the patient may transmit this prescription in any grower in Canada, who will then mail the supplies to this patient on a monthly basis," said Schollenberg. "The physician may not always know where the patient got that prescription filled."

Schollenberg maintains if a medical marijuana prescription was filled through a local pharmacy a doctor is accustomed to dealing with, there would be a greater chance of the physician intervening.

"There could be an intervention saying, `Before you refill the prescription again for Mr. X, please have him come and see me,'" said Schollenberg. "Physicians can do that now because they know the patient gets their prescriptions fills at Shoppers or Jean Coutu down the street. In this case, they may not know where that prescription is filled."

However, Schollenberg doesn't expect the dispensing protocol to change any time soon.

'Physicians just have to be aware of that and mindful there are yellow signs on this road that say slow down and do things differently.'- Dr. Ed Schollenberg, registrar College of Physicians and Surgeons of New Brunswick

"The reality is that's the way it is," he said. "That's not going to change because any changes will have to be done by the federal government, they will be glacial at best.

"Physicians just have to be aware of that and mindful there are yellow signs on this road that say, Slow down and do things differently because you don't have the same controls you might have for actually much more dangerous drugs, like some of the narcotics and some of the sedatives physicians prescribe for patients,'" said Schollenberg.

"Right now, if a pharmacist has any reason to question something about a prescription, they contact the physician and they pass the information along," he said. "We have no idea whether the commercial growers will feel the same obligation, whether they'll even be aware of issues.

"They will be dealing very much at arm's length. It won't be somebody walking into their store to physically pick the stuff up. Everything will be done at a long distance and it's really unclear whether they will be that interested in intervening."

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Brain aging: 5 ways to stay sharp

Keep physically, socially and intellectually active, the Institute of Medicine's brain aging committee chair says. (Eric Risberg/Associated Press)

Those lost car keys that were an annoyance in your 30s can spark major anxiety in your 60s. Turns out it's pretty normal: The brain ages just like the rest of your body, says a new report that urges Americans to take steps to keep sharp in their senior years.

The prestigious U.S. Institute of Medicine examined what scientists know about "cognitive aging," changes in mental functioning as we get older.

This isn't a disease like Alzheimer's but a natural process — and it's not always bad. Wisdom can indeed increase with age, and years of experience can prove invaluable, stressed Dr. Dan Blazer, an emeritus professor of psychiatry at Duke University who chaired the IOM committee.

"The brain ages in all of us. But there's wide variability in the way the brain ages," Blazer said.

Staying cognitively sharp is one of the biggest concerns of seniors, with good reason. Tuesday's report warns that even subtle slowdowns can affect daily life, making seniors more vulnerable to financial scams, driving problems or other difficulties in a technology-driven world.

Indeed, while some people will experience little if any cognitive change, many older adults process information more slowly, and have more difficulty multitasking than when they were younger, the report found. What's called working memory — the brain's short-term storage — often declines with age but typically long-term memory remains intact even if it takes longer to recall someone's name.

That kind of change may not be obvious until, say, someone is faced with a complex financial decision or forced to make a transaction quickly and has trouble, Blazer said. Older adults are losing nearly $3 billion US a year, directly and indirectly, to financial fraud, the report noted.

What's the difference between normal aging and cognitive decline?

"There's no clear line that we can draw here," Blazer cautioned.

Someone experiencing memory difficulty needs to be checked by a doctor, said IOM panelist Dr. Jason Karlawish of the University of Pennsylvania. With Alzheimer's, nerve cells in the brain die. With normal cognitive aging, neurons don't die — they just don't work as well, he explained.

The best advice for staying sharp as you get older: Be physically active. The sooner you start the better, but it's never too late, Blazer said.

The IOM also recommended:

• Control high blood pressure and diabetes, and don't smoke. Those are key risks for heart disease, and what's bad for your heart is bad for your brain.
• Some medications commonly taken by seniors — including certain anxiety or sleep drugs, antihistamines, bladder drugs and older antidepressants — can fog the brain, so ask about yours.
• Keep socially and intellectually active.
• Get enough sleep.
• Be careful of products that claim to improve cognitive functioning. There's no evidence that vitamins and dietary supplements like ginkgo biloba help, Blazer said. And the jury's still out on whether computer-based brain-training games do any good, he said.

The IOM also urged more research into normal cognitive aging, which has been left somewhat behind the study of diseases like Alzheimer's, and more education of doctors about their patients' risks. For example, hospitalized seniors are at increased risk for delirium — sudden confusion and agitation — that can cause lingering cognitive decline after they go home, but there are ways to prevent it.

The IOM also said government agencies and communities should consider cognitive aging as they set policies and programs. It cited a California law to protect older adults who are signing up for reverse mortgages, and a Michigan plan to improve older driver safety through such steps as adjusting traffic lights to counter glare.

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German mother of 13 pregnant with quadruplets at age 65

Any pregnancy of a woman over age 45 has to be considered a high-risk pregnancy, a German obstetrician says. (Dragan Grkic/Shutterstock)

A 65-year-old German mother of 13 is getting ready to give birth again — this time to quadruplets.
 
Annegret Raunigk, a Berlin schoolteacher who is due soon to retire, is expected to give birth to the four babies within the next two months, Bild newspaper and RTL television reported.

She already has children ranging in age from 9 to 44, from five fathers. Raunigk said she decided to become pregnant again because her 9-year-old daughter wanted a younger sibling.
 
Her decision was met with widespread criticism by medical professionals as a risk both to her and the unborn babies.
 
"Any pregnancy of a woman over age 45 has to be considered a high-risk pregnancy; over 60 this is naturally extreme," Dr. Holger Stepan, head of obstetrics at the University of Leipzig, told the dpa news agency.
 
"The 65-year-old body is definitely not designed to carry a pregnancy, not of one child and certainly not of quadruplets," he said.
 
Raunigk told Bild that donated eggs were fertilized and implanted at a clinic outside Germany, which was successful only after multiple attempts.
 
She defended her decision: "How does one have to behave at 65?"
 
"They can see it how they want to," she said, "and I'll see it the way I think is right."

The Canadian Fertility and Andrology Society represents fertility doctors. The society does not have an age limit in its guidelines for IVF, but individual clinics often do.

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Medical marijuana prescription challenged by dead man's family

A New Brunswick family has some tough questions over the prescribing and use of medical marijuana. They believe it may have played a part in the death of a husband and father.

Steve Saunders of Fredericton was prescribed medical marijuana to help him cope with an old shoulder injury and they claim that under its influence he became manic.

He lost control of his life, drove away family and friends, emptied his savings and eventually killed himself.

In March 2014, Saunders was given a one-year prescription for 10 grams a day of medical marijuana, enough for about 16 joints. He started taking the marijuana the following month.

According to his family, it was premium pot with high THC content of more than 20 per cent. (THC is tetrahydrocannabinol, the chemical responsible for most of marijuana's psychological effects.)

'Manic is what he eventually became.'- Jake Saunders

Within four months, Saunders's family says he had become manic. He slept little, hardly ate and was spending a lot of money.

"Manic is what he eventually became," said his son Jake Saunders.

"He went out and he bought a Harley-Davidson. He bought at Porsche. He bought a hotel in Nackawic.

"The spending was just non-stop. Eventually, mother had to freeze the accounts because by that time, everybody knew there was something wrong."

Recreational pot user

Saunders, 54, was as entrepreneur and businessman who ran a bed and breakfast with his wife of 33 years, Kathy, in a Victorian-era home on University Avenue. He was just beginning a new career as a real estate agent.

Saunders's family says he had been a recreational user of marijuana for years, but was always concerned about getting caught on the wrong side of the law.

Saunders and his wife Kathy operated the Carriage House Inn bed and breakfast on University Avenue. (Mynewbrunswick.ca)

"The same way I'd drink a beer on weekends, he treated pot the same way," said Jake Saunders.

Saunders had some residual pain from a shoulder operation he'd had and was being treated for some anxiety he suffered following the deaths of his parents a few years ago.

His family doctor discouraged medicinal marijuana use because of Saunders's background, which included a previous brush with alcohol addiction and anxiety. 

She didn't think it was a good idea and warned Saunders against it.

When Saunders got the prescription from another doctor, Dr. Paul Smith, he sent for a supply of medical marijuana and started using it in April 2014.

"We were all a little shocked when he got the prescription so quick because we thought it was going to be a bit of a process," said Jake Saunders.

'I could tell that he was smoking too much, especially with the strong stuff. You don't need that much.'- Luke Saunders

Luke Saunders said his father lost control of his pot smoking soon after receiving the first two ounces in the mail.

"Smoking joint after joint, three in a row first thing in the morning before anyone is out of bed," said Luke Saunders.

"I could tell that he was smoking too much, especially with the strong stuff. You don't need that much."

Family attempts intervention

Last fall, Saunders's family tried to intervene, setting up appointments with their family doctor and the province's addictions services program.

The family also filed a formal complaint with the New Brunswick College of Physicians And Surgeons against Smith.

Saunders, right, committed suicide in March 2015. (Submitted by Saunders family)

They were upset because they allege the prescribing doctor didn't consult with Saunders's family physician.

Smith told CBC News that Saunders was referred to him by another doctor Saunders had consulted, and not by his family physician.

The family is also upset Smith wrote a year-long prescription without any follow up.

"There's very clear guidelines on how to prescribe medical marijuana and this guy, the doctor did not follow them," said Jake Saunders.

"There was no consultation with our family doctor."

He said his father had been told for so long from his family doctor that he was not a candidate for medical marijuana, so there should have been more follow up after he received the prescription.

"When you prescribe something like this, you can't just give somebody 10 grams a day and go away and just think that everything is going to be fine," he said.

Smith says patients are briefed and coached on the use of medicinal marijuana, but, as with any drug, it's up to the patient to use it correctly.

Smith describes the 10 grams a day as "a ceiling dose," or the maximum amount that can be taken a day and not a prescription to use that amount every day.

Last fall, Saunders was stopped by the RCMP in Cape Breton, N.S., with a quantity of non-medicinal marijuana in his car.

Saunders's behaviour was so alarming he was admitted to the psychiatric unit in Sydney on an involuntary admission and transferred to the Dr. Everett Chalmers Hospital in Fredericton and eventually discharged.

By November 2014, with the help of his wife and family doctor, Saunders had stopped smoking marijuana.

But in January, Saunders received a summons from RCMP in Cape Breton and was informed he'd be charged with possession of marijuana for the purpose of trafficking.

Saunders's condition and behaviour appeared to be improving, but his wife says he was sad.

On March 5, Saunders was found dead in the family home. He had taken his own life.

College responds to complaint

Three weeks after Saunders's death, the College of Physicians and Surgeons responded to the family's complaint about Smith.

Both Smith and the college's complaints committee suggest an undiagnosed condition of bipolar disorder may have been an aggravating factor in Saunders's case. Other drugs that Saunders was prescribed for anxiety may also have played a part.

Smith also says Saunders appeared to be mixing the medicinal marijuana with his own supply.

"The guy was a rare circumstance," states Smith, who also said, "our program was lacking, we have acknowledged that."

The College of Physicians and Surgeons has recommended a number of changes as a result of the complaint:

• The prescribing physician now require that patients for medical marijuana have a witness to accompany the patient to ensure unexpected reactions are reported back to the doctor.
• More vigorous follow up of patients be carried out.
• In the future, most patients be given prescriptions of shorter duration so they have to come back to the doctor for renewals and assessments.
• The above recommendations be made known to all doctors through the college's next newsletter.

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HPV vaccine for boys may prevent cancer and save money

Vaccinating boys against the human papillomavirus (HPV) might be cost effective over their lifetimes to prevent a type of throat and mouth cancer, new Canadian modelling suggests.

Dr. Lillian Siu, a senior medical oncologist at the Princess Margaret Cancer Centre in Toronto, has treated oropharyngeal cancer that starts at the back of the throat and mouth for about 18 years, and has seen the incidence of the disease rise.

The HPV vaccine is covered for girls to prevent cervical cancer. The vaccine also reduces anal cancer in both sexes as well as some cancers of the penis and oropharyngeal cancer. (Valentin Flauraud/Reuters)

The HPV vaccine is covered by provincial medicare plans for girls to prevent cervical cancer. The vaccine also reduces anal cancer in both genders as well as some cancers of the penis and oropharyngeal cancer, which also involves the tonsils and base of the tongue.

"We would see now about 80 per cent of our oropharyngeal cancer patients are what we call HPV positive," said Siu. "It is a morbid disease so I think we have to spend some time thinking about how to prevent it."

To that end, Siu and her team created a model to compare the potential cost savings of vaccinating a theoretical group of about 190,000 boys at age 12 followed over their lifetime using factors such as vaccine cost, vaccine effectiveness, costs of cancer treatment and how the quality of life of cancer patients diminishes.

"We don't know how to predict who will get the disease and anyone who is sexually active is at risk of developing such a cancer," Siu said.

In Monday's online issue of the journal Cancer, Siu and her coauthors concluded the vaccine could potentially save between $8 million and $28 million over the boys' lifetimes, or up to nearly $42 per person per year, compared with no vaccine.

Siu isn't advocating for the vaccine to be offered free to boys until more research is done. "I think if we can raise the awareness to start looking at this question in greater depth, we've achieved our goal."

MP Peter Kent says he wants to use his prominence as a public figure to draw attention to the use of HPV vaccines for boys. (Stephanie Matteis/CBC)

One limitation of the model is the researchers weren't able to account for the interaction with smoking, another risk factor for oropharyngeal cancer. In developed countries, HPV is surpassing smoking as a cause factor, she said.

Conservative MP Peter Kent became an advocate for HPV vaccination after his diagnosis in 2013.

"It was my first confrontation with mortality and I thought, well, here we go," Kent recalled. "The diagnosis was Stage 4 HPV-related cancer, which is a fairly ominous diagnosis."

Kent had seven weeks of radiation treatment and three rounds of chemotherapy.

"I don't want any youngster today to face what I did, to experience what I did, 10 or 20 or 30 or 40 years down the road because it is avoidable and I think that governments have to face their responsibility and make that investment in the future."

Three doses of the vaccine cost about $500. B.C. and Quebec use two doses for girls. Currently, Alberta and Prince Edward Island cover the cost for boys. Nova Scotia's new budget includes plans to add HPV vaccines for boys in Grade 7 in the fall. 

Toronto pediatrician Dr. Marvin Gans tells families about the costs and benefits of HPV vaccination for both girls and boys.

Some studies point to benefits for men by vaccinating women through herd immunity. "Clearly, the more girls that get [vaccinated] the decrease we'll see in males. However, that's not a guarantee of how to do things."  

At Gans' office, Fern Stark sees the preventive value. "I think boys, teenaged boys, should have the vaccine. In fact my older son who is almost 17, has had it and I'm going to be making arrangements for my younger son, who is 13, to get it."

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Egg freezing: the 'options' approach to parenthood

By Dr. Brian Goldman Posted: Apr 13, 2015 1:43 PM ET Last Updated: Apr 13, 2015 1:43 PM ET

The Quebec government is looking at scaling back its in vitro fertilization program to only cover infertile couples. (Radio-Canada)

Some women are paying up to ten thousand to have their eggs frozen so they can become parents later on. A new article in CMAJ says doctors should play a pivotal role counseling women about the pros and cons of a new and growing practice with the Orwellian-sounding name of 'social egg freezing.'

Egg freezing has been around since the late 1990s.  It was first developed for young women with cancer - where the cancer itself, chemo or radiation could cause sterility. Doctors use hormones to stimulate the ovaries to produce a lot of eggs.  The eggs are frozen and stored until the cancer is treated; the eggs are fertilized and implanted to enable the woman to become pregnant.  

Social egg freezing (I love the jargon) means taking the same technique and applying it to women who don't have cancer but who want to postpone motherhood. Once the eggs are retrieved and frozen, it's theoretically possible to store them for years or even decades.  The woman chooses when to thaw the eggs, they're fertilized with sperm, and the resulting embryos are implanted - years or even decades after the eggs were retrieved. It's been called 'the perfect 30th birthday present for women.'

Social egg freezing is not covered by provincial health.  The cost ranges between five and ten thousand dollars per treatment.  Storage cost for the frozen eggs is between three and five hundred per year - which adds up if the eggs are stored for ten or even twenty years.  Add to that the cost of in-vitro fertilization or IVF - to fertilize the thawed eggs and implant the embryos - and you're looking at thousands of dollars, putting it well beyond the price range of most women.  The cost and the lack of providers are two reasons why there are probably only a handful of women who have had it done so far.

How successful is social egg freezing has been so far is anyone's guess. Let's assume the clinic uses the most successful technique - flash freezing the eggs and using chemicals that protect the eggs from the effects of being frozen.  In that case, between ninety and ninety-seven percent of the thawed eggs survive.  Close to eighty percent are successfully fertilized, and up to forty-one percent are implanted.  The actual pregnancy rate per frozen and thawed egg is no more than twelve percent.  The American Society for Reproductive medicine estimates that between two and twelve percent of women end up having a child.  The younger the woman at the time the eggs are retrieved, the better the success rate.

Not surprisingly to me, critics are all over the risks to the procedure.  Top of the list is a medical condition known as ovarian hyperstimulation syndrome, which is caused by the use of fertility drugs.  At worst, the condition can cause blood clots, shortness of breath, vomiting, dehydration, abdominal pain, and hospitalisation. There are risks to IVF itself.  Then, there are the risk associated with being an older mother.  If the woman postpones pregnancy until her fifties, she is more likely to have diabetes, high blood pressure, and elevated cholesterol.  There may also be risks to the child.  Should such pregnancies be high risk, then there could well be increased medical costs that taxpayers will need to bear.

There are ethical and cultural implications of social egg freezing.  Is this an attempt to pressure women to have it all by giving them a means to postpone motherhood?  Does the cost bias motherhood in favour of those who can afford it?  

There is a simmering controversy in the medical community.  Last October, the Canadian Fertility and Andrology Society declared social egg freezing an option for women.  In the US, the American Society for Reproductive Medicine and the Society for Assisted Reproduction cautioned against the use of egg freezing.

So, what should women do? The article in CMAJ says part of the reason for the controversy is that you have vested interests trying to influence women.  For example, fertility doctors make their living providing assisted reproduction to women, and social egg freezing will increase the market.  For that reason, the authors say it's important that family doctors counsel women objectively about the benefits and the risks of the procedure - and how it fits in a broader discussion about reproductive health and the many options for having a family.

At the end of the day, the technique exists.  I think it's up to women to choose whether they want to plunk down as much as $15-20,000 for an optional pregnancy later on. This is one debate that ethicist should sit out.

For more on this, check out this free podcast put out by CMAJ.

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Pitt Meadows Meats expected to plead guilty in E. coli case

Pitt Meadows Meats is expected to plead guilty on Monday to at least one count of selling E. coli-tainted meat in 2010, CBC News has learned. 

Pitt Meadows Meats is expected to plead guilty on Monday to selling E coli tainted meat in 2010. (Curt Petrovich/CBC)

One of British Columbia's largest meat processing plants, which now calls itself Meadow Valley Meats, was charged with 11 counts under the Food and Drugs Act for selling meat unfit for human consumption after a former employee contacted the Canadian Food Inspection Agency.

The coverup came to light when Daniel Land, who oversaw the plant's quality assurance, later contacted CBC News, saying officials at Pitt Meadows Meats told him to keep quiet about the positive test result obtained on Sept. 9. 2010.

Land said a manager failed to report lab results that showed a sample of its product was contaminated with the deadly E. coli O157 strain.

Regulations require federally licensed plants to report such findings.

"They told me that this would be looked after — they would pull it off the shelf," Land said from his home in Edmonton. "Shame on them. There was tainted meat in the marketplace and they did nothing."

Plant shut down, food recall

Land was fired and decided to report the incident to the CFIA, a month after the test came back positive for E. coli.

Federal inspectors shut down the plant for a month and issued a recall, warning consumers that Pitt Meadows beef and lamb products may be contaminated with E. coli and should not be consumed. 

Daniel Land says the Pitt Meadows plant manager ignored a positive test for E. coli. (CBC)

All the products were halal, meaning the animals were slaughtered in accordance with Islamic tradition, and distributed in the Metro Vancouver area.

The company was charged with 11 counts of selling tainted meat to 10 different markets and restaurants, according to the indictment. It has apologized to customers and businesses harmed by the recall for not alerting federal officials sooner.

Following the E. coli tests, plant officials said they internally recalled the products and destroyed 61 cases.

Pitt Meadows Meats repeatedly described Land as a disgruntled employee who may have tainted the beef himself. 

"That's a lie. We had a positive E. coli O157," Land said.

"The meat was out there in the industry. When CFIA got involved and pulled it off shelves the meat was already in stores and people had already consumed it."

There were no reports of illness and later tests were negative for E. coli.

'Justice has been done'

Land said he is relieved the case is finally coming to an end, though he was more than willing to testify if there was a trial.

"It's taken a long time, five years it's taken. I just hope they realize how serious this situation was and I'm glad justice has been done."

The directors of the numbered company doing business as Pitt Meadows Meats, Ken and Jeff Kooyman, also own Chilliwack Cattle Sales, a dairy plant that was targeted in a hidden camera investigation by Mercy for Animals Canada, a non-profit group.

Video shot by a former employee showed employees beating and kicking cows. Some processors cancelled their milk orders. At the time the Kooymans said the behaviour was inappropriate and followed up by firing the employees they said were responsible.

Through a spokesperson, the Kooymans declined CBC's request for an interview. Their company is expected to issue a statement after Monday's court appearance.

The case will be heard at B.C. Supreme court in New Westminster.

Read the indictment. 

Indictment Pitt Meadows (PDF)
Indictment Pitt Meadows (Text)

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$1 per Canadian? Brother hopes to match Terry Fox's goal on run's 35th anniversary

Thirty-five years ago today, Terry Fox set off on a run that has raised over $700 million for cancer research. It all began with a humble goal and the generosity of a small Newfoundland town.

When Fox dipped his prosthetic leg into the ocean off of St. John's, N.L., on April 12, 1980, he dreamed of raising a total of $10,000.

But when he saw that the town of Channel-Port Aux Basques, N.L., alone raised $10,000, their generous response fired his imagination.

"Terry thought, 'If they can raise a dollar for every citizen, why can't we raise a dollar for every Canadian in Canada?'" says Fred Fox, Terry's older brother, who works for the Terry Fox Foundation.

Terry ran more than 5,000 kilometres to train for the gruelling journey and logged his progress in a journal. (Adrian Wyld/The Canadian Press)

After that initial fundraising boost, Terry's goal for the Marathon of Hope grew to $24.17 million, which mirrored Canada's population at the time.

This year, to commemorate the run's 35th anniversary, the foundation hopes to raise $35 million. Serendipitously, that works out to roughly $1 per Canadian based on today's population.

"It would be wonderful," Fred says.

Today, all Running Room stores in Canada will host walk/run events at 8:30 a.m. to start this year's Terry Fox Run fundraising season. The official annual run takes place on Sept. 20.

Marathon of Hope's humble start

Terry was only 18 years old when he was diagnosed with osteosarcoma in 1977. Doctors amputated his right leg 15 centimetres above the knee. During Terry's subsequent chemotherapy treatments, he struggled with watching other young people die from cancer.

'If they can raise a dollar for every citizen, why can't we raise a dollar for every Canadian in Canada?'- Fred Fox. remembering his brother Terry's quote

"[Terry] often said that getting cancer probably made him a more caring person," Fred says of the growing empathy that drove his brother to train for the cross-country run fundraiser.

Terry wrote "very passionate" letters to companies hoping they could help on his journey, says Fred. Adidas gave Terry running shoes, Ford provided a camper van, Esso offered gas vouchers.

His family and friends in Port Coquitlam, B.C., organized a fundraiser to cover other costs during his trip.

Terry Fox ran an average of 42 kilometres a day for 143 days during his Marathon of Hope. (Canadian Press)

"I am not a dreamer, and I am not saying that this will initiate any kind of definitive answer or cure to cancer," Terry wrote in a letter to the Canadian Cancer Society, asking them to support his run. "But, I believe in miracles. I have to."

When Terry departed on his journey, few people knew what he was doing, his brother says.

But as he ran an average of 42 kilometres each day and visited schools and communities along the route, people and the media started to talk about the young man with the prosthetic leg running across Canada.

"They saw that Terry was committed, dedicated," says Fred. "His personality, his honesty, his integrity were 100 per cent genuine. And that's why they jumped on board and gave him the support he needed."

By the time he crossed into Ontario, Terry was a household name.

But on Sept. 1, 1980, Terry's own cancer brought the run to a halt near Thunder Bay, Ont. With nearly 150 days and more than 5,000 kilometres under his belt, Terry returned to B.C. to get treatment for the cancer that had spread to his lungs.

CTV soon organized a five-hour telethon that raised $10 million. Five months before Terry died, he reached his goal of $24.17 million.

'Cubans love Terry Fox'

Today, Terry's influence is still felt around the world, and his foundation has raised nearly $700 million. He is particularly popular in Cuba, which hosts the largest Terry Fox run outside Canada. Some two million people participate each year, Fred estimates.

A Cuban music group even created a music video celebrating the run and what it stands for.

Watch Cubanos en la Red's music video:

In 2010, Terry's mom, dad and sister, Judith, visited Cuba for the annual run. One day, Judith walked into a small store. The cashier couldn't speak any English, but became very animated when she recognized the figure on Judith's Terry Fox Run shirt.

"Cubans love Terry Fox," says Fred, who believes they appreciate the story of how much an average person can accomplish simply through perseverance.

"Terry was just an average Canadian kid," his brother says, adding that Terry would be the first to admit he wasn't the biggest, fastest, strongest or even the smartest, and always had to work a little bit harder to achieve his goals.

"He was ordinary, but did an extraordinary thing."

150 lives saved by foundation's research

That extraordinary thing, which still compels so many people to donate money to cancer research, has saved Canadian lives, says Victor Ling, the Terry Fox Research Institute's president and founding director.

The institute was launched in 2007 thanks to funds from the Terry Fox Foundation, which garnered a plethora of donations after the run's 25th anniversary. The institute aims to increase the turnaround time between laboratory discoveries and practical solutions for cancer patients.

Terry Fox was willing to sacrifice himself to make a difference in other people's lives, his brother Fred Fox says. (Courtesy Fred Fox)

In an ongoing project, the foundation has teamed up with health centres in major Canadian cities to screen heavy smokers for early stages of lung cancer using a CT scan and other parameters, Ling says.

In a pilot study to better detect lung cancer, doctors discovered early stage cancers in about every four out of 100 people screened.

"There's over 150 people now in Canada that are alive because of this [project]," he says.

Terry would be very surprised but happy to learn that his efforts didn't stop when he died, his brother says.

"He was willing to sacrifice himself to make a difference in other people's lives."

---

Marathon of Hope by the numbers:

• Terry Fox ran more than 5,000 kilometres during training.
• He originally aimed to raise $10,000.
• Fox ran roughly a marathon a day, averaging 42 kilometres daily. He covered 5,373 kilometres over 143 days.
• Fox reached his goal for one dollar per Canadian ($24.17 million) on Feb. 1, 1981. He died less than five months later.
• More than 300,000 people participated in the first Terry Fox Run in 1981, raising $3.5 million.
• The Terry Fox Foundation has raised nearly $700 million since the Marathon of Hope. That's $130,281 and change for every kilometre Fox ran.
• Fourteen schools and 15 roads in Canada bear Fox's name.
• Millions of people in nearly 25 countries participate in Terry Fox fundraising events each year, including the national school run day and the Terry Fox Run.
• The largest Terry Fox run outside of Canada is in Cuba. Approximately two million people participate in that country's event every year, Fox's brother Fred estimates. Cuba has a population of just over 11 million.

— The Terry Fox Foundation, The Terry Fox Research Institute

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HPV vaccine for boys may prevent cancer and save money

Vaccinating boys against the human papillomavirus (HPV) might be cost effective over their lifetimes to prevent a type of throat and mouth cancer, new Canadian modelling suggests.

Dr. Lillian Siu, a senior medical oncologist at the Princess Margaret Cancer Centre in Toronto, has treated oropharyngeal cancer that starts at the back of the throat and mouth for about 18 years, and has seen the incidence of the disease rise.

The HPV vaccine is covered for girls to prevent cervical cancer. The vaccine also reduces anal cancer in both sexes as well as some cancers of the penis and oropharyngeal cancer. (Valentin Flauraud/Reuters)

The HPV vaccine is covered by provincial medicare plans for girls to prevent cervical cancer. The vaccine also reduces anal cancer in both genders as well as some cancers of the penis and oropharyngeal cancer, which also involves the tonsils and base of the tongue.

"We would see now about 80 per cent of our oropharyngeal cancer patients are what we call HPV positive," said Siu. "It is a morbid disease so I think we have to spend some time thinking about how to prevent it."

To that end, Siu and her team created a model to compare the potential cost savings of vaccinating a theoretical group of about 190,000 boys at age 12 followed over their lifetime using factors such as vaccine cost, vaccine effectiveness, costs of cancer treatment and how the quality of life of cancer patients diminishes.

"We don't know how to predict who will get the disease and anyone who is sexually active is at risk of developing such a cancer," Siu said.

In Monday's online issue of the journal Cancer, Siu and her coauthors concluded the vaccine could potentially save between $8 million and $28 million over the boys' lifetimes, or up to nearly $42 per person per year, compared with no vaccine.

Siu isn't advocating for the vaccine to be offered free to boys until more research is done. "I think if we can raise the awareness to start looking at this question in greater depth, we've achieved our goal."

MP Peter Kent says he wants to use his prominence as a public figure to draw attention to the use of HPV vaccines for boys. (Stephanie Matteis/CBC)

One limitation of the model is the researchers weren't able to account for the interaction with smoking, another risk factor for oropharyngeal cancer. In developed countries, HPV is surpassing smoking as a cause factor, she said.

Conservative MP Peter Kent became an advocate for HPV vaccination after his diagnosis in 2013.

"It was my first confrontation with mortality and I thought, well, here we go," Kent recalled. "The diagnosis was Stage 4 HPV-related cancer, which is a fairly ominous diagnosis."

Kent had seven weeks of radiation treatment and three rounds of chemotherapy.

"I don't want any youngster today to face what I did, to experience what I did, 10 or 20 or 30 or 40 years down the road because it is avoidable and I think that governments have to face their responsibility and make that investment in the future."

Three doses of the vaccine cost about $500. B.C. and Quebec use two doses for girls. Currently, Alberta and Prince Edward Island cover the cost for boys. Nova Scotia's new budget includes plans to add HPV vaccines for boys in Grade 7 in the fall. 

Toronto pediatrician Dr. Marvin Gans tells families about the costs and benefits of HPV vaccination for both girls and boys.

Some studies point to benefits for men by vaccinating women through herd immunity. "Clearly, the more girls that get [vaccinated] the decrease we'll see in males. However, that's not a guarantee of how to do things."  

At Gans' office, Fern Stark sees the preventive value. "I think boys, teenaged boys, should have the vaccine. In fact my older son who is almost 17, has had it and I'm going to be making arrangements for my younger son, who is 13, to get it."

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Anti-vaccination parents could be denied government benefits in Australia

Parents who refuse to vaccinate their children will miss out on government benefits of up to $15,000 per child under a new measure announced by Australian Prime Minister Tony Abbott.

Under current laws, families with children who are not immunized can still receive annual childcare rebates and other benefits if they have a personal, philosophical or religious objection.

Australian Prime Minister Tony Abbott says rules would be tightened to only allow a small number of religious and medical exceptions to opt out of vaccinations. (Stefan Postles/Getty Images)

Abbott said the rules would now be tightened to only allow a small number of religious and medical exceptions, but he would not say how much the move was likely to save.

"This is essentially a 'no jab, no pay' policy from this Government," Abbott said.

"It's a very important public health announcement, it's a very important measure to keep our children and our families as safe as possible."

Social Services Minister Scott Morrison said he only expected a very small number of families to be exempted from the new policy.

Morrison said parents seeking a religious exception would need to be registered with their church or similar organization.

"That's the only basis upon which you can have a religious exception, and there are no mainstream religions that have such objections registered so this would apply to a very, very small proportion of people," he said.

"It'd be lucky to be in the thousands, if that."

"The choice made by families not to immunize their children is not supported by public policy or medical research, nor should such action be supported by taxpayers in the form of childcare payments," Abbott added in a joint statement with Morrison.

Under the policy which the coalition took to the last election, and which is supported by Labor, "conscientious objection" would no longer be allowed for parents who refuse to vaccinate their children but still want to receive child care payments and family tax benefit supplements.

Opposition Leader Bill Shorten said it was a sensible step.

"We believe fundamentally in the science of vaccinations and we fundamentally believe that policy should be made by the best evidence and the best science," he said.

"And we would say to the Liberal Government, we're pleased that you're agreeing with our position and yes we will cooperate to make sure that the safety of our children is what is paramount in public policy."

Jo Briskey from advocacy group Parenthood has also welcomed the move.

"Well this will hopefully increase the rates of immunisation, which unfortunately are starting to fall behind the rates that are safe for our community," she said.

"So we're hoping to see less parents choosing not to vaccinate their kids."

Australia has vaccination rates of over 90 per cent for children aged one to five years.

But the government said more than 39,000 children aged under seven were not vaccinated because of their parents' objections — an increase of more than 24,000 children over the past decade.

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Brain training games: No proof they prevent cognitive decline

The idea of playing a game to make you sharper seems like a no-brainer. That's the thinking behind a billion-dollar industry selling brain training games and programs designed to boost cognitive ability.

But an investigation by CBC's Marketplace reveals that brain training games such as Lumosity may not make your brain perform better in everyday life.

Brain training games, such as Lumosity, are a billion-dollar industry. Many people are worried about maintaining their brain health and want to prevent a decline in their mental abilities. (CBC)

Almost 15 per cent of Canadians over the age of 65 are affected by some kind of dementia. And many people of all ages are worried about maintaining their brain health and possibly preventing a decline in their mental abilities.

"I don't think there's anything to say that you can train your brain to be cognitively better in the way that we know that we can train our bodies to be physically better," neuroscientist Adrian Owen told Marketplace co-host Tom Harrington.

To test how effective the games are at improving cognitive function, Marketplace partnered with Owen, who holds the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging at the Brain and Mind Institute at Western University.

---

Watch the complete investigation, Mind Games, a special one-hour season finale of Marketplace, on Friday at 8 p.m. (8:30 p.m. NT) on CBC TV and online.

---

A group of 54 adults, including Harrington, did the brain training at least three times per week for 15 minutes or more over a period of between two and a half and four weeks. The group underwent a complete cognitive assessment at the beginning and end of the training to see if there had been any change as the result of the training program.

The assessment tested performance in memory, reasoning, concentration and planning.

At the end of the training period, researchers analyzed the results and found no significant improvement on any of the tests.

'Taking control of your own brain'

The group used a training program called Lumosity, created by California-based Lumos Labs, which describes itself as "a leader in the science of brain training." Lumosity is one of the most popular cognitive training programs, with 70 million members in 180 countries.

"I don't think there's anything to say that you can train your brain to be cognitively better in the way that we know that we can train our bodies to be physically better," says neuroscientist Adrian Owen. (CBC)

The Lumosity program is made up of more than 40 games designed to improve cognitive abilities, including memory, attention and problem solving. Members are supposed to play the games for 15 minutes, three to five times a week. Membership costs $15 per month.

A 2007 press release from the company calls the games "a scientifically developed online brain fitness program demonstrated to improve memory and attention with fun and effective brain workouts."

"Lumosity is a personal trainer that helps you exercise your brain," a video on the company's website says.

Lumosity declined to speak with Marketplace on camera about the investigation. In a statement, the company said: "We cannot comment on unpublished research. Numerous studies have shown that cognitive training, including Lumosity, improves cognitive performance. Well designed cognitive training studies include sufficient training time — at least 10 hours."

The company launched in 2005. Co-founder Michael Scanlon said he started to learn about the brain after both his grandmothers were diagnosed with Alzheimer's disease.

"I started getting excited about the possibility of leveraging your brain's plasticity and the way it changes to make a product that people could use and to really become more empowered about taking control of your own brain," he said in an interview with the technology news site TechCrunch.

No 'magic bullet'

But researchers are concerned that the benefits of brain training have been overstated.

Last October, 70 scientists released a statement titled "A Consensus on the Brain Training Industry from the Scientific Community," expressing concern about the way that brain games such as Lumosity are marketed.

The group in the Marketplace test underwent a complete cognitive assessment that assessed performance in memory, reasoning, concentration and planning. (CBC)

"We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do," the statement reads.

"The promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles. In the judgment of the signatories, exaggerated and misleading claims exploit the anxiety of older adults about impending cognitive decline."

Zachary Hambrick, professor of cognitive neuroscience at Michigan State University, says companies need to demonstrate that playing the games make you better at doing everyday tasks, not just better at the games themselves.

"What they really need to demonstrate — in a randomized controlled trial of the sort that a company would have to do for approval of a drug — is that Lumosity training actually improves real-world outcomes like performance in the classroom, the workplace, etc., and in everyday tasks like driving, remembering to perform errands," he says.

"In my opinion, the science so far has failed to establish that real-world relevance."

Owen, who designed the Marketplace test, said that if the games had long-term effects, they would have been evident after a few weeks of training.

"These people have done, I think, what most people would consider a reasonable investment of their time, they've put in quite a lot of effort; they've done quite a bit of training. And there's not even a hint of an effect," he said.

Owen says the games may be fun – just don't expect them to be effective.

"If you enjoy playing these games, fine, play the games. But just don't do it if you think it's making you smarter. Because I don't think the scientific evidence supports that," says Owen.

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Expired drugs found on pharmacy shelves

Expired medications should be taken off the shelf before they have a chance of reaching consumers, say pharmacists who stress manual checks of the expiry dates.

After Shoppers Drug Mart recalled one lot of Alesse 21 birth control pills that expired in September 2014 and were sold to about 100 women, a Richmond, B.C., resident sent CBC News photos of a newly purchased non-prescription allergy medication stamped with an expiry date of August 2014. A CBC producer found more on the shelf at the same store.

When CBC News checked a dozen drug stores from three chains in Toronto, journalists found a diabetic nutritional supplement that expired last October, other past due allergy medications, an expired sleep medication and a number of products that expire this month.

Expired medications, both prescription and non-prescription, should be taken off the shelf before they have a chance of reaching consumers, said Phil Emberley, director of pharmacy innovation at Canadian Pharmacists Association in Ottawa.

Pharmacists are fallible, but there are ways to prevent expiry date errors. (Paul Sancya/Associated Press)

"In a well-run pharmacy and drug store, there is a procedure for ensuring expired drug products are taken off the shelf before they expire," Emberley said.

"Consumers would not find expired product if they were to go, if they were to pick a product from the shelf. Further, in the dispensary part, there would be a fairly routine procedure, for example, once a month, to identify products that were soon to expire so that they would not be inadvertently dispensed by someone."

Regarding the Alesse recall, Emberley speculated that pharmacists made an assumption about newly arrived stock.  

"They may have assumed it was well within its expiry, when in fact it arrived at the store already expired. I think there may have been that false sense of comfort that this product was still dispensable, when in fact it wasn't."

Shoppers Drug Mart said it is reviewing its practices to prevent a recurrence.

In response to questions about the expired medications CBC News found on shelves, Shoppers said, "As a standard practice in our stores, our store teams regularly rotate in new product and check the expiry dates on the product on our shelves. Our policy is to remove expired product and note future expiry dates so that products can be culled before they expire.

"If any of our customers discover that they purchased expired product, we will refund it."

The other pharmacy chains did not respond to CBC News's requests for comment about their expired non-prescription products.

Guardian Pharmacy told CBC they were just made aware of the medication being available for sale on Thursday, and that they're taking the matter seriously.

"Guardian and I.D.A. are working with the store owner/operator to ensure that this particular product is removed and no longer available for sale," they said.

Julie Greenall, director of projects and education at the Institute for Safe Medication Practice Canada, said the Alesse recall illustrates how technology is not fail-safe and manual checks of expiry dates by pharmacists remain paramount.

"I think as we move to electronic systems that we do have an increasing reliance on those electronic systems and also we sort of take that for granted that that's already checked," Greenall said.

Currently, electronic inventory systems may include the drug name and strength in the bar code, but not the lot number and expiry date, an advance Greenall expects will come.

"There have been a number of studies done on expired medications that have found that they do tend to hold their potency over extended periods of time, but every medication is different. What we do know is that [most] expired medications are unlikely to be harmful," Greenall said.

Given that pharmacists are fallible, Greenall's institute recommends ways to prevent errors, including:

• An alphanumeric system for expiry dates that includes letters to make the numbers stand out.
• Expiry labels with the full four digits for the year.
• Printing EXP clearly to indicate the expiry date rather than the lot number.
• Have consumers check the expiry date themselves when possible.

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Ebola still global emergency despite big drop in cases: UN

WHO's Ebola emergency committee believes the risk of the virus spreading globally appears to be dropping even though officials don't know where the virus is spreading in most cases in Guinea and Sierra Leone. (Baz Ratner/Reuters)

The World Health Organization says the year-long Ebola outbreak in West Africa still qualifies as an international emergency even though the number of cases has plummeted.

Last August, the U.N. health agency declared the epidemic of the lethal virus to be a global emergency after the deaths of nearly 1,000 people, mostly in Guinea, Sierra Leone and Liberia.

At the peak last year, hundreds of new cases were being reported every week. In an update this week, WHO reported there were 30 confirmed cases last week in Guinea and Sierra Leone; the last case in Liberia died on March 27.

Dr. Bruce Aylward, who is leading WHO's Ebola response, said the decline appeared to be real, rather than just "a pothole on the bumpy road to get to zero cases."

During a press briefing in Geneva on Friday, Aylward said WHO's Ebola emergency committee believes the risk of the virus spreading globally appears to be dropping even though officials still don't know where the virus is spreading in most cases in Guinea and Sierra Leone.

"We are still not controlling the epidemic," said Brice de le Vingne, director of operations for Doctors Without Borders, who noted past lulls in the outbreak have often been followed by surges in cases. He said the designation of Ebola as a global emergency is also necessary to speed up paperwork for the ongoing experimental drug and vaccine trials in West Africa.

Other experts agreed it's too early for WHO to downgrade the status of the biggest-ever Ebola outbreak and warned the recent fall in cases may be deceptive.

"It is just that we are used to [seeing] large numbers of cases and deaths," said Oyewale Tomori, a Nigerian virologist who sits on WHO's Ebola emergency committee. "These numbers should still frighten us."

Tomori said that though cases have fallen dramatically, it is too soon to relax. "The three countries had declared themselves [Ebola-free] at one time, only to find dead bodies all over the place later," he wrote in an email.

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Canada's top doctor to visit Ebola clinics in West Africa

Dr. Gregory Taylor, Canada's chief public health officer, is preparing to travel to West Africa to get a first-hand look at the efforts to defeat the Ebola outbreak, which has claimed more than 10,000 lives. 

The trip, which runs from April 13 to 19, will take Taylor to Sierra Leone and Guinea, two of the three West African countries that have been at the centre of the outbreak.

Taylor plans to visit the 70 Canadian health-care workers in Guinea and Sierra Leone, including the military staff working at a treatment facility being run by British armed forces personnel in Freetown, Sierra Leone's capital city.

The World Health Organization has said that the Ebola crisis is still considered an international emergency, even as the number of new confirmed cases decreases.

The most recent WHO data shows the number of new confirmed cases dropped to 30 last week, and health officials are hoping to get that down to zero. Liberia, the third of the hard-hit West African nations, had no new confirmed cases in the same period.

Dr. Gregory Taylor, Canada's chief public health officer, will visit some of the clinics set up to contain the outbreak in West Africa and assess what Canada can do to help the region rebuild. (Adrian Wyld/Canadian Press)

For most of the past year, Taylor said, the need has been for acute care workers to treat those infected with Ebola, but the needs on the ground are changing.

"So it's an opportune time for me to go, to help Canada decide how can we best contribute to ending this outbreak, [and] then the other health issues that will appear after the outbreak is over," Taylor told CBC.

Many other diseases have not been treated because of the focus on dealing with Ebola, he said.

"I've read some modelling that suggests that the deaths from measles may exceed the deaths from Ebola because the clinics were closed down. Doctor's offices were closed down. Hospitals were closed. Children weren't getting immunized," he said.

Taylor said that although the number of cases is dropping, "there's lots of rumours of unreported cases, so let's hope that those are simply rumours and we do manage to get it to zero."

While in West Africa, Taylor will also check in on the field trials for the Ebola vaccine that was invented at the federal lab in Winnipeg.

He said the vaccine is being used in so-called "ring trials" involving people at high risk of contracting Ebola.

"We still don't know if the vaccine works in humans, so that's the thinking around the ring vaccine trials. For example, if you vaccinate all of the contacts, these are people with a very high risk of developing the disease, and [if] they don't get Ebola, then you know that it's working," Taylor said.

Taylor plans to return home from the region next weekend.

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Ebola still global emergency despite big drop in cases: UN

WHO's Ebola emergency committee believes the risk of the virus spreading globally appears to be dropping even though officials don't know where the virus is spreading in most cases in Guinea and Sierra Leone. (Baz Ratner/Reuters)

The World Health Organization says the year-long Ebola outbreak in West Africa still qualifies as an international emergency even though the number of cases has plummeted.

Last August, the U.N. health agency declared the epidemic of the lethal virus to be a global emergency after the deaths of nearly 1,000 people, mostly in Guinea, Sierra Leone and Liberia.

At the peak last year, hundreds of new cases were being reported every week. In an update this week, WHO reported there were 30 confirmed cases last week in Guinea and Sierra Leone; the last case in Liberia died on March 27.

Dr. Bruce Aylward, who is leading WHO's Ebola response, said the decline appeared to be real, rather than just "a pothole on the bumpy road to get to zero cases."

During a press briefing in Geneva on Friday, Aylward said WHO's Ebola emergency committee believes the risk of the virus spreading globally appears to be dropping even though officials still don't know where the virus is spreading in most cases in Guinea and Sierra Leone.

"We are still not controlling the epidemic," said Brice de le Vingne, director of operations for Doctors Without Borders, who noted past lulls in the outbreak have often been followed by surges in cases. He said the designation of Ebola as a global emergency is also necessary to speed up paperwork for the ongoing experimental drug and vaccine trials in West Africa.

Other experts agreed it's too early for WHO to downgrade the status of the biggest-ever Ebola outbreak and warned the recent fall in cases may be deceptive.

"It is just that we are used to [seeing] large numbers of cases and deaths," said Oyewale Tomori, a Nigerian virologist who sits on WHO's Ebola emergency committee. "These numbers should still frighten us."

Tomori said that though cases have fallen dramatically, it is too soon to relax. "The three countries had declared themselves [Ebola-free] at one time, only to find dead bodies all over the place later," he wrote in an email.

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Expired drugs found on pharmacy shelves

Expired medications should be taken off the shelf before they have a chance of reaching consumers, say pharmacists who stress manual checks of the expiry dates.

After Shoppers Drug Mart recalled one lot of Alesse 21 birth control pills that expired in September 2014 and were sold to about 100 women, a Richmond, B.C., resident sent CBC News photos of a newly purchased non-prescription allergy medication stamped with an expiry date of August 2014. A CBC producer found more on the shelf at the same store.

When CBC News checked a dozen drug stores from three chains in Toronto, journalists found a diabetic nutritional supplement that expired last October, other past due allergy medications, an expired sleep medication and a number of products that expire this month.

Expired medications, both prescription and non-prescription, should be taken off the shelf before they have a chance of reaching consumers, said Phil Emberley, director of pharmacy innovation at Canadian Pharmacists Association in Ottawa.

Pharmacists are fallible, but there are ways to prevent expiry date errors. (Paul Sancya/Associated Press)

"In a well-run pharmacy and drug store, there is a procedure for ensuring expired drug products are taken off the shelf before they expire," Emberley said.

"Consumers would not find expired product if they were to go, if they were to pick a product from the shelf. Further, in the dispensary part, there would be a fairly routine procedure, for example, once a month, to identify products that were soon to expire so that they would not be inadvertently dispensed by someone."

Regarding the Alesse recall, Emberley speculated that pharmacists made an assumption about newly arrived stock.  

"They may have assumed it was well within its expiry, when in fact it arrived at the store already expired. I think there may have been that false sense of comfort that this product was still dispensable, when in fact it wasn't."

Shoppers Drug Mart said it is reviewing its practices to prevent a recurrence.

In response to questions about the expired medications CBC News found on shelves, Shoppers said, "As a standard practice in our stores, our store teams regularly rotate in new product and check the expiry dates on the product on our shelves. Our policy is to remove expired product and note future expiry dates so that products can be culled before they expire.

"If any of our customers discover that they purchased expired product, we will refund it."

The other pharmacy chains did not respond to CBC News's requests for comment about their expired non-prescription products.

Guardian Pharmacy told CBC they were just made aware of the medication being available for sale on Thursday, and that they're taking the matter seriously.

"Guardian and I.D.A. are working with the store owner/operator to ensure that this particular product is removed and no longer available for sale," they said.

Julie Greenall, director of projects and education at the Institute for Safe Medication Practice Canada, said the Alesse recall illustrates how technology is not fail-safe and manual checks of expiry dates by pharmacists remain paramount.

"I think as we move to electronic systems that we do have an increasing reliance on those electronic systems and also we sort of take that for granted that that's already checked," Greenall said.

Currently, electronic inventory systems may include the drug name and strength in the bar code, but not the lot number and expiry date, an advance Greenall expects will come.

"There have been a number of studies done on expired medications that have found that they do tend to hold their potency over extended periods of time, but every medication is different. What we do know is that [most] expired medications are unlikely to be harmful," Greenall said.

Given that pharmacists are fallible, Greenall's institute recommends ways to prevent errors, including:

• An alphanumeric system for expiry dates that includes letters to make the numbers stand out.
• Expiry labels with the full four digits for the year.
• Printing EXP clearly to indicate the expiry date rather than the lot number.
• Have consumers check the expiry date themselves when possible.

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Brain training games: No proof they prevent cognitive decline

The idea of playing a game to make you sharper seems like a no-brainer. That's the thinking behind a billion-dollar industry selling brain training games and programs designed to boost cognitive ability.

But an investigation by CBC's Marketplace reveals that brain training games such as Lumosity may not make your brain perform better in everyday life.

Brain training games, such as Lumosity, are a billion-dollar industry. Many people are worried about maintaining their brain health and want to prevent a decline in their mental abilities. (CBC)

Almost 15 per cent of Canadians over the age of 65 are affected by some kind of dementia. And many people of all ages are worried about maintaining their brain health and possibly preventing a decline in their mental abilities.

"I don't think there's anything to say that you can train your brain to be cognitively better in the way that we know that we can train our bodies to be physically better," neuroscientist Adrian Owen told Marketplace co-host Tom Harrington.

To test how effective the games are at improving cognitive function, Marketplace partnered with Owen, who holds the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging at the Brain and Mind Institute at Western University.

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Watch the complete investigation, Mind Games, a special one-hour season finale of Marketplace, on Friday at 8 p.m. (8:30 p.m. NT) on CBC TV and online.

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A group of 54 adults, including Harrington, did the brain training at least three times per week for 15 minutes or more over a period of between two and a half and four weeks. The group underwent a complete cognitive assessment at the beginning and end of the training to see if there had been any change as the result of the training program.

The assessment tested performance in memory, reasoning, concentration and planning.

At the end of the training period, researchers analyzed the results and found no significant improvement on any of the tests.

'Taking control of your own brain'

The group used a training program called Lumosity, created by California-based Lumos Labs, which describes itself as "a leader in the science of brain training." Lumosity is one of the most popular cognitive training programs, with 70 million members in 180 countries.

"I don't think there's anything to say that you can train your brain to be cognitively better in the way that we know that we can train our bodies to be physically better," says neuroscientist Adrian Owen. (CBC)

The Lumosity program is made up of more than 40 games designed to improve cognitive abilities, including memory, attention and problem solving. Members are supposed to play the games for 15 minutes, three to five times a week. Membership costs $15 per month.

A 2007 press release from the company calls the games "a scientifically developed online brain fitness program demonstrated to improve memory and attention with fun and effective brain workouts."

"Lumosity is a personal trainer that helps you exercise your brain," a video on the company's website says.

Lumosity declined to speak with Marketplace on camera about the investigation. In a statement, the company said: "We cannot comment on unpublished research. Numerous studies have shown that cognitive training, including Lumosity, improves cognitive performance. Well designed cognitive training studies include sufficient training time — at least 10 hours."

The company launched in 2005. Co-founder Michael Scanlon said he started to learn about the brain after both his grandmothers were diagnosed with Alzheimer's disease.

"I started getting excited about the possibility of leveraging your brain's plasticity and the way it changes to make a product that people could use and to really become more empowered about taking control of your own brain," he said in an interview with the technology news site TechCrunch.

No 'magic bullet'

But researchers are concerned that the benefits of brain training have been overstated.

Last October, 70 scientists released a statement titled "A Consensus on the Brain Training Industry from the Scientific Community," expressing concern about the way that brain games such as Lumosity are marketed.

The group in the Marketplace test underwent a complete cognitive assessment that assessed performance in memory, reasoning, concentration and planning. (CBC)

"We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do," the statement reads.

"The promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles. In the judgment of the signatories, exaggerated and misleading claims exploit the anxiety of older adults about impending cognitive decline."

Zachary Hambrick, professor of cognitive neuroscience at Michigan State University, says companies need to demonstrate that playing the games make you better at doing everyday tasks, not just better at the games themselves.

"What they really need to demonstrate — in a randomized controlled trial of the sort that a company would have to do for approval of a drug — is that Lumosity training actually improves real-world outcomes like performance in the classroom, the workplace, etc., and in everyday tasks like driving, remembering to perform errands," he says.

"In my opinion, the science so far has failed to establish that real-world relevance."

Owen, who designed the Marketplace test, said that if the games had long-term effects, they would have been evident after a few weeks of training.

"These people have done, I think, what most people would consider a reasonable investment of their time, they've put in quite a lot of effort; they've done quite a bit of training. And there's not even a hint of an effect," he said.

Owen says the games may be fun – just don't expect them to be effective.

"If you enjoy playing these games, fine, play the games. But just don't do it if you think it's making you smarter. Because I don't think the scientific evidence supports that," says Owen.

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Canada's top doctor to visit Ebola clinics in West Africa

Dr. Gregory Taylor, Canada's chief public health officer, is preparing to travel to West Africa to get a first-hand look at the efforts to defeat the Ebola outbreak, which has claimed more than 10,000 lives. 

The trip, which runs from April 13 to 19, will take Taylor to Sierra Leone and Guinea, two of the three West African countries that have been at the centre of the outbreak.

Taylor plans to visit the 70 Canadian health-care workers in Guinea and Sierra Leone, including the military staff working at a treatment facility being run by British armed forces personnel in Freetown, Sierra Leone's capital city.

The World Health Organization has said that the Ebola crisis is still considered an international emergency, even as the number of new confirmed cases decreases.

The most recent WHO data shows the number of new confirmed cases dropped to 30 last week, and health officials are hoping to get that down to zero. Liberia, the third of the hard-hit West African nations, had no new confirmed cases in the same period.

Dr. Gregory Taylor, Canada's chief public health officer, will visit some of the clinics set up to contain the outbreak in West Africa and assess what Canada can do to help the region rebuild. (Adrian Wyld/Canadian Press)

For most of the past year, Taylor said, the need has been for acute care workers to treat those infected with Ebola, but the needs on the ground are changing.

"So it's an opportune time for me to go, to help Canada decide how can we best contribute to ending this outbreak, [and] then the other health issues that will appear after the outbreak is over," Taylor told CBC.

Many other diseases have not been treated because of the focus on dealing with Ebola, he said.

"I've read some modelling that suggests that the deaths from measles may exceed the deaths from Ebola because the clinics were closed down. Doctor's offices were closed down. Hospitals were closed. Children weren't getting immunized," he said.

Taylor said that although the number of cases is dropping, "there's lots of rumours of unreported cases, so let's hope that those are simply rumours and we do manage to get it to zero."

While in West Africa, Taylor will also check in on the field trials for the Ebola vaccine that was invented at the federal lab in Winnipeg.

He said the vaccine is being used in so-called "ring trials" involving people at high risk of contracting Ebola.

"We still don't know if the vaccine works in humans, so that's the thinking around the ring vaccine trials. For example, if you vaccinate all of the contacts, these are people with a very high risk of developing the disease, and [if] they don't get Ebola, then you know that it's working," Taylor said.

Taylor plans to return home from the region next weekend.

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