A prescription for logic- and evidence-based healthy living
News
1. Landlord licensing
Apartment buildings in Halifax. Photo: Zane Woodford
This March, a proposal for landlord registration will go before Halifax regional council, but Jen Powley argues the public should demand more:
Registration would give HRM a better handle on the number of units available for rent in the municipality. But it would do nothing to help the tenants who deal with unsafe living conditions. That is why ACORN is demanding landlord licensing for the safety of people who rent.
Toronto ACORN championed and campaigned landlord licensing starting in 2005. They were finally successful in winning in 2016 with the creation of the RentSafe TO program, which has similar provisions to landlord licensing. Under Toronto’s program, residential buildings are inspected a minimum of every three years. More, if their condition warrants. An inspection can also be triggered by a tenant complaint if one is logged in on the telephone complaint system.
If an inspection finds that the condition of the building justifies an audit, this comes at the landlord’s expense. The inspector does not have an interest in the way you keep your apartment and the landlord should not be part of the inspection. With the program, the inspector is looking for building infractions, not whether you have hung that picture in the right spot. Because the landlord would not be around, the tenant does not need to worry about the landlord finding a reason to evict the tenant.
In addition to the inspections, the city must maintain a database of all the infractions incurred by the landlords or the corporations the building is registered under. A potential tenant can access the information on the municipality’s website and prepare for what the actual living conditions will be.
Click here to read Powley’s story.
2. People’s Park
Nick Meagher Park, or People’s Park, on Friday morning, the same day as the rally outside the Friendship Centre shelter. Photo: Ethan Lycan-Lang
Victoria Walton at The Coast has this story about Halifax Regional Police and HRM staff dismantling a kitchen that volunteers and residents at People’s Park were building on the weekend. The plan wasn’t for it to be a “real” kitchen, but rather a place to store food out of the elements and away from rats. Construction on the deck part of the structure started in January — and police were away — but now it’s all gone. Walton writes in The Coast:
On Saturday, February 26, a handful of residents, former residents and volunteers planned to finish the structure. But shortly after the kitchen’s vertical frame went up, police were on scene. “Police pulled up and told us to stop and that if we continued building we would be arrested,” says Patterson. So they stopped. By 6pm, police had left. Feeling like the situation was resolved, Patterson went home to the north end. But just after 10pm she got an alarming text from a park resident “saying that he heard drills, he heard crowbars, he heard smashing.”
By the time Patterson got back to the park, it was too late: municipal staff were midway through dismantling the structure, and three police vehicles were watching the scene. Just before 10:30pm, the wooden materials, which Patterson estimates have a $1,200 value, were driven away in the back of a Halifax-branded pickup truck.
Halifax Twitter was talking about this most of Sunday. The HRM sent out this statement late in the afternoon in which they called the pantry a “illegal and unsafe structure.”
In a Twitter thread, Walton said she contacted the municipality to find out why they considered the structure unsafe. She said she’s still waiting for a response from the municipality.
3. Cop confidential
The Halifax Regional Police office in Dartmouth in July 2020. — Photo: Zane Woodford
Stephen Kimber had three questions in this week’s column: What really goes on behind closed doors? Do those doors need to be closed? And does the Halifax Regional Police need more money to do its job properly?
Kimber had those questions after Halifax councillors and Halifax Regional Police chief Dan Kinsella met in camera last week because Kinsella had some “disturbing facts” to share. Kimber writes:
We don’t know what Kinsella said in those in-camera sessions.
We do know, however, that after his one-hour private briefing for the board of police commissioners, its members voted 4–3 to give the chief everything he asked for.
And we know too that, after two-and-a-half hours’ worth of behind-closed-door sessions with Kinsella, the council’s budget committee (which is to say all of the council, including Mayor Savage) voted 9–8 in favour of a motion by Coun. Tony Mancini to fund at least part of the chief’s wish list — “12 new patrol constables, one new ‘member reintegration’ constable, and four of the requested emergency response (911) communicators.”
(In reality, of course, council has no control over how the chief would actually allocate Mancini’s proposed $1,393,850 sweetener. But whatever.)
So it goes.
Where does that leave us? Nowhere, really.
Click here to read Kimber’s column.
4. Peter Gurnham steps down as chair of the UARB
Peter Gurnham. Photo submitted
Today is is Peter Gurnham’s last day in a very big job: chair of the Nova Scotia Utility and Review Board (UARB). Jennifer Henderson writes:
Gurnham, a lawyer who worked at Cox & Palmer prior to joining the UARB 19 years ago, says he hopes he will be remembered for making the board’s decision-making process “more transparent” and “improving customer service” to the public.
It was Gurnham who pushed to establish both a consumer advocate and a small business advocate. Under his leadership, the UARB was one of the first regulators in the country to set up a system where all evidence at public hearings and decisions can be accessed online through the UARB’s website…admittedly, it’s often pretty geeky stuff. Public hearings can now be watched online and the Board’s eight members have taken courses in “plain language” to help explain their written decisions.
The irony is that the media (ourselves included) now pay less attention to regulatory proceedings than when the UARB was pretty much a closed shop. There are easier stories to pursue and tell and reporters’ attention is often distracted by “breaking news” or the flavour of the month.
The Houston government has yet to appoint a replacement for Gurnham. Asked what he thinks will be the biggest challenge for his successor and Nova Scotians in general, Gurnham predicted it will be the impact of government decisions to close coal-fired power plants and move to 80{614fc3c32b079590f5b6a33afe99f1781dd92265c15f5c1e8aa861cac1d0c269} renewable energy by 2030.
Click here to read Henderson’s story.
5. Hundreds in Halifax protest Russian invasion of Ukraine
One of the handmade signs brought to Saturday’s ‘I Stand With Ukraine’ call to action in Halifax. Photo: Yvette d’Entremont
Yvette d’Entremont was in downtown Halifax on Saturday afternoon as hundreds of people with signs and flags protested the Russian invasion of Ukraine. d’Entremont interviewed Kateryna Stepanova, who moved to Canada from Ukraine with her parents and two younger brothers in 2014. That was after the first Russian invasion in the eastern part of the Ukraine, and the annexation of Crimea. d’Entremont writes:
Stepanova said she has “a huge amount” of family in Ukraine and described herself as heartbroken.
“When the first attack happened this Thursday early in the morning and I got a message from my mom that the war had begun, well it kind of breaks you from the inside out and you don’t have the words to talk about it,” Stepanova said in an interview.
“Then you try to reach out to people back home, and whenever you talk to your grandparents and your friends who just tell you ‘Hey, I’m really really scared right now,’ you kind of lose the earth under your feet because there’s nothing I can do.”
Click here to read d’Entremont’s story.
6. COVID update: 2 deaths
Tim Bousquet had Friday’s COVID update when the province announced two new COVID deaths: a man and a woman, both in their 80s, and who both lived in Nova Scotia Health’s Eastern Zone. A 170 new cases were also announced and here’s the breakdown by Nova Scotia Health Zone:
• 64 Central
• 42 Eastern
• 25 Northern
• 39 Western
Click here to read Bousquet’s update with the hospitalization and vaccination data.
7. Councillors vote for 0.5{614fc3c32b079590f5b6a33afe99f1781dd92265c15f5c1e8aa861cac1d0c269} police budget increase
Halifax Regional Police headquarters on Gottingen Street in June 2021. Photo: Zane Woodford
Zane Woodford was at the Halifax regional council’s budget committee meeting on Friday where debate on the HRP and RCMP budgets continued in a virtual meeting. That meeting started where they left off on Wednesday, in camera. Woodford writes:
That private session lasted another hour and 10 minutes, totalling two and a half hours in camera, where Chief Dan Kinsella made the case for more staffing. It’s unclear why that had to be done without public scrutiny, and it’s uncommon for councillors to hold in camera sessions during budget deliberations.
Coun. Tim Outhit said Kinsella had “disturbing facts” for councillors during the in camera meeting, but it wasn’t enough to convince them to vote in favour of his full request for a $2-million increase over last year’s budget.
Kinsella has argued that he needs the funding to hire enough officers to stop a cycle of burnout within the force. At a budget meeting in December, he told the board HRP is in “dire straits.” To fix the issue, Kinsella argued he needs 26 new sworn officers and 10 civilians, for a total budget of $90.8 million. After hearing from two dozen people in opposition, the board voted in favour of the full request. Councillors heard more of that opposition from 20 people this week.
After more debate — analogies about people drowning — councillors voted to give Kinsella 13 of the new sworn officers, but limit the increase. So, that means the budget is back to the Board of Police Commissioners, which has a meeting today, and more debate could happen on the budget then. Woodford will be there and will have a report later today.
Click here to read Woodford’s full story.
8. Halifax Water wants to raise rates
Halifax Water headquarters in November 2019. Photo: Zane Woodford
Zane Woodford reports on Halifax Water’s application to the UARB to raise its rates for water, wastewater, and stormwater. Woodford writes:
The municipally-owned utility submitted an 820-page application to the Utility and Review Board (UARB) on Friday, seeking approval to raise rates in September 2022 and April 2023 “to maintain the current level of service to customers, recognize additions to utility plant in service, and continue investment in water, wastewater and stormwater infrastructure.”
The increase is an average of 3.6{614fc3c32b079590f5b6a33afe99f1781dd92265c15f5c1e8aa861cac1d0c269} for residential customers’ bills, according to Halifax Water’s news release, equal to $2.51 per month in September and an additional $2.60 in April 2023. But the rate application notes it’s dependent on multiple factors.
Click here to read that full story.
9. Pharmacists, nurse practitioners to work together in new pilot project
The Lawtons Drugs store on Cobequid Road in Lower Sackville in July, 2021. Lawtons locations in Truro and New Glasgow will be the test sites for a new collaborative health care model called Pharmacist Walk-In Clinic. Photo: Yvette d’Entremont
Two locations of Lawtons Drugs — New Glasgow and Truro — will be test sites for a new collaborative health care model called Pharmacist Walk-In Clinic. On Friday, Yvette d’Entremont was at the announcement about the project, which was made by Nova Scotia Health (NSH) interim president and CEO Karen Oldfield. d’Entremont reports:
Oldfield called the pilot “a test and try” program, adding it will be a blueprint for “possible planning for future sites.”
“We’ve certainly heard, and we know that Nova Scotians need, more options to access primary care, both for those who have a family doctor and more especially for those who do not,” Oldfield said before the collaborative care model launch.
The pilot sites will be located above two Lawtons Drugs pharmacies — one in New Glasgow and one in Truro.
“We will evaluate the project to learn about patient experience, the provider’s experience, the delivery of care, and more,” Oldfield said.
The project builds on the pharmacist walk-in clinic model in operation at the New Glasgow Lawtons’ site since the spring of 2021.
Click here to read d’Entremont’s story.
Views
Thinking critically about the evidence in health care
Graham MacKenzie.
Pharmacist Graham MacKenzie has made headlines over the last several years about decisions he’s made about what he sells at his pharmacy, Stone’s Drug Store, in Baddeck, NS.
In 2014, MacKenzie stopped selling sugary drinks, like pop, diet pop, juice, and vitamin water, from the shelves of Stone’s Drug Store. As he told CBC Maritime Noon at the time, “It made no sense to me. Just in good conscience, we just couldn’t continue selling.”
Then, in 2018, MacKenzie pulled all homeopathic products off the shelves of his store. (Tim Bousquet mentions this in his Morning File here).
And in July 2021, MacKenzie set up a makeshift vaccine clinic in a hardware store in town where, as Erin Pottie with CBC reported, he gave out 5,000 doses of the COVID-19 vaccine, with about 3,200 of those as first doses.
In late 2021, MacKenzie, who’s been a practicing pharmacist for 30 years, published a book called Healthy Logic that was 10 years in the making; it includes not only information on what he titles The Sugary Beverage Story and why he removed homeopathic treatments from his store, but also details and easy-to-understand information about evidence-based healthy aging. I spoke with MacKenzie on Sunday afternoon about his book, misinformation, and how patients can think critically about what they hear about medical treatments.
MacKenzie said he was initially inspired to write because his clients started asking about therapies beyond what the pharmacy would normally provide. In the introduction in the book, MacKenzie wrote, “medicine does not have all the answers, and making up therapies in an attempt to fill in these holes is a disservice to the patient.”
The book really taught to me look at what evidence there is, and I really started to rethink how the public perceives what I was selling at the store really changed my mind on what I should have in [the book]. There was perhaps some physiological basis behind some of them that would work, but over time I started to realize this book is supposed to be about stuff that works. It really changed over the last 10 years. It changed what I was recommending and it changed what I was writing about.”
Clients go to pharmacists like MacKenzie for treatments on self-care. And they have a lot of questions. While MacKenzie didn’t want to focus the book on COVID, he says misinformation certainly has changed over the last few years.
There’s always been misinformation on self-treatment. That’s part of the reason I wrote the book. We have someone saying, ‘you should do this for this medical problem,’ but when COVID-19 came out, we were inundated daily. Social media certainly help propagate a lot of this with tonnes and tonnes of information. It was a timely point it came out, not only because COVID misinformation is everywhere, but the misinformation about a lot of medical conditions that people are trying to treat. You go online for literally five minutes and you can feel like you’re an expert on a topic.
The book is 250 pages and covers a lot of topics in its 12 chapters. And it’s an easy read — MacKenzie said he wrote it with the general public in mind. I am still reading it, but I’m skipping around through chapters, reading information based on my own health care questions.
The first chapter explains evidence-based medicine, including explanations of functional medicine, conventional medicine, and the difference between good and bad evidence. The book wraps up with a chapter on healthy grocery shopping. In between, there are chapters on sleep, exercise, biomarkers, arthritis, nutrition and genetically-modified organisms, the immune system, cancer, and pain and compounding.
There’s also a chapter on MacKenzie’s personal clinical experiences and lists “hits” and “misses” based on what he’s learned at his pharmacy. Some of his misses include ginkgo biloba for memory, detoxes, and, homeopathy. And there are the hits, including Omega-3 for pain, probiotics, Relora for anxiety, and vaccines. Here’s what he writes about that:
There is no safer treatment for curing diseases in humans than vaccines. I must stress the importance of vaccines and the complete selfishness of not vaccinating. I am certainly pro-vaccination, not only to protect yourself, but to protect the unprotected who are in legitimate danger of contracting disease, like the immunocompromised and infants not yet vaccinated.
I asked MacKenzie what he tells patients who say that a product makes them feel better, even though there may not be any evidence that it works.
That’s not uncommon and as pharmacists, we deal with these — we call them anecdotal studies — every single day. And it really does sway how you give recommendations to people.
He says the placebo effect is “very strong.”
That’s the one thing I try to balance out — what a placebo-controlled study will show us, and what someone standing in front of me shows me is working for them. You cannot discount just because we don’t have a study out there saying something doesn’t work in a randomized control study; just because you don’t have that doesn’t mean necessarily that something doesn’t work.
In his book, MacKenzie lists his core philosophies:
- Safety first, benefit second
- Rely on evidence-based decision making
- Lifestyle changes are often a good first approach
- We cannot reverse aging, but we can help the odds of
being upright longer- Sticking with science rather than gimmicks will serve you
better in the long run
In our interview, MacKenzie expanded on that first philosophy of safety first, benefit second:
It seems kind of odd that I would put ‘having the product working’ second behind ‘not harming,’ but really that’s what we want. So, someone is taking something they swear is working, it’s for a medical condition and won’t affect their quality of life, it’s not going to be spread to somebody else, and they feel it’s working for them. However, you can always open up the conversation and say, ‘if you find you’re not getting the relief from this you want, there are other things we might have some better evidence for.’ If you leave it at that, they may come back in a month and say, ‘you know what, after I was talking to you I realize maybe the headache I was trying to treat with this product really wasn’t going away like I thought it was. Maybe I will try something you can recommend.’ There are some people that there is no changing. And as long as they aren’t harming themselves taking what they’re taking, then I am fine with that. But if it’s for a condition that can progress or something that the product is harming them, then we will definitely be more aggressive in that conversation.
Pharmacists are some of the most accessible health care professionals out there. Over the years, their scope of practice has changed and now they can diagnose and treat conditions like cold sores, urinary tract infections, and more. MacKenzie says he gets lots of questions about lots of topics and most of those questions are on self-care.
I find now with the internet, I find people think there is more that could have been done for them. And it’s too bad because there are a lot of doctors and pharmacists doing a lot of great work out there.
Clients still ask about the sugary drinks, and MacKenzie said people were confused when he took the homeopathic products off the shelves. At the time, he said he respected the decision of other pharmacists and stores who decided to keep those products.
As we’ve seen in the news since then, this is something that is not popular with a lot of the medical community, when you’re selling homeopathy. I think people are slowly coming around with that.
MacKenzie said what he wants to accomplish with the book is to get people thinking about the information they get about their health and health care.
All I am trying to get them to do is to critically think about the evidence that is out there, and the book tells them how to determine what is good and bad evidence. I would like them to think that just because they’ve been told something by their neighbour or they read it online or from whatever source — or even from the pharmacist — there is a process that brought that to being true or not. If your neighbour said they used something and it worked, doesn’t mean it will for you. It doesn’t mean it’s working for them. I would just like people to have some critical thinking around what they’re being told from all their sources, from their health care provider, down to the internet.
Noticed
Photo: Jeremy Bezanger/ Unsplash
I’ve been limiting my time on Twitter over the last several days for reasons that don’t matter here. But last week Philip Moscovitch sent me a link to this podcast, Cancel Me, Daddy with Katelyn Burns and Oliver-Ash Kleine. The episode is called Why Everyone On Twitter Is A Jerk and features sociologist Katherine Cross, who studies online harassment.
In early February, Cross wrote this piece for Wired Magazine with the headline, It’s Not Your Fault You’re a Jerk on Twitter. This is basically what she talks about on the podcast, too. Okay, I was skeptical about all of this. I mean, of course it’s people’s fault they’re jerks on Twitter!
But Cross argues it’s the design of sites like Twitter that causes people to be assholes on those sites. Cross has spent the last couple of years working on peer-reviewed research on the sociological theory of the structure of online harassment campaigns, and that even when people on Twitter are being nice or standing up for a target it’s still causing damage to that target.
In her research, Cross describes three qualities of a campaign of harassment: crowdsourcing, organization, and longevity. While one or two people may start tweeting a target, it’s actually the platform that does the work, encouraging others who might have something to add to retweet, like, quote tweet, and so on. And that harassment can go on for days and even weeks. Cross illustrates the harassment in an inverted pyramid with descending order of severity. Here’s what that looks like:
The first two orders are pretty obvious in what they mean. If you’re on Twitter you’ve seen it in action. But in her article Cross focuses on the third order. This is where the nice people and the defenders are. Just commenting on a tweet or thread keeps the harassment going.
And subtweeting can be considered harassment, too. That means commenting on someone on Twitter without using their name or Twitter handle.
The point of subtweeting is, specifically, to avoid commenting on the target directly. It can even be perceived as a kindness. It seems a painless way to comment on a Main Character without contributing to a flood in their mentions, and without the risk of incurring backlash from their defenders, while enabling one to just vent their spleen harmlessly into the ether. But it still often provides moral reinforcement for the more devoted, less scrupulous attackers.
But it was this part that I found fascinating: the way Twitter is designed encourages bad behaviour in kind of the same way that traffic design encourages bad driving. Here’s how Cross explains it:
Road design in countries like the Netherlands promotes what is known as “traffic calming,” reducing pedestrian deaths and car accidents; by contrast, road design in North America promotes high-speed driving, passively nudging drivers to step on the gas, giving them less time to stop, even in crowded areas. Understood this way, you can get away from solely individualist narratives about accidents—about bad drivers or “pedestrians who weren’t looking”—and focus on how design encourages broad outcomes not attributable to any one actor.
Similarly, social media is designed in a way that agitates, rather than calms, its traffic. It leans into, rather than curbs, the augmented reality aspects that arise from computer use—tricking you into believing you’re somewhere other than reality.
You see, nearly all internet use is fundamentally dissociative, subtly divorcing us from the consequences of our words and deeds—what psychologist John Suler dubbed the “dissociative imagination.” In my own research, I came to this conclusion from the other way around, arguing that in online gaming spaces, the magic circle conceit of video gaming enabled people to extend the game’s unreality to their own words and actions. But I eventually realized that it wasn’t just games that had this effect. It was the entire online space, disinhibiting and ludic all at once.
There is a seductive quality to posting into the void, a Möbius strip sense that you’re the voyeur who no one can see, and the exhibitionist who everyone must see.
…
The problem isn’t that Twitter’s users are toxic, it’s that the platform makes toxicity the path of least resistance, and turns even intentionally positive commentary into just more fuel for the fire.
This is what the road design of social media has wrought; like a wide, straight road encouraging dangerous speeding, the limitless void of social media encourages pained shouting, and its financially backed incentive structures make an addicting game out of the whole affair.
This is one of the things I hate about Twitter: the shouting and the pile-ons. Do issues ever get solved by all the shouting and piling on people on Twitter? That’s a serious question.
So, what can we do about it? Not much, Cross says, who says staying off Twitter is just self-censoring and certainly not a solution for people who consider Twitter a lifeline. Getting the cops involved in harassment campaigns may just make the oppression worse. And she says any technical fixes by Twitter itself would just “tinker around the edges.”
In the podcast, Oliver-Ash Kleine wonders if roundabouts on the internet, like those on the roads, would help. You know, slow people down, reducing collisions, and so on. I have no clue how that would work online.
I think I will limit my Twitter use for now, even if that’s self-censorship. I don’t think of Twitter as a lifeline, but rather a tool (and a limited one at best) with a lot of tools on it. I also tend to just interact with users who I know behind the avatar and handle.
My pinned tweet says, “most people are not on Twitter. Opinions here represent thoughts of those on this platform, not necessarily off of it.” I don’t need to share every opinion I have and people won’t even benefit from it.
And I prefer to get off that information highway and onto the real-life backroads to meet people and hear what they have to say. It’s a lot nicer, too.
Government
City
Monday
Executive Standing Committee (Monday, 10am) — virtual meeting
Board of Police Commissioners (Monday, 12:30pm) — virtual meeting
Advisory Committee on Accessibility in HRM(Monday, 4pm) — virtual meeting
North West Community Council (Monday, 6pm) — virtual meeting
Tuesday
Halifax Regional Council (Tuesday, 10am) — virtual meeting
Province
Monday
No meetings
Tuesday
Community Services (Tuesday, 10am, Province House) — also via video conference; Wrap-Around Supports for Homeless Nova Scotians, with representatives from the Department of Community Services, Shelter Nova Scotia, Mi’kmaw Native Friendship Society, and United Way
On campus
Saint Mary’s
Monday
Speaker Series on Women in Sport & Health (until March 18) — Student-organized speaker series featuring seven pre-made 15-30 minute videos created by women working in sport and/or health. The goal is to amplify women’s voices as they present their health-related careers or sport participation and the challenges that have empowered them. Videos uploaded every Friday.
Kemet Udjat: African Heritage Month Film Festival (Monday, until March 4) — film screenings and discussion; more info and registration details here
Tuesday
Isthmus Engineering: A Case Study on Worker Co-op Governance (Tuesday, 1pm) — online webinar with Ole Olson and Margaret Lund:
This panel brings to life a case example of a worker-owned co-operative in a technical field. Learn about how the co-op manages participation and governance, project management techniques to streamline democratic decision-making, running meetings that work and other aspects of worker-ownership and governance.
In the harbour
Halifax
03:30: ZIM Qingdao, container ship, sails from Pier 42 for New York
05:00: Tropic Hope, container ship, arrives at Pier 42 from Philipsburg, Sint Maarten
13:00: Tortugas, car carrier, sails from Pier 31 for sea
13:00: Selfoss, container ship, arrives at Pier 42 from Portland
17:30: Tropic Hope sails for Palm Beach, Florida
21:00: Atlantic Sky, ro-ro container ship, arrives at Fairview Cove from Norfolk, Virginia
21:30: MSC Rachele, container ship, sails from Pier 41 for New York
22:00: Selfoss sails for Reykjavik, Iceland
Cape Breton
06:00: Algoma Victory, bulker, arrives at Coal Pier (Sydney) from Point Tupper
10:00: CSL Metis, bulker, sails from Aulds Cove quarry for sea
14:00: Seacalm, oil tanker, arrives at Point Tupper from Es Sider, Libya
Footnotes
I have an in-person interview this afternoon for a story I’m working on. It’s been months since I did an in-person interview. We’ll wear masks, of course, and we’re interviewing in a very large space, but I’m looking forward to getting out.
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