Prevention: The New Focus in Healthcare

Source: FreeStockPhotos

Hospital-acquired infections and drug-resistant superbugs are some of the biggest concerns in healthcare right now. In fact, the World Health Organization (WHO) estimates that by 2050, more people will die from antibiotic-resistant bacteria than from cancer (2016). Furthermore, many of the diseases that cause people to be in the hospital in the first place, are preventable, such as heart disease and diabetes. This means that people are needlessly going to hospitals and subsequently risk being exposed to harmful infections. This is one of the reasons why a main priority right now in healthcare is shifting towards prevention and keeping people out of hospitals in the first place.

According to Nancy Brown, from the American Heart Association, “many of the things that bring people to the hospital can be prevented” (2019). In fact, during the World Economic Forum on the Future of Hospitals, which featured Brown as a speaker, it was discussed how 80% of health does not happen at the hospital, but rather, it happens at home, where individuals should consciously be making better decisions to be healthier.

Education about health should be a key priority for governments, hospitals and medical professionals, as it will reduce healthcare costs, prevent risks and occurrences of serious illnesses, and just make people more healthy in general. Brown stated that the way to doing this is to change people’s behaviours, either by inspiration, advocacy or even regulation. She also identified two key factors that are critical in influencing people’s unhealthy habits: environment and lifestyle. To quote her again,

“If you don’t have access to fresh foods, and the only thing you can have is processed and packaged food which is high in sodium and high in added sugar, why are we surprised that there’s an epidemic of obesity and type 2 diabetes?”

Nancy Brown, American Heart Association, 2019

Brown provides very interesting information about prevention, which is becoming more and more important in healthcare. According to Regina Benjamin, MD, it is crucial that disease prevention be intertwined into every aspect of our every day lives.

Benjamin lists 4 keys areas to improve in order to better prevent diseases:

  • Healthy and safe community environments
  • Clinical and community preventive services
  • Empowered people
  • Elimination of health disparities

People have the ability to prevent many diseases. With a good education about health, people can become more knowledgeable about how to take care of themselves and what diseases they are more prone to. This will lead to fewer hospitalizations and healthier people with a better quality of life. That is why this trend in healthcare is so important and it is great thing to move towards.

To watch the World Economic Forum discussion of The Future of Hospitals, see the video below:

Sources:

https://www.youtube.com/watch?v=j5MZP6dbhFI&t=1064s

https://drkevincampbellmd.wordpress.com/2017/02/13/changing-the-focus-of-healthcare-from-treatment-to-prevention/

http://www.un.org/apps/news/story.asp?NewsID=54928#.WnikApM-cWo

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185312/

Will “good” viruses replace antibiotics in the future?

A major health concern for the future

Antibiotics have been around for almost 100 years now, and have proven to be very effective against fighting harmful bacterias. However, during this time, these bacteria had time to evolve and many of them are now becoming “drug-resistant”, meaning that these bacteria have developed a resistance to antibiotics. There are even some bacteria, known as “superbugs”, that have become resistant to nearly every existing antibiotic. If a person is infected with a “superbug”, this means they cannot seek treatment from antibiotics and will have to rely solely on their immune system to fight the disease. This could result in death by diseases that were once treatable. According to the United Nations World Health Organization, “By 2050, estimates indicate that more people could die from antibiotic resistant infections than those who currently die from cancer” (2016), making drug-resistant bacteria one of the most serious health concerns that we face. 

Source: Wikimedia Commons

So if antibiotics are becoming ineffective, then what can be done? Researchers are now turning towards a “good virus” called a “bacteriophage”, or simply phage, that kills bacteria, which was previously overlooked by researchers and scientists.

Phages: The Virus that kills drug-resistant superbugs

First of all, what is a phage? Simply put, phages are viruses that infect specific bacteria (Motherboard, Vice). This means that bacteriophages do not infect human or animal cells. There are more phages on earth than any other living specimen, and they can be found almost anywhere. There are also many different kinds of phages, and each phage does not fight the same bacteria.

Phages kill bacteria by binding themselves to the membrane of the bacteria when they come in contact with it and then releasing an enzyme that drills a hole in the bacteria cell. The phage then injects its own DNA into the cell and reproduces more phages inside of it. This causes the bacteria cell to explode (Motherboard, Vice). Phages can therefore be used as a natural alternative to antibiotics, and may prove to be even more effective.

 

Source: Wikimedia Commons

 

In the early 1900s, phages were studied by many researchers and scientists all over the world, however, after the invention of antibiotics, Western countries became less interested in phages and any research about the viruses were put to a halt. The Soviet Union, on the other hand, kept investing in phage research and Russia, Georgia and Poland are among the only countries that use phage therapy today as a bacteria-fighting technique. Research scientist Benjamin Chan (Yale University) explains that the United States has been “hesitant to use bacteriophages because they’re a virus.” However, he goes on to explain that there are many types of viruses and virus does not always mean that there is a disease involved.

Will phages replace antibiotics in the future?

Maybe. It will take some time, as much research still needs to be done by Western countries. Many science researchers believe that they will begin to be used out of desperation. One thing is for sure though: our current antibiotics will no longer be a sustainable option and we need to find another alternative and fast!

For more information on the subject, watch the video below by Vice:

 

SOURCES:

https://motherboard.vice.com/en_us/article/9kdbqa/bacteriophages-phage-therapy-antibiotic-resistant-bacteria?utm_source=mbfb

http://www.lemonde.fr/sciences/article/2012/06/14/les-phages-des-virus-guerisseurs_1718745_1650684.html

https://en.wikipedia.org/wiki/Antibiotics

http://www.un.org/apps/news/story.asp?NewsID=54928#.WnikApM-cWo

Good Practices in Waste Management

Waste management can be a real headache especially if you work in a hospital or university! In Quebec, the legal and regulatory framework has evolved for more than 50 years and in 2017, several municipal, provincial and federal laws and regulations are in force. Let’s see how we can classify and demystify the different types of waste.

Waste Management

Credit photo Joseph Barrientos via unsplash

Good practices in waste management

To properly manage waste, it is imperative on one hand to be well aware of the characterization of your waste and on the other hand to know the regulations that apply to your situation.

Safe Handling

The safe handling of waste, whether at the time of its production, handling, storage or disposal, must be accomplished with appropriate protective measures for your own safety, safety of of others and protection of the environment.

Communication

Each department must also be informed of the way in which they dispose of the waste they produce in a safely manner. That’s why a good communication plan is also important!

Reduction at source

Take action by initiating gradual changes in how you manage your residual materials on the basis of the 3RV-E principle that promotes source reduction, reuse, recycling and valorise until residual materials must be eliminated.

  • Reducing at source is the fundamental principle of management to decrease the quantity of goods consumed, which necessarily decreases the amount of natural resources consumed.
  • Reuse is to give a second life to objects and use what others do not need anymore.
  • Recycling is the process of converting a residual material into a raw material for the manufacture of a new product
  • Valorisation is to give a second life to the products but in different ways, usually this is done by the biological way for example compost or energy like biofuels
  • Elimination when all efforts have been made in the 3RV and waste is finally disposed of.

Classification of waste by category

In industrial and institutional environments, waste is generally grouped into 7 categories:

  • General Waste
    • Non-recyclable waste with no reuse or recovery potential
  • Biomedical waste
    • Human anatomical waste
    • Animal anatomical wastes
    • Non-anatomical waste
      • Piercing, sharp or breakable objects that have been in contact with blood
      • A liquid or a biological tissue
      • Biological tissues, cell cultures, cultures of micro-organisms;
      • Live strain vaccines;
      • Containers of blood and blood-soaked equipment, etc.
  • Pharmaceutical waste
    • Hazardous pharmaceutical waste
      • Drug residues
      • Toxic expired drugs
      • Cytotoxic drugs
    • Non-hazardous pharmaceutical waste
      • Other drug residues
      • Non-hazardous expired drugs
  • Chemical waste
    • Chemicals from laboratories
      • Laboratory reagents
      • Laboratory solvents
    • Pressurized containers
  • Radioactive waste
    • Residues containing radioactive isotopes above standard
    • Syringes, reactors, lead cylinders (nuclear medicine)
  • Electronic waste (or with heavy metals)
    • Hardware
      • Computers
      • Screens
    • Cell phones
    • Battery
    • Articles containing mercury
      • Thermometers
      • Fluorescent or compact fluorescent bulbs
  • Recyclable waste
    • Paper
    • Cardboard
    • Plastic
    • Glass
    • Metal
    • Food and compostable residues
    • Organic waste
    • Construction debris
      • Brick
      • Concrete
      • Unpainted gypsum board
      • Metal
      • Wood

Legislative and regulatory framework for waste management in Quebec

  • Loi sur la qualité de l’environnement (chapitre Q-2)
  • Règlement sur l’enfouissement et l’incinération des matières résiduelles (c. Q-2, r. 19)
  • Règlement sur la santé et la sécurité du travail (chapitre S-2.1,r. 13)
  • Code de sécurité pour les travaux de construction (chapitre S-2.1,r. 4)
  • Règlement sur les déchets biomédicaux (c. Q-2, r. 12)
  • Code de la sécurité routière (chapitre C-24.2)
  • Règlement sur le transport des matières dangereuses (c. C-24.2, r. 43)
  • Règlement sur les matières dangereuses (c. Q-2, r. 32)
  • Règlement sur la récupération et la valorisation de produits par les entreprises (c. Q-2, r. 40.1)
  • Code de sécurité pour les travaux de construction – amiante (chapitre S-2.1, r. 4)
  • Loi sur la sûreté et la réglementation nucléaires (L.C. 1997, ch. 9)
  • Règlement général sur la sûreté et la réglementation nucléaires (DORS/2000-202)
  • Règlement sur la radioprotection (DORS/2000-203)
  • Règlement sur l’emballage et le transport des substances nucléaires (DORS/2000-208)
  • Règlement sur les substances nucléaires et les appareils à rayonnement (DORS/2000-207)

Learning, Understanding, Implementing, Enhancing

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Source: Guide de gestion des déchets du réseau de la santé et des services sociaux