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Saturday, February 8, 2014

Hospitals too full to be safe? Not in London, Ontario.

The front page headline warned: " Hospitals too full to be safe." A follow up online story delivered the second punch to the gut: Overloaded wards likely contributing to spread of dangerous superbugs, says head of infection control for London hospitals. On reading the story I was surprised to learn infection rates have not been on the rise generally in London hospitals and in some cases rates have actually declined. A concerted effort at infection control led by Dr. Michael John is credited for the surprisingly good numbers.

Maybe it's just me and my personal bias when it comes to London hospitals and health care in Canada but I thought the newspaper missed the story. Many experts believe hospital acquired infections (HAI) increase when bed occupancy rates climb above 85 percent. Rates in London have surpassed 100 percent at times, and yet there has not been a corresponding increase in HAI rates.

Dr. John revealed to the paper that "beds have been fitted with hygienic liners that can be disposed, new disinfectants kill spores and patients who can’t be isolated are given separate commodes." Chalk up a win for Dr. John and the health care staff in London.

For some reason, the reporter seemed intent on focusing on the shortage of hospital beds. By comparing the number of hospital beds per thousand in Ontario to the average number available in Europe, a huge mix of countries, the reporter made the shortage seem even more dire: A classic "comparing apples and oranges" error.

Let's try comparing apples to apples: countries to countries. According to the most recent numbers released by The World Bank, Canada has 3.2 beds per 1000 people. Both The United States and Britain had a smidgen less at 3.0 beds per 1000. Sweden fared even worse with only 2.7 beds.

There are more than 50 countries listed by The World Bank with fewer beds per 1000 than Canada. Admittedly, for the most part, having bed numbers that are better than these 50 is not a surprise. Still, Canada can take solace in the fact that Norway has only  3.3 beds per 1000 or a mere .1 more beds than Canada. Norway has some excellent health care numbers despite having a low bed number.

According to the newspaper article, Ontario has only 2.4 hospital beds per 1000. It sounds bad and it is bad but Ontario does not sport the worst numbers on the continent. For lower numbers look south. Ontario has more beds than almost 40% of the American states according to The Henry J. Kaiser Family Foundation. Oregon only has 1.8 beds per 1000 and California, Hawaii and Vermont have numbers that are little better.

A more telling number is the percentage of Americans reporting that in the past 12 months they failed to see a doctor despite needing one because of cost. In some regions of the States the number of people who have stopped seeking medical help despite needing it is more than 1 in 5. That is downright frightening. The link provided takes one to a page with some very conservative numbers.

Researchers with The Commonwealth Fund in the United States calculated a much higher number. 37 percent of Americans in the Commonwealth survey went without recommended health care, not seeing a doctor when ill, or failing to fill prescriptions because of costs.

The number of hospital beds per thousand has been dropping all over the globe for years. As can be seen by the number in London, the medical profession is trying to rise to the challenge, and it is a tough challenge.

Recently I had an ablation procedure performed at University Hospital in London. After being sedated by an anesthetist, a heart specialist threaded thin, flexible wires from my groin up through my body to my heart. The surgeon guided the wires into my heart where heat was used to destroy the heart muscle causing my cardiac problem.

Today this procedure is often done as day surgery. My procedure was done in the morning and I was home for dinner. One way to cut down on hospital acquired infections is to get the patient out of the hospital quickly. My recovery bed was my own.

Are more hospital beds needed? Of course, there's no argument there, and the shortage is neither new nor news. The big story is how well those in the health profession in Canada are delivering some damn fine health care despite facing some pretty daunting problems.

We may be short of beds and our ER departments may take far too long to see all patients, but in the end the important numbers are good. For instance, we live longer, healthier lives than our neighbours to the south.

I tip my hat to the fine Canadian doctors and nurses without whom I would not be here today. I truly owe them my life. Thank you.

Saturday, February 1, 2014

She said, he said: A lame excuse for balance

It was a small post. A reporter at the local paper claimed to have balanced his coverage of a political speech by seeking out and publishing the comments of a well known political adversary of the speaker.

Did the reporter question the speaker's statements? Did the reporter think the claims being made were simply bold-faced political puffery? Why did the reporter not simply report what was said and move on? Considering the source for the alternate point of view, I really don't know the answer. The reporter consulted Joe Fontana, the present Mayor of London, Ontario, a man who needs no introduction, as they say.

In my original post, I called the balance obtained by contacting Fontana an example of faux balance. A more accurate label of what was done might be "she-said-he-said-journalism." How does this work?
  • Take a public statement and create a dispute.
  • Conflicts make news; The created dispute will be newsworthy.
  • Make no attempt to assess validity of claims, claims which are the very essence of the story.
  • The symmetry of two sides provides the necessary faux balance.
And how do reporters respond to criticism like the above? They attack the messenger. Newspaper reporters believe this is good journalism. It is balanced.

Balanced? I am left shaking my head in disbelief.

Wednesday, January 29, 2014

Faux balance unbalances news stories

Without realizing it, reporter Patrick Maloney made a confession in the daily newspaper. Without grasping the true importance of his words, he admitted that The Free Press committed the common media blunder of faux balance.

It seems that some years ago, feeling the need to balance its coverage of Mayor Anne Marie DeCicco-Best's state of the city address, the daily paper chased down Joe Fontana vacationing out of town in the sunny south. According to Maloney, "Fontana ripped his old rival with unexpected vigour."

Unexpected vigour? Really? Fontana's vitriol-laced words were unexpected? I humbly suggest the newspaper sought out Fontana hoping to get some good quotes, and Fontana delivered.

It is interesting to note that the original story, as posted to the Web, makes no mention that Fontana was chased down by the paper, that he was not even at the event but was instead on vacation. The omission was not for lack of space. Fontana dominates from 40 to 50 percent of the first story, depending upon how one approaches the calculation.

Journalists have forgotten how to report straight-news straight. Faux balance does not add accuracy or objectivity. What it does add is risk, and one of those risks is the risk of being used by the person chosen as a counter-balance. Fontana welcomed the opportunity to grab some front page attention. He criticized his former opponent and took full advantage of the moment to further his own political ambitions.
_________________________________________________________________________

Personal Twitter attack by the reporter who wrote both stories mentioned in the above post.
 
Interesting response to my post. What makes it interesting, at least to me, is that it is but another in a long list of rude reactions from a reporter at The London Free Press, the newspaper at which I worked for thirty some years. While working at the paper I was mainly a staff photographer but I also wrote two weekly columns -- one on photography and another, Celebrating the Thames, on the river that flowing through London.

I have kept the letters and e-mails from these journalists but I don't publish them as the writers usually request that I not publish their thoughts on my blog. I respect their wishes. I have attacked financial advisers and others but the only rude responses I have received are from reporters. Other than reporters, I don't recall anyone else attacking me on a personal level. Some of the reporter e-mails have not only been rude in content but rude in form -- written in screaming solid caps in very large, bold fonts.

I have been disappointed by the responses from professional reporters. When I worked at newspapers I believed journalists had thick skins. And they did back in the '70s when I got into the profession. Not so today.

No one working at the paper should be surprised at the tone of my posts. When I saw stuff with which I didn't agree while working at the paper, I was known to walk into the publisher's office or the editor-in-chief's office and voice my disapproval. I vented, they listened and that was it. I was never able to spur anyone into taking any action. (I believe, if asked, Paul Berton, a former editor-in-chief at the Free Press, would confirm this statement.)

Writing a blog is far more satisfying that making futile noises as an employee at a paper. I have had more than 164,000 hits and the number keeps growing. I vent and someone listens and another and then still another. Right now my most popular post has been hit more than 12,500 times.

If you are a journalism junkie, please read the story that inspired my post: London mayor hints at re-election platform with promise to keep taxes at 1% a year and then read the "balanced" story done at the time of Anne Marie DeCicco-Best's state of the city address: Mayor's race replay?

A writer for The Economist's Democracy in America blog wrote:
"Balance is easy and cheap. In political journalism, a vitriolic quote from each side and a punchy headline is all that is needed to feed the news machine."

Seeing the anger my posts generate, I try to be careful when discussing errors made by local journalists. Still, newspapers are too important to be above criticism. I've decided to be careful but at the same time to be true to myself and to continue to openly discuss my unease with some aspects of how the media operates. An open, free media is a pillar of our way of life.

Discussion is called for, not personal insults.

That's not an argument.

I have some friends who like to argue. An evening spent with this group can be expected to deliver at least one example of toe-to-toe of verbal sparring. I'm ashamed to admit that in the past I've been sucked into the maelstrom, but I'm learning to keep my lips buttoned.

I decided to start clamming up after I mentioned that the insulating blinds installed in my kitchen are causing a thick build up of ice to form at the bottom of the windows. The ice, and resulting water, are damaging the wooden sills.

I thought the blinds were an example of an incomplete understanding of how insulation interacts with water vapour in a home. Buildings are facing an increasing number of problems with black mould and I believe the causes are insulation and moisture combined with ignorance.

My statement found no agreement at the table. In fact the fellow beside me said I was failing to credit these new, insulating blinds with delivering great energy savings during hot, summer nights.

Soon I found that no matter what I said I was going to be contradicted. I felt like I was entering the world of Monty Python -- and I was right. I had entered the Argument Clinic.



Part of the pleasure of this sketch is derived from the undeveloped meta-argument put forth. Meta-argument: An argument about an argument.

Embracing the meta-argument position, one soon understands not even getting into an argument in some situations is the rational thing to do. More to the point, arguing strenuously with others whom have all gathered to enjoy a fine dinner is simply bad manners. (I hang my head in shame for my role in the minor dinner table brouhaha.)

Emily Post suggested on try to change the subject the minute a discussion feels like it is escalating into an argument. (Now, how do I get my friends to read this post?)

Tuesday, January 21, 2014

Being rich isn't bad -- but being a leech is.



Kevin O'Leary has made a career out of pulling the chains of Canadians, especially those who watch CBC. Recently The Lang & O'Leary Exchange touched on an Oxfam report: Working for the Few. The report reveals that the 85 richest people on earth have a combined wealth equal to that of the entire bottom half of the world’s population. According to Oxfam: "Wealthy elites have co-opted political power to rig the rules of the economic game, undermining democracy."

O'Leary's unthinking, by rote response was to applaud the news. "What can be wrong with that," he asked. The small time business man, but big time self-promoter, went on to say it was wonderful to see this happening. It encourages people to work hard, to get ahead.

Mr. O'Leary doesn't seem to realize many of those in the third world already work damn hard. Many possibly harder than Mr. O'Leary. Millions of children in the Third World are Born To Work. This is the title of a book by GMB Akash, a Bangladeshi photographer.

It should be noted that the percentage of people living in dire poverty around the world has been declining over the past decades. It must also be noted that, contrary to O'Leary's statement, in countries with the greatest income inequality an expanding GDP does less to alleviate poverty than the same growth in a country with a more equal distribution of wealth.

Amanda Lang mocked O'Leary as she imitated a Third World worker getting up in the morning. I can get ahead, thinks the worker: "I just need to pull up my socks. Oh wait, I don't have any socks."


At least, Ms. Lang gets it. For instance, some 10,000 people, including over 2500 women and 1000 children, earn a living collecting stone and sand from the Piyain River in Bangladesh. The average wage is less than $2 US a day. Times may be tough for these folk while they are working but for four months a year it gets even worse. Work is suspended during the annual rainy season. Click on the link and check the pictures. Lang is right. Many of these workers don't have socks.

Monday, January 20, 2014

Falls from beds injure children

I'm a bit of a worrier, even my granddaughter thinks so. When she has a sleep-over at our home, I worry. The guest bed is about 80cm off the hardwood floor. That's a long drop in my estimation. We push the bed against the wall and then I insist that someone sleep with the 4-year-old, keeping her sandwiched between the wall and a sleeping adult (usually mommy.)

The other night the little girl slept over. She was excited. Sleep-overs are fun. She climbed onto the bed and rolled back and forth in glee. I moved in close to the edge of the bed, warning her that what she was doing was dangerous.The words were hardly out of my mouth when she had rolled too close to the edge of the bed. She was sliding off and could do nothing to stop it. Her face filled with fear -- and then relief. I had reached out and caught her in mid-air.

"Gaga!" You caught me!" This was not the first time I've been in the right place at the right moment to catch the very active little girl. I've been told that I can't always be there. This makes me smile. She won't always need me to be there. She's four. It won't be long until the falls will be, for the most part, out-grown. I'm not putting a six-year-old in a shopping cart seat.

But my relatives seem to be sending me an underlying message: She should fall. It would do her good. She'll  learn a lesson. Kids don't get hurt falling, I am always being assured. Kid are resilient. I'm not convinced.

It didn't take a lot of research to confirm my worst fear: The proportion of kids injured by short falls is small but the extent of the injuries among those children injured is major. Knowing the exact proportion of children injured is impossible. Children who are not harmed in any way are not taken to the hospital and therefore there is no record of these incidents. But among the relatively small number of children taken to emergency, the number of injuries is surprisingly large and the extent of the injuries frighteningly major.

In one study involving 104 children, there were eight skull fractures among those children who fell less than 60cm. When the child fell more than 60cm but less than 120cm, the number of skull fractures jumped to 23. When all factors were accounted for, the researcher concluded:

  • It is common for children to suffer fractures from falls.
  • Significant, but not life-threatening injuries, are common in short falls.
  • Children tumbling from low heights can suffer unexpectedly severe injuries.
  • The greater the height of the fall, the more common it is to suffer a skull fracture.

Threats:
  • Stairs
  • Beds, especially bunk beds
  • Playground equipment
  • Shopping carts (Store floors are often hard, non-energy-absorbing surfaces)
  • Wooden floors are more dangerous than carpeted floors

One last, sad note. The figures may be skewed by child abuse. Sometime the injuries don't mesh with the details surrounding the incident and the care-givers are suspect. For this reason, I didn't go into too much detail with numbers and links, etc.

Source: Cincinnati Children's Hospital Medical Center






Saturday, January 11, 2014

Big isn't bad; Bad is bad.

When I was a boy jams, jellies, pickles and other assorted products were made by small, family-owned producers. Today, not so much.

When Heinz announced the closure of their plant in Leamington and Free Press columnist Larry Cornies wrote an apology for big business, I decided I had had enough. Cornies wrote about "The deal we make with them [Big Business] in the free-market system."

Cornies was wrong, in my opinion, about the deals we make but he did start me thinking. I don't want to make deals with big companies. Before Heinz announced the closure of its Leamington operation, I thought of Heinz as a pretty fair company with which to do business. Now that has all changed.

The headline above the Cornies column read: Answer lies in understanding, not boycotting. Cornies tells his readers to understand the pressures facing big business, to clearly understand the issues facing departing manufacturers — rather than reflexively boycotting certain brands.

I feel these companies are breaking the free-market deal I personally have with these businesses. Cornies may not agree but he sees the world differently than I do.

I'm not exactly boycotting big brand name food products, but I try not to buy them. Think of Kraft cheese. It's O.K. but I like Brights or Thornloe better. I always try to pick up some Brights Cheese when passing through Bright, Ontario, on the way to my sister's in Wellesley. Closer to home, I buy Thornloe cheese from Angelo's Italian Bakery and Market just a short drive from my London home. The Thornloe aged chedder is wonderful. Far more flavour than the Kraft product.

As I began writing this, I began wondering just whom I was supporting. I looked into the stories attached to a couple of the companies. I learned, Brights Cheese has a history going back to 1874 when a group of dairy farmers began working together to make cheese. Brights is still a cooperatives today.

Thornloe is also owned by a farmer-owned cooperative. Five years ago a global dairy producer, Parmalat, announced it was closing what is now the Thornloe operation. A local dairy farmer led the move to save the plant. Today some 3 million litres of milk runs through the plant annually.

I looked through my fridge and checked out the kitchen pantry. No Smucker's jams and jellies in my home. Smuckers bought Bick's pickles and moved production from Dunnville, Ontario, to Ohio. I now buy pickles made by Lakeside Packing Co. Ltd. located in Harrow, Essex County, Ontario. For a treat I love to pick up some Kosher dill pickles from Moishes Kosher Foods, Montreal.

It is interesting to note that to buy the Moishes I must go to Costco. Costco may be big but it is a fair employer. They pay their staff well and offer decent benefits. Do I have anything purchased from Walmart? No, I have nothing. Big is not necessarily bad. It is bad that is bad.

The truth is Mr. Cornies, we all make our own deals with Big Business. The deal that I have struck seems to be quite different from yours.

Sadly, all too often we are not given the option of not buying from Big Business. When I moved to London, kitchen ranges were still being made in town. Today I have no choice. My stove, fridge and dishwasher all come from Mexico.

The other truth, Mr. Cornies, is that all too often we do not make any deal with Big Business. Big Business dictates the terms and we have no choice but to go along with whatever is offered.