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This semester the McMaster Museum of Art is infusing art and healthcare onto the same canvas. On display until March 26, Picturing Wellness is a two-part exhibition that concentrates on using a health-humanities perspective as a guide in understanding resilience through treatment, care and social action.

The first segment, Picturing Wellness I: From Adversity to Resilience, is currently on display at the museum. Coordinated by Christine Wekerle, Associate Professor of Paediatrics at McMaster, the didactic exhibition examines how visual literacy can be used by health professionals to develop their observational and empathetic skills.

The exhibition developed out of two collaborative courses at McMaster, offered by the Faculty of Health Sciences: “Engaging and Educating in Child Maltreatment” and “The Art of Seeing.”

“We really wanted to have that opportunity to engage the student community in what really is social action,” said Wekerle.

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The scientific basis of healthcare is often thought of as being strictly separate from the arts. Yet, as Wekerle hopes to demonstrate with the exhibit, there is considerable overlap between the two fields. “Both in [visual] arts and in sciences, we rely on systematic observation, natural experiment, and interdisciplinary methods,” she explained. “Even when considering something such as surgery, the process of determining which actions to take and where to make incisions, these decisions can certainly be considered artful.”

The fact that art can enhance evidence-based healthcare practice is due to the observational skills gained from visual literacy. Specifically, visual literacy entails for perceptual accuracy of details and a template for systematically moving through a visual.

“[The exhibition] aims to show that art and science both have a lot of emphasis on detail,” explained Wekerle, “because much of the details [in healthcare] are open to interpretation, education in visual literacy provides practice in a no right-or-wrong situation.”

“Visual literacy means that you develop a language and tolerance for ambiguous situations,” Wekerle added, “when you encounter a distressful situation and you are capable to have a very systematic method which mimics the scientific method, you begin to realize that science and art are very closely aligned.”

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Picturing Wellness I features a number of works from the McMaster collection, including those by David Blackwood, Blake Debassige, Michelle Bellemare and Betta Goodwin. The pressing issue of mental health and child-abuse resonates from a significant number of these works.

“Collectively we can play a part in alleviating the stigma for mental health, especially in men. The MSU Mental Health Strategy has a vision of different ways to encourage McMaster students to reach out, and reinforcing the notion that reaching out is resilience,” affirmed Wekerle.

“We know that child abuse is unfortunately also a common experience, and one that should be disclosed as soon as possible, to ensure better mental health as an outcome,” she added.

Picturing Wellness II: Museums and Social Engagement reflects on broader issues concerning trauma, body, memory, medicine, history, health and the museum. The opening reception will take place on Jan. 14 followed by a panel discussion on Feb. 25.

Photo Credits: Jon White/Photo Editor

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Sarah Yuan
The Silhouette

The topic of two-tier healthcare systems has been a frequent subject of discussion since Dr. Jacques Chaoulli’s win against the Attorney General of Quebec and the Attorney General of Canada. Though the arguments for the privatization of healthcare are sensible, there are many underlining factors that must also be considered. Canada has the second most expensive health system in the world in terms of GDP, but we don’t have the second-best health outcomes in the world. Our beyond-expensive system offers us just mediocre outcomes. It is true that our capabilities should be much higher but moving towards the establishment of a two-tier healthcare system is not the answer.

Contrary to belief, having more private funding will not improve the sustainability of our healthcare system. Countries in which private spending is high actually spend more in total on healthcare. The U.S., for example, spends more public dollars per person than Canada does and yet 48 million Americans remain uninsured. It seems that Americans are not getting much more after paying all these extra expenses, but they do pay much higher prices for what we as Canadians take for granted.

On top of that, private clinics often “cherry-pick” the healthiest patients with minor or acute care needs (people who are the most profitable). More complicated and chronic patients are often denied services because they require more time and care, resulting in a decline of the clinic’s profit.

If Canadian physicians were permitted to give private care to patients, an equitable portion of people who make a reasonable living will be able to choose to spend a few hundred dollars to see a good physician or maybe even a couple thousand to have some cataract surgery done immediately. Sounds like a good plan, right?

Although a loan might be required for surgery, your medical expenses should be deductible from your taxes in April. This would satisfy almost everyone who is employed except the millions of poor people, pensioners, immigrants, people with disabilities, and people with large families who don’t have sufficient resources to experience such luxury.

Moreover in countries that have two-tier systems, typically only the wealthiest can afford such service. In the U.K. for example, only 11.4 per cent of the population holds a subscription to private health insurance. In other words, a majority of Canadians would not actually benefit from being able to purchase private health insurance as they will either not qualify for it, or they won’t be able to afford the premiums.

Ultimately it’s no secret that there isn’t really an equality of access in the Canadian medical system, as those with better education and better connections can more effectively find a way to receiving prompt treatment. A study that appeared in the Canadian Medical Association Journal found that wealthier patients were 50 percent more likely to be taken on as new patients by doctors than welfare recipients.

It is worrisome to find a conspicuous bias against poor patients within our healthcare system. Not only do they have fewer resources than wealthier patients, but they also face many more barriers to good health and are the ones who will benefit the most from the access to a physician.

Allowing the establishment of a two-tiered healthcare system is to allow the drawing of a thick and definitive border between the rich and the poor. Access to healthcare should be based on an individual’s need and not their ability to pay. If available resources are restricted we should revisit what is and is not essential. Healthcare should never turn into a competition for those earning the greatest profit.  Is this what you would want for the country we’ve all lived in and loved?

J.J. Bardoel
Silhouette Intern

The case of a former McMaster PhD student, claiming he was not accommodated after suffering a head injury, continues. In 2008, before Jason Tang was about to complete the exams required for his degree, he suffered a serious brain injury, which left him with post-concussion syndrome. The symptoms called for certain accommodations, which Tang claimed were not provided by McMaster.

After proposing an oral examination, a proposal he claimed received positive feedback from numerous members of faculty within McMaster, he was eventually told that he must write the examination format that was designed for all students in that program. Although he claimed that he was offered a longer time period to finish the exam, as well as writing support, he stated that that the sporadic nature of his disability hinders his ability to complete exams.

“I still have the intellectual skills to write the paper,” he said in an interview to CBC Hamilton. “I just can’t predict when I’m able to engage in the work.” This would eventually cause Tang to withdraw from his PhD studies.

ARCH Disability Law Centre, a clinic specializing in cases regarding injustices for the disabled, quickly picked up Tang’s case. Laurie Letheren, an ARCH staff lawyer, hopes that the case will set a precedent for similar cases in the future regarding student discrimination. She told CBC before the initial tribunal meeting, “This is an important case because it will address some of the unique questions that arise for students with disabilities at a graduate level.”

Following the allegations, McMaster released a statement to CBC Hamilton affirming that they will defend against the claims. McMaster University stated that it “is aware of this claim and has worked with the student over the years to identify solutions that provide the accommodations necessary so that he could complete his studies, while ensuring the maintaining of appropriate academic standards.”

The original tribunal meeting was set for July 19, 2013 but with no public decision reached, the case is still ongoing. ARCH Disability Law Centre was contacted and not able to comment.

McMaster is known to have the cheapest but sparsest student health insurance plan in the province.

But at Sunday’s SRA meeting, a motion was passed to allow for a referendum to ask students if they want an extended health plan that would include vision care, oral contraceptives and paramedical care.

Extending coverage to all three categories would result in a $47 increase in student fees.

The referendum, which would be attached to the 2013-14 Presidential Ballot, would offer students the choice for no increase, a $15 increase for vision care, a $19 increase for oral contraceptives or a $47 increase for the vision, oral contraceptives and paramedical care package.

Paramedical care includes vaccines, physiotherapy, massage therapy, chiropractic and naturopathic care, psychiatric care and speech therapy. In some cases, there is only partial coverage of these services.

Simon Granat, SRA Social Sciences, who introduced the motions and was part of the Health Care Task Force, noted that McMaster has one of the few student unions that doesn’t provide more comprehensive care.

The Assembly was especially concerned with how a change to the healthcare plan would impact the MSU’s current opt out policy. Currently, students can choose to opt out of the health plan, the dental plan or both. However, students who choose to do this must prove to the MSU that you have equal or comparable coverage.

Jeff Wyngaarden, MSU VP Finance, explained that under a new plan, “equal and comparable” coverage would need to be re-defined.

Under the new policy, students would most likely not be able to opt out of specific segments while choosing to use others. Oral contraceptives was specifically mentioned as an example of coverage that some students may want to opt out of.

Granat identified oral contraceptives as a core part of the coverage, ensuring equitable coverage for all those who may face financial barriers. He also reiterated the importance for men to “step up” to this.

However, Wyngaarden stated that a change to the plan represented a fundamental shift from solely emergency care to a more supplementary plan that provided services that were “tangential” in nature.

This prompted a noticeable response from several representatives who argued that these services were in fact essential to student life and members should not be debating about particulars of services that should ultimately be decided by students in a referendum.

Granat explained that by putting the referendum on next year’s Presidential ballot it gave the Healthcare Taskforce and the MSU ample time to hash out details and would guarantee quorum on the vote.

A student survey is also planned to gauge students’ interest on an extended healthcare plan and to understand the impact of increased fees on students.

“The survey is ready but we just held it off because there have been a lot of surveys recently and there could be survey fatigue,” explained Granat. “[But] I think there is a hunger for this and I think a survey won’t hurt us by seeking feedback.”

Wyngaarden explained how he would be interested to understand why students would vote against the referendum, especially if they found the costs to be prohibitive on top of their tuition or the services inapplicable.

Granat argued that part of the plan’s intent should be to provide equitable coverage to all students, mimicking the vision of the greater Canadian healthcare system.

“Students would be paying slightly over $100 per year, which is still $12.43 less than the provincial average, and possibly getting a better plan than they get from their parents. I think this is a risk we [the MSU] should be willing to take.

Sue Grafe and Nikki Bozinoff have a first-hand look at how last year’s changes to the federal health care program affect refugee health care in Hamilton.

Grafe is a nurse practitioner at REFUGE, a Hamilton refugee clinic, as well as a nursing professor at Mac. Bozinoff is a McMaster medical student and member of Hamiltonians for Migrant and Refugee Health.

Along with Mac economics professor Michel Grignon, they discussed the impact of last year’s refugee health cuts Tuesday at a panel hosted by the Global Citizenship Conference.

Cuts to the Interim Federal Health Program (IFHP) were brought into effect on June 30, 2012, intended to minimize abuse of health privileges. As of then, refugees not assisted by the government have no vision, dental or medical coverage except in emergencies. Refugees from a “designated country of origin” don’t get any coverage.

At the panel, Grafe and Bozinoff said since the cuts were implemented, there has been a great deal of confusion among practitioners about who has coverage and who doesn’t.

“We [at REFUGE] see people regardless of coverage, but the problem becomes, what do you do?” said Grafe.

“There are pregnant clients who don’t get prenatal care because they fall within the gap of having and not having coverage.”

Bozinoff added that there were problems with IFPH even before the cuts were made.

“Even before the cuts, many [refugees] were turned away if they didn’t have a knowledgeable providers,” she said.

Grafe said that prior to the cuts, many Hamilton refugees had been using walk-ins, but because of the confusion, they seem to be using those services less.

She anticipates that refugees from Hungary, Slovakia and the Czech Republic are most affected by the cuts in Hamilton, recognizing that refugees from various countries tend to settle differently across cities.

Grafe also observed some “ironic” inconsistencies in the system with changes to the IFHP.

In some cases, she said, “you can get their medication covered if they qualify for Ontario Works, but you can’t run any blood work.”

In getting coverage through Ontario, she and Bozinoff pointed out, the health care costs are downloaded to the Province.

According to Citizenship and Immigration Canada, the IFHP costs $84 million per year, and the cuts would save $20 million annually to a total of $100 million after five years.

Michel Grignon, director of the Centre for Health Economics and Policy Analysis, approached the issue from a socio-economic perspective.

On whether or not Canada’s international image would be negatively affected by the cuts, Grignon doesn’t think so.

“We’re still doing reasonably well in terms of [the numbers] of refugees who come here—we are still seen as fairly generous.”

Currently, Canada is home to 5 refugees per 1000 people. The US has a ratio of 0.9 per 1000 while Syria has 49 per 1000.

He did express some qualms about the policy moving Canadian healthcare toward a two-tiered system.

“What’s great about universal coverage is that doctors don’t have to worry about who is covered. In the UK nobody will ask you anything, they just treat you,” said Grignon.

Miranda Babbitt

McMaster’s School of Nursing has helped to set the path towards significant developmental aid for Hamilton youth, but this initiative is at risk of losing funding by the New Year.

The program, called Primary Care for At-Risk Youth, has been providing nursing services in the local high schools of Hamilton. Once a week, a nurse practitioner along with several third-year Nursing students, offer their services for half a day at Sir John A. MacDonald and Cathedral Secondary School.

The results of such a program have been clear, with as many as 15 students seeking attention every hour. Larissa Glover, a third-year McMaster Nursing student involved with this initiative, has noted that the numbers are set to increase, “with more and more students learning about the centre.”

At Sir John A. MacDonald, one third of the student population is without family doctors, and 50 per cent of the students do not speak English as their first language.

Dyanne Semogas, an Assistant Professor in the School of Nursing and a project leader, stated, “ESL significantly influences access to healthcare, and the Hamilton Center for Newcomer Health, [a joint initiator of the program], is one of those places that sprung up with a grass roots approach to addressing gaps to health services for newcomers.”

The Primary Care for At-Risk Youth initiative attempts to forge bridges between immigrant students and healthcare resources within their own community. Semogas explained that in many families stricken by poverty, some students are still unable to fully benefit from their services if the link between their help and overall community resources remains vulnerable.

Because nutritious food is often unavailable in low-income communities, if students are prescribed antibiotics that need to be taken with food, they may take it with unhealthy food. As a result, the program can also provide supplementary nutritional resources that will benefit the students beyond their immediate concern.

The need for readily available access to healthcare within inner-city high schools is pressing, and this is precisely what drove McMaster’s School of Nursing and local Hamilton school boards to begin the talking about how to build a program that addresses youth health.

Semogas previously stated that, “Studies have shown that youth having access to health care in schools are more likely to stay in school.”

The benefits of the initiative extend beyond the scope of the high school students to the very students behind the desk – McMaster nursing students are able to gain valuable experience towards their future practice. “Any place where you can interact with the population is really beneficial,” says Glover.

First-year Nursing student Emma Carscadden re-iterated the program’s importance.

“In the past there were nurses in most schools, and it’s a shame that nurses have been taken out of these important roles. I hope that this initiative will be successful, as nurses have a vital role in promoting healthy lifestyles and choices to children who need it.”

Despite the program’s progress and its considerable role in providing youth health services, funding is set to end in December. Semogas and Glover remained hopeful about the potential fundraising opportunity offered through the Aviva Community Fund, which contributes $1 million to Canadian projects that enable positive change.

With several qualifying rounds, the Primary Care for At-Risk Youth initiative has made it to the semi-finals. However, the future still remains tentative. “Some programs have crazy numbers of votes, up in the thousands, and they may outbid us,” said Glover, “but I am really, really hopeful for it.”

Kacper Niburski

Assistant News Editor

 

What’s hotter than a nurse? A male nurse. What’s hotter than a male nurse? McMaster’s Nursing Health Services Research Unit (NHSRU).

On Nov. 3, the provincial government’s new Chief Nursing Officer, Debra Bournes, extolled the NHSRU for their efforts in pioneering undergraduate research with the Undergraduate Student Research Internship Program (USRIP) at an educational showcase event hosted by the Faculty of Health Sciences.

For twenty years, the NHSRU has held the USRIP as an opportunity for undergraduate students to delve into healthcare-related research.

Each year, under the funding of various bodies such as the Canadian Health Services Research Foundation and the Ontario Critical Care Secretariat, two or three students from a variety of undergraduate levels are involved in research that centers around both patient care and public health policy.

It was only in early November of this year, however, that the program was analyzed and subsequently deemed a success.

To come to this conclusion, the initiatives of the program, from how to best build and sustain the nursing efforts to how to enhance a student’s research skills through education, were assessed in an evaluation entitled, “Preparing Tomorrow’s Leaders Today: Investing in Capacity Building for Nursing Health Services Research”.

After applying the document’s framework, which is an assessment strategy to foster capacity building, it was determined that the USRIP is both a valuable and a cost-effective approach to building research capacity.

In addition to this, the variety of funds granted continual insurance and enhanced the ability to invest in future healthcare leaders through the program itself.

“The program exposes students to what they would not get exposed to during their academic experience,” said Andrea Baumann, scientific Director of the nursing research unit.

“Students get the opportunity to meet those in high-level civil services in health and education. They get exposure to bureaucracy and clinical management, which they wouldn’t get in school per se. We thought it would be good if they received those types of exposures during their university experience so they get certain generic skill sets such a writing, ability to do research, ability to critically analyze material.”

She continued, “I only wish that undergraduate research was very common. So far, it isn’t.”

Perhaps, though, the success of the program, where both the researchers and leaders of tomorrow are being built, may serve as a stepping stone for such innovative opportunities for undergraduate research.

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