Author: UBC Abbotsford-Mission Family Practice Residency Program

“British Columbia’s decision last year to make contraception free led to a spike in the number of women choosing long-acting options, such as intrauterine devices, that are better than the pill at preventing unwanted pregnancies, new data show.

Researchers at the University of British Columbia have been tracking how the policy, which kicked in April 1, 2023, is influencing the number and type of birth-control products dispensed across the province.

They noted a significant shift to IUDs, implants and other types of long-acting birth control as soon as those products, which can cost as much as $400 upfront, became 100 per cent publicly funded.

“It’s a really substantial change, more than we really thought we might find and more than we generally see for cost-sharing policy changes in other kinds of clinical areas,” said Laura Schummers, a reproductive epidemiologist and assistant professor in the department of pharmaceutical sciences at UBC.”

Read more on UBC research shows increase in birth-control use after province made contraception free via North Shore News.

Calling all health professional education faculty on the Educational Leadership track! Are you uncertain about promotion requirements? Frustrated by the lack of community with people who share your experiences? Longing to find others on the same track with whom to share insights and experiences? Have we got a webinar for you! Dr. Marion Pearson, Professor of Teaching, Associate Dean of Students (Faculty of Pharmaceutical Sciences), CHES Scholar, and past-Chair of the UBC Senate Appointments Committee will be leading a discussion about what is expected of faculty on the Educational Leadership track and how to frame your work when putting together promotion materials. This will be a great opportunity to connect with others in similar situations and possibly plant the seeds for future connections. Following Dr. Pearson’s presentation, Dr. Laura Yvonne Bulk, Assistant Professor of Teaching (Occupational Science & Occupational Therapy) will lead a conversation among attendees about how we can build a community of educational leaders to support one another as we navigate this career journey. This will be a great opportunity to connect with others in similar situations and possibly plant the seeds for future connections. Mark your calendars and please. REGISTER HERE if you are planning to attend. Date: Monday, January 27, 2025 Time: 11:30am – 1:00pm (PST) Zoom ID: 629 6489 5358 / Passcode: 371990 Click here to add the seminar to your calendar.We look forward to joining you for this conversation!If you have any questions about this seminar, please reach out to CHES at ches.communications@ubc.ca.

“Previous research in a laboratory setting has shown that people’s cognitive performance improves in the hours after exercise, but how long this benefit lasts is unknown.

The new study, published in the International Journal of Behavioral Nutrition and Physical Activity, found that, on average, people aged 50 to 83 who did more moderate to vigorous physical activity than usual on a given day did better in memory tests the day after.

Less time spent sitting and six hours or more of sleep were also linked to better scores in memory tests the next day.

More deep (slow-wave*) sleep also contributed to memory function, and the research team found this accounted for a small portion of the link between exercise and better next-day memory.”

Read more on Short-term cognitive boost from exercise may last for 24 hours via Science Daily. Image by OpenAI.

“Introduction: Since its release, ChatGPT has taken the world by storm with its utilization in various fields of life. This review’s main goal CHATGPT is a CHATGPT developed by Open AI. This robot is trained with the help of artificial intelligence on a large amount of data to learn language patterns. In the medical application of CHATGPT, the main topic is the conversation between doctors and patients. Method: In this study we searched in Scopus, Google scholar, PubMed databases and by searching with keywords such as “Nursing Services”, “Importance of CHATGPT” and “Medical Education” during 2018-2024 to obtain articles related to the selected keywords. This innovation has the potential to automate daily tasks such as generating patient records or writing reports. By studying more than 45 articles about CHATGPT and the role of artificial intelligence in medicine, the results of this study showed that CHATGPT, with its very high potential, can play an important role in the field of interactions between humans and artificial intelligence and intelligent systems in the future.

Results: The move towards the use of artificial intelligence in medicine, which is informed by patient information, can provide more personalized and clinically accurate answers to patients. Also, according to the findings of this research, it can be said: Automating administrative functions, scheduling visits, simplifying notes, checking insurance approvals for drugs, and other repetitive daily tasks can reduce the focus on administrative tasks and more time for providing medical care in to authorize the personnel. Conclusion: In this research, the researchers noticed the mistakes of CHATGPT chat bot in creating cancer treatment programs. According to these researchers, this chat bot had provided one-third of its answers in the field of designing treatment programs with incorrect information.”

Read more on CHAT-GPT and artificial intelligence in Medical Endocrine System and interventions via Eurasian Journal of Chemical, Medicinal, & Petroleum Research.

“Generative artificial intelligence (AI) models are increasingly utilized for medical applications. We tested whether such models are prone to human-like cognitive biases when offering medical recommendations. We explored the performance of OpenAI generative pretrained transformer (GPT)-4 and Google Gemini-1.0-Pro with clinical cases that involved 10 cognitive biases and system prompts that created synthetic clinician respondents.

Medical recommendations from generative AI were compared with strict axioms of rationality and prior results from clinicians. We found that significant discrepancies were apparent for most biases. For example, surgery was recommended more frequently for lung cancer when framed in survival rather than mortality statistics (framing effect: 75% vs. 12%; P<0.001). Similarly, pulmonary embolism was more likely to be listed in the differential diagnoses if the opening sentence mentioned hemoptysis rather than chronic obstructive pulmonary disease (primacy effect: 100% vs. 26%; P<0.001). In addition, the same emergency department treatment was more likely to be rated as inappropriate if the patient subsequently died rather than recovered (hindsight bias: 85% vs. 0%; P<0.001). One exception was base-rate neglect that showed no bias when interpreting a positive viral screening test (correction for false positives: 94% vs. 93%; P=0.431).

The extent of these biases varied minimally with the characteristics of synthetic respondents, was generally larger than observed in prior research with practicing clinicians, and differed between generative AI models. We suggest that generative AI models display human-like cognitive biases and that the magnitude of bias can be larger than observed in practicing clinicians.”

More on Cognitive Biases & Artificial Intelligence via NEJM AI.

“The state of childhood in Canada has reached a breaking point. The seventh annual Raising Canada report, released today, finds that the top 10 threats to childhood are escalating, with children’s quality of life in Canada demonstrably worsening. The report includes an urgent call for policymakers to address and overcome these pressing issues. It also calls on community leaders to recognize the value of youth engagement as a critical element of creating and implementing solutions to complex social issues.

The annual Raising Canada report is published by Children First Canada, based on research conducted by the University of Calgary and McGill University. Researchers compiled existing data and conducted interviews with youth, parents and other subject matter experts. It comes as Canada ranks 66th out of 194 countries on the global Kids Rights Index.

Among the startling findings:

• 28.4% of children under 18 live in food-insecure households, an increase from 24.3% the previous year.
• One in five kids (20%) in Canada have diagnosed mental health challenges.
• Two-thirds (60%) of Canadians reported experiencing maltreatment (including physical and/or emotional abuse) before the age of 15.
• Police reports of online sexual exploitation of children have nearly tripled since 2014; Sextortion reports have increased by 150% since June 2022 and online sexual luring reports have surged 815% over the last five years.
• Hospital stays for children under four have increased by 32% due to respiratory illnesses.
• Child homicide and filicide are significant threats to children’s survival, with 40 child homicides reported in 2022.

This year’s report also highlights several cross-cutting themes, including the influence of technology on children and adolescents. Researchers note that digital platforms have made it easier to create and share messages of hate, discrimination, and cyberbullying, which adversely impact mental health, physical activity, and the risk of violence and abuse. Evidence also concludes that the negative effects of technology on mental health have intensified since the onset of the pandemic, with the RCMP warning that victims face extreme outcomes of sextortion, including self-harm or suicide.

“Children today are facing unprecedented threats—from rising poverty and mental health crises to violence in their homes and online. Parents are struggling to offer their children a better way of life than they had,” says Sara Austin, Founder and CEO of Children First Canada. “Canada’s kids deserve better—a better childhood and a brighter future, and their survival and ability to thrive depend on the choices we make today. We must act with urgency and conviction to turn this around.”

Read more on New Report Reveals Record Increases in Violence, Poverty, Mental Health Issues and Sexploitation Among Canada’s Kids (2024) via Children First Canada.

The Global Health Conference is an annual event bringing together a community of students, trainees, clinicians, researchers, and faculty from across health professions and disciplines to share knowledge. We hope that you will join us for a conversation on “Creativity Through Crisis: Lessons from Global Mental Health” with conference co-Chairs Dr. Jana Davidson and Dr. Mohamed Ibrahim. This year, we will examine the intensifying impact of global events such as conflict, climate change, and COVID-19 on mental health disparities worldwide. Our goal is to create an inclusive discussion forum for anyone interested in global health or mental health – everyone is welcome to attend.

Registration is now open!

Date: Thursday April 10th, 2025
Time: 8:30 am – 1:30 pm
Location: In-person (Chan Centre for Family Health Education, BCCHR) + Virtual

“A 77-year-old woman was referred to a geriatric day hospital with concerns about mobility and falls, pain, constipation, cognition and polypharmacy. Comorbidities included cerebrovascular disease, coronary artery disease, hypertension, dementia, fibromyalgia, myositis, bipolar disorder, arthritis, remote duodenal ulcer and hypothyroidism. A stroke 3 years earlier resulted in increasing difficulties with transfers and ambulation, leading to 3–4 falls weekly. Chronic pain was attributed to fibromyalgia. The patient was frustrated by her loss of independence, because she now required daily assistance with washing and dressing. Staff at her retirement residence managed her complex medication regimen (see Box 1 for the list of medications). Placement in a long-term care facility was being considered.”

Read more on the case of managing polypharmacy in a 77-year-old woman with multiple prescribers via CMAJ.

Learn more about polypharmacy risk reduction via SharedCare Partners for Patients.

Causation vs. Correlation: The Coffee and Baby Sleep Saga

Imagine you’re on your 24-hour call shift and you notice a strange trend: the nights you chug coffee after dinner, the clinic’s tiniest patients—babies—seem to cry more. Hmm, you think, “Does my coffee cause baby insomnia?”

Before you start banning coffee on call, let’s unpack two key concepts:

1️⃣ Correlation: This is when two things happen together. In this case, your coffee habit and baby tears seem to rise in tandem. Coincidence? Maybe. Correlation is like spotting two family members wearing plaid shirts at the same time—they’re connected somehow, but you can’t be sure it’s because they planned it.

2️⃣ Causation: This is when one thing directly causes another. If your coffee somehow made its way into those babies’ milk bottles, then you’d have causation.

Here’s the twist: just because two things are correlated doesn’t mean one causes the other. Maybe babies are just naturally fussier on stormy nights, and you drink coffee to power through those wild weather calls. The real culprit could be thunderclouds, not caffeine.

Key Takeaway: Don’t jump to conclusions! Always dig deeper, just like when a patient’s mysterious rash pops up. Is it an allergy (causation) or coincidence?

Background: In Canada, many patients face substantial out-of-pocket costs for prescription medication, which may affect their ability to take their medications as prescribed. We sought to conduct a comprehensive analysis of the burden and predictors of cost-related nonadherence in Canada.

Methods: Using pooled data from the 2015, 2016, 2018, 2019, and 2020 iterations of the Canadian Community Health Survey, we calculated weighted population estimates of the burden of cost-related nonadherence in the preceding 12 months and used logistic regression models to measure the association of 15 demographic, health, and health system predictors of cost-related nonadherence overall and stratified by sex.

Results: We included 223 085 respondents. We found that 4.9% of respondents aged 12 years or older reported cost-related nonadherence. Those who self-identified as female, belonging to a racial or ethnic minority group, or bisexual, pansexual, or questioning were more likely to report cost-related nonadherence. Younger age, higher disease burden, poorer health, non-employer prescription drug coverage, and not living in the province of Quebec were associated with cost-related nonadherence.

Interpretation: Our nationally representative findings reveal inequities that disproportionally affect marginalized people at the intersections of sex, race, age, and disability, and vary by province. This foundational understanding of the state of cost-related nonadherence may be used to inform potential expansion of public drug coverage eligibility, premiums, and cost-sharing policies that address financial barriers to medication adherence.

Predictors of cost-related medication nonadherence in Canada: a repeated cross-sectional analysis of the Canadian Community Health Survey via CMAJ.