Along my current educational journey, I have increased my research abilities by examining such concepts as: health determinants and how the WHO classifies health, the health of Canadians, chronic disease management on a provincial and federal level, as well as examining vulnerable populations in healthcare such as our aboriginal people of Canada. I have applied these learning opportunities to my eportfolio in blog posts, summarizing what I have learned from each concept. This has helped provide me with a more complete eportfolio in addition to refining my own current digital identify and social media presence as a healthcare professional. I have also adopted a website repository for my online personal research: Mendeley, which serves to store my online articles and resources that I have acquired thus far during my scholastic journey.
From self-reflection combined with observation from my peers in my class I feel that maintenance of professionalism on social media is mandatory for health professionals. As healthcare professionals we are held to respective codes of conduct as well as ethical behavior. Some such aspects of the code of conduct for my healthcare company that I work for Alberta Health Services, include thinking how our actions may impact our patients, having the courage to stand up for what is right, exercising our best judgement and protecting the information entrusted to us. Also, our mission statement includes striving for the following values: compassion, accountability, respect, excellence, and safety[1]. When I sit back and think about these values it becomes apparent to me the necessity for integrity as a healthcare worker in that I need to embody integrity through my actions to be held with respect and to be trusted by others. As I have mentioned in a previous blog on my eportfolio site here, ‘words are limited in their ability to provide personal context online’. To avoid being misinterpreted on social media, keeping my personal life events minimal is ideal. Also, the application of fact to substantiate my social media postings well will help assist with obtaining a trustworthy and respected professional digital presence.
In terms of health, the WHO defines it as such: ‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’[2] Observing that this definition could be potentially viewed by some as vague or ambiguous, I could understand why such readers would request further explanation, however, at the same time I also believe that perhaps part of the reason this ‘definition’ has never been changed was that by being so broad in itself, it could cover a wider spectrum of potential concepts for a case-by-case basis, without becoming too detailed and overwhelming. Also, it would constantly require updating of more precise data due to our modern day’s ever-increasing research data. Without constant refinement of this basic definition the potential opportunity for greater freedom in terms of applied care arises for actual care providers. When such health care providers then consider ‘what is health or healthy”, they could tailor this definition more specifically to each individual patient as the definition’s criterion itself would not serve as a “one size fits all” especially considering the vast influx of medical knowledge we have acquired since this definition was established by the WHO in 1948. Also, this decision not to revamp this definition has allowed each country the freedom to further build on this definition to suit their unique demographics.
In Canada we have the current social determinant of health: income and social status, education and literacy, childhood experiences, physical environments, social supports and coping skills, healthy behaviors, access to health services, biology and genetic endowment and gender.[3] We are already seeing a current focus on the biology and genetic endowment social determinant of health currently with the amazing abilities of personalized medicine which includes gene therapy: a means to correct a disease or disorder through the insertion of a proper and functional gene that could be absent or malfunctioning. This is a current research interest of mine that I would like to pursue.
Another research interest of mine that I have further explored is Type 2 Diabetes (T2D). T2D is a disease where insulin production cannot meet the requirements for the glucose in the blood, resulting in high blood glucose levels. Diabetes is inflammatory by nature and affects specific immune cytokine cascades in the body in that they inhibit the insulin signal which prevents the binding of insulin to its specific cell surface receptor contributing to insulin resistance.[4] Sustained high glucose levels in the body are destructive and activate respective inflammatory responses to already damaged tissues. Chronic inflammation can also enable the affected host to be more susceptible to specific infections such as viral infections. T2D is also strongly associated with cognitive impairment as neuronal cells are unable to properly uptake glucose for absorption for required cellular metabolism. Another disease affiliated with this specific glucose shortage mechanism (via insulin growth factor signaling, inflammatory cytokine signaling and glycogen synthase signaling in the brain) is Alzheimer’s disease [5].
Both T2D and Alzheimer’s are diseases and place heavy demands on the healthcare system. Diabetes in particular is considered a chronic disease. ‘Between 2011/12 and 2021/22 new cases of diabetes are estimated to result in $15.36 billion in Canada health care costs, almost two-thirds of which will be spent on acute hospitalizations and physician services…’[6] Knowing that begs the question of what’s being done for prevention on a national level to help prevent further spread of this disease amongst the population. ‘Canada has one of the highest prevalence rates among OECD countries.’[7] It’s evident that more is needed to be done in terms of prevention insomuch to slow the spread of the disease over the population because if we continue at current determined rate of occurrence, we as Canadians will not be able to financially sustain this disease as our population continues to increase, and therefore such affected patients will not be able to receive the care they require. More education amongst care providers as well as in our educational systems is required. Alberta and Manitoba when compared face the same issue in terms of funding in that they tend to focus mainly on the management of the disease and not necessarily much for the prevention.
Our aboriginal people are a specific population of vulnerability in Canada that have an increased risk of T2D by 3 - 5 times[8]. This risk has been estimated over time as a result of the social status in that the colonization that occurred long ago has left a scar on these people. However specific programs have been initiated by the Government of Canada to help mitigate this risk in this specific demographic. Their vulnerability lies within how they are treated within the healthcare system as part of their ethnicity. Studies conducted have claimed that this ethnicity suffers the risk of neglect and bias when they present to healthcare facilities and as many are automatically assumed to be “homeless’ by first glance.[9] Also, an interesting side note about this specific demographic is on the research aspect in that “interventional medical research has largely failed to consider the unique aspects of involving indigenous patients in research.’[10] This such discrimination cannot go on as it not ethical for one, and for another: by excluding such data from sample statistics our data loses accuracy of the true sample pool area it is sampling from. This in turn leads to much less accurate conclusions regarding healthcare and medical decisions needing to be made for whatever sample was being clinically studied for.
Recognizing that healthcare is constantly changing in terms of health research data, this particular data needs to remain evidence-based and not opinion-based so that we can improve upon our current structure so that we can have a stronger and more reliable structure in which we build our practices on. Scientific data is to remain ethical and honest, without bias, and therefore presenting factual information in an “as-is” format is essential. This information could then be applied to the structure of a health-care system (global as well as national) along with the social health determinants that the country in question has selected, so that it can represent its’ populations’ health care needs appropriately. Populations between countries may vary and so may their vulnerable populations. These specific populations as well need to be kept in this scope of consideration of building a healthcare foundation so that we can remain inclusive and unbiased in terms of who we treat as clinicians and health research workers.
[1] ahs-pub-code-of-conduct.pdf (albertahealthservices.ca) [2] Frequently asked questions (who.int) [3] Social determinants of health and health inequalities - Canada.ca [4] Kuby, et al. Immunology 7th ed. W.H Freeman and Company, New York, 2013.P511. [5] Is Alzheimer's disease a Type 3 Diabetes? A critical appraisal - ScienceDirect [6] The cost of diabetes in Canada over 10 years: Applying attributable health care costs to a diabetes incidence prediction model - HPCDP: Volume 37-2, February 2017 - Canada.ca [7] International Comparisons: A Focus on Diabetes (cihi.ca) [8] Highlights: in Canada: Facts and figures from a public health perspective - Canada.ca [9] Healing racism in Canadian health care (nih.gov) [10] Ibid
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