Becoming Scientifically Literate. Weeding out the junk. CDA/Medtronic Talk October 15th 2016 Winnipeg

Thank you again to the Canadian Diabetes Association and Medtronic for hosting the event last weekend. I really enjoyed it. Here are the links I promised everyone to resources related to understanding science and getting the best resources for decision-making:

Remember this acronym DEPLOR-

Ask yourself, what was the: Design, Exposure/Intervention, Population, (Liars?), Outcome, and... was it Rigged?

Design - interventions and systematic reviews are ideal

Exposure/Intervention - Is it relevant, realistic, measured/delivered in the right way?

Population - Was it relevant to me? or was it a group of university undergrads?

Liars - Was the population human or were they mice/rats? If animals were not mentioned in the title  - journalist is a liar :)

Outcome - Were the outcomes relevant to me as a patient?

Rigged - Did a company fund the study?

Where to get good information?

Know the 6S pyramid of evidence

ACCESSS  plus.mcmaster.ca to get e-mail updates and search for studies

NEJM Watch 

Obesity Offerings- Latest research findings and information on obesity

Nutrition Evidence Library - Latest up to date reviews on diet and health

Who Should I Follow on Social Media?

NPR Health

NY Times Health

Atlantic Health

Stat News

Dr. Holly Witteman lives with type 1 diabetes and does research on patient-informed decision making

Dr. Michael Joyner MD at Mayo clinic with expertise in exercise, general medicine and diabetes/heart disease

Dr. David Katz is a the director of Yale Prevention Centre and tweets/writes on diet/obesity

Dr. Jeff Flier former Dean of Harvard Medical School and leading scientist in obesity/type 2 diabetes research

Dr. Eric Topol cardiologist and leading author

Some fun things to read/watch in science

John Oliver from HBO's Last Week Tonight on Scientific Studies

FiveThirtyEight.com take on why Science isn't Broken.

Thoughts on Supporting Positive Mental Health for Indigenous Youth

In the wake of the suicide crisis in Attawapiskat this past week, I got a lot of questions from friends and colleagues about why this happens so often in Canada's First Nations. This week, I told everyone who asked to read editorials by Gabor Matte in the Globe and Joseph Boyden in MacLeans as they get right to the heart of the matter. The crises faced by Indigenous communities across Canada can be tied to one overarching cause -  the trauma of government-sponsored colonization and assimilation practices.

This blog is an attempt to use some science to support these claims. As I am about to join youth from across 4 communities in Manitoba to help a remote First Nation in crises, I will also provide some possible solutions. How can the trauma of colonization and residential school activities continue to impact the lives of Indigenous children in Canada today? A framework and rationale for health inequities among Indigenous people was outlined in a great review by Indigenous scholar Dr. Don Warne at North Dakota State University (great TedX Talk here).

For Western/settler people that have a hard time understanding this, perhaps this will convince you. Trauma, ( and the stress and anxiety that accompany it), imprint genes through "epigenetic" signatures that alter our genes. These imprints may limit a persons ability to response to stress or predispose individuals chronic diseases. The best and most extensive example of this was demonstrated in the ACEs (Adverse Childhood Experiences) study.  Children exposed to adversity early in life are more likely to adopt risky health behaviours, develop chronic diseases and die at a younger age. Indigenous children suffer from a number of these traumas, in addition to the trauma of poverty, food insecurity, living in overcrowded homes, and more intensely the lasting legacies their ancestors faced at the hands of racist government policies, that linger today within the Indian Act. The trauma Indigenous youth experience from generations of government-sponsored, racist assimilation (genocidal) policies cannot be solved through greater assimilation or moving to the big city. They need to be solves through respecting Indigenous people, their teachings and reconciliation.

Where do we start the healing process for youth facing so much trauma? Indigenous leaders across Canada often talk about the importance of land, culture and language. As a non-Indigenous person, this may be challenging to understand. I will admit that I had a very hard time appreciating this view, as I was trained in a western, reductionist approach to health and science. As non-Indigenous people are less in-tune with concepts of wholistic well being, connection with one another and connection to the land. We are also less able to see the larger social determinants that drive health inequities. Over the past 3 years, working closely with Indigenous youth and their community leaders, I have finally seen the light. We need to embrace these teachings if we want to stem the tide of inequities facing Indigenous people in Canada.

In the same way an unnatural change in the environment is killing polar bears in the far north, an unnatural social-political environment in Canada is killing Indigenous people across their own land. Trying to find the gene for diabetes, or the pill to prevent depression is meaningless if the social environment does not change is tantamount to genotyping bears to determine why they can't handle heat or creating novel cooling vests for them. More importantly, I believe that when we ignorethe wisdom of elders and stakeholders we are re-traumatizing and re-colonizing Indigenous communities. If you need "evidence" for their claim, here is the most important graph that every newspaper and columnist should reference when discussing suicide in Indigenous communities:

Rates of suicide are ~140 x lower in communities with extensive cultural continuity

Rates of suicide are ~140 x lower in communities with extensive cultural continuity

The study from BC published back in 1998 revealed that suicide rates were dramatically lower in communities that had greater control over services, land claims and cultural connection. For communities that were largely self-governed and connected to culture, suicide rates were LOWER than those in non-Indigenous communities. Importantly, these trends were observed independent of poverty and other social determinants of health. Experimental trials in Indigenous people at risk for type 2 diabetes reveal that culture and language-based programs are superior to traditional knowledge-based education about healthy living for improving risk. Promoting cultural activities, particularly if they are conducted in nature leads to better self esteem and enhances resilience among Indigenous youth in Canada. A large team if Indigenous elders, stakeholders and scientists are working with Western scientists to determine if culture is a treatment for addictions among Indigenous people. In light of this very compelling evidence, it pains me when white journalists and health care providers scoff at the notion that culture is a key solution for overcoming health disparities among Indigenous people.

What can we do? First, I would like to apologize to the youth, elders and community members of Indigenous Canada for the century of racist policies and government-sponsored assimilation practices my forefathers inflicted on your people. More of us need to apologize. Second, I suggest everyone turn off their biases and the noise in their heads to listen to the youth. Third, learn more about Indigenous culture, tradition and their history dealing with western cultures. In this way, we might respect the notion that land, culture, language and community connection are sources of healing. Fourth, make the government accountable to addressing disparities. Schools that support the growth of Indigenous youth receive ~50% less funding that schools that support white youth. This has to change. Our Minister of Indigenous and North Affairs is a white woman and follows a long-line of white men. This has to change. (How is that even possible in this day and age?) The Indian Act, a government sponsored cultural genocide that inspired apartheid in South Africa, is still in place today and wreaking havoc on Indigenous communities. This has to change. Finally, take time to read the Truth and Reconciliation Report and it's calls to action to understand what Indigenous leaders believe will begin to restore inequities and injustices in Canada.

This is the movement of our generation and until "White Canada" starts listening and responding to the Indigenous people, on who's land we live, work and play, these crises will continue into the next generation.

Paper of the Week February 25th 2016

How much weight does a person need to lose to improve health? If you relied solely on the news media to determine the impact of excess weight on a persons health, you would (wrongly) assume that overweight individuals all live with type 2 diabetes, high blood pressure and are heart attacks waiting to happen. If they were children or adolescents you would (again wrongly) assume that they have organs that are 10 yrs older than their birthdays and suffer from diseases that they share with their parents. However, the science of overweight tells a much different story. In fact, 50% of adults and youth who are overweight live without any of the chronic diseases that most people associate with obesity. Furthermore, the association between body weight and life expectancy is not a linear relationship. In fact, advocates for being healthy at any size often point to the observation that being overweight may be associated with a lower risk of mortality, when they lobby against the movement for obesity being considered a medical disease.

The intimate link that we often make between obesity and chronic diseases has several consequences, particularly for fellow citizens who are overweight. First, health care providers often focus on excess weight and weight loss as a primary target to achieve “health” for persons who are overweight. Second, for persons living with overweight/obesity focusing on health consequences of overweight creates the unrealistic expectation that they need to achieve a "normal" weight status to avoid chronic diseases. A paper published in Cell Metabolism last week could shift this bias.

For the past 2 decades clinical trials have focused on the best way to lose weight. By and large these studies reveal that a balanced lifestyle change that includes more physical activity, diet modification and frequent contact with a health care professional will lead to a 5-7% weight loss, that in some cases can be sustained for 12-24 months. Believe it or not, we have not identified the magic dietary pattern to achieve these results, nor have we found that HIITing it hard, pumping iron, or becoming marathon runners is any better than getting out and walking more each day. The problem with these studies however, is they focus largely on weight loss and rarely the chronic disease risk factors that accompany excess weight. Importantly, they have failed to identify the impact of modest weight loss on health outcomes. This week's "paper of the week" was designed to address this gap in the literature.

What was the research question? The article of the week, published in Cell Metabolism by Dr. Sam Klein and his team at Washington University, asked the following questions: “What are the metabolic benefits that accompany a simple 5% weight loss”, “Are the benefits related to changes in fat cell (adipocyte) function and “Are these benefits greater if weight loss extends to 10 or 15% of body weight”. Some of this work was discussed in the HBO documentary "Weight of a Nation" in the middle of the trial. These are the first results from this landmark trial.

How did they test the research question? The research team recruited 40 adults who wanted to lose some weight and randomized them to either weight maintenance or weight loss (only 33 completed the entire trial). Weight loss was achieved through weekly behavioural support from an expert, a structured meal plan that targeted reduced fat intake, meal supplements and additional support from a dietitian if they were not meeting targets. The participants in the intervention group were studied after achieving 5% weight loss (~6kg after 3.5 months), 11% weight loss (~11kg after 7 months) and 16% weight loss (~16kg after 11 months). Participants in the control group, were encouraged to maintain they pre-study body weight over the year of the trial.

What did they measure? This was a relatively small study sample because the research team relied on very precise, sophisticated measures of cardiometabolic health. They infused insulin into participants to assess their risk for type 2 diabetes. Participants wore monitors to track their blood pressure over 24 hours. They used MRI techniques to quantify abdominal fat mass and fat in the liver. Finally, they obtained biopsies of fat cells to study how they function and the substances they released. This last measure is important as we know very little about how fat cells adapt to weight loss. For decades we thought fat cells existed only to store energy to be used when food was less abundant. In the late 1990’s a group from Harvard discovered a hormone called leptin that was released from fat cells and seemed to control our appetite. Since then, thousands of studies have documented hundreds of substances, termed adipokines, that are released by fat cells and act on the various tissues in the body. More recently, it’s become clear that fat cells can become dysfunctional as people become obese, releasing cytokines that adversely affect health. What was unclear before this study, was whether this dysfunction was reversible with weight loss and if so, how much weight was needed to rescue the cells.

What did they find?  The intervention group was successful at meeting weight loss targets within the 12 mont trial. Impressively, a small 12 lb weight loss (5% of original body weight) in middle aged persons weighing over 200lbs resulted in improvements of 10-30% in multiple measures of cardiometabolic health. These included reduced blood pressure, liver fat and cholesterol as well as substantial improvements in insulin sensitivity, beta cell function and adipocyte-regulation of fatty acids in the blood. In some cases, the improvements were not greater with increasing weight loss (insulin sensitivity for example), while others particularly beta-cell function, continued to improve when weight loss continued beyond 30 lbs. In an effort to dissect the biological pathways involved in these benefits, the researchers examined the expression of genes involved in the metabolism of the fat cell. While fat cell metabolism was unchanged after 5% weight loss, the expression genes involved in fat storage and inflammation began to shift towards a healthier profile when weight loss improved to 10 and 16% of original body weight (See Figure 2).

Why is this important?  For patients and providers, the key message from this study, is that substantial health benefits are observed with small reductions in body weight. These data should reset patient and provider goals for weight loss and not target a normalization of BMI or body weight. Particularly, when we know that overweight individuals with a low cardiometabolic risk profile live substantially longer than peers with risk factors. Additionally, these data support the concept that the adipocyte is a dynamic organ with functional outcomes that are regulated by weight status. Importantly, the changes in adipocyte dysfunction were reversible with weight loss, but required ~10% weight loss to achieve detectable improvements. The take home message for patients and health care providers: small changes in weight = significant health benefits. Start with small realistic goals and applaud people that achieve them.

Strengths and Limitations: The study relied on precise and accurate tools to assess cardiometabolic risk, but was limited in sample size. Additionally, a substantial number of the control participants dropped out after being randomized to the control group, increasing the risk of a biased sample. Finally, the group specifically avoided the use of activity/exercise in the intervention to avoid the confounding effects of exercise on these cardiometabolic health outcomes. Future studies should determine if these improvements in cardiometabolic health are greater when weight loss is accompanied by regular exercise training or daily physical activity.

Notes from Alberta Health Talk February 17 2016

Thank you to the team at Alberta Health for providing Brian Torrance from Everactive Schools and myself with an opportunity to speak about the work we are doing on resilience in youth. Here are links to several papers and websites that were mentioned throughout are talks:

Harvard Center for the Developing Child work on Resilience

An in brief series by that group on resilience.

A working paper by the group on how to strengthen the foundations to support resilience in youth.

A link to the Pediatrics paper on the Aboriginal Youth Mentor Program.

A link to our paper in JAMA Pediatrics on Peer Mentoring

A link to the paper in JAMA Pediatrics on the benefits of volunteering for teens.

A video from BC on how to apply the Circle of Courage into practice.

Lakeview Elementary school's video on their interpretation of the Circle of Courage.

A resilience-guided pilot intervention for type 2 diabetes management.

A systematic review of the effectiveness of resilience-based interventions for chronic disease risk factor management.

The Everactive Schools work with Kainai Board of Education released a video of the results from their photovoice work.

Videos by Indigenous scholars Joe Yratcheta and Donald Warne on Indigenous approaches to health research.

This video by Donald Warne titled All My Relations provides a great overview of the differences between western and indigenous approaches to health equity.

This video by Joe describes how the social determinants of health and differences in cultural/traditional lifestyle explain 5-fold different rates of type 2 diabetes among Pima Indian communities in the US and Mexico.

Thank you again for the warm welcome and we look forward to working with you in the future.

Article of the week -February 11th 2016

Why is this study important? As a follow-up to last week's article on the impact of policies to reduce sugar content in drinks, we will continue on the theme of policies to reduce sugar sweetened beverage intake. This is a hot topic currently as data suggest that calories from sugar sweetened beverages (SSB's) contribute adverse health outcomes in youth including weight gain and cardiometabolic risk factor clustering. More importantly, randomized controlled trials that target SSB reduction have shown positive effects on child and adolescent health. For example, a trial published in the New England Journal of Medicine found that an promotional intervention that advocated for choosing water or calorie-free drinks in place of SSB's delivered to families with overweight and obese adolescent, prevented weight gain in youth, particularly among Hispanic youth. With mounting evidence that modifying SSB intake may lead to better health outcomes in youth, population-based strategies or policies that could nudge families away from SSB's would be attractive to governments interested in reducing the global burden of obesity and chronic diseases in children and adolescents.

Labelling as a option to reduce SSB intake.  Labelling foods or menu items became a very hot topic a few years ago, when the US congress passed a law requiring chain restaurants to provide nutritional information on their menus. The city of New York received more attention than others for implementing the policy and early results were not overly exciting. Consumers were aware of the labels, but only a small portion (<20%) used the labels to change their menu choice. However, among those that did, they reduced their calorie intake by ~100 kcals for the meal purchased. As we saw last week, a seemingly meager 100kcal reduction per meal, could prevent hundreds of thousands of cases of type 2 diabetes. Based on this information, a group of Canadian scientists from the University of Waterloo designed a study, that was published this week in the journal Pediatrics, to evaluate the impact of SSB labelling on knowledge and behavior of parents of children. The hypothesis they had was: "that a warning label would be more likely to increase perceptions of the health harms of SSBs and reduce purchase intentions for SSBs relative to calorie labels or no labels. This research has the potential to inform regulatory efforts in states and municipalities considering SSB warning label policies."

How did they test the study hypothesis? Led by fellow CIHR Applied Health Chair, Dr. David Hammond, his team recruited ~3300 parents of children 6-11 yrs of age were randomly assigned to one of 6 conditions: two control labels; one with no label and one with simple calories and 4 intervention labels with various health warnings. After seeing the warning, they were provided with a simulated vending machine task and then asked to complete a short survey regarding various factors that might influence their decision about purchasing SSB's (See table 2 here).

What did they find? Compared to calorie-only or no label conditions, no one health-messaging label was better than another for altering knowledge or intended purchase of an SSB, therefore the authors collapsed all 4 health labels. When a health label was added to an SSB bottle however, parents were ~33% less likely to chose an SSB for their child (40% vs 60%) and convinced parents that SSB's were unhealthy for their child (Table 4). All of these changes were statistically significant. Most participants felt that a warning label would change their beliefs about the health benefits of SSBs and 73% supported labelling of beverages.

Why is this important?  As we try to build sandbags to defend the children and teenagers in our country against obesity and it's many consequences, we will need to rely on interventions that have the greatest impact and one's that nudge us to make the right choices. This study provides some evidence that providing a label that contains a health message on pop bottles, will change a parent's perception of how healthy the item is and more importantly, it will dramatically shift the purchasing behavior of the parent.

Limitations of the study. The study is strengthened by the large sample size, the randomized nature of the experiment and the use of multiple messages to influence behavior. The study however was a simulation, therefore it is unclear if this information will be as effective in the grocery store where people are distracted, influenced by sales tactics by the store and (perhaps more importantly) screaming children as they are marching down the aisles. The large effect seen in this simulation however (i.e. reduction in desire to purchase SSBs), makes me interested in seeing this type of study extended to a real-world setting on a larger scale. So, when you are voting for someone advocating for health policies, consider those who are aware of these nudge-grounded interventions that may have a population health impact at a relatively low cost.

Article of the Week - February 4th 2016

This is a new segment I want to start for my blog where I discuss an article that we should pay special attention to because it will either (1) influence the way people practice their craft in schools or health care or (2) shift the way you vote based on a candidates knowledge of a particular aspect of their platform. For example, if someone says they are advocates for population health approaches to preventing diabetes but are not familiar with the latest evidence, they may not be the best person to vote for. Knowledge is power. The more knowledge you have for your practice or, more importantly, the knowledge you have when you participate in the democratic process, the more likely it is that our society will grow and evolve into something better than the one we have now.

POPULATION HEALTH INTERVENTIONS: When is comes to population-based initiatives to prevent obesity there are many that governments taut as effective or cost-effective. Rarely do they refer to the science that backs up their claim. For example, in my province of Manitoba we have a policy mandating physical education for grade 11 and 12 students Ontario and Alberta have mandatory daily physical activity (DPA) policies and the Canadian government has policies that reduce the cost of organized sport through a fitness tax credit. Population health interventions are meant to nudge the entire population away from less healthy behaviours/risk and towards a more healthy profile. A new study has tested the theory that a population shift in sugar intake may be an effective approach to preventing obesity and type 2 diabetes.

THE STUDY: A recent publication in the prestigious journal The Lancet that describes a statistical modelling exercise which examined the theory that if we reduced the intake of sugar through drinks by 40% over a 5 year period it would shift the population towards a more healthy profile. The reduction of 40% may be ambitious, but a recent study in Mexico revealed that increasing tax on soda reduced consumption/purchase rates by 12% over one year (see an idiotic globe and mail review of the study here for an alternative interpretation).

THE METHODS: The study took data from two sources: (1) a nationally representative survey of diet profiles of people in the UK and (2) beverage consumption rates from the British Soft Drinks Association. They created a theoretical model that described a collaboration with the industry to lower sugar content within beverages, monitor intake through surveys, praise the industry and the model for achieving targets and increasing regulation if they didn't. The assumption was that (1) a predicted change in weight is associated with actual change in weight (which has been established) and (2) the change in weight would translate into a reduced risk for type 2 diabetes (established here).

WHAT THEY FOUND: Between 2005 and 2013 rates of overweight in the UK increased from 60.5 to 62.1% and average consumption was 272 g per person per day. ~85% of children (n=1900) and 65%  adults (n=~2200) consumed sugar-sweetened drinks daily. Rates of consumption were highest in the poorest households across all age groups. The proposed strategy predicted that daily consumption would reduce daily energy intake by 38kcals. This small reduction would translate into a small 0.4 kg/m2 decline in the average BMI in the population and "This reduction would in turn prevent about 274 000–309 000 incident cases of type 2 diabetes over the subsequent two decades (ie, roughly 15 000 per year)". Importantly, these benefits would be the greatest among the lowest income segment of the population, potentially contributing to a reduction in inequities in obesity and type 2 diabetes that characterized western countries.

WHY IS THIS THE PAPER OF THE WEEK? Working closely with industry and creating policies that result in small nudges or shifts in behaviours could prevent up to 1 million cases of overweight and obesity and protect hundreds of thousands of people from type 2 diabetes. The data provide a model for countries to try an test/validate and hope that small changes can lead to massive shifts in health.

LIMITATION: As this is merely a statistical model it does not prove that this would happen in a real life setting. A gradual reduction of sugar content in drinks may be realistic, but would consumers accept a 40% drop in the sweetness of drinks or progressively move towards less sweet options as was seen in the study in Mexico? Finally the data may be asking a lot of industry who seem reluctant to engage in population health efforts led by government. I suggest we would need some industry champions to be bold and act as role models as Bill/Melinda and Warren have for the poor and less fortunate.

 

 

Great New Video on a Better Model for Addressing Child Obesity in Schools and Clinics

Hello gang.

As you know, I am not a big fan of the narrow view that childhood obesity and type 2 diabetes are simply a function of diet and exercise. Not only does that lead to a perpetuation of weight bias it fails to recognize the complex nature of these conditions and the mental and emotional challenges they face.

A new whiteboard from the team from Trillium Health Partners has addressed this issue. They suggest we apply a S.A.F.E approach to dealing with youth. Promoting SLEEP and ACTIVITY for better emotional health, as well as Family Meals/Forget Pop and recognizing/addressing the EMOTIONAL needs of the child.

Check out the CIHR winning whiteboard video here

Updated Links from Shaping the Future Sessions

Thank you to the Everactive Team for another great conference. Here is the material and links that I promised during my talks

SESSION 1 - Resilience and Obesity:

Science of Resilience Mini-Review

Resilience summary from the Centre for the Developing Child at Harvard

Short videos on resilience and it's determinants

Self Regulation lecture by Dr. Stuart Shanker: 

DON'T BELIEVE THE HYPE: HEALTH NEWS 101

HOW TO SPOT BAD SCIENCE:

http://www.compoundchem.com/wp-content/uploads/2014/04/A-Rough-Guide-to-Spotting-Bad-Science-2015.png

My Favorite Health Blogs/News Outlets:

NPR

The Atlantic

Science Daily (though not always as solid as the two above - be weary) 

Information on latest diet information from systematic reviews

Obesity Offerings is also a great weekly round-up of obesity research with a section on "The Headline vs The Study" Link to blog is here

 

Resilience in Sport

Great Podcast with Dr Mustafa Sarkar hosted by Believeperform.com talking about resilience in sport. Resilience in sport was defined as the ability to maintain performance or even thrive under pressure/adversity in sport. I believe that a number of the elements discussed in the podcast, related to of building and training resilience in sport can be transferred to every day life or the lives of children in schools.

Teachers/Coaches: Some key elements of resilience are innate, like having a positive personality (outlook in life), being optimistic and being hopeful. Importantly, some are also trainable, including the ability to be proactive within ones environment, avoiding negative self talk and be aware, in real time when negative visualization or self talk is happening and turning it around. Other elements that school teachers can easily foster and aligns with Dr. Martin Brokenleg's Circle of Courage is the sense of social support (i.e. belonging).

Researchers - There is a need for a better understanding of how resilience and resilience training influences mental health outcomes. We need more intervention/experimental research to study the effects of promoting/fostering resilience. Very little research on younger athletes, and in my opinion younger people in general

Key learnings:

(1) Resilience is not about getting rid of weaknesses, but developing strengths. Need to focus on what's going well and focusing on strengths. It's not just about being optimistic, elements of realism are important to fostering resilience.

(2) People need to be exposed to adversity, spend time reflecting on it and subsequently learn from it. Take time to reflect on the adversity in order to speed the learning process.

(3) Avoid negative self talk and negative visualization. One thing we can teach youth in schools or living with chronic diseases is to recognize negative self-talk in real time and turn that into positive self-talk, in real time.

http://believeperform.com/audio/podcast-017-dr-mustafa-sarkar-resilience-in-sport/

Follow Dr. Sarkar on Twitter here

His research profile is here

New Resilience Scale

Check out this very nice infographic video clip from the Alberta Family Wellness Initiative   on the concept of resilience. https://vimeo.com/106322359

Great example of Knowledge Translation and beautiful overview of why some youth respond one way to stressors and others in a completely opposite way. Also reinforces the need to develop interventions, programs and supports for youth that are sensitive to their needs, prior experiences and biological disposition. As we have come to learn through years of failed randomized controlled trials in weight loss in clinical settings or schools for example, the variation in the response to interventions says a lot about the importance of creating individualized plans. Recognizing this, programs would be flexible, adaptable and response to a child's needs, particularly for those who live in challenging social environments or have experienced significant adversity early in life.

Whiteboard on Resilience

What makes resilience. Check out this great, 5 minute whiteboard that you can share with colleagues on students. Important lessons to learn when creating spaces that support thriving for children. This applies to health, education and sport. Foster resilience whenever you can.

Youtube clip here.
 

Sage against the Machine!

This is so great and we need way more of this type of journalism in Winnipeg. Check out this ultra-resilient, empowered Indigenous youth, Savvy Simon from the Mi'kmaq Nation on the east coast. Using her traditional language and culture she is spreading "positive vibes" to youth and non-native people about the power of land, culture and language. Thank you Savvy Simon for this great piece! As Wab Kinew says: Everything is Medicine.

Article from the The Coast website based in Halifax here.

Savvy Simon can be found here:

Youtube

Twitter

#SpeakMikmaq

Light of Hope and Resilience in Baltimore

Thanks to my friend Dr. Stasia H for sending me this link. She has an eye and ear for the good stuff, I wish she tweeted more often (insert winking smiley face). Here is a nice personal story of an actor from my favourite TV show, The Wire . If you haven't seen it, you should. Seems as close to the reality of life in streets of Baltimore, that has emerged in the news lately. Intertwined with deep, heart felt scenes of despair, tragedy and humanity, stories of resilience and the series is filled with stories of hope about youth growing up in the streets of West Baltimore. The series provides two sides to the streets, which is very different from the stories that have flashed on news reels daily for the past few weeks.

Actor Sonya Sohn tells her personal story of moving to Baltimore and realizing her desire and potential to be an activist and conduit of hope/resilience in her newly adopted home of Baltimore. Great stuff. I hope The Globe and Mail editors read this and contrast it with their coverage which I thought was one-sided and close-minded. Poverty is not a choice and emerging from poverty is not about "pulling up your boot straps" or having "fire in your belly", it's about creating environments where hop can thrive.

Thumbs up Sonja Sohn,. Thumbs down Craig Offman

NY Times Article here 

Nice lecture on building resilience in your schools

I am always on the hunt for easy-to-use references for teachers/professionals to create hope and resilience to support youth. In the fall of 2014, I was at a conference on child health hosted by CIHR bringing together philanthropists and scientists from across Canada. Dr. Michael Ungar from Dalhousie, the Director of the Resilience Research Centre gave a great presentation.

Key lessons: (1) Shape the environment to provide the support they need; (2) The most disadvantaged youth need the most support (i.e. time, resources, care) and often benefit the most from the efforts you make; (3) earlier interventions are better, but it's never too late to create support; (4) Complex problems require complex solutions - interventions need to be multi-dimensional and include schools, families and the community. and (5) More isn't always better - often times consistency is the key.

 Here is a short clip of his talk about how to create resilience within your school environment:

Dr. Michael Ungar resilience lecture.

Check out his upcoming conference here:

http://resilienceresearch.org/training/conferences/pathways-to-resilience-iii

 

Terry Fox - The Canadian Embodiment of Hope/Resilience

As this blog accumulates stories of hope and resilience, it would not be complete with one of the most inspiring stories of hope in Canadian history. That of Terry Fox. Steve Nash did a short documentary on his Marathon of Hope. Check it out here. Truly epic story of a fearless, self-less 21 year old trying to change the world. If this doesn't help you believe in the power of youth and the next generation, nothing will.

https://www.youtube.com/watch?v=fMbhCEZuWGw
 

Very cool outdoor/land-based resilience program

I recently attended the 3rd Indigenous Child Health Meeting focused on fostering resilience in youth. Mary Jo Wabano the education director at Wikwemikong Health Centre and Dr. Nancy Young a CRC Chair at Laurentian University presented on a new survey they developed by youth, for youth to assess child wellness in the community. Upon googling their information I ran across this great program they developed in  collaboration with Wikwemikong community that used outdoor leadership as a method to foster resilience. Researchers, focus on the methods as they exemplify participatory action research. Everyone else, read the quotes from youth at the end of the slideshow. Quoting Wab Kinew: Everything is Medicine. Land and nature would rank right up there as vital sources of medicine/healing .

Resilience and Well-being through Outdoor Leadership Report

Outdoor Adventure Leadership and Resilience Slideshow

Update: Documentary about the program.

Hope Wins

The Davan Overton Story is something every teacher and administrator needs to see.

"Hope. Everybody should have hope."

http://espn.go.com/video/clip?id=9898489

Thanks for the inspiration Davan.