Every four seconds someone in the world is infected with Mycobacterium tuberculosis, the main organism causing tuberculosis (TB), an infection characterized by persistent cough, fever, weight loss and night sweats. More disturbingly, someone in the world dies of TB every 19 seconds. Here's what you need to know about TB.
1. Most cases of TB in Canada originate outside the country Aboriginals, the homeless and drug users help to make up one-third of TB cases in Canada. The remaining cases are among people who were infected while living in or visiting areas of the world where TB is rampant.
Infection typically occurs when someone with active disease (of the lungs or airways) coughs or sneezes. Following infection, the bacteria are likely to remain walled off in the lungs, where the body keeps the infection at bay -- sometimes for decades -- until age, HIV infection or treatment with drugs that depress the immune system might cause it to break out, says Dr. Edward Ellis, the manager of tuberculosis prevention and control for the Public Health Agency of Canada in Ottawa.
Although TB bacteria mostly attack the lungs, they can also affect bones, joints, lymph nodes and kidneys. The general risk of developing active TB following infection is approximately 10 per cent over a lifetime, but that risk is largely concentrated in the first two years, when there's a five per cent chance of developing active disease.
2. Even those with dormant TB infection should be treated People with active TB (as detected on chest X-ray and skin test) must follow an antibiotic regimen that consists of a minimum of three antibiotics for at least six months. Too often people stop taking their medicine because they're feeling fine. “People start gaining weight, they're sleeping fine without sweating -- and [then] the bacteria come back,&" says Ellis. Not completing the antibiotic course can result in bacteria becoming drug resistant.
People with dormant or latent TB should take an antibiotic, too (experts recommend izoniazid) to prevent the infection from progressing to active TB. “People with latent TB are not infectious to others and they feel fine,&" says Ellis, but if someone tests positive for TB, “why run the risk of having TB in the future when you can take a pill now and virtually eliminate that risk.&" Taken faithfully, anti-TB drugs can cure more than 90 per cent of infections.
3. Everyone who comes into close contact with an infected person needs to be notified and tested for TB Physicians are required to report a person with TB to public health officials, who then attempt to track down that person's recent contacts. For example, if a person diagnosed with TB has been coughing for a month, “we will go back at least one month and assess people he or she has been most in contact with, typically household members and close personal friends,&" says Ellis.
All contacts undergo a chest X-ray and skin test. Anyone who tests positive -- the likelihood depends on how much the index person coughed or sneezed, how much bacteria was in the airborne sputum and how robust the contact individual's immune system was at the time of contact -- will be offered the six-month preventive antibiotic regimen.
4. TB in Canada is rarely fatal In 2005, officials recorded 1,616 new cases of active TB in Canada, and in 2004, there were only 27 deaths from TB. However, the disease is not insignificant: people still get sick with TB, and the disruption they face at work and home can be serious, says Ellis. It also takes six months to treat, and six months on antibiotic therapy is arguably not trivial either, he says.
TB and vaccination No vaccine is available yet to prevent infection with tuberculosis (TB), but there is a vaccine that can limit the spread of the bacteria in young children following infection, and it's being used in areas where the risk of TB infection is high.
If you're travelling to a developing country where there is still a lot of TB, “speak to your doctor about getting the TB skin test when you return,&" advises Dr. Edward Eillis, the manager of tuberculosis control for the Public Health Agency of Canada in Ottawa.
If positive, you should seriously consider taking the antibiotic izoniazid. “If you take it faithfully for at least six months,&" says Ellis, “it will dramatically reduce your chances of developing TB disease in the future.&"
Want an in-demand job with a healthy future? Look no further than the skilled trades in Canada. "There is an incredible amount of opportunity in the trades industry in Canada right now," says Peter Harris, editor-in-chief of Workopolis, who reports on trends and changes in the Canadian job market.
"Trades workers need not be subject to the boom-and-bust cycles of provincial economies, because trades jobs are evergreen and also come with a great deal of freedom of mobility," he says. For example, in every city across the country, homeowners are always looking for reliable, affordable work on their homes: renovation, plumbing, electrical, roofing and more, says Harris.
Positions in the skilled trades offer another bonus: These roles are far more insulated from being sent offshore and to automation, says Harris. "[These are] the two biggest threats to many career paths," he says. Furthermore, Canada faces a shortage of one million tradespeople by 2020, as many people in that field will be retiring, he says. "The average age of welders is 57, and large numbers of trades workers across the board are also into their 50s."
Defining the "best" trade is highly subjective; it depends on where you live and what you consider most valuable: lots of demand, high pay, flexibility to set your own hours or whatever you feel is vital to a good job. That said, based on the job opportunities being posted online in the skilled trades, Harris says the most sought-after employees are in these five vocations.
1. Construction workers Whether it be working on new home construction, infrastructure (like roads) or commercial enterprises, construction workers are in high demand in Canada. Construction is considered a cornerstone of Canadian industry and it represents about seven percent of the Canadian workforce, according to the Canadian Construction Association. While positions may be plentiful, construction work is often seasonal and contract-based.
2. Vehicle repair In the past year, the number of job postings for the mechanic trades has spiked 94 percent over June 2013, says Harris. As anyone who has ever owned a car knows, auto mechanics tend to be perennially busy. According to Human Resources Skills Development Canada, this job is also called automotive service technician, helpful keywords if you're searching for post-secondary education programs, which tend to use this title instead of "car mechanics."
3. Maintenance worker Although maintenance work comprises a very broad array of specialties, these jobs are in high demand across the country, says Harris. Not just hands-on repair (although it can include these skills), maintenance work encompasses operations, planning and information management skills as well. These jobs are posted under a variety of names, such as maintenance technician, maintenance mechanic, maintenance specialist and, of course, maintenance worker.
4. Electricians Electricity is vital to life as we know it in Canada. Licensed electricians lay out, assemble, install, test, troubleshoot and repair electrical wiring, fixtures, control devices and related equipment in buildings and other structures, according to Human Resources and Skills Development Canada. Electricians are highly sought-after in commercial, industrial and residential spheres. There are many positions open with electrical contractors, maintenance companies and industries, and there are also ample self-employment opportunities.
5. Heavy machinery operators (such as a backhoe, bulldozer) Wherever there's a freshly paved road or newly built construction, a heavy machinery operator isn't far behind. Operators work backhoes, bulldozers, graders and other heavy-duty construction vehicles. Another term that describes this trade is heavy equipment operator, which is the terminology post-secondary schools and colleges use to designate program offerings. Like construction work, these roles can be plentiful across the nation, but also tend to be seasonal.
Breathe new life into this wardrobe staple with a bit of style inspiration.
There's a reason why we love the white button-down. Whether it's oversized, fitted, short sleeve, cropped, silk or cotton, it's always a chic—but unfussy—way to embrace classic style. But, like even the most stylish women, we sometimes get stuck in a fashion rut. Which is why we pulled together some great white button-down shirt looks from some seriously stylish women. Discover new and fresh ways to wear a white button-down below.
There's nothing chicer than a casual white button-down shirt under a blazer. Keep the look modern with boyfriend jeans and patent brogues—extra points for embracing metallic.
You can make this borrowed-from-the-boys piece feminine in an old school way by pairing it with a pleated midi skirt and sharp kitten heels.
If you're worried about a white on white look, just remember to play with texture. The silk shirt paired with crisp denim and leather shoes makes this look a winner.
Embrace the menswear vibe of this piece by pairing it with a classic black blazer and trousers—though we might recommend ditching the tie to avoid any waiter confusion.
Keep this piece cozy by topping it with an oversized knit. We especially love the addition of a statement piece of jewellery.
Pair your button-down with tailored separated for the office. A pencil skirt (in a fun print or colour) plus chic heels is a no-brainer when it comes to professional dressing.
This look is for the bold. Pair statement pants and shoes with a white button-down and a classic blazer. Think of this as business on top and party on the bottom.
Put a little prep in your step with trousers, loafers and fun socks. For the extra preppy, add a fisherman knit and drape it over your shoulders. Very refined gentleman, no?
Your hair needs help from your diet, the products you use and even your style choices to stay healthy.
Beauty comes from within—literally. Strengthen your hair by working inside out and ingesting good-for-you ingredients. When it comes to the outside, hair health relies on the right products—and putting down the heat tools.
CALL IN THE REINFORCEMENTS
According to research from hair-growth-supplement brand Viviscal, one in three Canadian women will suffer from hair loss—a life stage we'd rather skip, thanks. Viviscal's now extra-strength oral supplement is formulated with 50 percent more AminoMar C (the active ingredient promoting hair growth) than the original, as well as zinc, iron and vitamin C. Clinical results show noticeable thicker, fuller and healthier looking hair—no wig required.
Put in a solid 30 minutes of hairstyling time early in the week, then use quick styling changes and dry shampoo for the rest of the week. "On Monday, start with tight curls achieved with a curling iron," says Roger Medina, a Toronto-based hairstylist and Garnier Canada ambassador. "Then, on Tuesday, push your hair to the side, and on Wednesday, add a braid. Thursday, put it half up in a bun. By Friday, you might be greasy—remember to use dry shampoo as needed—so brush your hair out and put it in a low pony. Stretching out your wash to last all week saves your hair from heat tools and hot water."
YOU ARE WHAT YOU EAT
Healthy hair starts with your diet. "Hair is predominantly made up of protein," says Casey Berglund, a Calgary-based registered dietician and the owner of worthyandwell.com. "However, it requires fats and micronutrients to be healthy." Consider unprocessed whole foods your best starting point. Healthy proteins (lean meat, eggs, beans, nuts), omega-3s (oily fish, chia seeds, walnuts, tofu) and vitamin B12 (meat, fish, dairy, nutritional yeast) are essential for strong, healthy hair. "When people are malnourished or chronically dieting, hair can appear dull and weak—and even fall out," says Berglund.
BUILD BETTER HAIR
These gel tubes from Nexxus are designed for hair that's been intensively damaged or exposed to harsh treatments, such as double processing (when hair is lightened by more than two shades and it's first bleached to remove pigments, then dyed to achieve the desired shade). They're also great if you have healthy fine hair that needs some responsiveness, says Kevin Mancuso, global creative director for Nexxus. Jam-packed with elastin proteins and marine collagen, the treatment strengthens and improves elasticity while repairing porosity. "Think of it as insulating the hair and rebuilding the cuticle wall from the inside out," says Mancuso. First, shampoo and rinse. Then, cover your hair in one dose of Emergencée Reconstructing Treatment, pressing it into your hair, and let it sit for 10 minutes, until it's almost hardened. Next, shampoo out the treatment and use a hair mask or conditioner.
Here are some scary truths: 70 percent of new Alzheimer's patients in Canada will be women, and we're diagnosed with depression and dementia at twice the rate of men. But new research says there are three simple lifestyle changes we can make right now to keep our brains healthy as we age.
You brush your teeth to prevent tooth decay and check your blood pressure to monitor for signs of heart problems. But are you doing anything to keep your brain in tip-top shape? Because you should be. Brain health, which experts define as a combination of cognitive (memory, attention, thinking) and mental (emotional well-being) fitness, is a major, albeit under-the- radar, health issue for Canadian women.
It's major because as we age, so do our brains. Vascular changes can decrease blood flow; we can lose volume in key areas, including the hippocampus and the prefrontal cortex, the regions responsible for learning and memory. Myelin, a fatty material that makes up the protective coating around nerve fibres, starts to deteriorate, causing the brain to slow down. And nerve cells can develop plaques and tangles— structures caused by the buildup of proteins called beta-amyloids that can disrupt the brain's normal function. In some people, these and other signs of normal aging can cause mental health problems, strokes and brain disorders such as dementia and Alzheimer's, and increase the risk of diseases such as multiple sclerosis.
Brain health is an under-the-radar issue because, though women are more likely to experience cognitive decline (thanks to dementia or Alzheimer's) and to suffer from depression, most of the research on these conditions still focuses on men.
Thankfully, studies are showing that straightforward lifestyle changes—exercising regularly and not smoking are at the top of the list—help shore up what researchers call "cognitive reserve," a buffer that "delays the changes or makes your body better equipped to handle those changes," says Lauren Drogos, a brain researcher at the University of Calgary.
In fact, Drogos says there's evidence to show that, in some people, even serious symptoms do not necessarily develop into cognitive impairment. She points to the Nun Study, a famous long-running research project on aging and Alzheimer's that has been tracking 678 nuns from convents across the United States since the mid-1980s. One of the nuns, Sister Mary, died at the age of 101 showing no outward signs of cognitive decline—but when researchers examined her brain, they were shocked to find she had "abundant neurofibrillary tangles and senile plaques, the classic lesions of Alzheimer's disease." Scientists don't know exactly why some people can have severe symptoms, such as plaques and tangles, without experiencing cognitive decline, but, happily, cases like Sister Mary do show that dementia isn't an inevitable part of aging.
And since women are more likely than men to be diagnosed with many of these problems, the more we consider brain health when making our day-to-day lifestyle decisions, the better. (Bonus: These changes also benefit your heart and help prevent other diseases, including Type 2 diabetes and cancer.) So here's what you can do to take care of your brain.
This is your brain on exercise If you had to pick just one lifestyle change to make in the name of brain health, experts agree exercise tops the list—especially for women.
We consider neuroplasticity, the brain's capacity to form new neural connections, an exciting part of a child's development, but we now know our brains can continue to grow, repair and improve as adults, too. Physical activity is a well-researched trigger. Not only can working out bolster our day-to-day functioning and alertness but it also appears to help us repair brain damage. Plus, it slows down aging and the onset of age-related brain diseases.
Working up a sweat and pumping up your heart rate can lead to a healthier vascular system in the brain, which decreases blood pressure and oxidative stress (when your body's antioxidants can't fight off free radicals), and increases antioxidant activity, according to Marc Poulin, an Alzheimer's researcher and professor of physiology at the University of Calgary. Vigorous exercise also floods the bloodstream with a protein called brain-derived neurotrophic factor, which readies the body for repair and heightens the brain's ability to learn and form new memories. Plus, hitting the gym helps the brain repair myelin; a lack of the nerve fibre–protecting substance is a factor in developing multiple sclerosis.
Exercising can also restore crucial brain volume. Research has shown that the hippocampus— home to memory, learning and emotion—starts shrinking after age 55 by about one to two percent a year, but just one year of moderate-intensity aerobic exercise done three days a week can increase its size by two percent.
And while most of the research is about the benefits of getting in your cardio, Dr. Teresa Liu-Ambrose, an associate professor and Canada research chair at The University of British Columbia and the Vancouver Coastal Health Research Institute, says strength training is also effective, as it can enhance brain performance and function by 11 to 17 percent. "Women live longer [than men], and age itself is the greatest risk factor for dementia," she says. "But the good news is when we look at the benefit of aerobic exercise on cognition in older adults, women seem to benefit more."
The takeaway: You can reap the rewards from even a 15-minute walk. Of course, the longer you exercise, the better, especially if you get your sweat on and your heart rate up. If you want to tick a few other brain health tips off your list, consider joining a team sport. It blends physical, social and cognitive skills, and "can also add pleasure and meaning to our lives," says Dr. Nasreen Khatri, a registered clinical psychologist, gerontologist and neuroscientist at the Rotman Research Institute at Baycrest Health Sciences in Toronto.
If you have an office job and find you're sedentary most of the day, take a few minutes every hour or so to get up and move around. Research also suggests switching to a standup desk may improve your brain function.
Did you know? Taking care of a loved one—most often a spouse in your later years—can be a risk factor for developing depression and, eventually, dementia . But research out of the Rotman Research Institute at Baycrest Health Sciences in Toronto found, for the first time, that cognitive behavioural therapy, a form of talk therapy, can improve both mood and cognition.
This is your brain on sleep After a good night's sleep, you feel alert and ready to tackle the day. But that's not just because your brain has been resting. It has also been busy filing away memories and taking out the trash, so to speak, thanks to the glymphatic system, which washes the brain of waste materials. For example, a protein called betaamyloid, which is known to play a role in the development of Alzheimer's, acts as a neurotoxin when it builds up, killing neural cells in the brain. But a good sleep removes excess beta-amyloid and other waste materials, says Dr. Liu-Ambrose.
Because one of the common symptoms of Alzheimer's is disrupted sleep, it's unclear whether a lack of shut-eye should be considered part of the progression of the disease or a risk factor on its own, due to the buildup of beta-amyloids.
Nevertheless, poor sleep hastens your brain's aging process—much like sitting in the sun sans SPF speeds up your skin's aging process. And disturbed sleeping has been linked to all aspects of brain health, including an increased risk of depression and a decline in cognitive functions such as memory and reasoning. In one U.K. study out of University College London Medical School, middle-aged women who reported a drop in the average number of hours they slept had lower scores on cognitive tests involving reasoning and vocabulary.
What's more, our central clocks—a.k.a. our circadian rhythms—can drift from the patterns of our childhood, making it hard to get that much-needed rest. "As we age, our central clock is less sensitive to stimuli like light, food and physical activity," says Dr. Liu-Ambrose; this change makes it harder to fall, and stay, asleep. We can also become more vulnerable to stress and anxiety, which further disrupt those rhythms.
One way to combat these fluctuations is to try what seasoned travellers do for jet-lag recovery: Get exposure to real daylight and eat your meals on time to nudge your brain into a routine. And don't use bright screens at night, especially before bed, because they mimic sunlight and tell our circadian system that it's day, not night—and, therefore, not time to sleep. Those who need more help might consider light therapies that have been developed to treat seasonal affective disorder, says Dr. Liu-Ambrose.
The takeaway: Many researchers consider six to eight hours of sleep a night to be the standard sweet spot, though this can vary by individual. If you're routinely getting less than that and waking often in the night, not feeling refreshed in the morning and experiencing bouts of sleepiness during the day, talk to your doctor about sleep strategies—especially if you're experiencing anxiety or depression. In the short term, napping can reverse some of the effects of poor sleep, including memory loss and increased stress. And you only need a 30-minute catnap to feel the results.
This is your brain on a healthy diet There's no perfect "brain food," but eating a nutritious diet (lots of veggies and fruit, lean meat, fish and healthy fats) is the smartest way to maintain long-term brain function and memory, and to slow the development of brain diseases.
Getting enough of specific nutrients like omega-3 fatty acids is important but not the holy grail. University of Pittsburgh researchers recently found that people who eat broiled or baked fish at least once a week have larger brain volumes in the areas used for memory and cognition, despite varying levels of omega-3 in the fish they ate. Senior researcher James Becker concluded that he and his colleagues were "tapping into a more general set of lifestyle factors that were affecting brain health, of which diet is just one part."
In a 2015 study from Rush University Medical Center in Chicago, researchers looked at the broad set of eating habits of more than 900 people over 4 1/2 years and found that those who adhered to a diet high in fish, vegetables, nuts and berries, and low in fat and sugar, slowed down their brains' aging by about 7 1/2 years when compared to those with less-healthy diets. The healthy eaters cut their risk of Alzheimer's by up to 53 percent. And even when those people only adhered to the diet part time, they saw some benefits— an effect that has not been found in other diets, says Drogos.
The researchers dubbed the most promising cluster of these eating habits the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, which blends the longevity-boosting Mediterranean diet and the heart-healthy low-fat DASH (Dietary Approaches to Stop Hypertension) diet that doctors recommend to patients at risk of high blood pressure and heart disease. More studies need to be done on why it works, but in the meantime, there's no downside to eating healthier and ditching the junk.
The takeaway: Add more veggies to your diet. Research shows that older adults who report eating more of this food group perform better in mentally stimulating activities than those who don't.
Did you know? "Menopause brain" is a real thing. As with "pregnancy brain," its more famous counterpart, women approaching menopause really do experience memory problems and brain fog. Researchers think a drop in estrogen levels might be the cause.
Can you train your brain? Does firing up a brain-training app actually help improve your memory and ward off dementia? Sorry to disappoint, but right now, evidence for the benefits of computer-based brain games is weak, says Dr. Teresa Liu-Ambrose, an associate professor and Canada research chair at The University of British Columbia and the Vancouver Coastal HealthResearch Institute. Brain games appear to help you learn to play them better, but research doesn't show that those tasks transfer to other aspects of brain performance. The same goes for crossword puzzles and sudoku, which help your vocabulary and math skills, but nothing more.
How to maintain your mental edge at any age
In your 30s: This is the time to make sure you establish healthy habits—such as getting plenty of exercise and sleep, and eating a good diet—that will affect your brain health throughout your adult years. "When it comes to maintaining brain health, the best time to start is yesterday," says Dr. Nasreen Khatri, a registered clinical psychologist, gerontologist and neuroscientist at the Rotman Research Institute at Baycrest Health Sciences in Toronto. If you feel you need a boost at work, consider old-fashioned writing instead of typing on your computer. A study in the journal Psychological Science found that university students who made handwritten notes were better equipped to recall conceptual ideas from their professors' lectures than those who had typed notes on their laptops.
In your 40s and 50s: People in this age group are part of the "sandwich generation," and often face caring for their aging parents on top of dealing with their other work, financial and parenting obligations. So, unsurprisingly, they're super stressed—and this can affect both mental health and day-to-day brain function. Dr. Khatri says it's essential to prioritize and edit out activities and commitments that increase stress without adding value to your productivity or happiness. That's because "maintaining mental health in early and mid life is key to safeguarding cognitive health later on," she says. "Untreated depression in midlife doubles your risk of developing dementia in later life."
In your 60s and beyond: In your senior years, socializing with friends and family, and picking up activities that allow you to connect, such as volunteering, are key to maintaining brain health. And sorry, keeping up with folks on Facebook isn't enough. "Ask yourself: Is social media rounding out my real-life social experiences?" suggests Dr. Khatri. What you need is face-to-face interaction.