health – Jewish Independent

Complexities of autism

Israeli neuroscientist Dr. Ilan Dinstein was in Vancouver last month to talk about autism research. (photo by Adele Lewin)

Neuroscientist Dr. Ilan Dinstein was in Vancouver last month to share research and expand knowledge on best practices internationally. An associate professor of psychology and cognitive and brain sciences at Ben-Gurion University of the Negev (BGU), Dinstein is the director of the new National Autism Research Centre (NAC) in Israel.

David Berson, executive director of the Canadian Associates of BGU for British Columbia and Alberta, told the Independent: “CABGU was delighted to be a part of hosting Dr Ilan Dinstein in Metro Vancouver. This visit was spearheaded by Dr. Grace Iarocci, Dr. Elina Birmingham and Dr. Sam Doesburg from SFU [Simon Fraser University] and Dr. Tim Oberlander from B.C. Children’s Hospital.

“Ilan Dinstein is a true reflection of the pioneering spirit that is unique to the Negev region of Israel, where, over the past five years, clinicians from Soroka University Medical Centre and researchers from Ben-Gurion University of the Negev have organically come together to collaborate for the betterment of all of the residents with ASD [autism spectrum disorder] in the region.”

Dinstein spoke with the Independent about the new centre and the purpose of his visit to Canada.

“We started the centre five years ago, to try to understand different causes of autism,” he said. “Autism is not one disorder. There are different sub-types of autism, with different possible roots and risk factors. Some of those factors are biological or genetic; others might be environmental. For example, a premature birth might be a risk factor in the child developing autism. Or the age of the parents – a child of older parents might have a higher risk of autism diagnosis than if the same parents were younger. We at the centre are trying to discover how the combination of genetic and environmental issues affects autism development.”

According to Dinstein, one of the reasons for the creation of the centre was the way science is funded in Israel. “The funding usually comes for one specific question,” he explained, “but autism is a complex, systematic disorder and it needs many facets of study, measurement and research; it needs collaboration and sharing of information. At the centre, we are able to combine different fields of study with the clinical applications, as we work together with the Soroka medical centre.”

The scientists of the NAC study autistic patients from different multidisciplinary angles: neuroscience and cellular biology, language pathology and motor tracking, even facial features.

“The truly unique thing is that we do all our studies inside the hospital,” Dinstein said. “Parents come in with their children, usually when the children are about 3 years old and the parents and the children’s teachers notice the kids’ uncommon behavioural patterns. The diagnosis of autism usually takes four visits. During those visits, we work in collaboration with the doctors, measuring various characteristics of the child’s development to arrive at the right diagnosis.

“We also started a database of all our patients, so we have a centralized well of knowledge about how various biological, cultural and social factors might contribute to autism development.”

Of course, not all of the parents agree to have their child added to the database, but Dinstein said that their recruitment rate is about 80%.

After the diagnosis, the scientists participate in determining a personalized treatment program, based on their research. “Such a program might include teaching the children useful behavioural habits, helping them with language acquisition or providing occupational therapy,” explained Dinstein. “Some autistic kids are very agitated and certain motions, like spinning, might calm them down. Sometimes, autistic children need to learn basic skills: how to dress themselves or brush their teeth.”

Pharmaceuticals can also help children cope with autism, but Dinstein said that only about 10% of patients use medications.

At the NAC, the scientists don’t treat patients, but rather study and make recommendations, develop new technologies and new methods of dealing with the disorder. Working together with clinical professionals, they hope to contribute to a higher rate of success in treatment.

One of the most important aspects of Dinstein’s and his colleagues’ work is an annual follow-up on the patients in the database. Families are required to come back once a year after the initial diagnosis, so the service providers can see their progress, determine what worked and what didn’t, and adjust their recommendations accordingly.

“We are still in the process of enlarging this project,” said Dinstein. “We want to open other locations in Israel, make our database to cover the entire state of Israel.”

The centre’s autism research, in particular its database of patients with autism, inspired interest locally, from scientists and clinicians to families and service providers. The invitation for Dinstein to visit Vancouver came from a range of people.

“Your researchers want to create a similar database to ours, Canada-wide,” said Dinstein about his presentation at the Children’s Hospital. “I met with scientists from UBC [University of British Columbia] and SFU, even some from Victoria. I also met medical professionals, parents, some service providers and stakeholders. I see these meetings as the beginning of a close relationship between autism research in Israel and in Canada. There are similarities there, but there are differences, too. Both countries have different ethnic maps, cultural traditions and genetic variations. We all want to know how such diversity affects autism.”

Olga Livshin is a Vancouver freelance writer. She can be reached at [email protected].

Looking for a family doctor?

Arthur and Anna Wolak opened King Edward Medical Centre on Sept. 16. (photo from KEMC)

The King Edward Medical Centre, a full-service family practice in Vancouver offering comprehensive primary care, officially opened its doors on Sept. 16.

Located in King Edward Mall (at Oak Street), the centre was launched by physician Dr. Anna Wolak and her husband Arthur Wolak, PhD. It is open to individuals and families throughout the Greater Vancouver area.

Longstanding and active participants in the community, the Wolaks believe this is an opportune time to help those lacking a doctor.

“Given there are so many people without family doctors – and there will be more soon, as there is a slate of family doctors who will be retiring within the next few months – people will be looking for a family physician,” said Arthur Wolak, executive director of the medical centre.

Anna Wolak is a family physician and clinical assistant professor of family medicine at the University of British Columbia. Fluent in English and Filipino, her practice focuses on all ages.

She studied medicine at the University of the Philippines in Manila, the University of Texas MD Anderson Cancer Centre in Houston and the University of Adelaide in Australia. In 2007, upon completing her training in family medicine at the Royal Adelaide Hospital and the Modbury Public Hospital, also in Australia, she moved to Canada.

Before practising in Vancouver in 2009, Wolak had a large family practice in Osoyoos, and was an emergency room doctor at the South Okanagan General Hospital in Oliver.

She also has been active in medical education, having served on the planning committees of major medical conferences and programs. She spent many years as an active parent class representative at both the Jewish Community Centre of Greater Vancouver preschool and in various grades at Vancouver Talmud Torah.

In 2014, RBC selected her as one of the top 25 immigrants to the country for demonstrating “strong leadership within the medical community.”

“Despite my extensive medical background, I needed the support of an experienced businessperson to pursue this endeavour, as medical training doesn’t include business training,” she told the Independent. “My husband has the skills that I lack. Together, we decided that we could establish a medical centre in the heart of the local community that would fill a great need, as Vancouver is desperate for primary care physicians.”

An entrepreneur and writer who holds several university degrees, including a master’s in business administration, a doctorate in management and a master’s in Jewish studies, Arthur Wolak is the author of numerous articles and books on a wide range of issues, the most recent being The Development of Managerial Culture (Palgrave Macmillan) and Religion and Contemporary Management (Anthem Press).

Born and raised in Vancouver, he is also the president of CMI Chat Media, a marketing company he co-founded with his brother, Richard Wolak.

For his part, Wolak is very excited to serve as the executive director of King Edward Medical Centre, managing the many administrative aspects of the growing office. He had the idea for several years and, with their three children now all in school at Vancouver Talmud Torah, he convinced his wife that this was the time to create a place that would benefit the community.

“My father, Dr. Edward Wolak, was a physician and I was brought up with an understanding of the importance of helping people. It was a natural fit for me, even though my academic and professional background, though very broad, was not medical. Anna has the medical skills. I bring other skills to the centre,” he said.

His mother, Elizabeth Wolak, was renowned as both a music teacher and choral conductor, having established and led Jewish choirs in Vancouver for nearly 50 years. She was awarded the B.C. Community Achievement Award and the Queen Elizabeth II Diamond Jubilee Medal for her Jewish choral work in Canada.

Both his parents were Holocaust survivors from Poland.

Over the years, Arthur Wolak has been active in various Jewish organizations. He was treasurer of the Western Association of Holocaust Survivors – Families and Friends, on the advisory board of Vancouver’s Melton School of Adult Jewish Learning (an initiative of the Hebrew University) and on the planning committee of the Vancouver Jewish Film Festival. He is presently a member of the board of governors of Gratz College, the oldest independent and pluralistic college for Jewish studies in North America, situated in suburban Philadelphia.

King Edward Medical Centre is currently accepting new patients. The website is kemedical.ca.

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

Wonderful night of honours

Jewish Seniors Alliance’s first silent auction, which offered a selection of close to 30 items, from gift certificates from local businesses to paintings and prints. (photo by Susan Curtis)

How do you say thank you to individuals who strive to better the lives of people in the community? Jewish Seniors Alliance’s answer is an appreciation dinner, part of its annual general meeting, which comprises a tribute to three conscientious community personalities. As well, at this year’s AGM on Sept. 19, thanks were given to outgoing JSA president Ken Levitt and new co-presidents Gyda Chud and Larry Shapiro were welcomed.

Levitt’s leadership was praised by Shapiro, who noted the outgoing president’s “ever-present love of life, which inspires everyone and brings out the best in each person whom he meets.”

Chud read a poem, “Captain Ken,” written by JSA honourary life member Binny Goldman. It noted: “You listened with your ear and understood with your heart. Your experience, knowledge and judgment always saw us through successfully – you are a leader, a man above most men.”

Anne Kang, MLA for Burnaby-Deer Lake, spoke about the ongoing efforts of the B.C. government on seniors’ issues, including improved long-term care assistance and training of care workers, and the overseeing of buildings and streets, to ensure that they are accessible and safer for seniors.

Emcee Jack Altman began the honouree ceremony with a tribute to Tzvia Estrin, who was nominated by Yaffa House.

Estrin’s son Avie, who is the current president of Yaffa House, recounted the efforts of his mother and late father Aaron, who worked for 10 years to establish Yaffa House. It opened in 2001 as Western Canada’s first home dedicated to housing community members with mental illness in the context of a Jewish living environment, including kosher food. He said his mother continues full-throttle, being at Yaffa House every day, usually at 6:30 a.m. And he emphasized that “nobody could have achieved what Tzvia has attained and continues to do for the most vulnerable segment of our own community.”

Yaffa House presently oversees four homes across the city, including a newly opened women’s facility. Its mandate is to provide permanent non-transitional housing and has in-house support. It takes people off the streets and tries to keep them off the streets.

Tzvia Estrin thanked everyone and read the poem “Don’t Turn Your Back,” which emphasizes the importance of taking the time to compassionately listen to others’ needs and to help them as lovingly as one is able.

Cindy Charkow, a director of Yaffa House, noted the outstanding, much-needed service that the facility provides and stressed that, “without Tzvia, there wouldn’t be a Yaffa House.”

The second honouree, Jack Wizenberg, was recognized for his work with Tikva Housing Society, which helps lower-income Jewish people find affordable housing. He said, “Seeing Jewish individuals and families who are alone, struggling and having to rely on social insurance and the food bank to survive, touches my heart.”

Wizenberg served on the Tikva board for six years, bringing to the position his 41 years’ experience in property management, as well as a lifelong involvement in a range of Jewish organizations and causes in Calgary, Edmonton and Vancouver.

He said he felt “extremely moved” when reading a Jewish Federation of Greater Vancouver housing needs study indicating that, in 2015, 16% of the Jewish population in Greater Vancouver were living below the poverty line “and, in all likelihood, those numbers have increased over the last four years.” He emphasized that things beyond their control prevented these people from working and, in a blink of an eye, they found themselves in need and relying on social assistance to survive.

Wizenberg began his service at Tikva helping with maintenance and tenant issues at Dany Guincher House. Since the first 11-suite apartment building in Marpole was purchased in 2008, he said, Tikva has made available 18 units of mixed single and family housing in the Diamond Residences in Richmond and another 32 family townhouses will be available in the Ben and Esther Dayson Residences in Vancouver’s Fraserview area. Last year, 100 individuals were helped by the Esther Dayson Subsidy Program, which provided those in need with adequate funds to allow them to continue living in their current accommodations.

Tikva president Shelley Karrel said Wizenberg seemed to have a passion for property management and often joined the property management and/or fire-safety group when doing walkthroughs to evaluate building conditions and the need for repairs. His positions have included treasurer, building committee head and acquisitions committee head.

“He was always seeking to ensure the best for Tikva, the buildings and its tenants,” said Karrel. “He is a person who respects others, is very organized and is a great team player. We are blessed to have Jack as a board member and friend.”

Evening honouree , whose tenor singing voice has brought joy to countless individuals and organizations throughout the Jewish and general communities for more than six decades, was introduced by JSA president emeritus Serge Haber.

“We’re honouring people who love community,” said Haber. “Maurice has helped seniors so very much by enthusiastically and nobly giving his special talents, his outstanding voice to the community, and particularly to seniors. Your father, George Moses, a celebrated rabbi/cantor in Bangalore, India, would have been most proud of you. Without question, you are most deserving of this honour.”

Moses spoke of the pleasure he receives by entertaining, and especially in doing so for senior citizens, emphasizing that “our precious seniors should not be ignored and they should be entertained and respected for their countless contributions to life in the community. The only way that I can thank seniors for all they have done is through my singing. It gives me great satisfaction to see their smiling faces, their faces lighting up when I see them react to a song familiar to them.”

Moses shared some of his many religious/concert participations for seniors, including singing for 17 years at Shabbat services at Louis Brier Home and Hospital. He has sung with the Jewish Community Centre Choir, the Shiron Singers, with Elizabeth Wolak and Muriel Morris, and the Rinat Ensemble, all of which performed for seniors. He also has produced a Vision TV show, Let’s Sing Again, which featured a popular tunes sing-along aiming to revive seniors’ nostalgic memories.

He has sung and danced for the past 10 years with the seniors’ concert group Showtime, which is produced by Beryl Israel, as well as with the Vancouver Jewish Men’s Choir (VJMC), the Kol Simcha Choir (composed of members from all synagogues), at Temple Sholom services with Cantor Emeritus Arthur Guttman, at Beth Hamidrash, at Beth Tikvah Synagogue and at Chabad Richmond with Cantor Steve Levin. He is an active participant with the Choir of the Performing Arts Lodge (PAL), which stages a variety of special shows for community seniors.

Moses said his enduring love for seniors was developed by his interactions with the late Beth Israel Cantor Murray Nixon, who constantly stressed the importance of treating older people with respect.

“I am so pleased,” said Moses, “that this evening is taking place at Beth Israel, truly ‘my home away from home,’ where I served in the synagogue’s choir for 66 years under seven different cantors and six different rabbis – and with Pucky Pelman, my mentor for 45 years.”

Moses expressed appreciation to his “guest of honour,” his daughter Melissa, “who has been by my side through three bouts of cancer, making me drink lots of water, eat healthy foods, and go on long walks at the Southlands.”

He gave “a most sincere thank you” to a number of people: Arnold Selwyn, his “35-year wonderful partner in song”; Morris, a pianist with whom he has performed for 55 years; Miriam Breitman, with the Rinat Ensemble and now the PAL chorus, and PAL co-founder Bill Harvey; Binny Goldman, for her help at Louis Brier services; Stan Shear, VJMC musical director; Cantor Yaacov Orzech with the Kol Simcha Choir; and Jonathan Berkowitz of BI’s Purim Shpiel.”

He ended by singing “Let’s Sing Again” and, with Selwyn, Adon Olam.

A video on JSA’s outreach and peer support activities, produced by Cory Bretz of Heirloom Films, was screened, followed by the JSA’s first silent auction, which offered a selection of close to 30 items, from gift certificates from local businesses to paintings and prints.

The event was co-chaired by Tammi Belfer and Larry Shapiro, with committee members Tamara Frankel, Helene Rosen, Marshall and Marilyn Berger, and JSA staff Elizabeth Azeroual and Rita Propp. Catering was provided by Nava Creative Cuisine; the photographer was Susan Curtis.

Bob Markin is a longtime Jewish Seniors Alliance supporter.

Billinkoff runs in record time

With Lou Billinkoff, fourth from the left, are, from left to right, his grandson Asher, grandson Jordan, wife Ruth, son Errol, grandson Mitchell, son Lorne and daughter-in-law Marilyn. (photo from Lou Billinkoff)

Growing up in Winnipeg’s North End, Lou Billinkoff, 96, was never into sports, though, in his 20s, he did enjoy going for a jog once in awhile. Today, he is one of the fastest short-distance runners in his age group.

“I used to do some running but I never thought of it as competitive,” Billinkoff told the Independent. “I just ran for the pleasure of it when I was younger.”

Billinkoff worked as an engineer with Winnipeg Hydro (now called Manitoba Hydro) for 40 years, designing power lines. When he was well into retirement, at the age of 89, he had a heart attack.

“When I was recovering, the doctor suggested I take some rehab physical therapy at a centre they have here, a program specially suited for people recovering from heart attacks,” said Billinkoff. “Part of the program is to walk on a track. I did that for maybe a year and, when I recalled how much pleasure I got when I ran earlier in life, I thought I’d just try it out and see what I still could do.”

The first time Billinkoff tried, he could only run 40 metres but, more importantly, he liked it. Two days later, he ran 45 metres, and kept on adding distance with each try. Eventually, he was running well over 100 metres and loving it. So, he decided to set up a training program and reached the point at which he could run 100 metres 10 times in one session – a feat he refers to as “running a kilometre.”

“I did that for about two years,” said Billinkoff. “After that, I found it was getting too hard, so I went down to five times 100. Gradually, I found this too was getting too hard, so this past year or two, I’ve been running 50 metres.

“When I was running the 100 metres, my son, Errol, clocked me and said, ‘You know, you’re running in championship speed rankings?’ This was a surprise to me. Errol suggested I get into competition. I wasn’t really interested to pursue it, but Errol entered me into a competition here and, the first time I ran, I ran quite well.”

Nowadays, Billinkoff runs 50 metres three times per workout session at the Reh-Fit Centre, where he goes three times a week. While he ran outdoors when he was younger, he feels that, at his age, it is wiser to run at the centre.

“Going outside has limitations,” he said. “The weather is not always good. You can fall and break your neck and nobody would see you. It’s not a good idea to be running outside.”

Once Billinkoff hit the competitive circuit, he began sending his running times to Athletics Canada.

“The way the rankings work is that age groups go in five-year periods,” he explained. “So, when I started out, I was in the age group of 90-94. They call that the M90. Now that I’m 96, for the last year and this year, I’m in the M95 group, which is 95 to 99.

“In the M90 group, I had the fastest time in Canada, at 29.73 seconds. And, in the M95 group, in the 50-metre record, my time indoors was 14.58 seconds; a good speed. Later, I ran the outdoor in 15.68 seconds, and I had strong wind against me. It took me a second longer and I attribute that to the wind.”

image - Lou Billinkoff has set running records

Lou Billinkoff has set running records. (images from Lou Billinkoff)

In most races, Billinkoff has been the only runner in his age category, often running with people half his age.

“There are so few people my age running that you very seldom – unless you live in New York or Chicago – get more than three or four people running in my age group,” said Billinkoff. “I don’t think it’s worth the effort for me to spend several days of discomfort and hardship [traveling] to run for a couple of seconds. They have a Canadian registry where all the Canadians who are competitors send in their results and they set up their rankings. Then, they send it to a world organization that sets up the rankings throughout the world.”

A few years ago, Billinkoff hired a coach for a few months. “He gave me some tips about getting away fast from the start,” said Billinkoff. “And he explained that running is just as much psychological as it is physical. He helped me, psychologically, to have confidence, and that’s very important.”

For now, Billinkoff is keeping up with his training, hoping to compete again next summer. He will continue to do so, he said, “as long as I’m able, and I get pleasure out of it.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Jewish women in West

When Jeanne Abrams told a friend she was planning to do her doctorate dissertation on an aspect of Colorado Jewish history, her friend replied, “What a wonderful idea! You’ll hardly have any work to do.” She proved wrong.

“While I was researching my dissertation and finishing up my PhD, I visited the Beck Archives of Rocky Mountain Jewish History at the University of Denver,” Abrams told the Independent. “The director, when she retired, asked me to interview for the job. The rest is history. As director of the Beck Archives, one of my tasks was to become an expert on Western American Jews, and that’s how the book came about,” she said, referring to Jewish Women Pioneering the Frontier Trail: A History in the American West (New York University Press, 2006).

“I’ve always had an interest in American Jewish women, and found there were some differences that I wanted to point out, and that Jewish women played a very important part in settling and developing Jewish communities in the American West,” she said.

Abrams herself was born to Holocaust survivor parents in Stockholm, Sweden. Sheltered there after the war by the Swedish Red Cross, her family moved to the United States when Abrams was less than a year old.

Through her research, she has learned that, in the United States, while Jewish men were very involved in city and organization building, it was often left to the women to develop religious continuity and community.

She said Jewish women “were in the forefront of founding synagogues, keeping Jewish tradition alive in the home, and they also branched out in many areas – particularly strong in philanthropy and charitable enterprises. At the same time, because of a combination of factors, including the more open environment in the West and that kind of spirit of adventure, Jewish women also really ventured into professions, into higher education.

“I think this environment in the West made this area of the country different for Jews in general. I certainly don’t want to suggest that there was no antisemitism in the West but … [Jews] were more prominently accepted into general society, so American Western Jews, men and women … were often leaders in both the general community and the Jewish community simultaneously.”

Throughout Denver’s history, there have been many endeavours that have involved people of different faiths. As an example, Abrams cited the Denver Charity Organization Society, which was organized in 1887 by a Jewish woman, a rabbi, a Catholic priest and a Protestant minister. The society evolved into what is now known as the United Way.

“Jewish women were also in the forefront of political life here in many ways, and I don’t think that most people realize that women voted in the West long before they did on the East Coast…. We’re coming up to the 100th anniversary of the amendment that allowed women to vote in the U.S.,” said Abrams. “In 1893, women were already voting in Denver. It was the largest city in the U.S. in which women could vote. I think people often think of women’s suffrage with the East Coast, New York, and minimize the amount of influence that early suffragettes had in California, here in Colorado, and in many other cities.”

In 1899, the National Jewish Hospital was founded as a place for people with tuberculosis. It drew patients and staff from all over the country, and was funded by people all over the country. According to Abrams, this was likely one of the first national Jewish organizations to hire a Jewish woman in the role of executive director, in 1911.

While Abrams’ research has primarily focused on Denver’s Jewish population, she also has come across parallels in Canada.

“We know Jews have a very long tradition of philanthropy and social justice. I found that across the border as well,” said Abrams. “But, in terms of the hospitals, when I studied them, I’d say, in Denver, the two Jewish sanatoriums actually had more interaction by women than I saw in Montreal.”

With her book, Abrams wanted to impart a sense of appreciation for women in the American West – of them having been leaders.

“They’ve often been overlooked, because historians tend to be very East Coast-centric,” she said. “I think that people generally seem to be surprised that there are Jews living out in the West. If they thought of anyone, they had the stereotype of cowboys living there.”

While more people associate Denver with the gold rush, Abrams noted that more people actually came to Colorado in search of health than wealth, specifically referring to the tuberculosis treatments available.

These days, Abrams has mainly been studying early American history. Her most recent book was, she said, “on America’s first three ladies. It’s called First Ladies of the Republic: Martha Washington, Abigail Adams, Dolley Madison and the Creation of an Iconic American Role. I’ve moved back and forth, but I’ve enjoyed the different topics I’ve covered.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Using AI in health care

Prof. Yuval Shahar, left, and David Berson with Dr. Rachael Ritchie of Vancouver Coastal Health. (photo by Shula Klinger)

The use of artificial intelligence is intended “to harness the power of computers with math and statistics theory to improve the diagnosis and care of patients,” according to Dr. Yuval Shahar, professor of Ben-Gurion University of the Negev’s software and information systems engineering department.

Between May 23 and 30, Canadian Associates of BGU, B.C. and Alberta Region, hosted a visit from Shahar, whose research explores how information technologies can be used to improve numerous aspects of healthcare.

Shahar has spent 30 years working in digital medicine, gained his bachelor and medical degrees from the Hebrew University, and a master’s in computer science from Yale University. He did his doctorate at Stanford University, where he also spent 10 years as a faculty member in the computer science and medicine department. He founded BGU’s Medical Informatics Research Centre in 2000 and, in 2017, was elected as a founding member of the International Academy of Health Sciences Informatics.

During his time in Vancouver, Shahar presented his work to full lecture halls across town, including at Simon Fraser University, University of British Columbia, various government offices, Vancouver General Hospital, Pacific Blue Cross and some start-ups.

The program with which Shahar works requires patients to wear an ECG (echocardiographic) belt around their chest to monitor their heart, as well as a blood pressure cuff. This allows a patient to receive care 24 hours a day. Using Bluetooth, the data collected from these devices are sent to the patient’s cellphone and then to the program’s server in Israel.

MobiGuide was developed with 13 partners in Europe, including Italy, Spain, the Netherlands and Austria. Even with 63 other projects competing for funding – including teams at Oxford and Cambridge universities – the MobiGuide team received seven million euros. “Ben-Gurion already had the necessary technology working,” said Shahar.

The program is led by an Israeli team in the main technology centre at BGU, with the partners from across Europe. Shahar explained how the system works, using the analogy of today’s mapping software. “It’s like a medical version of GPS,” he said. Right now, the program’s focus is on diabetes and hypertension.

One advantage of MobiGuide is the way the server handles massive amounts of clinical research, explained Shahar. For instance, when international guidelines for treating hypertension change, you can update that information in one place and it will be reflected throughout the entire system. That information is then immediately available to all patients and their physicians on the MobiGuide system.

“There are millions of patients on the system now,” said Shahar. “Each cellphone has a customized version of the guidelines in the program so the phone alerts the ‘mothership’ and the server examines the data for anomalies. The mothership knows the full patient history and clinical guidelines.”

The server in Israel also reminds patients to make adjustments, such as to their diet. A phone can contact the mothership to ask for advice, and recommendations are customized for each individual. Personal preferences can be adjusted depending on the patient – for example, when they prefer to be alerted to take their medications. If they are on vacation, they can ask the system not to alert them as frequently.

The system can also be notified to anticipate spikes in blood glucose. For instance, if a patient is attending a wedding and expects to eat rich food, she can tell the system first that it need not be concerned about this. Likewise, if a patient lives alone and has nobody to rely on for support with their health, the system can issue different instructions than for someone with a companion.

Humans are, however, still essential to the smooth running of the system. Shahar relies on “medical-knowledge engineers, graduate students,” who digitize clinical knowledge so that it can be applied on the system. But, he said, “It’s a sign of the future. Chronic patients won’t need to be in clinics all of the time. You want to be there only if there’s no other way.” It is cheaper to offer care in the community, especially in remote areas, even while offering round-the-clock observation.

To date, feedback from patients and the professional community has been consistently good. Compliance with clinical guidelines by physicians has improved, preventing a great deal of human error and possibly fatal mistakes, said Shahar. Likewise, he said, “Compliance was very high, we saw real patient empowerment.”

Patients “said that their quality of life had improved, they felt more secure and safe,” said Shahar. This is important, he explained, because AI in healthcare is not just about technology – human psychology has a huge impact on both patient treatment and outcomes.

As an example of the program’s success, Shahar said, in Barcelona, pregnant women with gestational diabetes were studied. The blood pressure of the research patients was significantly lower than in the control group, who attended in-person clinics. Shahar explained that these data were accompanied by a sense that a “benevolent big brother was monitoring them, and someone was sending alerts and recommendations every few days.”

After a four-year evaluation hosted by a veterans hospital in Palo Alto, Calif., there is evidence that the software developed by Shahar’s team has helped physicians manage oncology data better than before. With only seven to 10 minutes to give to each patient, physicians simply do not have the time to review all the material they need to, while considering its application and significance to individual patients.

In his talk at the Eye Care Centre at VGH, Shahar recalled asking a patient if she minded getting numerous texts from MobiGuide every day. “She laughed, I get 50 texts from my friends, what’s another 20?” he said. But, in reality, she clarified, “How could I mind? This is about the health of my baby.” Shahar added, “They feel that someone knows them deeply.”

According to David Berson, regional executive director of CABGU, Shahar’s visit was a success. He said BGU will examine how Shahar’s research in medical informatics can dovetail with local efforts to revolutionize healthcare, exploring the potential for “patient empowerment, remote monitoring, decision-making support and beyond.”

BGU board member and innovation expert Jonathan Miodowski said there was a need to balance between “blue-sky research and practical solutions” to real-world problems. “Multidisciplinary approach is a hot topic for universities these days – it is critical to bring different perspectives to the research,” he said.

Miodowski described Israel as a world leader in innovation. Last year, Canada raised $4.7 billion in start-up capital, he said, noting that Israeli start-ups, by contrast, raised $10 billion. “For a country that is two-thirds the size of Vancouver Island, that’s pretty significant,” he said. “In a sense, the size of the territory is very convenient. Cross-pollination of ideas is inevitable.”

Miodowski also spoke well of the Vancouver visit. “We planted some seeds on both sides,” he said. “It was very positive. There was real interest in Yuval’s research, real appreciation for what Israel has done in terms of its innovation ecosystem.”

Shula Klinger is an author and journalist living in North Vancouver. Find out more at shulaklinger.com.

Masks, stories and dance

George and Tamara Frankel at Masks, Revelations and Selfhood, the spring forum of Jewish Seniors Alliance, in partnership with the Louis Brier Home and Hospital, which was held May 26 at the Peretz Centre. (photo from JSA)

Since August 2018, Louis Brier Home and Hospital residents have explored themes of personhood and creative expression, crafting masks, narratives and original dances with expressive arts therapist Calla Power and choreographer Lee Kwidzinski. The whole process was filmed by Jay Fox for a documentary.

Power, Kwidzinski and Fox, as well as Louis Brier resident Jennifer Young, who participated in the project, shared their experiences with guests at Masks, Revelations and Selfhood, the spring forum of Jewish Seniors Alliance, in partnership with the Louis Brier. The forum was held May 26 at the Peretz Centre for Secular Jewish Culture.

The four presenters brought with them many of the masks that were made by the Louis Brier residents, which they placed on tables near the audience. Everyone could examine them up close and try them on. This allowed people to experience the changes one feels when masked, hidden from others.

JSA president Ken Levitt welcomed everyone and spoke about JSA’s motto, “Seniors Stronger Together,” noting that JSA’s free peer support programs – which require the financial support of the community to continue – exemplify the power of older adults assisting other older adults. He then introduced Power, who has been working with residents at the Louis Brier for about five years.

The Masks Project lasted seven months, culminating in a program that includes masks, stories, poems, drama and dance. In her summary of the history of masks, Power said the oldest masks, dating from the Neolithic period, were found near Jerusalem several years ago. She explained that masks are used in many cultures as part of religious and/or spiritual ceremonies. In a slide presentation, she showcased masks from different cultures, including African, Indian and local indigenous cultures. Frequently, she said, those wearing the masks would represent “the gods” and be a conduit for messages from above.

Ginger Lerner, Louis Brier recreation therapist, had approached Power about making masks for Purim, obtaining a donation from the estate of Frank and Rosie Nelson that facilitated the project. Power did some research on Purim and discovered that many of the characters were masked; for example, Esther, who masked her origins, and Vashti, who refused to be unmasked. As residents engaged with the project, they discussed such topics as what parts of ourselves do we keep hidden behind a mask.

Kwidzinski, who specializes in dance movement, has 30 years of experience working with older adults, mainly those with dementia and those who are in wheelchairs. She has a dance company in Mission, and the dancers worked with the mask makers to create movements related to the masks and the residents’ ideas. The dancers became the bodies of the mask makers, who chose the movements and the music. The mask makers came on stage with the dancers for the performance.

Young, one of the mask makers, expressed how moving the entire experience had been. She said the group became close, even though they hadn’t known each other well before.

Young said she had been reluctant about the dance aspect but felt that the dancers were extremely supportive and, at the end, she said she found the movements liberating, as if she were also dancing. She said she gained energy and willpower from the experience, and thanked Power, Kwidzinski and Fox for giving her the ability and opportunity to “get up and keep going.”

Fox has produced award-winning films, documentaries, music videos and public service announcements. He was involved in the Masks Project from the beginning. He felt that the journey was as important as the film and the art produced. The film was screened at the forum, and can be viewed at youtube.com/watch?v=YspYE6juiy0.

Gyda Chud, JSA first vice-president, led the question-and-answer session. Members of the audience expressed their appreciation for the information and the beauty of the project. It was suggested that advocacy was needed to have this type of project adopted by other care homes and adult day-care centres.

I wrapped up the afternoon event with a thank you to the presenters, which was followed by snacks provided by Gala Catering.

Shanie Levin is an executive board member of Jewish Seniors Alliance and on the editorial board of Senior Line magazine.

Wonders of asparagus

(photo from pixnio.com)

In Israel, asparagus is not widely seen in the outdoor markets but, when it is, I am always happy to buy it. There are at least 10 reasons why we should eat more asparagus.

It contains lots of fibre, making it a good choice if you’re trying to lose weight, because your body digests fibre slowly, which keeps you feeling full in between meals. (It is also low in fat and calories: one cup is a mere 32 calories.)
It contains high levels of the amino acid asparagine, making it a natural diuretic. In other words, eating more of the spears can help flush excess fluid and salt from your body, which may help prevent urinary tract infections.
It is full of antioxidants that could help your body fight free radicals.
It contains vitamin E, another important antioxidant, which helps strengthen your immune system and protects cells from the harmful effects of free radicals.
It is a natural aphrodisiac, thanks to vitamin B6 and folate.
The minerals and amino acids in asparagus extract may help ease hangovers and protect liver cells from the toxins in alcohol.
It beats bloating by promoting overall digestive health – another benefit of all that fibre. And, thanks to prebiotics, which encourage a healthy balance of good bacteria, or probiotics, in your digestive tract, it can also reduce gas. Relatedly, since asparagus is a diuretic, it helps flush excess liquid, combating belly bulge.
It’s a rich source of folic acid, providing 22% of the recommended daily allowance of folic acid.
It’s filled with vitamin K, crucial for coagulation, which helps your body stop bleeding after a cut, as well as bone health.
It boosts your mood because it is full of folate, a B vitamin that could lift your spirits and help ward off irritability. Asparagus also contains high levels of tryptophan, an amino acid that has been similarly linked to improved mood.

Need I say more? Buy asparagus with straight stalks, closed compact tips and good green colour. Keep refrigerated and use within one or two days. Bend the stalk near the bottom to snap off the part that is too tough to eat. Cook in one inch of boiling salt water. Let the water boil again and cover. Cook whole stalks about five minutes and cut-up pieces about three minutes. Here are some ways to use asparagus.

VINAIGRETTE

1/4 cup olive oil or canola oil
1 tbsp red wine vinegar
1 tbsp Dijon mustard
1/2 tsp sugar
salt and pepper to taste

Combine all ingredients in a blender and mix for one minute. Pour over cooked asparagus.

MICROWAVED IN LEMON BUTTER DIJON SAUCE
(3-4 servings)

2 1/2 tbsp canola or olive oil
1 tbsp lemon juice
2 tsp Dijon mustard
1/2 tsp low-sodium soy sauce
1/2 tsp minced garlic
2 tbsp minced white onion
salt and pepper to taste
1/2 pound asparagus
chives or green onions for garnish

Arrange asparagus in a microwave steaming bag. Add oil, lemon juice, mustard, soy sauce, garlic, onion, salt and pepper. Microwave four to five minutes; let stand one minute. Place in serving bowl and garnish with chives or green onion.

FLAMANDE SAUCE
6 servings

4 mashed hard-boiled egg yolks
1/4 cup + 2 tbsp olive or canola oil or 1/2 cup melted margarine or butter
1/4 cup minced fresh parsley

Whisk oil or butter or margarine into egg yolks in a saucepan. Add parsley and heat sauce. Pour over cooked asparagus.

STEAMED WITH TARRAGON SAUCE
(6 servings)

1 1/2 pounds trimmed asparagus
2 tsp olive oil
6 thinly sliced scallions
1 1/2 tbsp chopped fresh tarragon or 3/4 tsp dry tarragon
3 tbsp lemon juice or cider vinegar
dash sea salt
3 tbsp water

Steam asparagus two to five minutes, rinse, drain and place in serving bowl. Heat oil in a pan and sauté scallions one to two minutes. Add tarragon, lemon juice or vinegar, salt and water; cook one to two minutes. Pour over asparagus.

Sybil Kaplan is a journalist, lecturer, book reviewer and food writer in Jerusalem. She created and leads the weekly English-language Shuk Walks in Machane Yehuda, she has compiled and edited nine kosher cookbooks, and is the author of Witness to History: Ten Years as a Woman Journalist in Israel.

How we can live after death

It is the instinct of all living things to try to stay alive, humans among them. Most religious doctrines pay a great deal of attention to this issue. And many people, whether part of an organized religion or not, believe that a spirit leaves the body after death. Where viewpoints vary mainly is what happens then.

In many belief systems, we stay alive in some form or another even after death. Hindus, like Buddhists, believe that a departing spirit is reincarnated into some other life form. Buddhists believe there is no guarantee that the life form will be human; they believe that liberation from the cycle of life is the only desirable objective, a state they call nirvana.

The monotheistic religions all have some concept of an afterlife, with outcomes based on our behaviour during our life on earth. Indeed, both Christianity and Islam see the afterlife as the most desirable state, at least for the righteous, compared with our life on earth, the current one being a “a vale of tears.” Judaism also sees a reward for the righteous, with a resurrection when the Messiah arrives to usher in the “End of Days” and heaven on earth. But Jews, in contrast, are urged to live the fullest possible life while alive, every life being precious.

Without entering into discussions on this issue as to the merits of one position or another, I have drawn some conclusions as to their relevance on the question of staying alive. Empirical evidence from religious enthusiasts is meagre, relying on faith rather than hard facts, or reports of a life, or lives, after death from thousands of years ago. These form the basis for the promise underlying the religious thesis.

The realization of a positive outcome in the religious sphere depends on an unblemished life experience. I cannot count on being among those judged as sufficiently righteous and deserving. That leaves me with the task of doing the best I can to extend the life I know about, the one I am living now. Having past the four-score mark is evidence that I have done some things right, having already survived many of “the slings and arrows of outrageous fortune.” I must have good DNA.

Chance has favoured me in my encounters with accident, disease and body-systems breakdowns. I have survived my encounter with “the big C” up to this time. I have diabetes under apparent control, but one never knows, as it works its damage asymptomatically.

I take pills in abundance to ward off the evils of sugar, high blood pressure and stroke. I quit smoking in my early forties and drink alcohol sparingly. My food habits are not outrageous, without denying myself the favourites that make life worth living. I exercise religiously when not on holiday. I have given up driving on the promise it will increase my life expectancy. Best of all, I pass my life with the woman of my dreams. Life is grand.

The other night, I spent some time with family. We found ourselves talking about our experiences with forbearers who had gone before us. For a short while, it appeared to me almost as if those ancestors were there with us, alive and sharing our good times. Like a lightning bolt, it struck me that that was truly another way of staying alive. The people in our lives who are important to us, those who have marked us in our life experience, they continue to be alive for us as long as they remain in our memories. They never disappear for us as long as we live; they go on being a part of our lives.

So, that’s the secret. We must continue to be important in the lives of the people who surround us. As long as we do that, we will stay alive even after we are physically gone. We have to cherish those we care for while we have them, in part so they will continue to cherish us.

But this does not apply to family only. It is true for all the people in our lives to whom we reach out, to all those we touch and those who touch us. If we want to stay alive, we have to do the reaching out.

Moses and Jeremiah and Isaiah and Jesus can thus be alive for us as well, if they have touched us and touched our lives. Shakespeare and da Vinci are alive for me. Spinoza is alive for me. Danny Kaye and Sid Caesar are alive for me, as is Beethoven.

They are all alive for me because they are a part of who I am. All the people who have made me what I am are alive for me every day of my life. I am surrounded by a crowd. Sometimes, they speak through me. You can’t spend much time with me without getting to meet some of them.

If I write something and it touches another soul, then I may still be alive for them whether I am physically there or not. Even for the people who no longer remember my name, I may still be alive for them in some cranny of their consciousness. That’s not so bad. If we can believe in that, in our own minds we have a future beyond our temporal experience of life.

So, now you know the secret. Go out there and talk to the people around you. Phone them. Write an email. Hug or kiss them if you can get away with it. You may get to live forever if they tell their children about you. If you know what you have done, if you have faith in it, as I do, regardless of your other beliefs, this can be your “promised land.”

Max Roytenberg is a Vancouver-based poet, writer and blogger. His book Hero in My Own Eyes: Tripping a Life Fantastic is available from Amazon and other online booksellers.

ED is a complex condition

Left to right: Pollock Clinics sex therapist Tom Foster and physicians Neil Pollock and Roozbeh Ahmadi. (photo from Pollock Clinics)

While there may be any number of reasons why the frequency of a couple’s intimate sexual contact may wane, it is a critical cornerstone supporting the continuation of a healthy relationship. Often, when a couple is having sex infrequently, or not at all, their relationship becomes vulnerable to anger, detachment, infidelity and divorce. One factor that can come into play regarding a couple and their sex life is erectile dysfunction.

“ED is a medical condition where a man is consistently unable to achieve and maintain an erection that allows for satisfactory sexual function. ED is also referred to as impotence,” explained Drs. Neil Pollock and Roozbeh Ahmadi of Pollock Clinics in an email interview with the Independent. “The Canadian Study of Erectile Dysfunction identified 49.4% of men over the age of 40 with ED (Canadian Urological Association erectile dysfunction guideline 2015). By the time men reach the age of 70, almost 70% of them will experience some form of erectile dysfunction.”

Conventional treatment for ED generally involves blocking the symptoms, with medications like Viagra and Cialis. “If pills are not working, the next step is the injection or suppository forms of medications that patients can inject into the penis or infuse into the urethra prior to having intercourse,” said the doctors. “If these medications are not satisfactory, then there is the option of a vacuum erection device that a patient will need to apply to the penis and get an erection through the vacuum created within the tube. If none of the options is satisfactory, then there is the option of surgery, such as penile implant surgery.

“The issue with pills, injection and pump is the fact that all need prior timing and preparation and, in the case of pills, they can cause significant side effects, such as headaches, flushing, upset stomach and visual changes, which a lot of patients cannot tolerate.”

There are many factors that can cause ED. “These include neurological disorders, hormonal imbalance, structural abnormalities, side effects of medications or surgeries, mood disorders,” said the doctors, but “the most important and prevalent one is vascular disease.

“When a man becomes aroused, the brain releases a neurochemical substance to increase the size of blood vessels carrying blood to the penis and reduce the size of the vessels that carry it out,” they explained. “Twin compartments that run the length of the penis, called corpora cavernosa, become flush with blood that is trapped in the shaft. This causes the penis to stiffen and become erect. If blood flow to the penis is inhibited or the blood vessels are clogged or constricted, erection cannot be achieved or maintained.”

High cholesterol and the buildup of arterial plaque, over time, cause blood vessels to narrow, lessening their capability to carry blood. One of the first places men will notice this reduced flow is with ED, which is why ED has been dubbed “the canary in the coal mine” – it can serve as a distress signal three to five years prior to a major heart attack.

Lifestyle choices and health conditions that can also contribute to ED include smoking, obesity, a sedentary lifestyle and chronic alcoholism and/or substance abuse.

“Sexual wellness is essential to men’s health and happiness,” said Pollock and Ahmadi. “It is an integral part of men’s overall wellness as they age. A great number of scientific studies have shown the many benefits of a healthy and active love life, which include living longer, greater well-being and a happier and longer lasting relationship with your partner.”

Pollock Clinics provides a few treatments for ED.

“In the last few years, there are innovative regenerative treatment options to deal with the root cause of the problem, and not just the symptom,” said the doctors. “These new modalities include low-intensity shockwave therapy and platelet-rich plasma therapy [also known as the PRP shot], and are currently used in many countries around the world.”

PRP is created from a patient’s own blood and is commonly used in orthopedics, plastic surgery and sports medicine. “Studies have shown that this penile injection contains several different growth factors that can stimulate the healing of erectile tissue and is a safe and effective option for penile rejuvenation and improvement of erectile function … by enhancing and increasing the blood flow to the erectile tissue, offering a longer lasting desired outcome.

“ED shockwave therapy,” the doctors explained, “also promotes the regeneration of blood vessels in the penile shaft. That, like PRP, leads to longer and more satisfying erections and is accomplished by directing painless energy waves into the shaft of the penis.”

In addition to these two treatments, Pollock Clinics offers therapy, since ED has both physiological and psychological causes.

“Pollock Clinics also has a certified sex therapist to deal with psychogenic issues that might be affecting a man’s sexual health,” said the doctors. The goal of therapy is to provide “strategies to get a patient’s mind working with him instead of against him in a sexual encounter.”

Pollock and Ahmadi strongly encourage men to talk to their own doctor about any health issues they may have and the treatment options available.

Rebeca Kuropatwa is a Winnipeg freelance writer.