Chiropractic + Naturopathic Doctor • October 2017 • Roundup

A Toronto lawyer has expressed concern a new Ontario legislation designed to protect patients from sexual abuse by a health-care professional may result in unintended consequences.

Tracey Tremayne-Lloyd, founder and principal of TTL Health Law, said the changes introduced by Bill 87 – the Protecting Patients Act – which recently passed in Ontario, is “completely unneccesary,” and could lead some health practitioners to become overly cautious in how they provide patient care.

Bill 87 amends the Regulated Health Professions Act, among other things, by expanding the list of sexual abuse offences that will result in mandatory revocation of a health professional’s licence.

“Under the current legislative regime, the sentence is commensurate with the crime, with the facts of the particular set of circumstances,” Tremayne-Lloyd told AdvocateDaily.com. “This legislative change would remove discretion from the disciplinary panel, which is the trier of fact.”

Tremayne-Lloyd said these panels take complaints seriously, weigh the evidence and carry out sanctions against the offending health professional appropriately.

“Throughout my 30 years of experience I have seen that the disciplinary panels consistently listen to the evidence, weigh the evidence and they get direction from an independent legal advisor – just like when a judge gives a charge to the jury before they deliberate – and they do not give light sentences,” she said.

She added that while the sexual abuse of patients is a serious concern, Bill 87 just misses the mark.

Other Bill 87 amendments to the Regulated Health Professions Act include: prohibiting a regulated health professional from continuing to practice on patients of a specific gender after an allegation or finding of sexual abuse; requiring the disclosure of a regulated health professional’s personal information, including their health records; and increasing access to patient therapy and counselling as soon as a complaint of sexual abuse by a regulated health professional is filed.

Tremayne-Lloyd said removing the panel’s discretion for how it hands out sanctions may impact the delivery of health care because many health professionals will “be afraid to do their job.”

“What impact will that reluctancy to give a full examination have on the patient?” she asked. “Are those physicians now going to say, ‘I’m going to treat what the patient was referred for and nothing else’ for fear of being accused of inappropriately touching that patient?”

The College of Chiropractors of Ontario (CCO) has informed its members about Bill 87 outlining the legislative amendments included in the new legislation. The college is currently reviewing its bylaws, regulations and standards of practice, policies and guidelines for possible amendments in view of Bill 87 implementation, according to Joel Friedman, director of policy and research at the CCO.

McGill University’s Montreal Neurological Institute and Hospital (Neuro) has been transforming into what is touted as the first research centre of its kind in the world dedicated to the principles of open science.

Along with the city’s artificial intelligence community, the Neuro is helping to make Montreal a world leader in the international push toward democratizing scientific research.

“To say you’re the first is pretty ambitious, but for all the evidence we have, we are the first,” said Guy Rouleau, director of the Neuro.

Open science is broadly understood as a movement to make scientific research and data open and accessible to researchers around the world.

It is currently building what it hopes will become the world’s largest library of brain imaging, clinical, demographic, genetic and cellular data, as well as biological samples from patients with neurological disorders.

The Neuro is also creating what it calls an open drug discovery platform, which will run tests on nerve cells from sick patients in order to explain how neurological diseases manifest and to help develop cures.

Thirdly, the centre is building an informatics system to share its large-scale research data.

All these project are to be open and accessible to researchers anywhere on the planet.

The Neuro, however, is still allowing its researchers to publish in expensive – and exclusive – commercial journals, a practice that reflects part of the academic culture that is slow to change.

Yoshua Bengio, Canada Research Chair in Statistical Learning Algorithms at Universite de Montreal, is on a personal crusade against commercial publishers of scientific journals and shames them publicly.

Bengio helped create the Journal of Machine Learning Research, one of the main publications in the artificial intelligence field.

Academics who submit papers to the journal must sign an agreement making their work open to the public, while authors retain the rights to their work.

Bengio said academics in all disciplines will eventually move to an open-publishing model. “It’s only a matter of time,” he said.

Rouleau said the Neuro’s project is still in the building phase and it’s too early to measure its impact.

But he and the project are getting attention from governments around the world as well as the Bill and Melinda Gates Foundation and the Chan Zuckerberg Initiative, a philanthropic organization started by one of Facebook’s creators.

The Neuro has secured $45 million for its three-pronged mission and Rouleau said it needs another $45 million over the next seven years.

Shoe orthotics alone or combined with chiropractic care can significantly improve low back pain experienced by millions of Americans, according to a new study conducted by National University of Health Sciences (NUHS).

The research, published online in the Archives of Physical Medicine and Rehabilitation, is said to be the first large-scale study to assess the effectiveness of shoe orthotics for back pain, instead of just foot pain, according to a statement from the NUHS.

In a six-week randomized controlled trial, researchers divided 225 adult subjects into three different groups. The control group received no care. Another group received custom- made shoe orthotics and a third received custom-made shoe orthotics plus chiropractic care that included adjustments, hot or cold packs, and manual soft tissue massage. The research study exclusively utilized shoe orthotics from Foot Levelers.

The results showed that although all groups demonstrated pain improvement in six weeks, only the patients using shoe orthotics had statistically significant improvements in both function and pain, the NUHS said.

“Chiropractic physicians have long prescribed custom shoe orthotics to their patients with the thought that back pain treatment might work best when addressing not only the back but also the hips, knees, ankles, and/or feet,” said Dr. Jerrilyn Cambron, the principal investigator of the study, a chiropractor and a research professor and chair of the NUHS College of Allied Health Sciences and Distance Education. “This newly published clinical trial demonstrates that shoe orthotics plus chiropractic care may be a highly effective treatment combination.”

The study used custom shoe orthotics from Foot Levelers, specifically designed to improve function of the lower extremities and low back. Pain can be caused by a disruption of the kinetic chain, an engineering concept used to describe the way segments of the body are connected. Such a disruption can move from the feet up to the low back, or from the low back down to the feet, the NUHS statement indicated.

Cambron believes the study will encourage further research into the way functional shoe orthotics can help improve other complex joint issues such as knee and hip pain.

Back pain, now considered a global epidemic, continues to affect about 80 per cent of the population. Meanwhile, widespread opioid addiction has caused physicians to limit the amount of opioids they prescribe to relieve pain.

“For those looking to avoid over-the-counter pain medication and opioids, shoe orthotics combined with chiropractic care may be an alternative worth considering,” Cambron said. “NUHS is proud to lead the research of non-invasive treatments for low back pain,” said

NUHS president Dr. Joseph Stiefel. “This major study may encourage health-care providers to offer new approaches to low back pain so common among their patients.”