LOST IN TRANSITION: Transitioning from the pediatric to adult health care system

This feature appears in Ottawa Magazine’s May 2014 issue. 

Sarah Mercer, Injuries, surgeries, and medication will always be part of her life, but that doesn't faze her as much as the transition to the adult health care system. Photo: Justin Van Leeuwen

Sarah Mercer — injuries, surgeries, and medication will always be part of her life, but that doesn’t faze her as much as the transition to the adult health care system.
Photo: Justin Van Leeuwen

By ROGER COLLIER For young people with chronic health conditions, turning 18 signals an important milestone. That’s when they transfer from nurturing, family-centred pediatric hospitals to the overcrowded, fragmented adult health care system. Not all make it to the other side “The scariest thing ever”

At the age of nine, while lounging on the floor of a friend’s home, playing Monopoly, Sarah Mercer attempted a feat that put her in hospital for three days: she tried to get up. Unfortunately, her left knee had other plans, opting to fracture rather than co-operate.

“That’s when I began using my wheelchair,” says Mercer. “I started walking again later, but I kept falling and breaking my bones.”

Mercer has spina bifida, scoliosis, osteoporosis, and a blood-clotting disorder called factor 5 Leiden. She was born with club feet, two hernias, and a partially split spinal cord. There have been about 40 surgeries over the years, the first when she was 12 days old. Her feet have been reconstructed, her spine has been fused, and several of her tendons are no longer in their original locations.

In short, Mercer’s health problems are chronic and complicated. Injuries, surgeries, pain, medication — these have always been parts of her life and always will be. At the Children’s Hospital of Eastern Ontario — or CHEO, as it’s known to everybody in Ottawa — Mercer is on a first-name basis with people in many departments.

Though the thought of yet another surgery doesn’t faze Mercer, there was always one thing that did worry her: a date. January 24, 2013. That was the day she turned 18, which meant her time at CHEO was coming to an end.

“It’s the scariest thing ever,” says Mercer. “The doctors there are like family. They’ve seen me grow up. They’ve been through really tough times with me. Leaving them is like graduating from high school or moving out of your family’s home. It’s very nerve-wracking.”

Mercer is hardly the only young person with a chronic disease to bid farewell to a children’s hospital with some trepidation. When patients “age out” of the pediatric system, typically at 18, they encounter an entirely different culture of care. They leave a nurturing, family-centred facility where all their health needs — physical and mental — are addressed under one roof. In pediatric hospitals, patients receive care from multidisciplinary teams, which could include nurses, physiotherapists, social workers, surgeons, psychologists, pain specialists, and other health professionals.

On the other hand, the adult health care system they enter is fragmented and difficult to navigate, particularly for those who require the services of many medical providers. Someone like Mercer, for instance, will have to visit multiple locations across the city. As well, the adult system is bloated with elderly patients, who outnumber young adults by an ocean-wide margin. Welcome to waiting lists, shorter appointments, and impersonality.

“I’m used to it being very personal and one-on-one,” says Mercer. “Now I go to an appointment, and it’s like, ‘What’s your name?’ ”

Adult health care providers expect patients to be independent. There is no handholding, no deferring to parents, no reminders to keep appointments. You are expected to be an expert on your condition and the primary advocate for your health. Gone are the days when you could lean on others to fill in the details about your medications, therapies, and equipment needs.

In other words, after you blow out those 18 candles, you move out of a cozy, full-service medical home and into a confusing, overcrowded medical maze.

“People become very comfortable at CHEO because everything is here,” says Diane Gregoire, who became familiar with Mercer during her years as coordinator of spina bifida care at the hospital. “They don’t always realize they will be leaving at 18. You can get so overwhelmed and busy, and all of a sudden, you’re a teenager and have to start thinking about life after CHEO.”

Like other children’s hospitals across Canada, CHEO is striving to ensure that transfer to adult care is not merely an administrative event but, rather, a carefully planned transition. The goal of transition programs, which are growing in number and scope every year, is to facilitate continuous and coordinated care between the pediatric and adult health care systems.

A good transition can help young adults with complex medical conditions enjoy a greater quality of life and function better socially, academically, and professionally. A poor transition, however, can lead to anxiety, complications, deteriorating health and, in some cases, disappearance from the health care system altogether.

Lost to follow-up

If you talk to experts in the field of transitioning to adult health care, you’ll hear one phrase time and again: lost to follow-up. What that refers to, in layman’s terms, is when someone leaves a pediatric setting and doesn’t see a doctor for a year or more. Once removed from the familiar and reliable structure of their childhood medical homes, some young people simply disengage.

“Sometimes they never make it to the other side and re-engage with the health care system only at a time of crisis,” says Dr. Khush Amaria, team lead for the Good 2 Go transition program at The Hospital for Sick Children (SickKids) in Toronto. “They show up in an emergency room, and nobody knows their health history.”

One study often cited as an example of this phenomenon followed 360 former SickKids’ patients between the ages of 19 and 21 with complex congenital heart defects. Slightly fewer than half of these young adults made their recommended annual follow-up visits to a specialized adult clinic, despite being at risk of complications such as arrhythmias and premature death. The study, published in 2004, found that more than a quarter of the patients hadn’t attended a single cardiac appointment since turning 18.

It is also common for newly independent young adults to get sloppy with their medication. Perhaps the drugs cause weight gain or acne, and the desire to make a good first impression at college or a new job sways sound judgment. Or it could be forgetfulness or indifference. Whatever the reason, the consequences of poor adherence to medication can be severe, depending on a person’s condition.

The health of young people with HIV, for example, can go south quickly if they interrupt antiretroviral therapy. Recipients of donated organs put themselves at risk if they skip their anti-rejection drugs. There isn’t an abundance of robust research in this area, but one 2000 British study of young people with transplanted kidneys did have troubling results. For eight of the 20 patients in the study, the donated organs failed within three years of transfer to an adult transplant unit.

Why would someone with a serious medical condition walk away from the health care system or stop taking their medication? Their health — their very lives — could be at stake. Well, it just so happens that the age when people transfer between health systems coincides with the peak period of risk-taking and experimentation in their lives.

Compared with adolescents, young adults are more likely to binge on alcohol, abuse drugs, or participate in risky sexual behaviour. It is a time of seeking new sensations, of pushing limits, of challenging rules. So perhaps it shouldn’t be a complete surprise that — after a lifetime of appointments, procedures, and pills — some young adults balk at the strict regime they had little choice but to follow when their parents were in charge.

“You have this period when people are already at higher risk of harm. Then you have young people with chronic illnesses, some who may have been sheltered all their lives. Now they have this blast of freedom, so they may stop taking their medication or take it erratically,” says Dr. Lorraine Bell, director of pediatric transition to adult health care at Montreal Children’s Hospital. “It could be because no one is watching, or it could be overt rebellion.”

Other factors can contribute to a less than stellar transition to the adult system. Young adults are a mobile bunch, and finding doctors in a new town can be challenging. People in their late teens and early 20s often struggle financially, making it difficult to pay for medication not covered under insurance or other costs related to their care. Furthermore, a busy or inflexible schedule at university or work limits their freedom to book and attend medical appointments.

However, the greatest challenge to planning and executing better transitions just might be getting all four parties that should be involved to work together.

The road to independence

When Sarah Mercer first entered preschool, her mother had to visit often to insert a catheter into her bladder. Lack of bladder control is a common complication of spina bifida. But for Mercer, depending on someone else to help her use the bathroom just didn’t cut it. “When I was four years old, I started catheterizing myself,” says Mercer, laughing at the memory. “I wanted to be in control.”

Mercer’s independent streak will serve her well in the adult health care system. Taking ownership of your health is vital to a successful transition. Unfortunately, not all 18-year-olds are prepared for that responsibility, says Deborah Thul, who runs the Well on Your Way adolescent transition program at Alberta Children’s Hospital in Calgary.

Thul says current research indicates that brain development continues for young adults into their 20s, so some may not have mastered the developmental skills needed to take on full responsibility for managing their own health care by their 18th birthday.

That is why plans for better transitions must include contributions from parents and medical providers from both the pediatric and adult systems. Of course, that is easier said than done.

One of the biggest challenges to getting parents fully onboard is their reluctance to let go. Many parents are overprotective of their children — even more so when those children have serious medical conditions. It is only natural that mothers and fathers accustomed to managing one crisis after another would struggle to pull back, think long-term, and see the sons and daughters they’ve accompanied to countless medical appointments as having the potential to live fulfilling, independent adult lives.

Mercer is fortunate that her mother, Laura Brown, has always stressed the importance of resilience and independence. That meant not using her condition as an excuse to fall behind in school and finding a part-time job when she turned 16, as well as going to the hospital only when absolutely necessary and returning home as quickly as possible. It meant not regarding life as a series of medical emergencies.

“The thing that was important for me was for Sarah not to see herself in the role of the sick person. She is more than her condition. Sarah has a chronic condition, and she needed to learn to live with it. That means living with pain, with a wheelchair, and with surgeries,” says Brown, who works in vocational rehabilitation to help people with disabilities find jobs. “I want Sarah to contribute to the world in some way. The world is not going to tailor itself for her. There will always be stairs, and it’s important for her to learn how to navigate them.”

The road to independence can be rough, though, when you encounter adult medical providers who don’t understand your struggles and have neither the time nor the skills to meet your needs. Sure, there are pockets within the adult health care system that have shown interest in improving transitions for younger patients, but in general, it isn’t seen as a priority. That’s because young people represent a very small proportion of the population, and most adult hospitals have their hands full with patients who are very old and very sick. With an aging population, that isn’t going to change anytime soon.

Furthermore, doctors on the adult side aren’t always familiar with treating some chronic conditions that start in childhood. There was a time not so long ago when many children with these diseases never saw their 18th birthday. But thanks to advances in technology, pharmaceuticals, and medical therapies, most youth with spina bifida, congenital heart disease, HIV, and other chronic conditions can now expect to live well into adulthood.

“There’s a new generation of patients that didn’t exist before,” says Dr. Sandra Whitehouse, medical lead of British Columbia’s Youth Transitions initiative. “There are more adults now with cystic fibrosis than children. It used be a children’s disease.”

In the pediatric system, however, transition is considered a hot topic. Pioneers in the field began to take interest about two decades ago. Now several of the larger children’s hospitals in Canada have transition programs and coordinators. Still, despite the advances, there is plenty of room for improvement.

“Closing the gap”

Here in Ottawa, CHEO began to focus on improving the transition to adult care in 2010, when it became part of the hospital’s strategic plan. Different approaches are being tested in various departments. In a pilot project, for example, doctors in the nephrology clinic partnered with colleagues in the adult system to improve transition for patients with kidney diseases and presented suggestions to youth and their families at a workshop.

The hospital has also created educational materials, including a readiness assessment tool to assist teenagers in figuring out if they’re prepared for transition. Do they know their new doctors’ names? Do they know all their medications? Do they know which pharmacy they’ll be dealing with?

“When people turn 18, there is so much happening. They are becoming independent, graduating from high school. They may be starting a relationship or a job,” says Shaundra Ridha, director of CHEO’s transition program. “There are so many changes in their lives, and if we can be a stabilizing influence, making the unknown less scary, that’s what we aim to do.”

As a member of the hospital’s youth forum, Mercer has provided input into how to better equip young people to transfer to adult care. “In time, the transferring is going to be smoother because they are going to start it earlier and all the departments will be on the same page,” she says.

Children’s hospitals in many Canadian cities — including Toronto, Vancouver, Montreal, and Calgary — are also making progress on improving transition. Many of the programs share similar principles, such as starting the process early, as young as the age of 10, and fostering independence in patients.

Transition coordinators also stress that the time of transfer should be flexible, factoring in the youth’s cognitive development and external support systems, as well as the availability of medical care. Other popular ideas include creating individualized transition and long-term care plans with input from both pediatric and adult providers, using electronic medical records to improve communication between youth and adult systems, and providing professional health care navigators for young adults.

Many transition experts point to the Good 2 Go program in Toronto and the ON TRAC (Taking Responsibility for Adolescent/Adult Care) model in British Columbia as leaders in the field. Good 2 Go offers a wide range of services and tools, including readiness checklists, transition timelines, discussion groups for parents and teens, and MyHealth Passport — a card for young adults that lists all their conditions, medications, allergies, and other medical information. ON TRAC provides separate toolkits for youth, parents, and health care providers, focusing on topics such as self-advocacy, sexual health, financial planning, and social connections.

The British Columbia Medical Association has also lent its support to the cause, releasing a policy paper on transition called “Closing the Gap.” The paper lists a number of recommendations, including having a family doctor from birth, individualizing transition plans, tracking young people with chronic conditions after they leave the pediatric system, and developing benchmarks to gauge transition success.

What is lacking, however, is consistency across the country. There are no national standards, no official guidelines, and no established best practices. To date, efforts to improve transition are mostly based on concepts rather than evidence. For good reason: though some data exist, much speculation remains. There is a need for more empirical research to quantify how transition services are actually affecting health outcomes. Do they reduce emergency room visits? Do they reduce in-patient admissions? Do they reduce deaths?

The good news is that interest is growing among researchers in obtaining that data, and this research guides the work being done by the Canadian Association of Paediatric Health Centres, which is presently developing national pediatric guidelines for transition from pediatric to adult care. So the future looks bright.

As for Mercer’s future, that’s looking pretty good too. She has moved into an apartment and, with the help of her mother, who stays over several days a week, has learned to cook, clean, and do laundry. She schedules her doctors’ appointments and gets herself there on public transit. And she still has the job she started when she was 16 at a movie theatre in Barrhaven.

In September, she enrolled in Introduction to Music Industry Arts at Algonquin College. A singer and musician (she plays guitar, piano, and ukulele), Mercer loves almost all forms of music, from acoustic folk to rock. The tattoo on her ribs — Come as You Are, a song by Nirvana — is evidence of that passion.

It is another of Mercer’s tattoos, though, that is particularly telling. The primary message her mother taught her — that her identity is not defined by her medical condition — has evidently sunk in. Mercer knows exactly who she is, and if she ever needs a reminder, she only has to look at the five words inked on her right forearm: To Thine Ownself Be True.

Photo: Justin Van Leeuwen

Five words inked on her right forearm: To Thine Ownself Be True.
Photo: Justin Van Leeuwen

REASON TO LOVE OTTAWA: Because Gerald Trottier’s legacy continues

By PAUL GESSELL

This feature appears in Ottawa Magazine’s April 2014 issue. Click here to subscribe to the print or digital versions.

Reasons-to-love-Ottawa

Ottawa Art Gallery senior curator Catherine Sinclair holds one of Gerald Trottier’s self-portraits (Photo: Justin Van Leeuwen)

The late Gerald Trottier has long been considered one of Ottawa’s most important artists. Now the artist’s family is donating 100 of his drawings, prints, and paintings to the Ottawa Art Gallery. It is the biggest donation of a single artist’s work in the history of the gallery.

Catherine Sinclair, senior curator at the Ottawa Art Gallery, is stickhandling the deal. She was invited last year to select works stored by the family since the artist’s death in 2004. She selected a bundle. “I was like a kid in a candy store,” Sinclair says.

She chose art from all periods of Trottier’s vast career, including his early social realist watercolours of the 1940s, paintings he took to the Sao Paulo Biennial in 1965 as Canada’s representative, religious paintings from the 1980s, and his dramatic self-portraits. According to a gallery statement, the newly acquired artworks “will begin to provide a more complete picture of Trottier’s prolific career, better demonstrate the diverse subject matter that he addressed, and more accurately show the depth of his artistic ability.”

Trottier’s legacy includes works at the National Gallery of Canada, liturgical appointments in several Ottawa churches, and a large mosaic mural in the H.M. Tory Building (the first art ever commissioned by Carleton University). And, as a teacher, Trottier influenced generations of young artists.

The Ottawa Art Gallery will celebrate the acquisitions with an exhibition of some of the donated works, plus other Trottier works for sale, until June 14 at Arts Court.

SNAPSHOT: Photos from the Politics and the Pen gala at Fairmont Chateau Laurier

On April 2, the annual Politics and the Pen gala welcomed notables from Canada’s political and literary worlds at the Fairmont Château Laurier. A fundraiser for the Writers’ Trust of Canada, an organization that seeks to further Canadian writers through a variety of programs, Politics and the Pen has become a premier event for writers and politicians to rub elbows with diplomats, journalists, and other leaders.

The evening culminated with journalist Paul Wells winning the $25,000 Shaughnessy Cohen Prize for Political Writing for his book The Longer I’m Prime Minister: Stephen Harper and Canada, 2006 —.

Click on the photos to launch a slideshow of photos from Politics and the Pen.

FROM THE ARCHIVES: Marisol Simoes

In the December 2008/January 2009 issue of OTTAWA MAGAZINE, Marisol Simoes was touted as a work hard/play hard entrepreneur. Now, she’s hiding from the camera and looking to shed her “defamatory libel” label. Here, a look back at Marisol in better times.

Marisol-Simoes-Ottawa

This photo ran in 2008, as Simoes was gearing up for a busy year with her restaurants. Photo by David Kawai.

Known for her tenacity and hands-on approach and rewarded for her success with a citing in Ottawa Business Journal’s 40 Under 40 this year, Marisol Simoes spends her days fussing with track lists, smoothing over staffing disasters, picking up ingredients, and generally staying on top of it all. Simoes, who, along with her husband, Zadek Ramowski, owns and operates three bustling clubs in the ByWard Market, has absolutely no plans to slow down in 2009. The new year will see Simoes catering parties with Kinki’s sushi platters and, in her spare time, launching a cooking show from the Mambo kitchen. In short, she’s bringing the party to you.

NEW YEAR’S RESOLUTION
To up the ante. “For years, we’ve been pushing the envelope, being a force for change in the Market. Next year we’re knocking on doors, bringing the taste and feel of Mambo and Kinki to anyone and everyone!”

I’ll BE RINGING IN THE NEW YEAR
Scurrying from club to club, champagne in hand.

IN SIX MONTHS I’LL BE
On vacation — yeah, right! “I’ve been dreaming of the beach for three years.” (It’s all part of the 10-year plan, Simoes swears.)

MY SECRET WEAPON
Guru. “I’ll drink a Red Bull if I have to, but Guru is all natural. It makes you feel great, and it makes you productive.”

YOU CAN CATCH ME
At your home or office, with trays of fusion fare from Kinki and Mambo.

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REASON TO LOVE OTTAWA: Because we have the world’s first waste-to-energy gasification plant that runs on hot air alone

In homage to Rod Bryden stepping down as CEO of Plasco Energy Group. Here’s hoping another kind of leadership can keep those gasification fires burning.
This story appears in the Winter edition of OTTAWA Magazine. Click here to subscribe to the print or digital versions.

Illustration by Alan King.

Illustration by Alan King.

When the city’s environment committee extended the deadline for Plasco Energy Group Inc. to secure financing for its high-tech waste-to-energy processing plant, many observers called foul. What are the rules on multi-million-dollar contracts? Does anybody know if this process even works? 

Eyebrows were raised when Rod Bryden first got the contract in 2012 to build the plant. After all, isn’t this the same guy who narrowly avoided personal bankruptcy when he owned the Sens? The guy so closely involved with financing the ill-fated WorldHeart mechanical heart scheme?

Indeed, anyone who was around in the tech boom years knows Bryden has lost money — his and others — on start-ups before. But that didn’t dissuade our elected officials from agreeing to a 20-year $180-million contract with Plasco, of which he is president and CEO, to convert waste to energy in a complex process known as plasma gasification.

Bryden and his crew were initially given until March 2013 to secure financing. That deadline came and went, and he was given an extension to late August. As the extension date drew near with no signs of anyone stepping up with cash, city staff became increasingly antsy, and Bryden insisted “It’s going fine.”

In August, following presentations by a waste expert who urged them to do otherwise, the city’s environment committee gave Plasco yet another extension — 16 more months to rustle up the moolah. The clock is now ticking down to December 31, 2014.

Opponents say it’s time to pull the plug. Proponents argue the city has nothing to lose. And Bryden? He says simply that he has underestimated the challenges in bringing enough investors on board.

As we wait to see what happens next, we can at least applaud the amount of hot air created around this project — even before the plant is up and running.

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WEB EXCLUSIVE: Chris Turner’s War on Science a convincing take on Harper’s policy

By Nicholas Savage

Chris Turner is angry. Having read his recent book, The War on Science, not only do I understand his anger, I also share it. While I have a great respect for faith and organized religion, I have never considered myself a ‘person of faith’, having no real convictions that I felt were beyond question.  Thanks to Turner’s book, I now know I was wrong.

While I’m familiar with ‘The Enlightenment’, that period of European history when writers and scientists threw off the shackles of religion’s stranglehold on knowledge and began to understand their world through the application of science and reasoned arguments, I didn’t recognize it as the birthplace for a belief that, thanks to Turner, I now realize is sacrosanct to me.  Simply put, I believe that decisions about how we as people interact with each other and the natural world should be governed by rational ideas derived from evidence. When applied to governance, those with decision-making powers should be beholden to those who gather information and process it in order to make the right informed choices.

Chris Turner

Chris Turner

At its core, The War on Science is an indictment of the Harper Conservative government for its betrayal of this ideal: not only are facts and evidence ignored when formulating policy, but scientists and institutes that may disagree with their irrational aims are routinely muzzled or find their funding put through the shredder.

Turner does an excellent job as prosecutor, noting how Harper and Co. began during their minority government days to slowly dismantle scientific research and fact gathering resources with measures like “the elimination of the Office of the National Science Advisor … and the tabling of a sweeping crime bill that went against decades of research.”

Then Harper finally won his majority and the floodgates were opened.  Bill C-38, the first ‘omnibus’ budget bill, gutted the Fisheries and Oceans Act, “reducing its mandate from all fish habitat to only that of “valuable” fish populations…” Now I’m no scientist, but I have seen enough Planet Earth to know that ecosystems are rather delicate, and that the life of so-called “valuable” species are linked to other, non-valuable ones. We eat fish, but they also eat fish and other organisms we don’t eat.  I could easily explain this concept to an 8 year old, so what are Conservatives not getting?

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FROM THE ARCHIVES: Frankly, do you give a damn?

Frank Magazine returns today in an online subscription format. The site is set to launch in a few hours with a bonus gift for the first hundred subscribers—a belly bobble Rob Ford doll. Follow twitter.com/FrankMagOnline for updates. From our Winter 2012 archives, here is a column on notable incidents in the history of the publication.

By Fateema Sayani

Pollster. Incentivise. Pop-up.

Then there’s the use of “full disclosure” to reveal irrelevant information. That’s my short list of annoyances when it comes to the tired language that’s used in media. That list is the kind of thing that would appear in Cliché-o-Matic, one of Frank magazine’s beloved features, along with the well-read Remedial Media section, which was full of insider newsroom gossip and juicy stories of inglorious mess-ups.

Politicians were also great fodder for the magazine, which was founded in 1987 in Halifax (and the Ottawa edition in 1989) by three ex-pat Brits who took their lampooning cues from the U.K. mag Private Eye. Byron Muldoon and Jean Crouton (Canada’s 18th and 20th prime ministers in Frank-speak) were favourite targets. The Ottawa edition folded in 2004, and its web edition shut down in 2008, likely a relief to Stephen Harper, who mostly escaped the low-level photoshopping and sophomoric name-calling that were Frank trademarks.

Marlen Cowpland was a favourite target

Marlen Cowpland was a favourite target of Frank Magazine, which recently returned as an online publication.

Harper has been spending time in the North, so maybe he’ll get the pet name Stevie Harpoon in a revived Frank. It’s the kind of nickname that reeks of imperial irony and makes people uncomfortable and titillated — the same factors that jolted sales of the irreverent twice-monthly publication, which sold 20,000 copies of each edition at its peak.

We hear tell that Frank magazine will return as a paid-subscription website in 2013. When asked, Michael Bate — who ran Frank in its various formats since 1989 — would say only, “It’s premature to be saying much,” though he has been meeting with his former co-conspirators and going over the back-end files of efrank.ca, the magazine’s former site. It was created in Flash Player, a format that’s fussy and problematic with today’s Apple devices.

When Bate killed the web edition of Frank four years ago, he sent a letter to subscribers saying that he couldn’t reach profitability. Besides, the web wasn’t enough of a lure for Bate. “The idea of working 12- to 15-hour days on a glorified blog didn’t appeal to me,” he told the Toronto Star at the time.

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MAN VS. BEAST: In the wake of elk shooting, a link to our spring feature on Ottawa’s struggle to come up with an effective wildlife strategy

By Ron Corbett

Forget about coyote sightings in Nepean and moose on the loose in Bell’s Corners. Forget about fishers dining on house pets in West Carleton and black bears meandering down Moodie Drive. For that matter, forget about beavers, white-tailed deer, the elusive eastern Ontario cougar, eels caught in a water filtration plant below Parliament Hill, and turkeys terrorizing senior citizens in Barrhaven. If you really want to know how plentiful and absurd wildlife stories can be in Ottawa, start with a robin.

Despite its geographic location, the city currently does not have a wildlife strategy — or a single worker tasked to handle wildlife strategies. Illustration by Anthony Tremmaglia.

Actually, let’s back up a little and start with a chipping sparrow. In June of last year, sightings of chipping sparrows along Holmwood Avenue sparked a row between some Glebe residents and a contractor hired to remove a stand of trees at Lansdowne Park as part of the redevelopment of the park. Chipping sparrows are migratory birds and, as such, are protected under the Migratory Birds Convention Act. According to the residents, if chipping sparrows were living in those trees, then work at Lansdowne had to stop.

To make their point, they chained themselves to trees, gave media interviews, and taped pages from the Dr. Seuss book The Lorax to a fence. Only when it was pointed out to them that chipping sparrows nest in bushes, not trees, did the residents unchain themselves and go home. Surprisingly, no one from the City of Ottawa was able to diffuse the situation. That’s because the city has not a single worker tasked to handle wildlife issues — lots of bylaw officers, but not a single biologist.

Anyway, back to that stand of trees. After the chipping sparrows left, a cardinal’s nest was found. A cardinal is also a migratory bird. Again, it looked as though work at Lansdowne was going to stop until, over the course of several days of round-the-clock surveillance of the nest, no cardinal appeared.

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POLITICS CHATTER: Arguing that the Quebec Charter of Values is more than purely cynical — it’s evil

Valeurs_depliant_version_longue-7.jpgQuebec is engaged in a nice, civil, democratic debate over whether a woman wearing a head scarf should be able to sit in the waiting room of a welfare office, or if a Sikh in a turban is such an outrageous affront to the secular state that he’s unfit to sell you a fishing license.

I find this debate as unbelievable as it is nauseous. If it proves anything, it shows that the Charter of Rights and Freedoms is a joke, as is the mealy-mouthed knock-off, the Quebec Charter of Human Rights and Freedoms. Because if a “charter of rights” is so empty that it can allow blatant and cruel discrimination against visible minorities, it is simply a lie to say that it protects anyone from anything.

The Quebec Charter of Values shows politics at its most cynical. It is an evil document drafted by people with an evil intent.

What people don’t seem to remember is that Quebec invited tens of thousands of French-speaking Muslims to settle in the province. Quebec’s birth rate has been in free-fall for two generations, despite big cash bonuses and, more recently, cheap daycare . More pur lainers are dying than are being born. So Quebec took over immigration from the federal government and invited Francophones to settle in the St. Lawrence Valley.

Very few came from France. Instead, they arrived from former French colonies like Algeria and Lebanon. Unlike the locals, the Muslims, at least in the first generation or two, have lots of kids.

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WIRED FOR SUCCESS: How innovative technologies are shaping Ottawa’s post-secondary institutions

If it’s been a while since you were in college or university, your image of what that looks like might be outdated. Today students and profs alike are on Twitter, courses can be taught online, and instead of soft scribbling in notebooks, you’re more likely to hear the tap-tapping of fingers on laptops. From eTextbooks to virtual campuses, we look at the city’s post-secondary institutions and the super-cool ways they’re using technology.

The University of Ottawa

•  Since September 2011, some professors have been using Top Hat Monocle, a web-based classroom response system that allows professors to ask questions of large classes that students can answer using their mobile devices. Responses are displayed at the front of the lecture hall, which helps profs gauge students’ comprehension, as well as jump-start discussion.

•  In the fall of 2012, the school opened a new fully equipped multimedia conference room. In this lab, professors can test new technologies such as Echo360, a system that allows them to record and edit course content, then publish it so that students can play back lectures and access materials.

•  Professors can take advantage of Techno-Talks, a series of presentations that focus on how technology is used at the university for teaching purposes. For instance, one talk was a show-and-tell session of professors’ favourite teaching and research apps.

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