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A Canadian high blood pressure study sees ‘exciting’ early results as investors bank on healthy returns

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It is early days, but investors in a unique health promotion experiment are bullish.

A six-month regime of personal coaching, exercise and healthy eating sponsored by the Heart and Stroke Foundation of Canada has succeeded in keeping blood pressure in check — without drugs — for several hundred Toronto-area adults at risk of developing hypertension.

Doug Purdy, 73, walks his Wheaten terrier Chloe near his home in the Keele and Finch area. Purdy says he’s lost 16 lbs. since he signed up for the Heart and Stroke Foundation's Activate program aimed at curbing high blood pressure.
Doug Purdy, 73, walks his Wheaten terrier Chloe near his home in the Keele and Finch area. Purdy says he’s lost 16 lbs. since he signed up for the Heart and Stroke Foundation’s Activate program aimed at curbing high blood pressure.  (Richard Lautens / Toronto Star)

The three-year, $3.4 million project that will eventually involve 7,000 participants in the GTA and Vancouver was launched last year as Canada’s first health-related social impact bond, or “pay-for-success” initiative.

Results for the first 500 enrolled last May are “very exciting,” says Heart and Stroke senior manager Erin Kim, who is leading the “Activate” project in partnership with the MaRS Centre for Impact Investing.

Eleven private investors, including businesses, charitable foundations and wealthy individuals, are funding the initiative through the MaRS Centre. The Public Health Agency of Canada will pay up to $4 million depending on how many participants are recruited, complete the program and see their blood pressure stay the same or go down.

Hypertension is the leading cause of stroke, a key risk factor for heart disease and one of the most common reasons for a person to see a doctor and be prescribed a drug, says Kim. It affects more than 6 million Canadians and costs the health-care system more than $14 billion a year.

Left untreated, half of Canadians over 60 with blood pressure in the “high-normal” range (121-139 systolic/80-89 diastolic) will develop hypertension within four years.

In the first cohort, more than 90 per cent stuck with the program for the full six months. And blood pressure readings for a sample of 100 of the first 500 participants showed an average 5.2-point drop. It means some participants moved their blood pressure readings from “normal-high” to “normal” — a significant finding for a drug-free intervention, researchers say.

Heart and Stroke is enrolling its second cohort of 4,100 participants from across the GTA between January and May. Another 2,400 participants in Vancouver will be signed up in 2020.

If the prevention initiative keeps average blood pressure stable for all 7,000 participants during the six-month program, Ottawa will pay the MaRS investors a return of 6.7 per cent. If the program overshoots this target and average blood pressure goes down, investors will receive an 8.8 per cent profit, or $600,000 in total. If the program fails to meet its goals, investors lose most of their money.

“Health promotion is hard. But it’s much better for individuals and society to adopt healthy lifestyle changes and prevent high blood pressure and the need for medication,” Kim says. “And that’s what this program is trying to demonstrate.”

Most of the support is provided through the Heart and Stroke’s “Activate” website and a specially designed app which includes coaching, health information, recipes, mindfulness training and goal setting, says Kim.

Participants with elevated blood pressure must be over 40, non-diabetic and not on medication for hypertension. Once enrolled, they are encouraged to keep a daily log of what they eat and how much exercise they get. The program includes free access to a Loblaws dietitian, a two-month YMCA membership and opportunities to meet others enrolled in the project through periodic community events. Participants receive PC Optimum Points as a reward for healthy behaviour.

The six-month program aims to help participants make “small, healthy choices” to help prevent the onset of high blood pressure, Kim says.

Toronto retiree Doug Purdy, who lost 16 lbs. “and two belt loops” between May and October, says the program changed his life.

“I always had good intentions about exercising. But this helped me get with the program,” he says.

Purdy, 73, credits his Wheaten terrier Chloe and a new exercise partner he met at the YMCA for keeping him on-track. He became so accustomed to working out at the Y, that he took out his own membership when the two-month free trial was up.

“My blood pressure is down to normal now,” he adds.

Regular exercise, along with healthy shopping and eating also produced positive results for Mississauga accountant Babatunji Farinloye, 50.

“I had a health club membership, but this program really helped me develop a habit,” he says. “Now, if I don’t work out, my body feels like something is wrong.”

A grocery store tour along with instructions from a dietitian on how to read product labels, “was a real eye-opener” Farinloye says.

“No more white bread,” he says with a laugh. “I am eating a lot more vegetables, especially colourful ones.”

Mississauga accountant Babatunji Farinloye, 50, says he's happy with the positive results produced by regular exercise and healthy eating since he became part of the Heart and Stroke Foundation's Activate project.
Mississauga accountant Babatunji Farinloye, 50, says he’s happy with the positive results produced by regular exercise and healthy eating since he became part of the Heart and Stroke Foundation’s Activate project.  (J.P. MOCZULSKI)

Elementary school teacher Teresa Galati, 56, says the program has helped her manage stress — and her elevated blood pressure.

“I have learned how to take time to meditate and it really helps,” she says.

Galati found the personal coaching particularly useful.

“I was able to go online and ask questions and even if my coach wasn’t available, someone always got back to me,” she says. “If you don’t have time to meet with someone, it’s great to be able to go online. It was phenomenal.”

Investors are also happy.

“We are very pleased with how the first cohort worked,” says MaRS director Adam Jagelewski. “We are setting ourselves up for the second and third cohorts that will ultimately dictate whether investors will get their returns or not.”

While some critics say government should not be paying a “middle man” to deliver public health and social services, Jagelewski says the pay-for-success premium makes everyone involved work harder and allows public officials to show taxpayers what their money has been able to accomplish.

“It doesn’t have to be a social impact bond,” he says. “Outcome-based contracts that have rigour around outcomes-based measurement are where we ought to be going generally.”

A social impact bond using private investors to take on the risk is just one way to do it. Governments could just as easily take this approach, he adds.

“The question is how can we learn from the way this program was designed and apply it to diabetes and other chronic disease and even mental health and addictions,” he says. “I’m hoping this program is a beacon of light for preventative programs across the board.”

As Heart and Stroke gears up to enrol its next cohort, the foundation is inviting employers, unions, health care providers, community associations and other groups to encourage their staff, members, patients and clients to join the free wellness program. Staff from Loblaws, Shoppers Drug Mart and CAA Club Group have already participated and Deloitte and others are on board for the next cohort, Kim says.

For employers with more than 500 staff, Heart and Stroke will send volunteers to the workplace to measure blood pressure and enrol those who qualify. Those who don’t qualify still get access to the foundation’s health resources and a free two-week YMCA membership.

“As everyone knows, a healthier workforce is a happier workforce, with less days off etc.,” Kim says. “We are really keen to know if corporations would spread the word for us because it could really benefit them too.”

Laurie Monsebraaten is a Toronto-based reporter covering social justice. Follow her on Twitter: @lmonseb

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Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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