Nicole Bodnar

�鶹ֱ��app researchers create digital 'atlas' to support effective planning of pharmacy services

Christopher.Sorensen — Fri, 25 Jun 2021 19:27:52 +0000

�鶹ֱ��app researchers create digital 'atlas' to support effective planning of pharmacy services

Christopher.Sorensen Fri, 06/25/2021 - 15:27

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Suzanne Cadarette, associate professor at �鶹ֱ��app's Leslie Dan Faculty of Pharmacy, is the lead scientist behind the Ontario Pharmacy Evidence Network (OPEN) Interactive Atlas Tool (photo courtesy of Leslie Dan Faculty of Pharmacy)

Nicole Bodnar

Topic

Our Community

Leslie Dan Faculty of Pharmacy

Researchers at the University of Toronto’s Leslie Dan Faculty of Pharmacy have launched an interactive atlas that provides a snapshot of pharmacist services across Ontario.

Among the first of its kind in Canada, the Ontario Pharmacy Evidence Network (OPEN) Interactive Atlas Tool enables regional comparisons, helping policy-makers plan pharmacist services more effectively.

“This tool is arriving at a critical time for decision-makers,” said Suzanne Cadarette, an associate professor at the Leslie Dan Faculty of Pharmacy who is the lead scientist and author of the atlas tool.

“It describes the evolution of community pharmacy practice in Ontario, can be used as a guide for the expansion of pharmacist service delivery across Canada, and may help health services delivery pivot in the face of external factors, including the COVID-19 pandemic.”

The province began funding several professional pharmacist services in 2007, starting with MedsCheck, a program that remunerates pharmacies for completing medication reviews among patients with diabetes or taking three or more medications for chronic diseases.

Ontario now also funds programs in which pharmacists communicate with prescribers regarding drug therapy-related problems, provide smoking cessation counselling services, administer influenza immunizations and provide COVID-19 testing.

In the initial research brief – published recently in the Canadian Pharmacists Journal – the authors describe how the OPEN Interactive Atlas Tool enables a comprehensive analysis of trends and regional differences in professional pharmacist health services delivery.

Using interactive data visualization software, the researchers display large-scale health care administrative data from 2007 to the most recently available date, then manipulate it based on region, calendar year, sex and age. For example, users can click forward or backward by influenza season to compare influenza immunization delivery over time, or play a video loop of the change in flu vaccine delivery by region.

With these features, the researchers found that more women than men aged 65 or older receive influenza immunizations, yet immunization rates are higher among older men.

Future research briefs for each service are in development that will provide broader context across Canada. Cadarette’s research team urges other provinces and territories to consider creating similar descriptive atlases of pharmacy services as a starting point for discussion, collaboration and education.

“Community pharmacists are one of the most accessible primary health-care professionals, providing a wide variety of evidence-based care. As such, the utility of a pan-Canadian tool would be tremendous,” said Ross Tsuyuki, professor and chair of the department of pharmacology in the Faculty of Medicine and Dentistry at the University of Alberta. He is also editor-in-chief of the Canadian Pharmacists Journal.

With additional funding, Cadarette hopes to update the atlas annually. Her team is also working on an initial descriptive analysis of the impact of COVID-19 on the delivery of professional pharmacist services.

The OPEN Interactive Atlas Tool was funded by the Ontario Pharmacy Evidence Network (OPEN) program’s peer-reviewed Health Service Research Fund, the Government of Ontario and the Leslie Dan Faculty of Pharmacy.

'Superstar' pharmacists play critical role at vaccine clinic hosted on �鶹ֱ��app’s St. George campus

geoff.vendeville — Wed, 24 Mar 2021 14:00:34 +0000

'Superstar' pharmacists play critical role at vaccine clinic hosted on �鶹ֱ��app’s St. George campus

geoff.vendeville Wed, 03/24/2021 - 10:00

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"Considerable finesse and technique" are required to draw doses from each vial of vaccine, says Linda Dresser, pharmacy director of a vaccine clinic hosted by �鶹ֱ��app on the St. George campus (photo by David Dubins)

Nicole Bodnar

Topic

Our Community

Coronavirus

Temerty Faculty of Medicine

UTogether

Leslie Dan Faculty of Pharmacy

Mount Sinai Hospital

University Health Network

Vaccines

Two hours before the COVID-19 vaccine clinic hosted on the University of Toronto’s St. George campus opens, pharmacists show up to receive the vaccines from the university’s hospital partners.

Linda Dresser, the pharmacy director of the clinic and an assistant professor at the Leslie Dan Faculty of Pharmacy, leads the 20-person team whose responsibilities include ensuring the cold chain is maintained throughout the vaccine’s transport.

The team stores and monitors the vaccine vials inside the clinic’s fridges, then prepares the supply using a careful aseptic technique. Each vial must be handled cautiously – no shaking, swirling or dropping.

“Considerable finesse and technique are required to reliably draw multiple doses out of each vial, so we trained a group of pharmacists to repeat these steps multiple times,” said Dresser, who is also on staff at University Health Network (UHN).

Pharmacists at the Toronto Public Health-approved clinic – a satellite site of UHN’s network of vaccination centres that’s managed and operated in collaboration with �鶹ֱ��app and Sinai Health – are also responsible for managing the process to ensure empty vials are recorded as empty, and then safely destroyed.

Natalie Crown and Linda Dresser, both assistant professors in the Leslie Dan Faculty of Pharmacy, prepare for a training session at the �鶹ֱ��app St. George vaccine clinic (photo by David Dubins)

The steps form part of the careful and critical process led by pharmacists to prepare and manage doses at the vaccination clinic near McCaul and College Streets, one of three planned vaccine sites across �鶹ֱ��app’s three campuses.

The St. George clinic welcomed its first patients earlier this month. By the end of March, it is expected to deliver more than 1,000 doses per day.

“We’ve essentially opened a pop-up pharmacy in a short period of time,” Dresser said.

“If these behind-the-scenes processes to prepare the vaccine don’t work really well, it could lead to downstream issues such as long waits or delays in vaccine administration.”

Dresser and her colleagues issued a call to pharmacists across the Toronto Academic Health Sciences Network (TAHSN) to work at the new clinic. The network includes a large number of pharmacy faculty, alumni and preceptors.

Dresser worked with a large group of pharmacy faculty, staff and students to train clinic staff, develop training materials and work on operations and logistics. The team included: Associate Professor David Dubins, Assistant Professor Natalie Crown, Assistant Professor Sandra Bjelajac Mejia, Assistant Professor Marcia McLean and Peter Zhang, a combined PharmD/MBA student.

The clinic hosted by �鶹ֱ��app on the St. George campus expects to vaccinate over 1,000 people per day by the end of March (photo by David Dubins)

During each in-person session, a pharmacy technician provided a refresher on aseptic technique, demonstrated the vaccine preparation steps, coached the pharmacists as they practised doing these steps themselves and built confidence in handling the delicate vials.

While using aseptic technique is part of every pharmacists’ scope of practice, for many it is not a routine part of their practice.

“You can imagine the pressure to meet the demand while working with a temperamental product,” Dresser said.

Lisa Dolovich, dean of the Leslie Dan Faculty of Pharmacy, praised the collaboration between the faculty and pharmacists across the university and TAHSN. “The speed with which we have come together to effectively open the clinic has been truly impressive,” she said.

Lynn Wilson, professor and vice-dean of clinical and faculty affairs at the Temerty Faculty of Medicine, added: “The �鶹ֱ��app health sciences community is committed to helping with the vaccine effort – one of the most important public health initiatives of this century – and pharmacy is essential to our collective success.”

As the vaccine clinic scales up its operations, Dresser anticipates opportunities for pharmacy technicians, pharmacy students and other health-profession learners to help.

Pharmacists may also participate in injections and follow up with vaccine recipients.

“We know there are many students waiting to lend their support,” said Jamie Kellar, an associate professor and associate dean, academic at the pharmacy faculty. “We aim to bring students from across the health disciplines into the space, both to contribute to their learning as well as to build capacity to support the province-wide vaccine rollout.”

Erin Bearss, the medical director of the St. George COVID-19 vaccine clinic and assistant professor in the Faculty of Medicine’s department of family and community medicine, also saluted the pharmacists working on site.

“The role of pharmacy as part of the interdisciplinary team is absolutely critical,” she said. “Our pharmacists are superstars.”

�鶹ֱ��app event to highlight biotech's potential to improve health care, drive post-COVID-19 economy

Christopher.Sorensen — Fri, 12 Feb 2021 15:11:11 +0000

�鶹ֱ��app event to highlight biotech's potential to improve health care, drive post-COVID-19 economy

Christopher.Sorensen Fri, 02/12/2021 - 10:11

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PRiME, a �鶹ֱ��app-led precision medicine initiative, is hosting a Feb. 17 event to highlight the high-growth potential for biomedical innovation and biotechnology in Canada (photo by JVisentin via Getty Images)

Nicole Bodnar

Topic

Our Community

Temerty Faculty of Medicine

Bioengineering

Biotechnology

Faculty of Applied Science & Engineering

Leslie Dan Faculty of Pharmacy

Mount Sinai Hospital

PRiME, a University of Toronto-led precision medicine initiative, is working with partners across Canada to generate support for the creation of a network of biotechnology research hubs across the country that would transform health care and propel the post-pandemic economy.

“Growing our talent base and creating a constellation of new companies launched from universities will be essential to realize the economic development and societal impact that the growth of the biotechnology industry can deliver,” said Shana Kelley, University Professor in the Leslie Dan Faculty of Pharmacy and director of PRiME.

To highlight the high-growth potential for biomedical innovation and biotech in Canada, PRiME is hosting a virtual showcase on Feb. 17 called Building Biotech: Science and Talent Accelerating Biomedical Innovation. It will feature a panel of biotechnology leaders, scientists, entrepreneurs and investors who represent Canada’s three main biotechnology ecosystems in Vancouver, Montreal and Toronto. The panelists will explore how investment in academic science can create societal impact and health security, while also helping to drive post-pandemic economic growth.

“Canadian biotech is a small industry with most of our graduates drawn to opportunities in the world-class U.S. biotech sector,” said Molly Shoichet, a University Professor in the Faculty of Applied Science & Engineering who is a member of the PRiME steering committee and a serial entrepreneur.

“It doesn’t have to be this way. We have homegrown talent with strengths in basic science fundamentals, drug discovery and therapeutic development. What’s missing is meaningful government investment along the continuum of research to commercialization to transform Canadian biotech from a fledgling industry to a true powerhouse of Canadian economy.”

Kelley, Shoichet and colleagues across �鶹ֱ��app say discussion is critical in the context of the pandemic. The global rush to deploy a COVID-19 vaccine – with Canada effectively being out of the game due to the lack of biomanufacturing capacity – highlights how a thriving biotechnology industry could improve the country’s pandemic response while also providing jobs for graduates and significant economic benefits.

There is already evidence the Canadian biomedical community is gaining momentum given recent successes including Repare Therapeutics, a therapeutics company that was based on discoveries made by Dan Durocher, a professor in the Temerty Faculty of Medicine and a researcher at the Lunenfeld-Tanenbaum Research Institute, part of the Sinai Health System. Repare raised more than US$250 million through an initial public offering last year on on the NASDAQ stock exchange. Fusion Therapeutics and AbCellera are two other spinoffs from Canadian universities that also had successful IPOs over the past six months.

Kelley will kick off the event with her talk, “Tackling Disease with Precision Therapeutics and Diagnostics: PRiME and the GTA Ecosystem.” She will be followed by four speakers representing Vancouver’s and Montreal’s biomedical innovation centres – all of whom lead translational and commercialization-focused organizations.

Following these sessions, Andrew Casey, CEO of BIOTECanada, will moderate a panel of entrepreneurs and investors discussing how to build momentum in the biotech sector. He believes that the social and economic impact of the pandemic has increased awareness of the important role the biotech sector can play in delivering innovative solutions.

“It will be biotech-based solutions – including vaccines and therapeutic drugs – that will facilitate the ability of society and the economy to return to normal,” said Casey. “The biotech sector can also play a foundational role in the significant economic rebuild that lies ahead.

“To maintain a globally competitive biotech sector, it is critical that Canada invest now in manufacturing capacity, research institutes, scientific and entrepreneurial talent and companies.”

Kelley said that establishing a network of biotechnology hubs in Canada could be crucial for post-pandemic economic recovery.

“It’s time to transform Canada from a resource-based economy to a knowledge-based economy,” Kelley said. “With government investment, we can work quickly to build infrastructure, gather talent and create a breakthrough-to-commercialization pipeline of made-in-Canada discoveries that will address the needs of today and the unmet needs of tomorrow.”

Christine Allen, �鶹ֱ��app’s associate vice-president and vice-provost, strategic initiatives, said investing in the future is important.

“The biomedical sciences at �鶹ֱ��app and across Canada are an area of significant strength and a critical national resource that must be cultivated,” said Allen, a professor at the Leslie Dan Faculty of Pharmacy. “We must invest in our future and support growth of our ecosystem in this area.”

�鶹ֱ��app expert shares tips and best practices for job hunting, virtual networking

Christopher.Sorensen — Mon, 14 Dec 2020 17:05:50 +0000

�鶹ֱ��app expert shares tips and best practices for job hunting, virtual networking

Christopher.Sorensen Mon, 12/14/2020 - 12:05

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(photo by fizkes via Getty Images)

Topic

Leslie Dan Faculty of Pharmacy

For many, networking is an uncomfortable experience at the best of times. But what happens when you are stuck at home behind a computer?

While the prospect of finding a job during a pandemic is daunting, there are steps University of Toronto students and graduates can take to stand out from the virtual crowd – particularly if you happen to be in a health-related field.

“There’s never been more attention paid to health care or the importance of scientific discovery,” says Monica Gautam, assistant professor, teaching stream, and industrial pharmacy residency program co-ordinator at the Leslie Dan Faculty of Pharmacy.

“I encourage everyone to think about leveraging this visibility when embarking on their career.”

Gautam, who is also managing director at COMPASS Medical Affairs Consulting and Medical Affairs Canada, is considered by many to be the Faculty of Pharmacy’s “personal branding guru.” She recently agreed to share her insights and career advice with pharmacy and pharmaceutical sciences graduates – though her tips on virtual networking and job interviews are applicable to any �鶹ֱ��app student or grad who is seeking to launch a career during COVID-19.

How do you approach networking in a virtual setting?

First off, I would say that networking events are still happening, albeit virtually, so I’d strongly encourage students and graduates to seek out opportunities and attend. Networking isn’t less awkward online. We still need to do the work: prepare, show up, meet new people and reconnect with established contacts electronically.

There are also some practical things that students can do. I’d encourage folks to dress professionally, ensure the lighting is good, position their webcam strategically (it’s better to be looking up than down). Manage your expectations – it’s better to engage meaningfully with two or three people than simply exchanging contact information with 10 people. And always follow up or connect on LinkedIn in a timely fashion after the event.

We can also leverage virtual communications tools to maximize the experience. For example, briefly share your screen if you need to walk through slides to support your discussion. Ultimately, however, you want to maximize your screen space to make the most out of personal engagement. I strongly urge you to test features in advance before giving a presentation. And don’t forget to smile – you want to stand out for right reasons.

Do you have a go-to question that you ask people in networking settings that gets people talking?

I don’t necessarily have one specific question, but people love to talk about their experiences and insights. Something students or recent graduates could ask is: “You’re so accomplished in your career, what advice do you have for someone starting out?”

I also suggest looking for people who are master networkers — those who seem to work the room with ease — and ask to join them.

What’s your approach to networking?

I try to set metrics for myself every month. I set goals for how many people I want to reconnect with and how many new people I want to meet.

I also prepare for each networking event. If it’s a speaker panel followed by networking, I research each panelist. If it’s a sponsored event, I’ll make sure I’m knowledgeable about the organization.

What advice would you give individuals looking for a job right now?

While it is a challenging time to be pursuing a job, remain positive. It’s a full-time job to find a job. Discipline, perseverance and initiative are critical. Employers are not knocking on your door and it’s not uncommon for it to take more than six months to find a job.

I encourage people to be open to – and make the most of – contract roles like maternity leaves, which are excellent opportunities to gain experience. Plus, if you land a contract position, it’s easier to find a job when you’re employed. For students and recent graduates, your first job is likely not going to be your dream job or your last job.

In this uncertain environment, companies are likely to use short-term contracts to fill gaps or allocate resources in creative ways. Applicants must be equally open and creative in their job-seeking approach.

A final word of advice is to be wise in your choice of references. It’s critical to select individuals who can truly speak to your work and character, which may or may not include professors. If you ask one of your professors and they decline, don’t take it personally. They likely feel unable to speak to all of your qualities. Also, never put a reference down without their knowledge.

Have you interviewed any job candidates virtually? Can you share some techniques that impressed you? Any that turned you off?

I’ve conducted about 30 interviews virtually and there are some things that stand out. I’m impressed by candidates that are respectful of time, prepared, pleasant and, when applicable, can deliver an expertly prepared presentation.

I appreciate those who tell a story rather than reading slides and seamlessly navigate technology. I also like when candidates effectively engage their audience by stopping their screen share during the discussion and don’t worry about finding the right slide to answer questions. These people exude a sense of calm and find ways to share their enthusiasm and personality when connecting with the interview panel.

Memorable candidates take the time to do something different such as administering quizzes, using polling features, asking insightful questions or sharing a unique experience.

Since the competition for top talent is high, employers are realizing they must be more efficient with hiring practices. So, I think students and graduates can expect more phone pre-screening interviews followed by a panel-style interview with three to four panelists.

There are also things that stand out for the wrong reasons. It’s always difficult when candidates don’t know how to use the technology. I’m forgiving – if it’s a genuine glitch, don’t sweat it – but test the technology ahead of time. Make sure you have the appropriate volume, find a quiet space and dress professionally. And make sure you are well prepared – it shows.

How are you building relationships during a time of limited face-to-face contact?

I try to be consistent about booking regular virtual coffee meetings, even if it’s just 15 minutes long. And it doesn’t always have to be about business. Ask how people in your network are adapting to the new normal and just check in. Most people are stuck in meeting after meeting and are craving social connection.

I like when people in my network let me know that they’ve moved on to another role, or when they published an important paper – these are great opportunities to quickly touch base and acknowledge their accomplishments. It’s a balance to delicately check in without being intrusive, but you must not reach out only when you need something.

I recommend using platforms like LinkedIn to your advantage. It’s a great way to connect during a time of limited face-to-face contact – plus it allows you to showcase successes while recognizing the people that helped you get there. It’s okay to toot your own horn.

Finally, when building your network, which starts with your peers, think about who else you need to help you achieve your goals – for example, someone in a different sector or new area of work that you want to pursue. I encourage reaching out to people outside of your circle by asking for an introduction or informational interview with decision-makers.

The pandemic brings tremendous uncertainty, but are there any upsides?

Never has there been more attention on health care or the importance of scientific discovery. Everyone sees clinicians and researchers making an impact on the news. Both pharmacists and pharmaceutical scientists are in the public eye now more than ever. It’s a great opportunity to leverage this visibility.

Health-care professionals are recognizing the value that pharmacists have in a community setting. When a COVID-19 vaccine is made available, pharmacists will be instrumental in vaccination education, distribution and administration.

It’s also a time when drug discovery and disease diagnostics are part of the public discourse. I urge pharmaceutical scientists to talk about their research impact to potential employers and not to underestimate the value of their personal story.

Finally, I would say that it’s easy to lead when times are easy. Challenging periods test our resilience and separate the true leaders from others. Now is the time to build critical skills, hone your personal brand and differentiate yourself from the pack.

Women in health care at increased risk for stress, burnout and depression during COVID-19: �鶹ֱ��app study

Christopher.Sorensen — Fri, 24 Jul 2020 14:05:17 +0000

Women in health care at increased risk for stress, burnout and depression during COVID-19: �鶹ֱ��app study

Christopher.Sorensen Fri, 07/24/2020 - 10:05

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The �鶹ֱ��app researchers' early findings suggest the pandemic is resulting a number of serious negative health outcomes for women, who comprise 80 per cent of Canada's health workforce (photo by Steve Russell/Toronto Star via Getty Images)

Nicole Bodnar

Topic

Breaking Research

Coronavirus

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Hospital for Sick Children

Research & Innovation

St. Michael's Hospital

Female health-care workers – who comprise 80 per cent of Canada’s health workforce – are at increased risk for stress, burnout and depression during the COVID-19 pandemic, according to a study led by researchers at the University of Toronto’s Institute of Health Policy, Management and Evaluation (IHPME) at the Dalla Lana School of Public Health.

The paper’s findings, which have not yet been peer-reviewed, are available in pre-print form.

“Our early findings suggest that the pandemic is resulting in a number of serious negative health outcomes for women, specifically younger and mid-career women, triggered by a variety of individual, organizational, and systems-level factors,” said Abi Sriharan, lead author on the paper and an assistant professor at IHPME.

Health-care workers are vulnerable to increased stress, burnout and depression during a pandemic, which can lead to substance abuse and suicidal thoughts. Recent reports show that COVID-19 has socially, psychologically and economically affected women because of their primary caregiving roles as parents and family caregivers.

Sriharan collaborated with Doina Lupea, of the Ontario Medical Association’s Physician Health Program, Savithiri Ratnapalan, of Dalla Lana and the Hospital for Sick Children, and Andrea Tricco, of Dalla Lana and St. Michael’s Hospital, to study stress, burnout and depression among women in health care during coronavirus pandemic and potential interventions. The work was supported by an operating grant from the Canadian Institutes of Health Research.

The research team identified a number of common triggers. They include: individual factors such as age and family status; factors relating to work conditions such as access to personal protective equipment and training and preparedness to care for COVID-19 patients; and systems-level factors such as clear guidelines and recognition for work.

“If we don’t act quickly to create organizational culture to support women working in health care, there will be significant, long-term impacts on our health-care delivery infrastructure,” said Sriharan, who also noted the lack of data on women’s socioeconomic, cultural and ethno-racial differences in mental health outcomes.

Sriharan and her colleagues found that static online mental health resources such as websites, psychological assistance hotlines and co-ordinated group activities for stress reduction are poorly utilized by women. Instead, just-in-time self-help resources such as self-help book recommendations, positive messages and social support are preferred.

A number of additional measures were identified that can positively impact female health-care worker well-being, including financial support, provision of rest areas for sleep and recovery, care for basic physical needs (for example, meal plans during shifts), manageable workload, training programs to improve resiliency, information on protective measures, access to leisure activities and counsellors if needed.

“It’s critical that hospitals pay attention to the work environment and provide health-care workers with tools and ongoing training to care for COVID-19 patients,” said Sriharan. “Further, managers must carefully assess and monitor work hours, workload and the number of COVID 19-positive patients a health-care worker can safely care for.”

Sriharan is hosting a webinar in September targeted at female health-care workers to create a space for discussion, knowledge and resource-sharing.

�鶹ֱ��app students in medicine, public health put their education to work during COVID-19 crisis

Christopher.Sorensen — Fri, 24 Apr 2020 14:20:10 +0000

�鶹ֱ��app students in medicine, public health put their education to work during COVID-19 crisis

Christopher.Sorensen Fri, 04/24/2020 - 10:20

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Ushma Purohit, a second-year student at �鶹ֱ��app's Institute for Health Policy, Management and Evaluation and the Faculty of Medicine, says her studies have never been more relevant than during COVID-19 (photo courtesy of Ushma Purohit)

Nicole Bodnar

Topic

Our Community

Coronavirus

Institute of Health Policy Management and Evaluation

Dalla Lana School of Public Health

Faculty of Medicine

It’s no coincidence that students at the University of Toronto’s Institute for Health Policy, Management and Evaluation (IHPME) at the Dalla Lana School for Public Health are rushing to respond to the COVID-19 outbreak.

That’s particularly the case when it comes to students who are part of the institute’s System Leadership and Innovation program (SLI). Many are actively curating resources and data to support health professionals and community members.

“What we’ve been learning about health-system leadership has never been more applicable and relevant,” says Ushma Purohit, a second-year SLI and �鶹ֱ��app Faculty of Medicine student. “We’re grateful to have the time, ability and resources to help front-line health care professionals and the Toronto community during this pandemic.”

Purohit is involved in a number of COVID-19 activities, including the COVID19 Central website, an online hub of news and resources that simplifies access to information for the general public as well as for health-care providers. To curate these online resources, Purohit worked with a team of SLI students, including Daniel Lee, Monisha Persaud and Geoffrey Sem. The website is currently scaling up to reflect local, provincial and national information.

Geoffrey Sem, Monisha Persaud and Daniel Lee helped create the COVID19 Central website, an online hub of news and resources that simplifies access to information for the general public as well as for health-care providers (photos courtesy of Faculty of Medicine)

Purohit is also working with a separate team to launch a site called COVID19Ask. The website seeks to provide well-researched and expert-verified answers to the most frequently asked questions regarding COVID-19. Under the leadership of �鶹ֱ��app Medicine Assistant Professor Michael Fralick, all answers are reviewed by a team of infectious disease experts, physicians and epidemiologists. Topics include COVID-19 transmission, risk factors, rules of social distancing and vaccine availability.

“The hope is that these websites will address the significant need for credible information regarding COVID-19, and consequently decrease the six-hour wait time that Telehealth Ontario is experiencing,” says Purohit.

Another big COVID-19 resource gap, according to Lee, is front-line health-care professionals’ childcare needs. That’s why during March Break, he helped recruit more than 500 student volunteers from medicine, public health, nursing, social work, and other health faculties to support health professionals with these day-to-day tasks.

“I think all of us were seeing our preceptors and instructors going to the front lines and we want to help out as much as we can,” says Lee, a second-year SLI and �鶹ֱ��app Medicine student.

Lee co-led a steering committee that matched student volunteers with health-care professionals on a one-on-one basis. Volunteer safety is paramount and the committee constantly reviews and discusses public health guidelines to evaluate risks, Lee says.

The student organization has helped hundreds of health-care professionals, clocked thousands of volunteer hours and earned significant media attention for their efforts. Lee says the group’s success is due in part to its clear vision and mission, which were carefully considered from day one.

“To mobilize a team of volunteers in the midst of a pandemic where face-to-face interaction was restricted, we knew we had to create a strong organizational culture that could be felt in a digital space,” says Lee.

Lee says that SLI training was invaluable to inform the scale and impact of volunteer efforts, and to ensure dedicated links of accountability. This experience leading a grassroots student initiative has taught Lee that he’s a systems thinker and ignited his passion for system leadership through structure, roles and architecture. Such thinking combined with a context that takes into account social determinants of health is helping shape the next generation of health-system leaders who understand that medicine is often an acute intervention at the end of a long timeline of social influences.

“The pandemic is highlighting issues among marginalized groups that already existed. For example, individuals that live in homeless shelters or long-term care homes with no option to socially isolate are being disproportionally affected,” Lee says.

To help address social isolation, Lee is also part of the Student-Senior Isolation Prevention Partnership (SSIPP), an ongoing initiative that pairs students with socially isolated older adults in the community to provide weekly phone check-ins to promote social connection and improve health literacy of COVID-19.

Lee works alongside fellow SLI students Persaud, Sem and Victoria O’Driscoll to lead more than 270 student volunteers across �鶹ֱ��app who signed up to participate in SSIPP during the pandemic. Beyond the regular check-ins, volunteers are also teaching seniors to use technology, assisting with grocery delivery and are developing a FAQ for seniors regarding COVID-19 and relevant community resources.

“Ageism and social isolation are among the most prevalent issues faced by seniors today, even before COVID-19, impacting mental health, health-care utilization and quality of life of seniors,” says Persaud, a second-year SLI and �鶹ֱ��app Medicine student.

The partnership is scaling up nationally to include more than 15 additional chapters at universities across Canada. Along with SSIPP’s executive team, Persaud is co-leading the expansion efforts by providing her national peers with process documents, individual training, recruitment guidelines and logistical support for matching.

“SSIPP has taught me about the role of empathy and advocacy in clinical practice,” says Persaud, who admires Assistant Professor Andrew Boozary’s work to address loneliness as a public health issue.

SSIPP fosters empathy and positive attitudes towards older adults, which has been linked to better quality of care amongst clinicians. These differences in outcomes are expected to be assessed in a potential new study of the SSIPP program in collaboration with a number of Toronto Western Hospital researchers, including Sabrina Akhtar and Noah Crampton.

Persaud, Lee and Purohit agree that working during a pandemic is a marathon, not a sprint, and are trying to strike a balance between productivity and self-care.

“I’m 10 times busier now and it’s difficult trying to balance both the SLI and Medicine programs, end-of-term projects and our volunteer commitments, but our instructors have shown flexibility with assignments, which we’re really grateful for,” says Purohit.

“I learned that I’m a better leader when I engage with the vision of the project. Where there’s a need, an opportunity for impact and I have a personal interest in the mandate of the project, I’m more likely to be successful.”

Making cancer risks clear boosts public support for higher alcohol prices: �鶹ֱ��app, UVic study

Christopher.Sorensen — Mon, 27 Jan 2020 16:33:47 +0000

Making cancer risks clear boosts public support for higher alcohol prices: �鶹ֱ��app, UVic study

Christopher.Sorensen Mon, 01/27/2020 - 11:33

Cutline

The study by researchers at �鶹ֱ��app and the University of Victoria involved affixing warning labels on bottles of alcohol in Whitehorse, Yukon (photo courtesy of the University of Victoria)

Nicole Bodnar

Topic

Our Community

Cancer

Dalla Lana School of Public Health

Global

Research & Innovation

People who learn alcohol is a carcinogen – fewer than 25 per cent of Canadians who consume alcohol are aware it can cause cancer – are almost two times more likely to support policies that raise the price of beer, wine and spirits.

That’s the finding of a novel study led by public health researchers at the University of Toronto and the University of Victoria that was recently published in the International Journal of Environmental Research and Public Health.

“Alcohol regulations, particularly regulations that increase the price of alcohol, tend to be unpopular in Canada, but improving public awareness of alcohol-related health harms like cancer, using tools such as adding warning labels to alcohol containers that link consumption and cancer risk for example, increases public receptiveness to alcohol control policies,” said Erin Hobin (left), an assistant professor of epidemiology at the Dalla Lana School of Public Health and senior author of the study.

Research shows that policies increasing the price of alcohol are the most effective intervention for reducing alcohol use and harms, which cost Canadians more than $14 billion annually.

According to Health Canada, 78 per cent of Canadians currently drink alcohol. Alcohol policies in Canada vary between provinces and territories and current trends in many jurisdictions favour deregulation, including in Ontario where beer and wine are now sold in hundreds of grocery stores.

Hobin and her research team hope to change the narrative around alcohol. Their paper described a Health Canada-funded study in Yukon that is part of a larger experiment testing three different tri-coloured alcohol labels: one with a cancer warning (linking alcohol use with breast and colon cancer); the second advising on safer levels of consumption and Canada’s low risk drinking guidelines; and the third illustrating the number of standard drinks per beverage container.

Yukon and the Northwest Territories have the highest alcohol consumption in Canada and their governments have applied alcoholic beverage labels since 1991, including warnings against drinking during pregnancy and an additional message in Northwest Territories that cautions about the dangers of drinking and driving.

But three days after the research team’s intervention launched in Yukon in late 2017, industry representatives requested the labels be removed, sparking international media coverage. Speaking to reporters, industry representatives denied the causal link between alcohol and cancer, and the legitimacy of using labels to communicate health information. The intervention was paused after the first month, but two months later the study resumed on the condition that labels that linked alcohol consumption and cancer was removed from shelves.

For more than 30 years, the World Health Organization has classified alcohol as a group one carcinogen, the same as tobacco smoke and asbestos. Drinking alcohol is known to increase the risk of at least seven different cancer types, even at low doses. For example, in terms of lifetime cancer risk, drinking one bottle of wine per week is the equivalent of smoking 10 cigarettes a week for a non-smoking women and five cigarettes a week for a non-smoking man.

Despite the outcry, the research team completed the study that followed individuals over time and demonstrated that increasing consumer knowledge about the risks of alcohol is associated with an increase in acceptance of strong preventive measures that can effectively curb alcohol use and harms. Just like with tobacco control, increasing pricing is the strongest mechanism to reduce the harms associated with drinking alcohol, the researchers argued.

“Our ultimate goal with this study was to determine if well-designed alcohol labels are an effective tool for supporting consumers in making more informed and safer alcohol decisions,” said Hobin.

“It’s time to change the story around alcohol, which is deeply ingrained in Canadian culture, and well-designed warning labels that provide new information to consumers about its serious health risks may be an important first step in de-normalizing alcohol in Canada.”

Hobin’s research team is also examining if this intervention shifted population-level alcohol consumption patterns using alcohol sales data. A number of follow-up studies are slated for publication later this year.

“With Ontario and other jurisdictions weakening alcohol regulations, we’re seeing increased availability and consumption, which ultimately leads to more harms caused by alcohol,” said Hobin.

“Given the high prevalence of alcohol use in Canada and the perceptions of alcohol as a relatively benign substance, we need innovative approaches to increase public understanding of alcohol risk factors, similar to what we saw as cigarette use and tanning became less socially acceptable because of the risks these behaviours pose for cancer.”

�鶹ֱ��app researchers identify four types of opioid stigma contributing to the current crisis

Christopher.Sorensen — Mon, 02 Dec 2019 16:37:25 +0000

�鶹ֱ��app researchers identify four types of opioid stigma contributing to the current crisis

Christopher.Sorensen Mon, 12/02/2019 - 11:37

Cutline

Methadone and other types of opioid agonist therapy can be an effective way to treat an opioid use disorder, but researchers found patients face stigma because of methadone's association with heroin use (photo by Hailshadow via Getty Images)

Nicole Bodnar

Topic

Our Community

Opioids

Dalla Lana School of Public Health

Graduate Students

Joint Centre for Bioethics

Research & Innovation

Researchers from the University of Toronto have identified four types of opioid-related stigma that depend on a variety of factors, including the context of opioid use, the social identity and networks of the person who is consuming the opioid, and what type of opioid is being consumed, including prescribed opioids.

Each type requires targeted strategies to address the unique stigmas and reduce health inequities, the researchers say. The study was published in the December 2019 edition of the International Journal of Drug Policy.

“We know that stigma is both a driver and consequence of the current overdose crisis, but opioid-related stigma is poorly understood,” said Daniel Buchman, an assistant professor at the Dalla Lana School of Public Health and a senior author of the paper.

North America is in the grips of an opioid-related overdose crisis and stigma, discrimination and prejudice are major contributors. Substance use in general is highly stigmatized, but stigma is a complex concept. Researchers say that there’s a lack of good evidence on the specific sources of opioid stigma, how it manifests in various contexts and its impact on affected groups.

Buchman worked with a research team to conduct a review of publications on opioid-related stigma. The team identified more than 8,500 papers of which 51 were analyzed. Four main themes emerged: interpersonal and structural stigma toward people accessing opioid agonist therapy, which involves taking long-acting opioid medications like methadone and buprenorphine to prevent withdrawal symptoms; stigma related to opioids for the treatment of chronic pain; stigma in health-care settings; and self-stigma.

“Labels like ‘addict,’ ‘drug-seeker’ and ‘junkie’ are barriers to accessing treatment and many people who use opioids internalize these labels and report feelings of self-blame, loathing, despair, shame and moral weakness,” said Melissa McCradden, first-author on the paper and a master of health science student at the �鶹ֱ��app Joint Centre for Bioethics.

Opioid agonist therapy is the gold standard of treatment for opioid use disorders, but researchers found that individuals receiving this treatment face stigma from multiple angles.

For example, methadone’s association with heroin use stigmatizes the medication and the people who use it. The literature suggests that some physicians refuse to prescribe opioid agonist therapy out of fear of being stigmatized by their colleagues. Some patients who are prescribed opioids for cancer pain feel compelled to disclose their identity as a ‘cancer patient’ at the pharmacy in order to differentiate themselves from people on methadone and avoid barriers in accessing their medications.

Stigma in health-care settings was another theme identified by the research team, both in the perception of physicians, nurses and pharmacists toward people who use opioids, as well as within health care’s bureaucratic systems. For example, excessive regulation, paperwork and requirements specific to prescribing opioids may intensify the stigma experienced by people who use opioids.

“The literature suggests that some health-care professionals will make a distinction between patients with legitimate pain who have ‘legitimate’ reasons for accessing opioids, and patients with ‘illegitimate’ pain who do not have legitimate reasons for accessing opioids,” said McCradden.

“This makes a harsh moral distinction between so-called ‘deserving’ and ‘undeserving’ patients. It entrenches stigma.”

Ultimately, researchers say that a paradigm shift is needed to address the structural forms of stigma – including social and economic determinants, laws and public attitudes – in order to have an impact at the individual level.

“Stigma is considered a fundamental cause of population health inequalities and an independent social determinant of health,” said Buchman, who is also a bioethicist at the University Health Network.

The social determinants of health are the conditions in which people live that are shaped by the distribution of money, power and resources. Social disadvantages – such as poverty, housing instability and discrimination – often occur simultaneously and can intensify stigma toward those who use opioids. This further marginalizes individuals, exacerbates health inequities and perpetuates stigma.

Buchman and McCradden say that evidence-based strategies to address stigma and its long-term impact on population health are critical to curb the overdose crisis.

“The more familiar you are with a person, the less likely you are to stigmatize them, so there’s tremendous value in including and amplifying the voices of people who use opioids in health policy-making,” said Buchman.

“Humanizing people who use drugs and moving towards decriminalization of all drugs are key to a cultural shift in re-thinking substance use and redressing opioid-related stigma.”

Perceived loss of social status linked to rising mortality rate among white Americans, �鶹ֱ��app researchers find

Christopher.Sorensen — Thu, 21 Nov 2019 21:45:43 +0000

Perceived loss of social status linked to rising mortality rate among white Americans, �鶹ֱ��app researchers find

Christopher.Sorensen Thu, 11/21/2019 - 16:45

Cutline

The study by �鶹ֱ��app researchers suggests that, possibly for the first time, a widespread population health phenomenon is being driven by a perceived threat to social status (photo by Christopher Burns via Unsplash)

Nicole Bodnar

Topic

Global Lens

Dalla Lana School of Public Health

Faculty of Medicine

Global

Research & Innovation

United States

A new study led by University of Toronto public health researchers suggests rising short-term mortality rates among white Americans “seems driven principally by anxiety among whites about losing social status,” even though there is no evidence that they are in fact worse off.

“This is a startling finding,” said Arjumand Siddiqi, an associate professor of epidemiology at the Dalla Lana School of Public Health and lead author of the study.

“For perhaps the first time, we’re suggesting that a widespread population health phenomenon can’t be explained by actual social or economic status disadvantage, but instead is driven by a perceived threat to status.”

Black mortality rates have been higher than white mortality rates in the United States since the beginning of the country's history. However, since 1999, the mortality fortunes of working-age whites have undergone a reversal while Black mortality rates – like mortality rates of all other groups and all high-income countries of Europe and North America – continue to fall.

The paper, titled “Growing sense of social status threat and concomitant deaths of despair among whites,” is published in the December 2019 edition of Population Health, and examined administrative mortality and social survey data from 2000 to 2016.

The worst outcomes are concentrated in the lowest education group, but signs of damaging trends can be seen through all educational levels. Prior to 1999, mortality rates of white Americans were declining by two per cent each year, on average.

Arjumand Siddiqi, the study’s lead author, is an associate professor of epidemiology at �鶹ֱ��app’s Dalla Lana School of Public Health (photo courtesy of Dalla Lana School of Public Health)

“The anxiety of whites is coming from a misperception that their dominant status in society is being threatened, which is manifesting in multiple forms of psychological and physiological stress,” said Siddiqi, who also holds an academic appointment at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

These psychological and physiological stressors are resulting in more “deaths of despair” – due to alcohol consumption, opioid use, drug overdose and suicide – and, to a lesser extent, rising chronic disease, including hypertension and obesity, according to the study. This widespread decline in health status is actually consistent with – and may even reinforce – a despair-based explanation for worsening white health, explains Siddiqi.

“Status is a major predictor of health so our team hypothesized that it was a perception among whites that Blacks are economically catching up to them, when, in fact, income inequality and other socioeconomic factors continue to affect Black Americans more unfavourably,” said Siddiqi.

Another important finding uncovered by Siddiqi and her research team is the association between rising white mortality and a growing share of Republican voters. From 2000 – when white mortality started to rise – to 2016, their country-level calculations suggests there was an increase in the proportion of Republican voters.

The 2016 presidential election illuminated a growing sense of a racial threat being experienced by white Americans and survey data show that voting for Trump was associated with anxieties about growing racial diversity within the U.S., and an increase in the interdependence of the U.S. with a broader globalizing world.

“With the very real rise in economic instability over the last several decades, we’d expect mortality rates to rise in the most socioeconomically disadvantaged groups of all races,” said Siddiqi.

“But this is not the case. Instead we’re seeing a striking reversal among working-age whites, which seems to be driven principally by anxiety among whites about losing social status to Blacks, even in the absence of evidence, which is a newly identified population health phenomenon that requires further research.”

�鶹ֱ��app's Joint Centre for Bioethics partners with charity on ethical AI for health

noreen.rasbach — Tue, 05 Mar 2019 18:40:30 +0000

�鶹ֱ��app's Joint Centre for Bioethics partners with charity on ethical AI for health

noreen.rasbach Tue, 03/05/2019 - 13:40

Cutline

(Image by geralt via Pixabay)

Nicole Bodnar

Topic

Our Community

Institute of Health Policy Management and Evaluation

Artificial Intelligence

Dalla Lana School of Public Health

Joint Centre for Bioethics

Research & Innovation

Subheadline

A new partnership with AMS Healthcare, a Canadian charitable organization, is supporting the University of Toronto Joint Centre for Bioethics (JCB) to increase research and inform practice on ethical artificial intelligence (AI) in health care.

“We are thrilled to partner with AMS Healthcare in exploring how AI may be a force for good to improve health and health care, particularly from the perspective of patients and providers,” said Jennifer Gibson, director of JCB, based at the Dalla Lana School of Public Health.

The gift is supporting JCB’s AI and the Future of Caring initiative, one of four priority themes in its Ethics and AI for Good Health strategy. The other three priority areas are: Public Trust of AI for Health, Ethical Governance of AI for Health and Equity and the Digital Divide.

AI and related digital health technologies hold promise for promoting healthy behaviours, enabling prevention, diagnosis and treatment of disease, and addressing equity gaps in health policy and planning.

However, there are important ethical questions about what impact AI-enabled health care and related technologies will have on patient-provider relationships and on public trust. For example, will AI tools replace tasks performed by health-care professionals and impact compassionate care delivery?

“This gift will enable us to ensure ethics and social innovation keep pace with the increasing spread of AI technologies in health, and that ethical concerns are addressed proactively, systematically and by design,” said Gibson (pictured left), who is the Sun Life Financial Chair in Bioethics and associate professor in the Institute of Health Policy, Management and Evaluation.

The JCB-AMS Healthcare partnership will support interdisciplinary research, scholarship, knowledge creation and translation activities, including pilot studies, seed grant funding and trainee opportunities. It will also build ethics capacity for research and practice of AI in health care by training and mentoring a new generation of ethics researchers and scholars, and integrate ethics knowledge into policy and practice.

“We’re committed to projects that support compassionate, equitable care. Together with the JCB, we will address ethical issues in the use of AI technologies in health care, particularly their potential impact on the patient-provider relationship and the caring environment,” said Gail Paech, CEO of AMS Healthcare, a nurse and Ontario’s former assistant deputy minister of health and long-term care.

AMS Healthcare aims to promote health-care innovation by supporting leadership development and advancing research in both the humanities and health, ultimately to improve the health of all Canadians.

“By creating a vibrant hub of ethics innovation and practice in a rapidly evolving health environment, this partnership between the JCB and AMS Healthcare demonstrates how our school is at the forefront of change in health,” said Professor Adalsteinn Brown, dean of Dalla Lana.

Nicole Bodnar

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�鶹ֱ��app researchers identify four types of opioid stigma contributing to the current crisis

Perceived loss of social status linked to rising mortality rate among white Americans, �鶹ֱ��app researchers find

�鶹ֱ��app's Joint Centre for Bioethics partners with charity on ethical AI for health

Women in health care at increased risk for stress, burnout and depression during COVID-19: �鶹ֱ��app study