Michael Kennedy

But University of Toronto economics professor Loren Brandt says the decline in the exchange rate of the renminbi (RMB) relative to the US dollar should be considered in the context of the declining rate of growth in the Chinese economy and the behaviour of other currencies. And he adds the devaluation shouldn’t come as a surprise as the RMB may actually be over-valued.

Brandt, who specializes in the Chinese economy, spoke to U of T News writer Michael Kennedy about what’s behind the move to devalue the RMB and the implications it could have for the rest of the world.

Why did China devalue its currency for the second day in a row?
The devaluation reflects continued weakness in the Chinese economy. As a result of the huge run-up in the debt/GDP ratio after 2008, China continues to deleverage, with predictable effects on the growth of both consumption and investment spending. Policy makers are hoping to offset weak domestic demand with an increase in external demand.

The decline in the exchange rate also needs to be viewed in the context of the behaviour of other currencies, including the Canadian dollar and Euro, both of which have depreciated considerably relative to US dollar (the Canadian dollar dropped approximately 25 per cent while the Euro fell about 10 per cent). Over the same period, the RMB declined only modestly relative to the USD, implying that it appreciated relative to the other two.

Given the fundamental weakness in the Chinese economy, the question in my mind was not so much will the RMB be devalued, but rather, when will it be devalued. How far this goes is hard to say, but weak fundamentals in the Chinese economy suggest a currency that may actually be over-valued at the moment.

How will international markets react?
International markets can be highly fickle; just look at their behaviour in the aftermath of the sharp decline in Chinese equity markets earlier this summer. This decline should not be unexpected. Much harder to interpret is whether the current behaviour of the RMB presages a new era of the RMB, and how it is determined.

What does this mean for Canada?
The Canadian dollar depreciated significantly against the RMB over the last nine months as the Canadian dollar declined in value relative to the USD and the exchange rate between the USD and RMB moved only slightly. The devaluation of the RMB the last few days has only offset a small part of that.

For the Canadian resource sector, this will make its exports to China slightly more expensive, but the impact is small compared to the decline in demand resulting from the sharply falling growth in the Chinese economy over the last two years.

What are the risks for China in taking this move?
The risks associated with allowing the exchange rate to fall are not big. A case can be made that the exchange rate should fall in line with weakening fundamentals.

The more serious concern is that this is one of a series of ad hoc interventions that do not do much to put the economy on a sounder footing for the long run. The heavy-handed interventions in the equity markets in China the last month or so do not do much to help allay some of these concerns. Time will tell if the devaluation is part of a shift to a more market-determined exchange rate and less government intervention, or to ad hoc policy adjustments that may have small, short-run benefits but, in the long run, are very costly.

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Research shows dramatic link between inflammatory bowel diseases and anxiety disorder

sgupta — Fri, 31 Jul 2015 07:58:43 +0000

Research shows dramatic link between inflammatory bowel diseases and anxiety disorder sgupta Fri, 07/31/2015 - 03:58

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Professor Esme Fuller-Thomson, Sandra Rotman Endowed Chair at U of T's Factor-Inwentash Faculty of Social Work (photo by Johnny Guatto)

Michael Kennedy

Author legacy

Michael Kennedy

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If you have inflammatory bowel disease – such as Crohn’s disease or ulcerative colitis – you are twice as likely to have generalized anxiety disorder as someone who does not have IBD, new research shows.

The findings come in a study published on July 28 by University of Toronto researchers.

“Patients with IBD face substantial chronic physical problems associated with the disease,” said lead-author Professor Esme Fuller-Thomson, Sandra Rotman Endowed Chair at U of T's Factor-Inwentash Faculty of Social Work. “The additional burden of anxiety disorders makes life much more challenging so this ‘double jeopardy’ must be addressed.”

Previous studies have shown a link between depression and IBD; however, anxiety disorders are more common than depressive disorders with an estimated 15 per cent of Americans experiencing an anxiety disorder in their lifetime. Generalized anxiety disorder is characterized by excessive fearfulness and worry about a variety of everyday problems, with sympotims worsening during times of stress.

Investigators reported that female IBD sufferers were particularly vulnerable to anxiety disorders. Women with IBD had four times the odds of anxiety when compared to men with IBD, said Fuller-Thomson.

The article was published online in the journal Inflammatory Bowel Diseases. Data were drawn from a representative sample of more than 22,000 Canadians, the 2012 Canadian Community Health Study: Mental Health. A total of 269 respondents reported that they had been diagnosed by a health professional with Crohn’s Disease or Ulcerative Colitis.

“The study draws attention to the need for routine screening and targeted interventions for anxiety disorders,” said co-author and adjunct lecturer Joanne Sulman. “Particularly among the most vulnerable patients with IBD: women, individuals who are in chronic pain and those with a history of childhood sexual abuse.”

Co-author and former graduate student Rusan Lateef noted two other factors that were associated with anxiety disorders among those with IBD.

“Of particular interest was the six-fold odds of anxiety disorders we found among those with IBD who had a history of childhood sexual abuse. Not surprisingly, we also found that those who reported moderate or severe chronic pain had twice the odds of anxiety disorders in comparison to those with only mild or no chronic pain.”

Patrick McGowan, an assistant professor of biological sciences at the University of Toronto Scarborough, says one of the reasons this study is so significant is because it underlines the important link between physical and mental health.

“We sometimes think of the two as if they are entirely separate entities but the reality is they are intimately linked,” said McGowan.“ Both involve genuine physical changes in the body and affect each other.” McGowan was not directly involved with the study.

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Toronto 2015 Pan Am/Parapan Am Games: the Change Room Project

sgupta — Mon, 06 Jul 2015 10:24:22 +0000

Toronto 2015 Pan Am/Parapan Am Games: the Change Room Project sgupta Mon, 07/06/2015 - 06:24

Michael Kennedy

Valerie Iancovich

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Michael Kennedy & Valerie Iancovich

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“The first time I encountered a homophobic slur, it was written on the wall in a locker room in my elementary school.” – Elise, lesbian, graduate student

Walking into a gym locker room can evoke a spectrum of emotions. For many users, it’s a get-in-and-get-out-fast type of experience. But few people talk about why they feel the way they do about these spaces.

Professor Caroline Fusco explores this world through the Change Room Project, an installation on display in University of Toronto athletic facilities just in time for the Toronto 2015 Pan Am/Parapan Am Games.

“This sort of space involves intersections of cleanliness, hygiene, nudity, the body and the sense of looking at other people’s bodies,” Fusco says. “It’s an everyday, mundane space; but it’s a very contested space, too.”

Inspired by graffiti, the student voice and fusing the academic and the co-curricular, Fusco surveyed 54 students, including some from her “Geographies of Health” class and others from U of T more broadly, including the LGBTQ community. The answers to her questionnaire, which explored various topics related to the locker room experience and culture, revealed themes of inclusion, gender, safety, the body, guilt, shame, homophobia and surveillance.

Amanda De Liso, Fusco’s graduate student and research assistant on the project, worked with Hart House’s program coordinator Day Milman and a graphic designer to turn excerpts from the survey responses into vinyl wall decals. The decals will be on display inside change rooms and common areas of athletics facilities on the downtown and Mississauga campuses, with an overview version installed at University of Toronto Scarborough during the Games.

Michelle Brownrigg, director of physical activity and equity for U of T's Faculty of Kinesiology & Physical Education, says the project should help to foster dialogue improve staff training and programming andcreate more welcoming and inclusive spaces at U of T.

“Visibility, voice, recognition and awareness are steps toward the creation of inclusive spaces,” Brownrigg says.“The Change Room project provides a voice and recognition, especially for LGBTQ students in a visible way to create awareness around the issues that can arise for members of those communities seeking to participate in physical activity and sport.”

U of T News writer Michael Kennedy spoke with Fusco about the Change Room Project.

Why did you create The Change Room Project?
The Change Room Project initiative is a collaboration among the PanAm Pride leadership group (i.e., Hart House, the Faculty of Kinesiology and Physical Education, 519 Community Centre, the UTSC & UTM Athletics Centres) and was initiated by UTSC principal and former Olympian Dr. Bruce Kidd. It seeks to critically engage issues of participation and inclusivity in physical fitness as it pertains to mega-games venues and legacy spaces. The Change Room Project investigates how the social and physical experiences of locker rooms impact levels of participation in physical fitness and recreation by LGBTQ students.

Physical activity is an integral component to overall health and well-being. The locker room is the gateway to participation in recreation and athletics, and attention needs to be paid to these spaces from an equity perspective. Voices and bodies of students from the transgender, lesbian, gay, and bi-sexual population are often muted or entirely erased from the design of athletics facilities as well as the policies that inform the usage of these spaces. Although sexual orientation and gender identity are distinct from one another, people who are gender non-conforming or whose sexual orientation is lesbian, gay, bi-sexual or queer, face higher rates of violence, harassment, and exclusion in athletics spaces.

Though the University of Toronto is deeply committed to equity and wellness, there is still much work to be done when it comes to creating safe, inclusive locker room spaces. The Change Room Project represents the continuation of an ongoing dialogue that places LGBTQ voices directly at the centre of the conversation.

What do you hope to see as a result of this project?
The project is designed to build awareness of the experiences of LGBTQ students in athletics and recreation spaces. In representing student experiences in their own words, we hope to shift behaviours and attitudes in locker rooms to be more inclusive, accepting, and reflective, and to advocate for more all-gender spaces that provide options for safer, more inclusive spaces.

Both the physical and social space of locker rooms reflects the cultural bias towards heteronormative, ablebodied, cisgendered individuals and contributes to the underrepresentation of LGBTQ populations in these spaces. Locker rooms are designed around restrictive notions of gender is binaries, one is either male or female. Increased awareness, through dialogue and reflection will help create physical and social spaces where gender and sexuality cease to be barriers to participation in physical activity and recreation.

We hope that as people read the words of LGBTQ students, that they reflect on their own experiences in locker room spaces. People might ask themselves , "what can I, as an individual and as a member of the University of Toronto community, do to create spaces accessible to all people: transgendered or cisgendered, straight or queer?" We are all responsible for creating safe, inclusive and positive spaces.

How effective have LGBT celebrities (Laverne Cox, Caitlyn Jenner, Chelsea Manning, and Canada’s own Jenna Talackova) been at building awareness around the challenges faced by this community?
I imagine that these celebrities do bring attention to the existence of trans gender individuals who have been closeted, passing, and silenced but I am not sure that the everyday lives of trangendered people will change dramatically. While there is a certain acceptance of difference because of the voyeuristic nature of celebrity culture, I would argue that acceptance of celebrity 'queerness' does not always translate to embracing transgenderism in the everyday.

In big cities and small towns across Canada and the USA, I would guess that, despite the visibility of celebrities, there are many transgendered individuals who live in fear of, and experience, violence and harrassment, they cannot get a job, they cannot access athletic facilities or teams, they are thrown out of their housing, and they are disowned by their families and friends everyday of their lives. At such times the realities of one's everyday and the hyper reality of celebrity culture must seem worlds apart. Perhaps, the celebrities but more so events such as the Trans March at Toronto Pride may signal hope for someone who dreams of, and for, a different world.

What advice do you have for LGBT athletes who face barriers to participation and inclusion in their sport?
Find out where the safe spaces are, seek out other LGBTQ athletes and allies, report bullying, homophobic and heteronormative harassment to people who will act on it, know your sport policy on gender non-conforming individuals, keep up-to-date with latest research/studies (e.g., see http://www.outonthefields.com/), be proud, be safe and celebrate your physicality always.

The exhibit will have a presence at Pride House Toronto and U of T Houses during the Games. You can learn more about the project on the Hart House website. Share your thoughts on Twitter #changeroomproject. Feedback will contribute to ongoing research on the locker room experience and will be used to help create more welcoming and inclusive spaces for all.

Also, watch the Canadian Olympic Committee's One Team video that features, athletes, coaches and allies working towards making locker rooms, classrooms and our sports environments more LGBTQ-friendly and welcoming for all.

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Why the U.S. Supreme Court was bound to legalize same-sex marriage: U of T expert analysis

sgupta — Fri, 26 Jun 2015 16:33:04 +0000

Why the U.S. Supreme Court was bound to legalize same-sex marriage: U of T expert analysis sgupta Fri, 06/26/2015 - 12:33

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(photo by Elvert Barnes via Flickr)

Michael Kennedy

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University College

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Understanding the legal arguments, context behind the ruling

In an historic victory for equal rights, the U.S. Supreme Court ruled 5-4 in favour of legalizing same-sex marriage in all 50 states: the constitutionally awarded right to marry will no longer be reserved for heterosexual couples in America.

“Under the Constitution, same-sex couples seek in marriage the same legal treatment as opposite-sex couples, and it would disparage their choices and diminish their personhood to deny them this right,” wrote Supreme Court Justice Anthony Kennedy in support of the ruling.

President Barack Obama hailed it as a victory for America in a statement read from the White House rose garden. “This decision affirms what millions of Americans already believe in their hearts,” said Obama. “When all Americans are truly treated as equal, we are more free.”

U of T News spoke about the Supreme Court’s decision with lawyer Kyle Kirkup, a U of T Doctor of Juridical Science 2016 candidate and former Trudeau Scholar.

Kirkup recently partnered with U of T Law professor Brenda Cossman, director of U of T's Bonham Centre for Sexual Diversity Studies and legal authority on same-sex marriage issues, to co-author a Globe and Mail article predicting the legalization of same-sex marriage this summer.

What’s the significance of the U.S. Supreme Court’s decision to legalize gay marriage?
Today's decision has profound implications. All 50 states of the union are now required to recognize same-sex marriage under the U.S. Constitution. Writing about gay and lesbian couples, Justice Kennedy wrote: "They ask for equal dignity in the eyes of the law. The Constitution grants them that right." In concrete terms, the decision means that couples like April DeBoer and Jayne Rowse, one of the plaintiffs in the case, will finally be recognized as the legal parents to their four adoptive children.

Does this decision come as a surprise, especially from this Supreme Court?
When the U.S. Supreme Court heard oral arguments in the case in April 2015, Professor Brenda Cossman and I wrote in The Globe and Mail that today's outcome was inevitable. No longer in a position to make legal arguments about the inherent sin of homosexuality, opponents of same-sex marriage were left to argue that including gays and lesbians would radically alter the institution. Heterosexuals, they argued, would no longer be interested in marriage if the right was also extended to same-sex couples.

The problem with this legal argument, however, is that there is virtually no empirical evidence to support it. While marriage rates have been declining across the board for years, countries that have legalized same-sex marriage, such as Canada, have seen no greater declines than countries that have upheld traditional definitions of marriage.

What is surprising, however, is to see Chief Justice Roberts issuing such a strongly-worded dissent opposing the court's decision. Many predicted that he would sign on to the majority opinion.

How does will the ruling impact states like Kansas, Montana and South Carolina?
The U.S. Supreme Court has made it clear that same-sex marriage is protected under the Fourteenth Amendment of the U.S. Constitution. All states will be required to follow today's decision, and organizations such as the American Civil Liberties Association (ACLU) will be on standby to ensure that there are no problems when gay and lesbian couples start requesting marriage licences in states like Kansas, Montana and South Carolina.

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Province should fund HPV immunizations for boys in Grade 8: U of T researcher

sgupta — Fri, 26 Jun 2015 12:14:13 +0000

Province should fund HPV immunizations for boys in Grade 8: U of T researcher sgupta Fri, 06/26/2015 - 08:14

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CBC interviews U of T researcher David Brennan at Toronto's Hassle Free Clinic

Michael Kennedy

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Michael Kennedy

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Ontario could save up to $28 million annually with step towards health equity

The province should consider publicly funding immunization against the human papillomavirus (HPV) for all boys and young men, says U of T social work researcher David Brennan – particularly when considering the long-term health of gay, bisexual, other men who have sex with men and those living with HIV.

“HPV poses a serious health problem for males and particularly for gay men, causing 80 – 90 per cent of anal cancers, 40 – 50 per cent of penile cancers and 35 per cent of oral cancers,” says Brennan, a professor at the Factor-Inwentash Faculty of Social Work and an Ontario HIV Treatment Network Applied HIV Research Chair in Gay and Bisexual Men’s Health.

“Right now, the HPV vaccine is provided free to girls in Ontario schools. We believe that all boys in Ontario as well as adult men at high risk for contracting HPV should receive the vaccine as well.”

Brennan’s call for the province to fund boys’ HPV immunization is part of a campaign whose supporters include 60 Ontario physicians, academics and community groups, as well as 13 U of T researchers.

In an interview on CBC Radio’s Metro Morning this week, Brennan said an HPV immunization administered to boys in Grade 8 would save the province $12 – 28 million annually as it reduces the cost burden of treating HPV-related cancers later in life.

“Evidence here and in other countries clearly demonstrates the cost effectiveness and fundamental equity in providing the HPV vaccine to boys and young men,” says Brennan.

“The government is only saving money in the short-term and will pay down the road to treat cancers that can now be avoided.”

Brennan explained the HPV campaign to U of T News.

What prompted your campaign calling on the province to extend HPV coverage to men and boys?

As an Ontario HIV Treatment Network Applied HIV Research Chair, I am part of a coalition of people committed to addressing the health disparities facing gay and bisexual men. HPV is one of the most urgent preventable health disparities. Importantly, it is one disparity that we have within our reach to address immediately!

The current policy to vaccinate only girls is based on out-dated science. HPV is now known to be associated with cancers other than cervical cancer, including oral, penile and anal cancers. The current policy is actually discriminatory to gay and bisexual men because it does not protect men who have sex with other men.

There are already high rates of HPV-related cancers among gay men. We cannot assume that 8th grade boys will know if they are to be at risk for HPV later in life. So it makes sense to vaccinate all boys.

It is also important to note that there are just as many HPV related cancers among men as women. Men are four times more like to have oral cancers that are HPV related than women.

Why would we not vaccinate boys? If it were the other way around, we would be very concerned about leaving girls vulnerable.

Why is the need for vaccinating boys against HPV such an important issue?

The HPV vaccine is not just about cervical cancer anymore. We now know that HPV causes specific cancers in men. Half the population at risk for HPV related cancers are not getting a proven, safe, and effective vaccine to prevent those cancers. We can save lives and promote health, as well as save money in the future, if we act now.

What led you to focus your research on social work and sexual health in the LGBT community?

I came out as a gay man in the early 80s as HIV was gripping the gay community. I was terrified. I dealt with that by getting involved in HIV work. As a social worker, I am very proud of my profession’s commitment to addressing issues such as social justice, diversity and health disparities. Because most of our sexual health education and information is focused on heterosexual sex, non-heterosexual people have limited ways to understand sexual health.

It is hard enough for young people to learn good information about sexual health, but for non-heterosexual young people there are even less resources and it is even more complicated.

Does a young man ask his mom, dad, minister, priest, teacher or older sibling about how to have healthy sex with other guys? Where should he go to get good information to protect himself and his partners? Social work must be at the forefront of ensuring equitable sexual health education for all.

Research shows significant health disparities affect the LGBT community when compared to the wider population. What can we do to address this?

Urgently, we need to support better more comprehensive sexual health information for our young people. If you had a teenage child who you did not know was gay, how would you want them to learn about having healthy sex? From an online website? From you? From a friend? From school?

We must support comprehensive sexual health education so that we are protecting Ontarians from long-term effects of sexual risk. Making useful, accurate and relevant resources accessible so that young people have a variety of ways to get good information is a great starting point. But it is only a starting point.

Secondly, we need to address how we deliver health care to LGBT people. Many LGBT people are not ‘out’ to the primary providers because of homophobia and so may not be getting culturally competent care. Or they may be ‘out’ to providers who may not know the best information about how to address the specific health care needs of LGBT people. Better training on these issues for health care providers is critical.

Along with publically funded HPV vaccinations for boys, what do you hope will happen as a result of your campaign?

I sincerely hope that we can continue to build coalitions that work to develop a stronger, smarter and more effective health care system for all Ontarians. I am working with partners to consider ways in which we can integrate health care systems for LGBT people so that LGBT people in the province have access to relevant, culturally competent and adequate health services.

We often think that equity is about treating everyone the same. This is not true. Equity is about providing an opportunity for everyone to have the same health outcome.

This means sometimes we have to treat some people differently in order to ensure they get quality care. In this case, young gay men who have not had the benefit of having their sexual partners vaccinated over the last six years should still get access to the HPV vaccine.

While we may give the vaccine to all girls and boys in eighth grade, we should still provide it to gay men of any age until gay men can get caught up with the elimination of this virus. That is equity.

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Beat It! Listening to music leads to longer workouts, U of T researchers say

sgupta — Fri, 19 Jun 2015 14:00:20 +0000

Beat It! Listening to music leads to longer workouts, U of T researchers say sgupta Fri, 06/19/2015 - 10:00

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Lee Bartel (photo by Michael Kennedy)

Michael Kennedy

Author legacy

Michael Kennedy

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You're more active during the rest of the day too, study finds

Listening to music while you exercise can increase the length of your workout by up to 70 per cent, shows new research from the University of Toronto. The study found that cardiac patients who listened to music that was synchronized with the tempo of their workout had greater compliance to exercise plans and increased their overall daily activity.

“People walking to music with a beat at the speed of their steps have better fitness results than people who do not use music,” says Professor Lee Bartel, founder and acting director of U of T’s Music and Health Research Collaboratory. “And when people listen to music with an amplified beat – sort of like walking to marching music where the walking beat is very strong – these people have even better fitness results than those just walking with regular music. The effect seems to be that they are more active throughout the rest of their day too, not just while doing their workout.”

The study, recently published in the journal Sports Medicine – Open, was conducted at the Toronto Rehab hospital and involved 34 cardiac rehabilitation patients.

One third of patients did not listen to music during their prescribed cardiac rehabilitation exercises and the other two-thirds listened to music that was selected because its tempo matched the patients’ prescribed walking or running pace – which researchers refer to as tempo-pace synchronized music.

“The music tempo-pace synchronization helps cue the person to take their next step or stride and helps regulate, maintain and reinforce their prescribed exercise pace,” said Dr. David Alter, a Senior Scientist at the University Health Network and professor in U of T’s Faculty of Medicine.

Half of the patients who listened to music heard songs that had been acoustically modified using a technique that amplified the beat. Songs were digitally altered by inserting extra rhythmic beats – called rhythmic auditory stimulation – to further enhance tempo-pace synchronization. The group was not aware their music had been modified.

Patients who listened to tempo-pace synchronized music exercised an average of 105.4 minutes per week longer than patients who did not listen to music. Furthermore, the group whose music had been sonically enhanced with extra rhythmic beats achieved the greatest increase in their total weekly activity, averaging an additional 261.1 minutes or more of weekly psychical activity than their music or non-music listening counterparts – corresponding to a 70 per cent increase in weekly exercise.

“We hope these findings will lead people to select workout music that is at the right pace for their activity instead of just listening to ‘high energy music,’” says Bartel. “We also hope to see a better understanding of the connection between the beat we hear and how our muscles respond. Ultimately, perhaps some product – like an app – might help people find the right music and enhance the beat to make it a more effective workout playlist.”

Researchers are planning future trials to further test the clinical application of tempo-pace synchronized music with and without RAS in cardiac rehab patients.

Bartel is director of U of T’s Music and Health Research Collaboratory (MaHRC), an institute within the Faculty of Music that explores the role sound plays in health. The inter-disciplinary institute was established in 2012 and has recruited 50 researchers from around U of T, its nine partner hospitals, universities around the world and organizations like the Royal Conservatory, the International Association of Music Medicine and the Canadian Hearing Society.

“I had first proposed something like this in 2005 and when Don McLean joined us as the new Dean in 2011, he came from McGill's Centre for Interdisciplinary Research in Music Media and Technology [CIRMMT; pronounced Kermit]. They’re a top-notch, world-class research organization that does a lot of the musical neuroscience in Montreal,” says Bartel. “So when McLean came here he wanted something similar to be established but not quite a replica of McGill’s CIRMMT. When I proposed the idea of MaHRC he was very supportive and appointed me as the first associate dean of research for the faculty which gave me the authority to negotiate and draw in the 20 – 25 labs, institutes and research centres who were willing to affiliate with us and create this Collaboratory.”

MaHRC researchers believe music and sound may play an important role in treating health complications. This year they will be studying the role music and sound can play in the treatment of mental health issues, neurological disorders such as Parkinson’s disease, hearing disorders, fibromyalgia and reducing cognitive impairments in children caused by radiation to treat brain tumours.

“The magic of MaHRC is that it has become a magnet to pull together health and music researchers who normally would not have collaborated,” says Bartel. “There has been good work done, but it has been done in silos. Now, working as a network, we see MaHRC as the root of an explosion of new knowledge that can be applied to many of the most serious health challenges we face.”

Listen to examples of tempo-pace synchronized music* (for best results, use headphones):

*Words & Music to "Need you now the same" by David Alter
Performed by David Alter Music
(c) David Alter 2012
www.davidaltermusic.com

Michael Kennedy is a writer with University of Toronto Communications.

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WHO backs U of T professor's recommendations for reducing pain of vaccines

sgupta — Tue, 02 Jun 2015 14:39:51 +0000

WHO backs U of T professor's recommendations for reducing pain of vaccines sgupta Tue, 06/02/2015 - 10:39

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Yellow fever vaccination drive in Togo, Africa (photo by Norbert Domy via flickr

Michael Kennedy

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When the World Health Organization asked University of Toronto Professor Anna Taddio for help increasing vaccination rates around the world her overriding message was: make the needles less painful and scary.

On May 29, WHO announced it will adopt many of the recommendations proposed by Taddio when she travelled to Geneva to address its Strategic Advisory Group of Experts. (Read about why Taddio was invited to address the group.)

“The World Health Organization has influence over immunization delivery in so many countries so this is a huge accomplishment,” said Taddio, a professor in the Leslie L. Dan Faculty of Pharmacy. “The recommendations we proposed will be implemented in those countries and since other nations look to WHO for guidance, we hope to see our recommendations gradually implemented even more broadly.”

An expert in pain management, especially for children, Taddio leads the Help ELiminate Pain in Kids (HELPinKIDS) project, an inter-disciplinary initiative that brings together clinicians, scientists, policy makers and educators. Her recommendations were aimed at reducing pain which, in turn, promotes vaccination.

“Concerns about pain can lead parents to avoid or delay vaccinations in children,” said Taddio. “And those same concerns or fears can also lead adults to delay their own vaccinations or avoid health-care treatments or decisions.”

In evaluating Taddio’s proposed pain mitigation techniques, WHO said it considered a range of criteria: benefits and harms; resource use and value for money; impacts on equity (would the intervention increase, decrease, or have no effect on health inequalities?), acceptability and feasibility.

While many of Taddio’s recommendations were adopted, her suggestion that topical anesthetics be used to mitigate pain at an injection site was considered unfeasible due to cost and lack of general availability in many low-income countries.

However, WHO acknowledged it is a highly-effective intervention in pain mitigation and recommended it for use in countries such as Canada.

Taddio (pictured at right) said she was pleased with WHO’s report and hopes her recommendations will lead to changes in the way vaccines are administered and an increase in the global vaccination rate.

“About one quarter of adults and two-thirds of children are afraid of needles,” Taddio said. “That’s why it’s so significant that pain and pain management are now explicitly recognized by WHO as part of immunization delivery and immunization programs.”

Taddio said she hopes to see more education about pain mitigation incorporated into the WHO and country-specific immunization field training programs.

“As the relief of pain during health-related procedures is also accepted as a basic human right, mitigation of pain at vaccination should be part of good vaccination practice around the globe.”

Michael Kennedy writes about health and wellness for U of T News.

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One Sweet App: leading nutrition researcher helps consumers check sugar level of food – for free

sgupta — Wed, 27 May 2015 09:23:28 +0000

One Sweet App: leading nutrition researcher helps consumers check sugar level of food – for free sgupta Wed, 05/27/2015 - 05:23

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(all photos by Johnny Guatto)

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She's known around the world for her scholarly research on the dangerous levels of sugar and salt creeping into North American diets.

Now, University of Toronto Professor Mary L’Abbé has helped develop a mobile app so anyone can avoid excess sugar consumption.

“The goal of my research is to help improve the health of Canadians,” says L'Abbé, “and what better way is there to get important health information quite literally into the hands of the people we’re trying to reach?”

One Sweet App is the first mobile application that identifies the ‘free sugar’ content within food products – sugars that are not currently listed on tables that list nutrition facts on food packaging.

Free sugar includes all sugar except what’s naturally found in whole fruit, whole vegetables and unsweetened dairy. Think of ‘added sugar’ plus a bunch of stuff you didn’t know you were supposed to be worried about: fruit juices (even 100% fruit juice), purees, concentrates, honey, and all syrups.

Using the app, a consumer standing in the beverage aisle in a supermarket could compare the sugar content of juices or beverages by brand to learn how much free sugar is packed into a single serving. For example, the app shows 29 grams of free sugar per serving of the President's Choice brand of cranberry and concord grape juice and a whopping 43 grams of free sugar per serving of the Compliments brand can of pink grapefruit drink.

The app will also allow users to record and track their sugar consumption – so, after drinking that beverage, you might choose Astro Original two per cent plain yoghurt (zero free sugars, four grams of naturally occuring sugar) over Activia Plain Sweetened yoghurt (12 grams of free sugar, six grams of naturally occurring sugar).

The app was launched as part of the documentary film Sugar Coated which has its TV debut May 27 on TVO.The award-winning documentary, which exposes an industry believed to responsible for skyrocketing rates of obesity, diabetes and heart disease, recently sold out its four screenings at the Hot Docs film festival.

“Right now nutrition labels tell us about total sugars but recent guidelines from the World Health Organization have shown that most health dangers actually come from free sugars,” says L’Abbé (pictured at right with PhD student Jodi Bernstein.)

There is currently no information available to Canadians on the amount of free sugars in packaged foods, something L’Abbé and the producers of Sugar Coated hope to change.

L’Abbé, the Earle W. McHenry Professor and chair of U of T's department of nutritional sciences, is renowned for her research around Canada’s food and nutrition policies. Her background includes roles as chair of the Canadian Sodium Working Group, co-chair of the Canadian Trans Fat Task Force and advisory positions with Health Canada, the World Health Organization and the Heart and Stroke Foundation.

(Read about L'Abbé's research into sugar in restaurant meals; read about her studies on salt in restaurant meals.)

After learning about L’Abbé’s extensive research around Canada’s food and nutrition policy, the documentary’s producers approached the distinguished scientist about using her food database and research as the engine underpinning a new mobile app.

“They knew they wanted their app to be based on credible data that’s grounded in good science, and that’s why they approached U of T’s department of nutritional sciences,” L’Abbé said.

According to the World Health Organization, people should limit their intake of free sugar to less than 10 per cent of daily energy intake – and less than five per cent whenever possible. That’s a feat many may find challenging, considering a single can of pop will put you over your recommended daily intake.

“The app aims to sensitize users to be aware of sugars and where they are found,” says L’Abbé. “And it allows consumers to identify foods that are high in free sugar, which I absolutely believe will translate to an increased awareness of sugar and its health-related issues.”

Soon, L’Abbé, working with Bernstein, hopes to expand the app to include a consumer research component with a focus on knowledge translation.

“Because we’re scientists and health researchers, we want to know whether this actually helps Canadians make informed decisions about their diet,” says L’Abbé.

They plan to introduce a brief questionnaire to gauge whether people really understand sugar. Through a new feature on the app that allows users to track their daily sugar intake, researchers will be able to measure how useful the app is and whether people are using it to make healthy decisions that change their diets.

“This is a platform that allows us to do research on a scale that is appropriate to the tool,” says L’Abbé. “And although not as intensive as the regular research we do at U of T, the platform allows for very broad distribution.”

L’Abbé says that working with the app’s developers was one of the most interesting and untraditional research opportunities she has ever had.

“As app developers they’re able to tell a scientific message in pictures that don’t require a lot of text,” says L’Abbé. “As scientists we can write you all kinds of paragraphs and supporting evidence but an infographic or visual representation is so much more impactful.”

The app is available online and free of charge from the Sugar Coated website and through iTunes.

Michael Kennedy writes about health and wellness for U of T News.

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Sharing mental health expertise at home and around the world: Dr. Lisa Andermann

sgupta — Fri, 08 May 2015 11:28:04 +0000

Sharing mental health expertise at home and around the world: Dr. Lisa Andermann sgupta Fri, 05/08/2015 - 07:28

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Associate Professor Lisa Andermann began doing outreach in Baffin Island during her residency at U of T (All photos courtesy Dr. Lisa Andermann)

Michael Kennedy

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Michael Kennedy

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As one of Canada’s preeminent cross-cultural psychiatrists, Dr. Lisa Andermann is at the forefront of tackling global mental health challenges.

And it’s a challenge she began preparing for even before medical school.

“I was already passionate about cultural psychiatry prior to entering psychiatry residency,” says Andermann, now an associate professor in the University of Toronto's department of psychiatry. “Having done a BA in anthropology and an MPhil in social anthropology I always knew I was looking for clinical opportunities to work across cultures.”

Today, Andermann is deeply involved with domestic and international mental health outreach programs that target underserved populations in remote locations and underdeveloped countries where mental health treatment must be approached with great cultural sensitivity. And she studies the cultural context of mental disorders and the challenges that can arise when treating mental illness in different cultures.

It's a little-known field that was highlighted recently at the Faculty of Medicine’s Global Mental Health Conference during Mental Health Week.

Since completing her residency at U of T in 2001, Andermann has spent three weeks each year providing psychiatric care to residents in Baffin Island through the university’s Northern Psychiatric Outreach Program (now located at CAMH).

Over the years, she’s learned to be prepared for a variety of different situations.

“Weather is always foremost in mind when planning a trip as a cancelled flight or blizzard can wreak havoc on a tight clinic schedule when a town only has a psychiatrist visiting twice a year for one week,” says Andermann (pictured below left with U of T psychiatry resident Dr. Vanessa Lentz, centre and residents of Igloolik).

“Alternatively, when the weather gets nice in spring and summer, there can be many no-shows to appointments because everyone is out on the land participating in traditional activities like hunting and fishing!”

When she first started travelling to Baffin Island there were no dedicated mental health nurses and, outside Iqaluit, not a single full-time doctor. Since then, the situation has changed. Each community now has an assigned psychiatric nurse who can triage patients, assist with support and follow-up and monitor medications.

In 2003 Andermann and two U of T colleagues traveled to Ethiopia as part of the first psychiatric teaching trip to Addis Ababa University (AAU). That experience became the foundation of the Toronto Addis Ababa Psychiatry Program (TAAPP), the flagship educational collaboration between U of T’s department of psychiatry and the department of psychiatry at Addis Ababa University (AAU) developed by U of T’s Dr. Clare Pain.

“Ethiopia had a number of excellent faculty – clinicians and researchers who were trained abroad, but there was not enough manpower for teaching, supervising and sustaining a new training program,” says Andermann.

So her team quickly got to work assessing the existing framework and helping develop the country’s first psychiatric training program.

“One thing we immediately realized was that we would have to balance instructive teaching in the classroom with offering a variety of opportunities for clinical supervision at rounds, in the emergency room, clinics and at the bedside – services which were very much needed.”

Andermann says her team also recognized a need to introduce various new teaching styles, as AAU professors had a very instructive and formal tradition in their medical education. Getting students to sit in a circle and discuss cases in a small group, engage in role playing activities and practice interview skills was a big cultural shift, says Andermann.

Thanks to the TAAPP initiative there are now five departments of psychiatry outside the capital city of Addis Ababa, run by graduates of the program, Andermann says.

“The country went from having less than 10 psychiatrists in a country of 80 million people to now having more than 50 and a fully operational training program for psychiatrists.”

Before this program was implemented, only the most severely psychotic patients would ever receive treatment at the one psychiatric hospital in the country. Less severe mental illnesses such as depression and anxiety would go untreated.

Today, Andermann leads the selection committee that chooses U of T psychiatry residents to participate in four-week teaching trips at AAU.

“The selection committee looks for residents who demonstrate an interest in teaching, an attitude of cultural humility, curiosity, and flexibility to be able to manage a four-week trip successfully,” says Andermann. “Outreach experiences such as NPOP or Baffin electives are excellent preparation for TAAPP residents as they need many of the same skills and have already had experiences with managing limited resources and working with staff psychiatrists in a very different setting than a downtown teaching hospital.”

Andermann and her colleague Dr. Kenneth Fung are the winners of the Faculty of Medicine’s inaugural Social Responsibility Award in recognition of their leadership on issues regarding equity, social justice and social responsibility, cultural psychiatry and global mental health, promoting dialogue to reduce stigma and increasing public engagement with mental health issues.

Michael Kennedy writes about health and wellness for U of T News.

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Chancellor Michael Wilson named chair of Mental Health Commission of Canada

sgupta — Fri, 17 Apr 2015 14:50:52 +0000

Chancellor Michael Wilson named chair of Mental Health Commission of Canada sgupta Fri, 04/17/2015 - 10:50

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(photo by Tim Fraser)

Michael Kennedy

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Michael Kennedy

The University of Toronto’s 33rd chancellor, The Honourable Michael H. Wilson, has been appointed chair of the Mental Health Commission of Canada.

The long-time champion of mental health initiatives in Canada will replace outgoing chair Dr. David Goldbloom. A professor in U of T’s department of psychiatry and a pillar in the mental health community, Goldbloom has served as both chair and vice-chair of the commission since it was established nearly 10 years ago by the federal government.

Meric Gertler, president of U of T, said he was delighted by the appointment.

“Mr. Wilson is a powerful advocate, nationally and internationally, for mental health care, and has worked tirelessly to help reduce the stigma that so often prevents people with mental illness from seeking treatment,” said Gertler. “These are matters of great importance to all members of our academic community, as well as to all Canadians. On behalf of the University of Toronto, I congratulate him on his appointment.

“I would also like to take this opportunity to thank and congratulate Dr. David Goldbloom, professor in U of T’s department of psychiatry and a prominent member of the Centre for Addiction and Mental Health, for his outstanding service and accomplishments during his term as chair of the commission.”

Elected to the House of Commons in 1979, Wilson served as a senior cabinet minister between 1984 and 1993 and Canada’s ambassador to the United States from 2006 to 2009. He has been a leading proponent of mental health for nearly 20 years, working with such organizations as the Centre for Addiction and Mental Health (CAMH), the Canadian Cancer Society, the Canadian Council for Public-Private Partnerships, and the Canadian Coalition for Good Governance.

In 2009, Wilson was instrumental in establishing the Cameron Parker Holcombe Wilson Chair in Depression Studies at U of T. The vice-chair of the Canadian Institutes of Health Research and honorary chair of Brain Canada, Wilson has also received countless awards for his advocacy.

After his new appointment was announced Wilson sat down with Michael Kennedy, who writes about health issues for U of T News.

It’s been 15 years since you co-founded the Global Business and Economic Roundtable on Addictions and Mental Health. What kind of changes have you seen in the treatment and understanding of depression and mental health in Canada and around the world?

When we got started with the Global Business and Economic Roundtable on Addictions and Mental Health there was very little awareness of mental health issues. I was speaking to a very senior executive of a large organization, for example, and I asked what his company was doing to address mental illness and addiction in the workplace. When he told me it wasn’t an issue I said, ‘Well that’s very interesting; you’re a statistical aberration as one in five people suffer from mental illness and others have an addiction.’

About a month later he called to apologize and said he hadn’t been aware of what was happening within his own company. It was this lack of awareness that we were addressing with the roundtable. We wanted to make sure that people in senior executive positions knew what was going on and were taking an interest so that they could support their colleagues who were suffering.

So, when we started, we needed to convey to people that there was work to be done; there was discrimination and an element of stigma in the workplace. People are still worried about talking to their boss about mental illness or addiction but it’s getting a lot better. People are more willing to go to their boss and say, ‘Look, I need time off and here’s the problem.’

What we’re trying to do with the Mental Health Commission Workplace Standard is make sure that people know what they can and should do when faced with mental illness. It’s no longer a question of awareness but rather doing the right job and making sure that people feel comfortable about talking about mental health. You wouldn’t think twice about calling your boss and saying, ‘I’ve got a bad cold today and I’m not able to come in to work.’ You know that’s not going to affect your job, but people still worry that if they say they have a mental illness it could cost them their livelihood. That’s changing but it’s still a struggle.

What further changes do you hope to see?

The Mental Health Commission of Canada has done tremendous work on a wide range of issues addressing stigma, helping first responders and helping teachers understand and identify serious behavioural changes in students. A lot has happened in the good work that the commission has done. My observation is that we need to put an extra effort on getting our message out. Whether it’s in documents the commission has produced, seminars for people who are affected, advertising, or use of websites and social media – all of these play an important role in distributing our message. So I would put the emphasis on outreach efforts at this stage rather than producing more good work. They’ve done some excellent work – now we’ve got to hear about it.

You’ve been a strong supporter of research in this area and helped established the Cameron Parker Holcombe Wilson Chair in Depression Studies here at U of T. What are the research areas you find most hopeful?

There are a couple of areas I’m very excited about and one is genetics. Dr. Jim Kennedy is doing some very promising work using DNA to narrow the search for effective antidepressants.

Dr. Kennedy can use a subject’s saliva sample to create their genetic makeup, which is then used to provide guidance on what the best medication will be – personalized medicine. In many instances, people with mental illness will cycle through five different medications before finding the most effective drug. It’s a lengthy trial-and-error procedure which takes time and means the patient is often exposed to the unpleasant side-effects that can accompany these drugs, which may lead them to stop taking the medication. Dr. Kennedy’s work has allowed doctors to narrow that search.

As our diagnostic equipment has become more sophisticated, Kennedy’s research is now being used to narrow a patient’s diagnosis. Sometimes psychiatrists know something is wrong with an individual but they’re not quite sure exactly what it is. When you tie what Dr. Kennedy is doing with some of the neuro-imaging research at CAMH, doctors are able to see exactly how and where a medication is working in the brain.

The Temerty Centre at CAMH is researching new treatments for a persistent type of depression that doesn’t respond well to medications. Doctors are using a technique called transcranial magnetic stimulation (TMS), a non-invasive therapy, to stimulate small regions involved with depression. An electromagnetic field generator, or coil, is placed near the patient’s head and, once activated, the electric currents stimulate regions in the brain responsible for mood control and depression.

2015 will mark 20 years since the death of your son by suicide. It isn’t easy to talk about grief and loss but can you tell us a little about him – what he was like?

Cameron loved sports. He was a good hockey, rugby and football player. He played hard and I think it helped him to be successful. I don’t think I’d ever characterize him as being a great student, but he loved sports. He made lots of friends, probably more than he realized. The turnout of his friends at his funeral was overwhelming. The funeral was in Toronto but a number of his friends came down from Ottawa, people that he’d grown up with, and a number of them said to me ‘if only we had known Cameron was suffering, we would have done everything we could to help.’

As he grew older, closer to the time when he died, he had a hard time with relationships because he got to be short-tempered and it ended up costing him his job. That was an indication to us that something was wrong – we weren’t sure what but he clearly wasn’t the fun-loving guy we knew when he was growing up.

In this country, Miriam Toews’ heartrending All My Puny Sorrows is not just an award-winning literary work but also a bestseller. And sports heroes such as Clara Hughes have helped us talk openly about the effects of depression. But how well do Canadians do when it comes to accommodating depression and mental illness in the workplace – or accepting those who seek treatment?

I think people are dealing with mental illness better, but there’s a vast difference between how organizations support their employees. Royal Bank and Bell Canada have been terrific. Royal Bank profiled staff members in their company bulletin who were living with depression and taking medication. They were holding on to their job, were holding on to senior jobs, and it sent some very good messages to people who were worried about talking about their mental illness. Employees realized they could speak openly once they saw people within the organization who had discussed their illness in a public forum and kept their job – they don’t automatically get fired because they have a mental illness or an addiction problem. That did a great job sending the right message to people within the organization who were having difficulties.

Bell Canada’s #LetsTalk campaign is a very important initiative and a great example of an organization affecting change in the mental health field. It has opened the lines of communication and made the work environment a more welcoming and accepting place. The campaign has raised a lot of money for mental health and by doing so, it has raised awareness and given people a sense of, ‘Well, we can talk about this’ and that’s an important part of overcoming the stigma.

But there may be other organizations where it’s not nearly as easy to open up about being directly affected by mental illness. I think we’re doing a lot better but we’ve got to do more.

There’s a generational element to this as well – younger people are more likely to talk about their illness. I met with a group of 40 young people at U of T who wanted to talk about what I had done in my career. During the discussion I mentioned my mental health work in passing and moved on to talk about other aspects of my career. But the students came back to my reference to mental health and wanted to discuss it further. About half a dozen of them talked openly about their own mental illness and one of them said, ‘Look, if anybody in this room has trouble, come and see me because I’ve gone through it all and may be able to help you.’ It was a very healthy, open conversation.

You’ve said that, one way or another, mental illness affects us all. Can you elaborate on that?

It affects us all in that the statistic is one out of five will suffer from a mental illness at some time during their life. But it’s not just the one; it’s the family of the one, and the friends of the one, who are also going to be affected. Mental illness affects rich people, poor people, successful people, not so successful people – it doesn’t discriminate. So when you think of the number of people, I would say it’s the most pervasive illness. It’s a chronic illness in many ways because it’s something that you live with.

Mental illness is a very pervasive and costly disorder. I mentioned the ubiquitous nature of mental illness but we need to remember that it’s also a very costly disorder. When people have to take time off work it impacts productivity and short term disability insurance. So someone may not be directly affected by a mental health disorder but because of these broader implications you can see how mental illness affects us all.

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