Dalla School of Public Health

Non-melanoma skin cancers up 30 per cent in Ontario: U of T study

Christopher.Sorensen — Mon, 04 Oct 2021 17:18:43 +0000

Non-melanoma skin cancers up 30 per cent in Ontario: U of T study

Christopher.Sorensen Mon, 10/04/2021 - 13:18

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(Photo by Steve Russell/Toronto Star via Getty Images)

Topic

Our Community

Temerty Faculty of Medicine

Cancer

Dalla School of Public Health

Research & Innovation

Women's College Hospital

Non-melanoma skin cancers – particularly in people under age 35 – increased 30 per cent in Ontario between 2003 and 2017, according to new research from the �ؿ�ζSM and Women’s College Hospital.

The researchers found that rates of basal and squamous cell cancers, the main types of non-melanoma skin cancer, decreased from 1998 to 2003 then reversed and climbed by almost one-third until 2017.

When stratified by age, the rise in rates in females aged 45 to 64 years outpaced those in males of the same age, while annual incidence rates of new cases were highest in adults under age 35.

“Our findings highlight the importance of stratifying by age when evaluating differences by sex in a population," wrote the study authors.

They were led by An-Wen Chan, a professor in the department of medicine in U of T’s Temerty Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health, and a Phelan Scientist at Women’s College Hospital.

The findings were published in the Canadian Medical Association Journal.

Non-melanoma cancers are the most common malignancies in Canada. Despite a low mortality rate, they nevertheless cause substantial illness and affect quality of life. Even so, mortality rates rose almost five-fold from 1998 to 2017, with rates about 1.8 times higher in males than females, according to the study. Most deaths occurred in adults over age 65.

The researchers suggested that early decreases in rates may be due to skin cancer prevention campaigns in the 1980s and 1990s and that later increases could be linked to the popularity of artificial tanning booths and other behaviours.

Behaviour may be a factor in the higher rates in males and younger females.

“Evidence suggests that males are more likely to have outdoor occupations and are less likely to engage in sun protective behaviours, and females are more likely to seek a tan through artificial tanning booths and sun exposure,” the researchers wrote.

Exposure to tanning is highest in young females and declines with age, the researcher says. Women are also more likely to examine their skin, which could lead to earlier diagnosis than in males.

The researchers urged renewed public health efforts to promote preventive behaviours and encourage early diagnosis.

The study was funded by the Canadian Dermatology Foundation, Biggar-Hedges Foundation and Skin Cancer Canada.

Startup built by U of T alumni aims to reduce wait times for echocardiograms

Christopher.Sorensen — Thu, 28 Jan 2021 18:32:19 +0000

Startup built by U of T alumni aims to reduce wait times for echocardiograms

Christopher.Sorensen Thu, 01/28/2021 - 13:32

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Cloud-based software developed by U of T alumnus Santiago Luna helps sonographers write summaries of echocardiograms for cardiologists, shaving as much as five minutes of the time needed to produce a report (photo by Scott Olson via Getty Images)

Alisa Kim

Topic

Our Community

Institute of Health Policy Management and Evaluation

Alumni

Dalla School of Public Health

Entrepreneurship

Research & Innovation

As a student in the executive master of health informatics (EMHI) program at the �ؿ�ζSM’s Institute of Health Policy, Management and Evaluation, Santiago Luna was tasked with a project: come up with an idea to use information technology to improve health outcomes. So, he drew on his experience as a sonographer specializing in echocardiograms, an ultrasound exam that checks the structure and function of the heart.

With the help of fellow alumni of the program Oliver Tsai and Prabhdeep Dhaliwal, Luna developed cloud-based software that works with any ultrasound machine and applies the latest clinical guidelines to anatomical measurements taken during an echocardiogram, or echo – a commonly prescribed test used to assess and diagnose diseases like heart failure. The software helps sonographers write a summary of the test to give to cardiologists.

Luna says that by shaving just five minutes off the time it takes to produce the report, the technology enables a sonographer to do 240 more echos per year. In jurisdictions like Manitoba, where the wait time for an echo is up to 18 months, the improved efficiency of the report-generating process could reduce wait times by one-third.

“It was only natural that [my] project would have to do with making the ultrasounds better in terms of workflow and process for both clinicians and patients,” Luna says.

The software, which Luna describes as a clinical virtual assistant, processes the anatomical measurements against current clinical guidelines for echocardiograms and highlights, for example, any anatomical issues that may be of concern.

“Our technology automates the report, which makes the reporting a lot faster and simpler, and makes the adherence to clinical guidelines a lot higher. As a result, the quality of the report is significantly improved,” says Luna.

Currently, there is no way to know if sonographers are working with the most up-to-date clinical echo guidelines, much less enforce their use.

Luna says that, like other medical specialties, it’s difficult to stay abreast of all the latest research.

“When you train as a sonographer or cardiologist, there’s a massive amount of information [to learn]. You study a lot and 10 years later, you’re practising and still using the same guidelines from 10 years ago. When new guidelines come out, you get a continuing education credit, but it’s not practical to implement into practice.”

He emphasizes that the tool does not replace the clinician. “We are not telling the cardiologist or clinician what they should be diagnosing or what the diagnosis is,” he says. “What we’re doing is putting the information they need at their fingertips so that they can do what clinicians do: take better images and make a diagnosis, which is what they’re good at.”

With Dhaliwal and Tsai, he is commercializing the software. They’ve named the product Augmented Reporting and have formed a company. Their efforts to move the technology to the medical marketplace are bolstered by seed money from the Lo Family Social Venture Fund, which will enable them to hire people to accelerate development of the tool.

Luna says that the EMHI program provided vital training to get the venture off the ground.

“Julia Zarb, the program director at the time, was instrumental in encouraging me, shaping the idea, and letting me run wild with my imagination while keeping me in line with what the future stakes would need to be,” he says. “The program gave me the foundational knowledge I needed – from project management to IT fundamentals. On top of that, it connected me with my co-founder and partner, Oliver Tsai. Without him, this would not be what it is right now.”

Luna says the ultimate goal is to share the tool as widely as possible to enable better and more equitable cardiac care.

Luna envisions the software being used in rural areas, for example, where there is less access to cardiology expertise, so that the quality of echos done in these areas is on par with that of echos done in big cities.

“The hope is to have a sustainable product that can make enough profit in metropolitan areas to subsidize the areas that do not have the resources to get something like this. The idea is to have technology do what it should do for clinicians: free their time so they can do what they’re supposed to be doing: diagnosing and doing medicine. That’s my hope.”

Do no harm? PhD students target pollution from health-care sector

Christopher.Sorensen — Wed, 09 Dec 2020 14:24:11 +0000

Do no harm? PhD students target pollution from health-care sector

Christopher.Sorensen Wed, 12/09/2020 - 09:24

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Research shows Canada's health sector accounts for 4.6 per cent of the country’s total greenhouse gas emissions, resulting in a staggering 23,000 years of life lost each year from disability or early death (photo by Peter Spiro via Getty Images)

Alisa Kim

Topic

Our Community

Institute of Health Policy Management and Evaluation

Climate Change

Dalla School of Public Health

Graduate Students

Sustainability

If it were a country, the global health-care sector would be the fifth-largest emitter of greenhouse gases – not a great look for a field that promises to “do no harm.”

That’s among the reasons PhD students Victoria Haldane, Anna Cooper Reed and Danielle Toccalino at the �ؿ�ζSM’s Institute for Health Policy, Management and Evaluation (IHPME) along with Dr. Colin Sue-Chue-Lam, are leading a grassroots organization called Emerging Leaders in Environmental Sustainability in Healthcare (ELESH).

The mission of ELESH is to foster interdisciplinary learning and action across the various disciplines and professions that deliver care.

“A lot of the work we do is advocacy-related,” says Cooper Reed, who notes that trainees in health services and policy research are rarely taught that health care is a major polluter.

In Canada, for example, the health sector accounts for 4.6 per cent of the country’s total greenhouse gas emissions, resulting in a staggering 23,000 years of life lost each year from disability or early death, according to a 2019 paper in the Canadian Medical Association Journal.

“This can be a newer area for many faculty and trainees – the nexus of climate change and health and health care. We want to build community and a movement and get students interested in this topic,” Cooper Reed says.

ELESH, which is supported by the Centre for Sustainable Health Systems (founded by IHPME professor Fiona Miller), has developed a framework for thinking about how to transform health systems so that they are more equitable, resilient and sustainable.

In October 2020, the group brought together 10 students from across Canada to form the Health Services and Policy Research Trainee Committee on Environmental Sustainability. The committee discusses how environmental sustainability can influence how research is carried out, what research is done and what students are taught.

The committee held a virtual town hall on Nov. 6 that was attended by representatives from the Institute of Health Services and Policy Research, part of the Canadian Institutes of Health Research (CIHR), to discuss recommendations that ultimately aim to better protect people and the planet.

“It laid out a framework and road map for what we as trainees are committed to doing to help embed [environmental sustainability] into our own practice and curricula, and outlining opportunities for CIHR to help facilitate this,” says Toccalino, who notes there will be another town hall with delegates from CIHR in the spring of 2021 to follow up on the ideas discussed.

The goal is to establish environmental sustainability as a way of looking at health services.

“The status quo is clearly harmful and we have to push towards better systems in whatever ways we can,” says Haldane. “Where there isn’t education, you try and build processes to get that awareness so that it becomes as common as applying a sex and gender lens to your research. We think about the impact of our research in terms of environmental sustainability. We’ve already shown it can be done with other lenses we apply to our work, so why not this lens?”

The group recently completed a virtual case challenge that drew participation from interdisciplinary teams across the country. The event, held jointly with trainees from Choosing Wisely Canada, had teams pitch solutions for single-use products in the Canadian health system, a major source of hospital waste with lasting impact on the environment.

The winning team was a trio of McGill University medical students. They were awarded the first prize of $1,000 for their proposal for equitable distribution and use of menstrual hygiene products in Montreal.

As part of their advocacy work, ELESH is committed to building capacity in environmental sustainability by educating trainees from diverse programs and faculties.

“As the health system is interdisciplinary, we must be, too, if we want to combat this problem,” says Cooper Reed. “I love learning from people from different disciplines like public health, medicine and nursing. It’s this collaborative effort that has been so central to ELESH.” The group holds book club meetings every other month to discuss climate and ecological issues more broadly, not just in relation to health care.

The group also represents trainees at the Sustainable Health Systems Community of Practice, a collaboration between hospitals in the Toronto Academic Health Sciences Network and U of T’s Council of Health Sciences.

Cooper Reed, Haldane, Sue-Chue-Lam and Toccalino are unanimous in their resolve to address the issue.

“I think IHPME training us to be health systems leaders asks us to step into big shoes and transform complicated and, in many ways, deeply flawed, institutions and systems,” says Haldane. “If, as emerging leaders, we want to think ahead to the health systems we will inherit, this is going to be one of the issues. It’s interconnected with equity, racism and with all of these public health crises that are already happening. We’re just trying to do our due diligence to be best equipped to deal with that.”

Sue-Chue-Lam, who is a general surgery resident, says he is optimistic because he sees opportunities for change.

“We are not without agency and health care has a parcel of emissions and ecological impacts that is under our institutional control,” Sue-Chue-Lam says. “Every tonne of carbon matters, so while I may have cynicism about the scale and pace of transformation of other systems that are outside of my control, I’m hopeful about our ability to transform health care and, hopefully, by mobilizing people within health care, that’s a mechanism for social transformation that pushes for bigger changes.”

U of T’s Kamran Khan on how his startup used AI to spot the coronavirus before anyone else: CNBC

rahul.kalvapalle — Wed, 04 Mar 2020 16:30:48 +0000

U of T’s Kamran Khan on how his startup used AI to spot the coronavirus before anyone else: CNBC

rahul.kalvapalle Wed, 03/04/2020 - 11:30

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(photo by Jacklyn Atlas)

Topic

Global Lens

Coronavirus

Institute of Health Policy Management and Evaluation

Artificial Intelligence

Dalla School of Public Health

Global

Startups

Nine days before the World Health Organization alerted the world to the threat posed by COVID-19, an artificial intelligence-powered startup led by the �ؿ�ζSM’s Kamran Khan had already spotted the first signs of an unusual outbreak.

In an interview with CNBC, Khan explained how his company, BlueDot, was able to scour big data and spot the emergence of the novel coronavirus before anyone else.

He said BlueDot uses machine learning and natural language processing to comb through masses of data, which are then reviewed by doctors and computer programmers who create threat reports.

“We don’t use artificial intelligence to replace human intelligence, we basically use it to find the needles in the haystack and present them to our team,” said Khan, an associate professor at the Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health and an infectious disease physician at St. Michael’s Hospital.

He said his experience treating patients during the SARS outbreak in 2003 inspired him to start BlueDot.

“What I learned during SARS is, let’s not get caught flatfooted, let’s anticipate rather than react.”

Read the full story at CNBC

Science Rendezvous brings U of T research from the lab to the streets

geoff.vendeville — Mon, 14 May 2018 13:27:47 +0000

Science Rendezvous brings U of T research from the lab to the streets

geoff.vendeville Mon, 05/14/2018 - 09:27

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Mason Godkewitsch, 8, makes shadow puppets on the walls of the “cell cave” in the student lounge in the McLennan building on the downtown Toronto campus (photo by Geoffrey Vendeville)

Geoffrey Vendeville

Topic

City & Culture

Dalla Lana School of Public Health

Dalla School of Public Health

Graduate Students

Ontario Institute for Studies in Education

Science Rendezvous

STEM

U of T Scarborough

Through fluorescent cells projected onto walls to solar-powered vehicles, the �ؿ�ζSM community showed thousands of people the wonders of science on Saturday.

Science Rendezvous brought U of T research from the lab to the streets to inspire the next generation of scientists. The science festival began in 2008 as an initiative of the �ؿ�ζSM, Ryerson University, York University and the University of Ontario Institute of Technology. It has since become the largest science festival in the country, organizers say.

U of T News captured some of the action over the weekend.

A girl adds to a poster about what it means to be a woman in science, technology, engineering and math (STEM) (photo by Geoffrey Vendeville).

Bulent, 3, looks up at his dad and MBA student Levent Timur from the wheel of Polaris, a solar-powered vehicle made by U of T's Blue Sky Solar Racing Team (photo by Geoffrey Vendeville).

Bona Kim (left), a physiology PhD student, teaches Emma Asgeirsson, 8, about the female reproductive system. Asgeirsson listened to a recorded fetal heartbeat through a stethoscope. "It sounds like someone eating," she says (photo by Geoffrey Vendeville)

Mason Godkewitsch, 8, poses for a photo inside the cell cave in the McLennan building at the downtown campus. The images on the walls are neural cells that started as pluripotent cells in the lab of Radha Chaddah, a visual artist who obtained a master of science in cell and molecular neurobiology (photo by Geoffrey Vendeville).

A boy looks inside a box containing glowing microbes. Scientists from the Centre for the Analysis of Genome Evolution & Function (CAGEF) displayed naturally fluorescent bacteria and bacteria that were made to glow with a gene from jellyfish.

Sylva Donaldson, project manager of CAGEF, says she hoped visitors learned that not all bacteria are bad. “There are a lot of good bacteria in us, on us and in the environment that actually fight off the bad ones.” (photo by Geoffrey Vendeville)

Kids inspect an R2-D2 replica made by the R2-D2 Builders Club at the Bahen Centre (photo by Geoffrey Vendeville).

At the �ؿ�ζSM Scarborough, young visitors learned about spiders from Maydianne Andrade (left), a professor of biological sciences and Canada Research Chair in Integrative Behavioural Ecology (photo by Sara Weales).

Mo Waja is the happiest man with smallpox. He dressed up in period garb for the Dalla Lana School of Public Health’s exhibit of contagious diseases, including whooping cough and measles. (photo by Geoffrey Vendeville)

Master of teaching students Robin Connolly (right) and Isabella Vitale entertain a young visitor to the Ontario Institute for Studies in Education booth (photo by Geoffrey Vendeville)

U of T faculty and alumni named among Toronto Life’s 50 most influential

geoff.vendeville — Tue, 21 Nov 2017 19:34:18 +0000

U of T faculty and alumni named among Toronto Life’s 50 most influential

geoff.vendeville Tue, 11/21/2017 - 14:34

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Margaret Atwood arrives at the primetime Emmy awards in Los Angeles on Sept. 17. She was one of many people with ties to U of T named in Toronto Life's list of influencers in 2017 (photo by Axelle/Bauer-Griffin/FilmMagic)

Topic

Artificial Intelligence

Dalla School of Public Health

Danielle Martin

Geoffrey Hinton

Subheadline

Geoffrey Hinton, Dr. Danielle Martin and many more make the list

Some of the biggest movers and shakers in the city can be found among �ؿ�ζSM faculty and alumni, according to Toronto Life magazine.

Its list of 2017’s most important influencers includes University Professor Emeritus Geoffrey Hinton, the “godfather” of artificial intelligence, and Associate Professor Dr. Danielle Martin, an author and activist who led U.S. Senator Bernie Sanders on a tour of Canadian hospitals.

U of T graduates, like Margaret Atwood, Mayor John Tory and Ontario Premier Kathleen Wynne, also figure prominently in the new ranking.

See the full list in Toronto Life

Hinton, who placed 10^thon the list, is famous for pioneering a field of artificial intelligence called neural nets, which let computers recognize patterns and learn like humans do.

“His breakthrough enables machines to think like humans, bringing to life the stuff of Star Trek-plotlines: self-driving vehicles and smartphones that can diagnose cancer,” the magazine says.

Hinton splits his time between the university, where he heads the Vector Institute for AI research, and a fellowship with Google’s AI research arm.

Want to see handwritten first drafts of The Handmaid's Tale? Visit U of T Libraries

Any list of influencers would be incomplete without some of the top government leaders and U of T alumni, from Mayor Tory (3^rd) to Premier Wynne (7^th) and her conservative rival Patrick Brown (21^st).

U of T alumna Olivia Nuamah was named among the most influential (17^th) after becoming executive director of Pride Toronto. The experienced social justice advocate, who has a bachelor's degree in international development and social anthropology, once worked on British prime minister Tony Blair’s campaign to end poverty.

Puerto Rico facing ‘disaster of major proportions’: U of T public health expert

ullahnor — Thu, 28 Sep 2017 20:32:07 +0000

Puerto Rico facing ‘disaster of major proportions’: U of T public health expert

ullahnor Thu, 09/28/2017 - 16:32

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People carry water in bottles retrieved from a canal due to lack of water after Hurricane Maria struck Puerto Rico a week ago (photo by Hector Retamal/AFP/Getty Images)

Noreen Ahmed-Ullah

Author legacy

Noreen Ahmed-Ullah

Topic

Global Lens

Dalla School of Public Health

A week after Hurricane Maria rolled through Puerto Rico, the island faces a public health crisis with no power and a growing shortage of drinking water and food.

The majority of the island’s 69 hospitals are without electricity or fuel for generators, according to the U.S. Department of Defense, and at least two people have died in an intensive care unit after it ran out of diesel. In many places, there’s no water to drink or bathe in or to flush toilets, with residents forced to use rainwater. U.S. Customs and Border Protection says a plane carrying 3,500 pounds of water, ready-to-eat Army meals, diapers and other supplies is on its way.

“This is a disaster of major proportions,” said Brian Schwartz, interim vice-president, science and health protection for Public Health Ontario, who is also an associate professor in the Faculty of Medicine and the Dalla Lana School of Public Health.

U of T News spoke with Schwartz about the humanitarian crisis unfolding in Puerto Rico.

“I think the real concerns are injuries, heat-related illnesses and dehydration, and infections, both food- and water-borne and then potentially vector-borne as well,” he said. “Because of the power outages and because of the very likely years of inadequate infrastructure and lack of backup generators and backup power, this is going to be a very prolonged and painful recovery period.”

What are the public health and medical concerns right now?

Early on, there were injuries. Now, there’s water shortages and problems especially with heat and dehydration, floodwater from runoffs and tainted food that may be spoiled because of lack of refrigeration. Then, you’ve also got exacerbation of people with chronic diseases like diabetes and heart disease. If people don’t have access to medications or to their health practitioners, their regular diseases are going to get much worse on top of all the things that have happened to them in the first week. The other thing is mental illness. People with mental illness may be in big trouble and not be able to take care of themselves. It’s just a culmination of the injuries of the first week – the heat-related illnesses, dehydration and, on top of that, infections. Going forward, there’s concerns now about vector-borne diseases as well, which we know have been in the Caribbean. This has all been made worse by the fact that there’s no power, and it interferes with transportation. People can't get around, and they don’t have access to the basics of life, in terms of food and water and shelter.

Which vector-diseases are you concerned about at this stage?

Mosquito-borne diseases like malaria, Zika, chikungunya and Dengue fever. And of course, water-borne diseases like cholera are a big concern as well.

Would you consider it a public health crisis at this point?

This is definitely a public health crisis. If you look at the World Health Organization definitions, this fulfils the definition of a disaster. The difference between an emergency and a disaster is an emergency overwhelms a public health system. A disaster actually takes out the health system and the public health system, and so you have neither. This is a disaster of major proportions.

So if we have a disaster here, what should be the next priorities? What needs to happen?

The priority is to get the infrastructure up and running so that services can be provided. Failing that, getting field hospitals with generators to look after the injured, and most importantly getting potable drinking water and proper sanitation. Those basics are the most important things for the population. You can treat the injured, but you also need to look after the entire population. That may be happening, but it’s not happening very quickly. That may be related to a lot of the assets being deployed in other places right now.

Because of the power outages and because of the very likely years of inadequate infrastructure, and lack of backup generators and backup power, this is going to be a very prolonged and painful recovery period.

‘We were always hungry’: U of T research links severe hunger at residential schools to today's health of Indigenous peoples

ullahnor — Mon, 14 Aug 2017 19:03:41 +0000

‘We were always hungry’: U of T research links severe hunger at residential schools to today's health of Indigenous peoples

ullahnor Mon, 08/14/2017 - 15:03

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(Photo courtesy of the General Synod Archives, Anglican Church of Canada)

Nicole Bodnar

Author legacy

Nicole Bodnar

Topic

City & Culture

Indigenous

Dalla School of Public Health

Subheadline

The severe hunger and malnutrition that many Indigenous children suffered at Canadian residential schools have contributed to Indigenous peoples’ elevated risk of obesity and diabetes, according to �ؿ�ζSM public health and anthropology researchers.

“Hunger has always been central to survivors’ accounts of their residential school experiences, and we strongly believe that this testimony must be taken more seriously by researchers and medical practitioners,” said Ian Mosby, a food historian who is an adjunct lecturer at the Dalla Lana School of Public Health.

Mosby and Tracey Galloway, an assistant professor of anthropology, at U of T Mississauga, published their findings in the Canadian Medical Association Journal. They found that for most of the history of the residential school system, Indigenous children were fed poor quality, often rotting food.

Based on survivor testimony, they estimate that the typical diet described by survivors delivered, on average 1,000 to 1,450 calories a day, with moderately active children requiring between 1,400 and 3,200 calories a day.

“We can now be fairly certain that the elevated risk of obesity, early-onset insulin resistance and diabetes observed among Indigenous peoples in Canada arises, in part at least, from the prolonged malnutrition experience by many residential school survivors,” said Galloway.

A lack of calories causes height stunting and a tendency to put on fat when calories are available, predisposing children to obesity, insulin-resistance and Type 2 diabetes. Improper nutrition also has reproductive effects, such as a higher risk of stillbirths, premature births and growth issues for babies.

“The possibility that generations of health practitioners and researchers may have overlooked childhood malnutrition in residential schools as one of the most significant factors influencing Indigenous health in Canada should be a call to action,” Mosby and Galloway write.

They urge health-care practitioners to include more community-driven and culturally appropriate approaches that recognize trauma, to help residential school survivors and their families, and to ensure current and future generations of Indigenous children have access to nutritious and healthy traditional foods.

Associate Professor Suzanne Stewart, director of Dalla Lana's Waakebiness-Bryce Institute for Indigenous Health, agrees this research should be a call to action.

“Indigenous knowledges and research methods must be part of solutions to improve outcomes and close the gap in the health of Indigenous and non-Indigenous people,” said Stewart.

“Further, heath-care systems need to take responsibility for past harms not simply by acknowledging them but by taking a close and hard look at how research and policies continue to oppress and make ill Indigenous peoples.”

How gender affects access to medical treatment in Uganda

sgupta — Fri, 12 Jul 2013 16:12:02 +0000

How gender affects access to medical treatment in Uganda sgupta Fri, 07/12/2013 - 12:12

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Obtaining treatment for diseases such as schistosomiasis poses different challenges for men and women, says Heather Rilkoff of the Dalla Lana Faculty of Public Health at U of T

Jelena Damjanovic

Author legacy

Jelena Damjanovic

Topic

Dalla School of Public Health

Subheadline

Neglected tropical diseases pose different challenges for men and women

Males and females face different challenges in accessing treatment for neglected tropical diseases (NTDs), say researchers at the �ؿ�ζSM's Dalla Lana Faculty of Public Health, Uganda Ministry of Health and Imperial College London.

Their study, published by PLOS Neglected Tropical Diseases July 11, explores the role of gender in access to treatment in the Uganda National Neglected Tropical Disease Control Program.

NTDs are a group of parasitic, viral and bacterial diseases that affect at least a billion people worldwide. Predominantly seen in rural and underserved communities in Africa, the Middle East and Southeast Asia, these diseases can pose significant health risks for both male and female populations. International donors have been funding mass-drug distribution programs to treat neglected tropical diseases for over a decade.

“For females, NTDs, such as schistosomiasis and soil transmitted helminths (worms), can cause pregnancy complications,” says lead author Heather Rilkoff. “On the other hand, NTDs are thought to be somewhat more prevalent in males because men are more likely to have occupational roles, such as farming and fishing, which increase their exposure to the diseases.”

The study suggested that men tend to have more difficulty accessing treatment, which is typically distributed annually house-to-house, as they may spend little or no time at home during the day due to occupational roles such as farming, trading or truck driving, which take place away from the household. Females, on the other hand, tend to be home more often and are more likely to receive treatment.

However, the study also found that women who were pregnant or breastfeeding at the time of the annual distribution, and the community health workers who distributed the medicines, were often unaware of which medicines were safe to take, when it was safe to take them, and where women could find access to the medicines once they were no longer pregnant or lactating.

WHO guidelines advise not providing two of the four medicines used in the program to pregnant or breastfeeding women until several months after delivery. In some communities, pregnant women were not given any treatments at all, even though they could still potentially receive treatments for schistosomiasis and helminth infections. This might lead to a large proportion of women who consistently miss treatment every year.

“This could have implications both for the individual women and the long term impact of the program. In these communities, a woman might spend 50% of her reproductive years pregnant or breastfeeding. Unless women are aware of when they’re allowed to take the medicines, and where to access treatment once the annual mass treatment is over, large proportions of women will go untreated year after year,” says Rilkoff.

Mass-treatment programs, which train community members to distribute medicines within their communities, have been identified as an effective strategy to treat affected populations. However, limited evidence is available to discuss challenges to treatment access, adherence, delivery and monitoring at the community level.

“While there were often similarities across communities involved in the study in terms of gender-based challenges to accessing treatment, there were differences as well. Ensuring that there is health education and effective training of community health workers in each community will definitely help, but the nuances we see between communities also suggests that each community should be supported to create their own solutions to these issues.”

The study suggests a more comprehensive understanding of the nuances and challenges of community-based treatment programmes is needed to address gender-related challenges and ensure future success of the programmes.

“The international community have put in significant efforts to establish these programs. But because the programs are community-based, there really needs to be more resources devoted to supporting the volunteer health workers who administer the medicines to address the gender-related challenges that they face, and to ensure that they are able to carry out their duties without taking time away from their own livelihoods,” says Rilkoff.

This study was co-authored by U of T's Rilkoff, Edridah Muheki Tukahebwa, of the Uganda Ministry of Health, Fiona Fleming and Jacqueline Leslie, of the Schistosomiasis Control Initiative, Imperial College London and Donald C. Cole, of the Dalla Lana Faculty of Public Health, �ؿ�ζSM.

Jelena Damjanovic is a writer with University Relations at the �ؿ�ζSM.

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U of T launches Dalla Lana Faculty of Public Health

sgupta — Tue, 02 Jul 2013 09:02:39 +0000

U of T launches Dalla Lana Faculty of Public Health sgupta Tue, 07/02/2013 - 05:02

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Howard Hu is dean of the Dalla Lana Faculty of Public Health (photo by Rob Waymen)

Nicole Bodnar

Author legacy

Nicole Bodnar

Topic

Breaking Research

Dalla School of Public Health

Non-melanoma skin cancers up 30 per cent in Ontario: U of T study

Startup built by U of T alumni aims to reduce wait times for echocardiograms

Do no harm? PhD students target pollution from health-care sector

U of T’s Kamran Khan on how his startup used AI to spot the coronavirus before anyone else: CNBC

Read the full story at CNBC

Science Rendezvous brings U of T research from the lab to the streets

U of T faculty and alumni named among Toronto Life’s 50 most influential

See the full list in Toronto Life

Read more about Hinton in U of T News

Want to see handwritten first drafts of The Handmaid's Tale? Visit U of T Libraries

Read more about Nuamah in The Toronto Star

Puerto Rico facing ‘disaster of major proportions’: U of T public health expert

‘We were always hungry’: U of T research links severe hunger at residential schools to today's health of Indigenous peoples

How gender affects access to medical treatment in Uganda

U of T launches Dalla Lana Faculty of Public Health