diabetes Archives | Research & Innovation

Chronic high-levels of stress hormone could lead to heart problems

muellerm — Tue, 23 Oct 2012 08:00:00 +0000

Chronic high-levels of the stress hormone cortisol could inhibit the growth of blood vessels and lead to cardiovascular complications, as well as poor skeletal muscle blood flow, in people with diabetes, obesity or Cushing’s syndrome, a new study by 91��ɫ researchers has found.

The study by principal researcher Tara Haas of 91��ɫ’s School of Kinesiology & Health Science and Muscle Health Research Centre in the Faculty of Health in collaboration with 91��ɫ kinesiology Professor Michael Riddell was published online in the peer-reviewed journal in October.

Tara Haas

“Cortisol is a steroid hormone normally present in our body in small amounts, but a continuous increase in cortisol levels is linked with the development of obesity and Type 2 diabetes,” says Haas.�� The research by her team looked at the effects of sustained increases in the levels of the stress hormone corticosterone (the form of cortisol found in rodents) on the smallest blood vessels, capillaries, within skeletal muscles.

What they found, says Haas, “was a substantial reduction, by 30 per cent, in the number of capillaries within the muscle.” As capillaries bring oxygen and nutrients to the muscle cells, this reduction could have significant consequences for muscle function and perhaps even blood sugar disposal.

“This is important as a reduction in the number of capillaries could influence the ability of a person to be active, which could cause their condition to worsen,” says Haas. The finding may help to explain why people with Type 2 diabetes have difficulty growing new capillaries in other tissues, such as the heart.

Michael Riddell

The researchers then took a closer look at the mechanisms involved in the reduced capillary growth by using cultured endothelial cells – those cells that form capillaries – chronically treated with the stress hormone. They found that corticosterone repressed several major intracellular signal pathways involved in controlling cell proliferation and migration, which likely contributes to the lack of capillary growth.

“This research is significant because it highlights that a chronic elevation of stress hormone can have significant negative consequences to the small blood vessels within skeletal muscle that are in charge of providing much needed oxygen and nutrients,” says Haas. “It also points the way to identifying how cortisol, through its effects on blocking appropriate blood vessel growth, may contribute to cardiovascular complications of diabetes or obesity.”

Skeletal muscle endothelial cells in culture

Haas says the findings warrant further research to determine if treatment with synthetic steroid hormones carries similar risks. The capillaries in the skeletal muscles studied were affected using a low, but continuous exposure, to the stress hormone. The amount of synthetic steroid hormones, such as hydrocortisone, people are usually prescribed to block inflammation in the body, can be 25 times higher than the amount used in the study.

Haas is a member of the newly formed Angiogenesis Research Group, which investigates the adaptation of the skeletal muscle capillary network to physiological and pathological conditions.�� The research was supported by the Natural Sciences & Engineering Research Council of Canada (NSERC) Discovery Grants to Haas and Riddell, as well as awards to 91��ɫ students, including Eric A. Shikatani, who was the recipient of a Heart & Stroke Foundation of Ontario Master’s Studentship Award. In addition, student Anastassia Trifonova was the recipient of a NSERC CGSM graduate scholarship, and Anna Krylova and Andrei Szigiato were recipients of NSERC Undergraduate Student Research awards.

By Sandra McLean, YFile deputy editor

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin to research stories on the research website.

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Despite benefits, heart failure clinics rarely used

muellerm — Tue, 14 Aug 2012 08:00:00 +0000

Outpatient heart failure clinics, which provide patient education on risk factor and ways to manage the condition, prescribe home-based exercises and monitor therapy compliance, have shown they reduce morbidity, mortality and health care costs, a new study has found.

Published in the current issue of the , the study reports that despite guidelines encouraging physicians to recommend heart failure clinics, few patients recently hospitalized with heart failure receive referrals or use one.

“Given the demonstrated benefits of these services, the rates of referral and enrollment in our study are discouragingly low,” says lead investigator Shannon Gravely (PhD ’11) of 91��ɫ, the University Health Network and the Toronto Rehabilitation Institute. 91��ɫ Professor Sherry Grace and Professor Liane Ginsburg both of 91��ɫ’s Faculty of Health were also involved with the study.

Shannon Gravely

The investigators recruited 474 heart failure inpatients from 11 hospitals across Ontario. The patients completed a survey that evaluated environmental and individual factors affecting heart failure clinic use. Environmental factors included hospital type, whether the hospital had an onsite heart failure clinic and whether the patient had been referred to other outpatient disease management programs (DMP), such as smoking cessation clinics or diabetes education. Individual factors included socio-demographic information, whether the patient lived in a rural area, marital status, perceived stress and depressive symptoms. Clinical indicators of the need for rehabilitative services were gathered from patient charts.

A year after the first survey, the patients received a second survey. The 270 patients who completed the follow-up survey reported on whether they had been referred to a heart failure clinic and if they had attended.

Results showed that 15 per cent of study participants were referred to a heart failure clinic and 13 per cent reported using one. Patients with higher education were five times more likely to use an outpatient heart failure clinic compared to those with lower education. Lower stress levels and more serious health conditions were also associated with heart failure clinic use. Patients who received a referral to another DMP were nearly five times more likely to use a heart failure clinic. The most important factor in determining whether a patient used a heart failure clinic was the presence of an established program at the patient’s original hospital.

“It’s likely that having an HR clinic on-site is related to greater awareness of the benefits of such services by physicians providing care,” says Gravely. “However, broader referral mechanisms are needed to ensure that all patients, regardless of where they receive care, have equitable access to heart failure clinics.”

In a related study published in the same issue, Gravely and colleagues examined more broadly the use of DMPs by patients with cardiovascular disease (CVD). The survey looked at factors that influenced DMP use and was completed by 1,803 hospitalized patients, along with a follow-up study a year later which assessed whether they had used any DMPs, such as cardiac rehabilitation, outpatient diabetes education, a heart failure clinic, stroke rehabilitation or a smoking cessation program.

Overall, roughly 40 per cent of patients did not access any post-acute DMPs, 50 per cent accessed one program and 10 per cent attended more than one. Among participants with a comorbid indication (diabetes, stroke, heart failure or smokers), 21 per cent of these participants reported that they used multiple programs. DMP participants were younger, more likely to be married and more highly educated than those who did not attend DMPs.

Overall, 53 per cent reported participating in cardiac rehabilitation, and among participants with a comorbid illness or risk, 41per cent of diabetics reported attending a diabetes education center, 26 per cent of stroke patients attended stroke rehabilitation, 13 per cent of patients with a heart failure diagnosis used a heart failure clinic and 12 per cent of smokers attended a smoking cessation program. Among all study participants these findings suggest a gross underuse of DMP services, particularly stroke rehabilitation, heart failure clinics, and most notably, smoking cessation programs.

“What is one of the most concerning findings is that only 12 per cent of current smokers reported taking part in a smoking cessation program,” says Gravely. “Participation in smoking cessation programs results in significantly higher cessation rates when compared with standard care.”

Gravely notes that future research is needed to explore not only patient-related factors, but also health-system factors, such as awareness and capacity that may be at play. “The appropriateness and cost repercussions of multiple DMP use should be investigated, as an integrated approach to vascular disease management may be warranted.”

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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New associate dean of research and partnerships appointed for Faculty of Science and Engineering

muellerm — Tue, 31 Jul 2012 08:00:00 +0000

Professor Robert Tsushima will take on the role of Associate Dean, Research and Partnerships in the Faculty of Science & Engineering for a three-year term, effective Aug. 1.

Tsushima, professor in 91��ɫ’s Department of Biology, holds a Career Investigator Award from the Heart & Stroke Foundation of Ontario. His research program investigates the molecular and cellular basis of heart and pancreatic islet function, with implications for addressing heart disease and diabetes. He has been supported by the Canadian Institutes of Health Research (CIHR), the Heart��& Stroke Foundation and the Canadian Diabetes Association.

Robert Tsushima

Prior to joining 91��ɫ in 2007, Professor Tsushima was a faculty member for eight years at the University of Toronto. He received his PhD in pharmacology from the University of Western Ontario, followed by postdoctoral training at Northwestern University in Chicago and Toronto General Hospital.

He has served on national and provincial grant review panels, including those of the CIHR, Heart��& Stroke Foundation, Canadian Diabetes Association, Alberta Heritage Medical Research Foundation and Banting Foundation, and reviewed for numerous international granting agencies. He is currently on the editorial board of the American Journal of Physiology, Endocrinology and Metabolism.

“We’re delighted to have an academic of Professor Tsushima’s distinction joining us in this role,” said Don Hastie, interim dean, Faculty of Science & Engineering. “He has already contributed much to the Faculty and to 91��ɫ as a whole. We look forward to working with him as we continue to shape and build our research program.”

Tsushima replaces Professor Imogen Coe, who will relocate to Ryerson University as the founding Dean of Science, effective Aug. 1.

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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Faculty of Health to celebrate its innovative research

fmaquito — Thu, 12 Jan 2012 10:00:00 +0000

Can exercise turn back the clock for aging muscles? Is aerobic or resistance exercise better for decreasing the risk of diabetes in youth? Those are just two of the questions researchers will discuss at the upcoming Faculty of Health Research Celebration.

Robert Haché (left), 91��ɫ's vice-president research & innovation, and Harvey Skinner (below right), dean of 91��ɫ’s Faculty of Health, will host the Research Celebration, Tuesday, Jan. 17, from 2 to 4 pm, in the Scott Library Atrium, Keele campus.

The celebration will highlight innovation in muscle health research at 91��ɫ and will include talks from four Faculty of Health researchers discussing their work.

"This celebration provides an opportunity for the 91��ɫ research community to share knowledge and ideas and to come together to learn more about the breadth and depth of innovative research taking place at the University,” says Haché.

The four researchers will discuss the role muscles play in everything from obesity and diabetes to osteoarthritis and reversing the aging process.

“Keeping people healthier longer, so that they can age positively and avoid chronic diseases and injuries, is at the heart of this celebration of ground breaking research underway in the Faculty of Health,” says Skinner.

Professor Rolando Ceddia, a Canadian Institutes of Health Research New Investigator, will discuss “Improving Muscle and Adipose Tissue Function to Treat Obesity and Diabetes: The Role of Exercise and Diet”.

“My research investigates the molecular and physiological mechanisms by which obesity induces dysfunctional metabolic alterations in adipose tissue and skeletal muscle; two tissues that play crucial roles in regulating energy and glucose homeostasis,” says Ceddia, of 91��ɫ’s Muscle Health Research Centre in the School of Kinesiology & Health Science.

Left: Rolando Ceddia��

“We study the effects of exercise, either alone or in combination with nutritional and pharmacological interventions, on glucose and lipid metabolism in diet-induced obesity.”

The presentation will look at the adaptive responses induced by chronic endurance training in skeletal muscle and adipose tissue metabolism, as well as the implications for whole-body energy expenditure. The main goal is to understand the role of exercise and diet in the prevention and/or treatment of obesity and its co-morbidities.

Professor Jennifer Kuk (right)��of 91��ɫ’s School of Kinesiology & Health Science will look at “Aerobic Versus Resistance Exercise for Decreasing Diabetes Risk in Obese Youth”. The focus of this talk is to examine the effectiveness of aerobic and resistance exercise for improving insulin resistance in youth using a randomized control design.

Insulin resistance at the site of the muscle is one of the hallmark characteristics of pre-diabetes and Type��2 diabetes, says Kuk. Increasingly, youth are presenting with insulin resistance. It is increasingly important to develop non-pharmacological interventions for treating insulin resistance.��

Aerobic and resistance exercise help improve insulin resistance in adults. Aerobic exercise improves muscle glucose metabolism and resistance exercise increases the muscle mass available for uptaking glucose.��

Biology Professor David Hood (left), a Canada Research Chair in the School of Kinesiology & Health Science, will discuss the topic, “Can Exercise 'Rescue' Aging Muscles?” Skeletal muscle occupies about 40 per cent of body weight and is a major contributor to whole body health and metabolism.

“As we age, we lose muscle mass, and this is apparent in elderly, frail individuals. The mechanisms of how this muscle mass is lost are not completely understood, but a prominent theory involves the increasing malfunction of mitochondria within muscle cells,” says Hood. “Mitochondria are the powerhouses of the cell, the organelles which supply the energy for cell survival.”

With age, mitochondrial content within muscle declines and they begin to produce molecules called “reactive oxygen species” which inflict damage on cellular DNA. If the DNA in any cell breaks down, the cell dies. In the case of muscle cells, they atrophy or shrink. If many cells atrophy, the body loses muscle mass.

“Research has shown that exercise is a potential non-pharmacological therapy which can be used to reduce the loss of muscle mass by improving mitochondrial function, thereby preserving muscle function as we age,” says Hood.

Professor William Gage (right), associate dean research & innovation, will examine “Muscles and Sore Joints: Arthritis and Muscle Activity”. The knee and hip joints experience large loads when a person walks, says Gage. To deal with those loads, the joints and surrounding muscles act together to allow a person to move, while protecting the joints from the loading that occurs during movement.

As a person moves, their muscles are activated or turned on at the right time by the right amount so their joints will not only move, but their limbs won’t collapse under the weight, says Gage. Sensors in the joints contribute to the nervous system’s knowledge of when and how the muscles should be turned on.

Previous research has shown that when a joint is painful or swollen the sensory information coming from these joint sensors is affected, which in turn affects the activation of the muscles around the joints. A long-term outcome of this response may be osteoarthritis, the most common form of arthritis, affecting more than 50 per cent of those over the age of 65.

“Recent research in our lab has examined how different strategies during walking may influence the amount of loading in the knee joint and how muscles around the joint respond to loads that are imposed on the knee joint,” says Gage. “Future work in our lab will explore how loading and muscle activity are affected by changes in the sensory information that arises from the knee joint.”

To RSVP to Lia Novario, by Friday, Jan. 13, or call ext. 33782.

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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High doses of vitamin D might affect Lou Gehrig's disease

fmaquito — Wed, 04 Jan 2012 10:00:00 +0000

High daily doses of vitamin D may improve the quality of life for patients diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s disease, a study at 91��ɫ has found.

Using an animal model, the study’s researchers found that the motor performance and muscle endurance of mice with ALS improved when they were given higher than normal doses of vitamin D.

“We are the only group in Canada that is looking at the connection between dietary interventions and the effects on the ALS model,” says 91��ɫ kinesiology Professor Mazen Hamadeh (left)��of the University’s Muscle Health Research Centre in the Faculty of Health. Hamadeh supervised the research led by 91��ɫ master of science degree students Jesse Solomon and Alexandro Gianforcaro in the School of Kinesiology & Health Science.

The researchers conducted three different studies looking at different amounts of vitamin D. The first looked at the effects of 10 times the adequate intake of vitamin D on the ALS animal model – the equivalent of 8,000 IU/day in humans. Results showed an improvement in both motor performance and endurance, but no change to disease outcomes, such as onset, progression or lifespan.

“We followed up with another study because we thought we didn’t give high enough amounts of vitamin D,” says Hamadeh. In the second study, the amount of vitamin D was increased to 50 times the suggested adequate intake amount or the equivalent of 40,000 IU per day in humans. Again, there was definite improvement in functional outcomes, but not in disease outcomes, confirming the findings of the first study, he says.

The researchers then thought that perhaps the recommended adequate intake amount of vitamin D was set too high and there was already an overabundance of vitamin D being administered. That led to a third study where only one fortieth of the recommended adequate intake amount was administered using the animal model, which induced a vitamin D deficiency. This study was published in PLoS ONE, an international online peer-reviewed journal, on Dec. 27.

This third study produced some interesting results, says Hamadeh. When vitamin D deficiency was induced before disease onset, disease severity was reduced, but after disease onset, it was worse. “So at very low levels there is something happening in the cell that is causing them to function better only for a little bit of time, only until disease onset, than they progress regularly,” he says.

The key now is to find out what molecular changes are occurring in the muscle, spinal cord and brain when vitamin D is administered, and that is what Hamadeh and his students are currently working on.

“ALS is the most common motor neuron disease and up until now there is no cure for it. It is also a fast-progressing disease. Between diagnosis and death, there are usually two to five years. We are trying to see whether by modulating the diet, by changing the diet, we can influence not only when the disease starts, but how fast it progresses and whether it can affect lifespan,” says Hamadeh.

“To find a dietary intervention that could influence a fast-paced disease after diagnosis of the disease, meaning after some irreversible damage has happened, means this particular nutrient has to be very powerful to either halt or slow the pace of the disease.”

The model Hamadeh works with suffers from heightened oxidative stress, a state of increased levels of free radicals or oxidants that are produced naturally inside the cell during normal functioning and metabolism. There is an association between oxidative stress and chronic, metabolic, autoimmune, neurodegenerative and neuromuscular diseases, including ALS, Type 1 and Type 2 diabetes, cardiovascular disease, obesity, hypertension, Alzheimer’s, Parkinson’s and multiple sclerosis.

Hamadeh hopes his research and that of his students will help not only ALS, but many other similar diseases that share common mechanisms with ALS.

By Sandra McLean, YFile writer

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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Biologists zero in on protein that may help treat obesity and diabetes

fmaquito — Thu, 11 Aug 2011 08:00:00 +0000

A newly identified protein may hold the key to keeping appetite and blood sugar in check, according to a study by 91��ɫ researchers.��

Suraj Unniappan, a��biology professor specializing in neuroendocrinology, is delving into the metabolic effects of a protein called nesfatin-1, abundantly present in the brain.��His studies found that rats administered with nesfatin-1 ate less, used more stored fat and became more active. In addition, the protein stimulated insulin secretion from the pancreatic beta cells of both rats and mice.

Left: Suraj Unniappan in his lab

“[The rats] actually ate more frequently, but in lesser amounts,” says Unniappan, a member of 91��ɫ’s neuroscience graduate diploma program, and a recipient of a Canadian Institutes of Health Research (CIHR) New Investigator Award. “In addition, they were more active and we found that their fatty acid oxidization was increased. In other words, the energy reserve being preferably used during nesfatin-1 treatment was fat. This suggests more fat loss, which could eventually result in body weight loss,” he says.��

The findings were reported in two recent research articles from Unniappan’s laboratory: one published today in and another in March 2011 in the . Discovered by a research team from Japan in 2006, nesfatin-1 was earlier found to regulate appetite and the production of body fat when injected into the brain of mice and rats.

Unniappan’s findings indicate that the protein stimulates insulin secretion from the pancreas, a glandular organ, which contains clusters of cells called the islets of Langerhans. These islets produce several important hormones, including the primary glucose-lowering hormone, insulin.

Previously, Unniappan’s team studied mice and found similar results; not only was insulin secretion stimulated, but nesfatin-1 was observed to be lowered in the pancreatic islets of mice with Type 1 diabetes and increased in those with Type 2 diabetes. In Type 1 diabetes, the body no longer produces insulin due to the destruction of cells within the pancreas. In Type 2 diabetes, the body becomes insulin resistant, and obesity often results.

Unniappan’s research, conducted in the Laboratory of Integrative Neuroendocrinology in the Biology Department at 91��ɫ, focuses on identifying and examining the biological effects of gut- and brain-derived appetite-regulatory and metabolic hormones in fish and mammals.��

“We call this the ‘gut-brain axis,’” says Unniappan. “While the brain is involved in many factors that regulate our energy balance, the gut is also responsible for many neural and endocrine signals responsible for regulating hunger, satiety and blood sugar levels. A major question we’re trying to address is how these peptides act and interact with other peptides in the endocrine network – which is so complex – in order to maintain steady blood glucose levels and body weight,” he says.

A better understanding of this gut-brain axis could contribute to developing potential pharmacological interventions for diabetes and obesity.

“New hormone-based treatments that would suppress body weight and blood sugar would be very desirable. However, we are far from developing nesfatin-1 as a candidate molecule. Our current research focuses on further exploring the therapeutic potential of nesfatin-1 in metabolic diseases with debilitating complications,” Unniappan says.

The lead author of both publications is Ronald Gonzalez, a recently graduated PhD student from Unniappan’s lab. The research was conducted in close collaboration with co-authors and 91��ɫ professors Robert Tsushima and Rolando Ceddia. Unniappan’s research is supported by grants from CIHR, the Natural Sciences and Engineering Research Council of Canada, (NSERC), the Canada Foundation for Innovation (CFI), the Ontario Ministry of Research and Innovation, and the James H. Cummings Foundation.

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin.

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New partnership embeds 91��ɫ researchers at Southlake Hospital

fmaquito — Mon, 14 Mar 2011 08:00:00 +0000

A new research initiative involving a partnership between 91��ɫ and in Newmarket will see��feature leading scientists from the University serving as embedded researchers at the hospital.

91��ɫ Professors Chris Ardern, , Paul Ritvo and Lauren Sergio will work on site��for one to��two days a week with hospital clinicians to foster research collaborations and knowledge exchange, and engage in joint knowledge mobilization efforts.

The partnership will realize important benefits to the research communities at both institutions and for the general public, says 91��ɫ Professor (right), associate vice-president research, science & technology, who led the effort to develop the partnership with Southlake Regional Health Centre.

"The embedded 91��ɫ researchers are senior scientists who will explore and cultivate research collaborations between 91��ɫ and Southlake researchers and clinicians," says Siu. "They will act as 'matchmakers' and brokers and will bring��91��ɫ's��research expertise and knowledge to Southlake to��facilitate collaboration.

"The partnership will broaden the research capacity for both 91��ɫ researchers and the Southlake clinicians," says Siu. "91��ɫ does not have a Faculty of Medicine��or��a teaching hospital. As a result,��University researchers do not��have the patient access��they would like to have. By working with Southlake,��the University is enhancing a collaboration that would benefit both parties."

The embedded��University scientists��bring to Southlake Regional Health Centre��their recognized expertise in biomedical and health research. Southlake is the only community-based hospital in Ontario to offer six regional tertiary programs, including child and adolescent mental health, maternal and child,��cardiac and cancer care.

"We anticipate this to be an outstanding opportunity for both Southlake and 91��ɫ," says , director of research at Southlake.

"Serving some 1.5 million people through our regional programs and providing tertiary level care in many areas, the depth and breadth of programs and services, and the unexplored opportunities for reasearch collaboration between Southlake and 91��ɫ are endless," says Clifford.

"Southlake is interested in strengthening its research in terms of breadth and depth and in fact, Southlake is developing a research institute with a plan to��become a teaching hospital with an official affiliation with a Canadian university," says Siu.

91��ɫ is��a preferred candidate for this kind of partnership with Southlake, says Siu,��because the two institutions have shared goals and visions, and a willingness to work together.

The partnership offers exceptional training and educational opportunities for graduate and undergraduate��students working in the research teams, says Siu.

In addition, the opportunity presented by the collaboration between the��two institutions��is consistent with the goal of integrating teaching and research with the world outside the University that was articulated in��91��ɫ's recent .

More about the 91��ɫ-Southlake embedded researchers

Chris Ardern (left) is a professor in the School of Kinesiology��& Health Science in 91��ɫ's Faculty of Health.��His current research��interests include the epidemiology of physical activity, obesity and cardiometabolic risk. His most recent work has focused on the use of risk algorithms, behavioural profiling and trajectory modelling approaches to identify high-risk subgroups for the development of the metabolic syndrome and cardiovascular disease mortality.��Arden is currently investigating the role of geospatial analysis to improve the surveillance of cardiovascular disease in 91��ɫ Region, and is a co-investigator on the Pre-diabetes Detection��& Physical Activity Intervention and Delivery (PRE-PAID) program, a six-month trial of culturally-preferred physical activity.��Ardern will be embedded in Southlake's chronic disease portfolio.

In her research, (right) works on a family of proteins known as nucleoside transporters. These transporters play significant roles in a number of clinical settings because they transport drugs used in cancer and are targets of drugs used in some cardiac care settings. Despite their clinical relevance, Coe, who is a��professor of biology in 91��ɫ's Faculty of Science & Engineering, says researchers��know very little about how these transporters work and how they differ in terms of their distribution, activity and regulation in individual patients.��Using a molecular diagnostics approach, Coe and her team will work with Southlake clinicians from both the cardiac care and oncology��portfolios to investigate the transporter profiles in individual patients and correlate these profiles with drug treatments and outcomes. The ultimate goal of this work is to contribute to the efforts to develop more personalized approaches to the treatment of disease.

Paul Ritvo (left) is a behavioural scientist who will serve as the research adviser, physical and mental health liaison and special projects scientist. A professor in 91��ɫ’s Faculty of Health, Ritvo’s research interests focus on electronic health interventions that employ cell phones, smartphones and online programs to change health behaviours in diabetics, HIV-positive individuals and individuals with mental health difficulties. Ritvo will work with Southlake clinicians to extend current intervention studies that use Blackberry smartphones and innovative software applications to help patients reduce health risks by way of healthy exercise, diet and improved medication adherence.

Lauren Sergio (right) is a neuroscientist working in 91��ɫ's Sherman Health Science Research Centre. Her��current research projects examine the effects of age, sex, neurological disease and past head injuries (of athletes versus non-athletes) on the brain's control of complex movement. In her role with Southlake Regional Health Centre, Sergio will be an embedded researcher in the chronic disease, emergency medicine and surgical portfolios.��She works with a wide range of adult populations, including professional hockey players and Alzheimer's disease patients. Her findings have implications for neurological disease diagnosis and rehabilitation and for understanding the fundamental brain mechanisms for movement control. She is using cognitive-motor integration research to test if new instrumentation developed in her laboratory can differentiate between��types of dementia. She is also��researching the long-term effects of concussion in young athletes. Sergio is a member of the .

The embedded researcher program at Southlake Regional Health Centre is an example of the collaboration between the Faculty of Science & Engineering and the Faculty of Health at 91��ɫ and is part of an ongoing commitment by the Faculties' deans to work together.

For more information on 91��ɫ's��partnerships with��regional��hospitals, see YFile,��April 17, 2009 and ��April 21, 2009.

By Jenny Pitt-Clark, YFile editor.

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin.

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91��ɫ partners with the Sault College in diabetes prevention program

fmaquito — Thu, 17 Feb 2011 10:00:00 +0000

Sault College has partnered with 91��ɫ and the Garden River First Nation to deliver a pre-diabetes detection and physical activity intervention delivery program, also known as PRE-PAID, wrote :

The PRE-PAID project, funded by the and , targets groups at high risk for diabetes and uses a community-based approach to engage them in the physical activities they enjoy. The 91��ɫ study has been operational since November 2009, and several diverse ethnic neighbourhoods in the Toronto area have participated. The Sault College project will involve individuals of First Nations descent.

"The PRE-PAID team is very excited to partner with Sault College for this important initiative,” states Chip Rowan, Researcher and Certified Exercise Physiologist at 91��ɫ. “Through this partnership, we hope to extend our program to a community that has a well documented risk for developing type 2 diabetes. Through the provision of free screening and targeting individuals with pre-diabetes, we hope that our physical activity intervention program will prevent or delay the development of type 2 diabetes for as many people as possible."

Canadian Diabetes Association Regional Branch Co-ordinator, Janie Bringleson, says the statistics involving those with diabetes are alarming. Nearly 1 in 4 Canadians either has diabetes or pre-diabetes and more than 20 people are diagnosed with the disease every hour of every day. The Health Council of Canada states that diabetes is much more common, and growing more quickly, among First Nations adults, who are two to eight times more likely to have diabetes than the overall Canadian population, depending on age group. Researchers hope to show participants the benefits of engaging in no cost, enjoyable physical activities. Second, it is hoped that the project will demonstrate the importance of investing in exercise to prevent diabetes. Through these interventions they expect to reduce diabetes by 60%.

The complete article is available on . More information about the is available through the Research website archives.

Posted by Elizabeth Monier-Williams, research communications officer, with files courtesy of YFile – 91��ɫ’s daily e-bulletin.

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Poverty makes us sick; Professor Dennis Raphael says it should make us angry

fmaquito — Mon, 10 Jan 2011 10:00:00 +0000

The sky in Lawrence Heights is low and the horizon is as wide as it gets in the city; no skyscrapers here. Dennis Raphael and I were walking through the neighbourhood on a chilly day, wrote columnist :

He is a professor of health policy & management in 91��ɫ University’s Faculty of Health, and he is an observant guy. No skyscrapers?

“Downsview,” he said.

I should have known. The airport; incoming likes it low. But there are other features of the neighbourhood that are much more notable, in particular the overlapping of the maps of poverty, illness and crime.

What kind of poverty? Crushing. What kind of crime? You name it. How about illness?

Let’s talk diabetes. Everyone’s talking about it these days. The national public broadcaster even has a bunch of people eating lettuce and doing jumping jacks on TV.

Is it lifestyle? Fooey.

Raphael did a health study in a while back. His findings show that the correlation [of poverty and poor health] is not between the couch and the potato. “People who are poor don’t have the resources to be healthy. Diabetes is three or four times more likely to occur among poor people.”

He talked freely as we walked along. “We interviewed low-income people. We were struck, when we did the study, by how unable people were to access resources: the poor don’t go to ball games, to movies. They never spoke of recreation, of volunteering, of going out with friends.In other words, the poor have fewer ways to relieve their stress, and stress is a factor of the disease of diabetes, and I don’t know any poor people who are relaxed.

I was going to ask about other factors when he said something that is encouraging and ridiculous at once.

“People with life-threatening illnesses overwhelmingly say they get good health care. And most people on disability get free meds, diabetes test strips, monitors, feet and eye exams; and, overwhelmingly, they had public housing.” That’s the good news.

“But even with those pluses, we found that 72 per cent of the people we surveyed couldn’t afford the food they needed to be healthy.” He wasted no time in pointing out the irony: “The health care system will treat you fine if you keel over, but we won’t provide you with the resources you need to avoid getting sick.”

An easy fix?

“People are suffering, but I see little evidence that things are getting better.” I shivered, not from the cold. We passed a solid little building. He said, “The community health centre here is great. And the Community Care Access Centre is great.”

His proof?

“The people in our study knew about blood monitoring.” That, by the way, is a constant for diabetics. “And they knew about eating healthy food. But we found they didn’t have the money to afford the food they needed.”

That’s an outrage, or it ought to be.

I noted that some people seem to think that if you are fat, you are more prone to diabetes. Raphael hammered away at his original theme: “It isn’t whether you are fat, it’s whether you are poor.

“Countries that have low poverty rates are countries that give things like child care, tuition, decent social assistance.” These are countries where — surprise, surprise — people’s health is generally better.

“But in countries like ours, where there is a good chance of being poor, you don’t get those things — you don’t get universal child care; you don’t get good, solid employment insurance.”

Funny how we say we can’t afford first-rate social programs, and yet many of our neighbours haven’t got the money they need to be healthy. The dots ought to be easy to connect.

Raphael has published extensively about the , and the social determinants of health in Canada and internationally.

Posted by Elizabeth Monier-Williams, research communications officer, with files courtesy of YFile – 91��ɫ’s daily e-bulletin.

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Diabetes crisis in Jane-Finch neighbourhood focus of 91��ɫ-led community forum on November 11

fmaquito — Thu, 11 Nov 2010 10:00:00 +0000

The high level of Type 2 diabetes in the Black Creek neighbourhood of northwest Toronto is imposing tremendous pain and suffering on a largely visible minority population, according to community health workers, researchers and educators who will meet Thursday at a community forum to begin developing an action plan to combat the disease.

91��ɫ's Health Leadership & Learning Network has partnered with the Black Creek Community Health��Centre and the to bring members of the community together for the Diabetes: Perspectives for Action��– Community Forum on Nov. 11, from 6 to 8pm at Westview Centennial Secondary School, 755 Oakdale Rd., North 91��ɫ.

Right: Maps of Toronto show the overlap between��the areas��of low income, visible minorities and the incidence of diabetes. Click maps to see interactive version. Courtesy of the Toronto Star

The��forum will��discuss the increasing incidence of Type 2 diabetes in the Jane-Finch neighbourhood, strategies to prevent it and community resources to improve the health of people living with the disease.

Income inequality is on the rise in Canada along with a parallel increase in diabetes mortality, especially in low-income neighbourhoods such as Jane-Finch, according to a recent 91��ɫ study that has been published online and will appear in an upcoming issue of the journal Health Policy.

Dennis Raphael, a professor in the School of Health Policy & Management at 91��ɫ and a co-author of the study, says it clearly shows that low income is associated with a higher risk of developing the disease, even when other risk factors such as obesity are taken into account. Separate maps of Toronto that show areas of low income, visible minorities and the incidence of diabetes clearly show the overlap between the three, says Raphael, who will speak first at the event.

Three representatives of the Black Creek Community Health Centre will speak about their work in the community. Community health worker Michelle Westin will discuss her experiences helping residents to identify and address issues related to diabetes prevention and management. Lisa Martin, a registered dietitian and certified diabetes educator, will speak about the importance of access to adequate resources in managing diabetes, as well as healthy lifestyle choices. Carla Da Mota, a diabetes nurse educator who has witnessed an increase in both the number of clients with diabetes and complications they experience due to poorly managed diabetes, will talk about her experiences in promoting prevention and management of the disease through education.

Professor Lesley Beagrie, associate dean, professional & global programs in 91��ɫ's Faculty of Health, will moderate the panel.

The Toronto District School Board has recently launched a Diabetes Awareness Strategy. Annie Appleby, superintendent of education for Ward 1 in the northwest part of Toronto – where the incidence of Type 2 Diabetes is at eight per cent –��will speak about the schools' efforts to promote healthy choices and change the behaviours of staff, students, and even families.

For more information, visit the website.

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin

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