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

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

The聽forum will聽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亚色 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亚色 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亚色'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 鈥� where the incidence of Type 2 Diabetes is at eight per cent 鈥撀爓ill 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鈥� 91亚色鈥檚 daily e-bulletin

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Researchers at 91亚色鈥檚 have come up with a pioneering way to convey their evidence-based research on what can happen when health-care mistakes are made 鈥� they鈥檙e putting on a play about it.

Seeing the Forest, inspired by a true story about what happens when a patient is not heard, will be staged as part of , Nov. 1 to 5.

Directed by 91亚色 theatre studies PhD candidate Laura Jayne Nelles (BA Spec. Hons. 鈥�84, MFA 鈥�07) and presented by聽91亚色's Faculty of Health and the 91亚色 鈥� UHN (University Health Network) Nursing Academy, the play will take place Monday, Nov. 1 at 1pm in 152 Founders Assembly Hall, Founders College, Keele campus. The event is free and open to everyone.

It will also be performed as part of a symposium at various health-care sites across the Greater Toronto Area.

91亚色 Professors Deborah Tregunno and Liane Ginsburg of the School of Nursing, are leaders in the field of patient safety culture. They collaborated with 91亚色 nursing Professor Gail Mitchell, who has experience with conveying research findings through the arts. This dramatic approach presents research from their studies conducted in four provinces, in cooperation with the Canadian Patient Safety Institute.

The play鈥檚 development was financially supported by the 91亚色鈥檚 Faculty of Health Interprofessional Education Fund (IPE). IPE programming is shared with the health-care community through the Faculty鈥檚 innovative .

Co-written by professional playwright Julia Gray (BFA Spec. Hons. 鈥�98, MA 鈥�07) and Mitchell, Seeing the Forest is being performed in collaboration with six organizations, including the Central Community Care Access Centre, the , , , and Unionville Home Society.

鈥淏y dramatizing research using the arts, the findings become more meaningful,鈥� says Mitchell. 鈥淭he play presents the complexity of real life from the perspective of the patient and health care professionals. The impact is much stronger than it would be if you were just reading words off the page of a research report.鈥�

The key character in the play, Healther, goes to the hospital for routine surgery and tries to communicate specific concerns to different health-care providers, yet things go awry. Research suggests that 2.9 to 16.6 percent of patients in acute care hospitals experience one or more adverse events.

鈥淗ealth care providers work hard to keep patients safe every day. However, there are often systemic issues that contribute to errors. This play is valuable because it strikes an emotional chord and engages people in conversations about improving safety,鈥� says Tregunno.

鈥淭his play is a great example of the innovative and interdisciplinary approaches to health care led by 91亚色鈥檚 Faculty of Health,鈥� adds Professor Lesley Beagrie, associate dean, professional & global programs. 鈥淚nstead of tailoring health-care programs to individual silos within the health profession, we aim to keep the focus on the end user 鈥� the patient.鈥�

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During a recent conversation with聽91亚色 President & Vice-Chancellor Mamdouh Shoukri, the Lieutenant Governor of Ontario, David Onley (Hon. LLD聽'09),聽expressed an interest in聽the research initiative. In response, Shoukri invited Onley to聽tour the facility and speak with researchers.聽On July 15,聽the lieutenant governor paid an informal visit to the University to hear first-hand from MEHRI researchers and therapists about their research into early childhood development.

Above: From left, MEHRI neuroscientist Jim Stieben; President & Vice-Chancellor聽Mamdouh Shoukri; 91亚色 Distinguished Research Professor Stuart Shanker, director of MEHRI; Rhonda Lenton, associate vice-president academic; Devin Casenhiser, MEHRI head of research; David Onley, the lieutenant governor of Ontario; MEHRI therapist Christine Robinson; Professor Lesley Beagrie, associate dean of professional & global programs in the Faculty of Health; Amanda Binns, MEHRI speech language pathologist; Alicia Allison, MEHRI community liason officer;聽Fay McGill,聽MEHRI speech language pathologist and floor-time therapist; Ana Bojcun, MEHRI budget & administrative officer; and Eunice Lee, MEHRI social worker

During聽his visit,聽Onley listened to remarks from聽the University's president and Stuart Shanker, 91亚色 Distinguished Research Professor of Psychology & Philosophy and the director of MEHRI. He then heard from MEHRI therapists and researchers about their work before taking a tour of the research facility.

Also present at the event were Rhonda Lenton, associate vice-president academic, and Professor Leslie Beagrie, associate dean of professional & global programs in the Faculty of Health.

鈥淚 believe that 91亚色 performs a very important and critical function in supporting postsecondary education, not only through the training of students but also through research," said Shoukri in his opening remarks.

"This particular initiative is very close to my heart. The Milton & Ethel Harris Research Initiative is led by its director, 91亚色 Distinguished Research Professor Stuart Shanker. One of the exciting aspects of this initiative is its focus on child development,"聽Shoukri said. "From all that I have seen so far, there is clear evidence that this initiative is on its way to having a significant national and international impact."

Following the president's comments, Shanker offered a brief history of MEHRI, including the role of the late Canadian philanthropist Milton Harris, whose support made the research initiative possible, (see YFile, June 23, 2005).

Right: Stuart Shanker

"We were very interested in a program called the Developmental Individual-Difference, Relationship-Based Model (DIR)聽for聽very specific reasons," said Shanker. "It focuses on the child鈥檚 core capacities. So that rather than trying to treat a symptom, you are trying to develop those underlying capacities that are constricted."

Conceived聽by the late Dr. Stanley Greenspan (Hon. LLD聽'06), a聽clinical professor of psychiatry, behavioural science and pediatrics at George Washington University Medical School and a practising child psychiatrist, DIR聽is a social interaction-based聽approach for treating children with autistic spectrum disorders. DIR聽engages children through play to expand their world and help develop their ideas and relationships and is at the heart of the extended聽study now underway at MEHRI.聽Shanker said the research will have an impact on the treatment of all children聽experiencing challenges and聽will聽play a聽role聽in enhancing聽the capacities of children developing typically.

"Suppose I had a child who was experiencing difficulty in learning how to read. Rather than doing intensive exercises to get the child to read, we would look at what are the underlying causes. Is there a problem with visual perception or motor control?" he said. "In addition to doing reading exercises, with DIR we would work very hard on strengthening the weakened capacities that are causing the deficits and rather than just treating the symptoms."

DIR is wedded to science, said Shanker, and at MEHRI, scientists and therapists are partners in the research underway into children's core capacities. "I saw this as a model for the 21st century, a framework for really enhancing early childhood development, because we would continually be revising and developing what we are doing," said Shanker.

"DIR also operates through the parent. The parent becomes the primary agent in the child鈥檚 development. What we have been seeing is that there聽has been a remarkable effect on family dyanmics. Families are being empowered by DIR," he said. "This is a program about understanding, for any child, why they may be having certain problems and聽what are the causes and then helping that child to develop a better ability to stay calm and focused.

"Milt Harris was very insistent that he wanted this initiative to inform public policy, so MEHRI has also been working very hard with the聽premier鈥檚 special adviser on early learning []," said Shanker. "MEHRI聽has played a聽role in seeing these ideas embedded in the core of the early learning program that is being rolled out in Ontario."

Lenton echoed Shanker's comments and reiterated that she was very pleased to see that the work underway at MEHRI, in addition to helping children with autism,聽would have benefits related to a general approach to early childhood development.

Onley聽then heard from MEHRI therapists聽Christine Robinson, Amanda Binns, Sonia Khan and Eunice Lee. The group spoke about their work with children with autism and showed聽before-and-after video clips that displayed the accomplishments experienced by聽a聽child after just a few weeks聽in floor-time therapy.

MEHRI researchers and offered a summary of their latest research to Onley. Their work examines the behavioural and neurological effects of a DIR-based treatment on young children with autism spectrum disorders.聽The two researchers previewed聽the results of their聽research to the lieutenant governor.聽The MEHRI researchers explained how they hope the results of their work will expand聽the range of options available in the treatment of all children through the use of DIR.

"This is remarkable," said Onley. "Thank you all very much, your research聽is most fascinating. The reality of autism is significant. I聽hear regularly from聽parents who express their deep concerns about autism. Please keep up the good work and I look forward to keeping in touch and following your research."

At the conclusion of the presentations, the lieutenant governor and聽Shoukri聽toured the MEHRI facility.

More about David Onley, the lieutenant governor of Ontario

In 2007, Onley was the first person with a physical disability 鈥� he had polio at the age of three聽鈥� to become a lieutenant governor. Before stepping into the role, he had a 22-year career as a broadcaster for Citytv and was the first senior newscaster with a visible disability.

For many years,聽he has聽championed disability issues聽as chair of the Government of Ontario鈥檚 Accessibility Standards Advisory Council and as an accessibility council member for the Rogers Centre and the Air Canada Centre. Onley has used his influence to highlight聽and help remove barriers to employment and housing for Ontario's 1.5 million people with disabilities.

On Friday, June 26, 2009, 91亚色 honoured Onley with an honorary degree in recognition of his work in advancing disability rights in Canada.

Republished courtesy of YFile鈥� 91亚色鈥檚 daily e-bulletin.

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McGuinty, accompanied by 91亚色 President & Vice-Chancellor Mamdouh Shoukri and 91亚色 West MPP Mario Sergio, began his visit with a tour of the University鈥檚 state-of-the-art Nursing Resource Centre and watched as nursing students practised inserting intravenous lines into patient mannequins. Dressed casually, the premier was openly animated as he chatted with students and spoke about his own undergraduate degree in biology and his youthful dream of entering medicine.

Left: McGuinty (left) is greeted by 91亚色 President & Vice-Chancellor Mamdouh Shoukri and 91亚色 West MPP Mario Sergio

As he toured the facility, McGuinty met and spoke with students聽enrolled in聽91亚色鈥檚 bachelor of science聽in nursing (BScN), the second entry BScN聽program, the BScN for internationally educated nurses and the master of science in nursing program for nurse practitioners.

The premier鈥檚 visit coincided with this week鈥檚 announcement by the provincial government that it was seeking applications to create 14 more nurse practitioner-led clinics, with a goal of having 25 nurse practitioner-led clinics by 2012. (The first cluster of 11 nurse practitioner-led clinics is set to open later this month.) In Ontario, nurse practitioners are able to treat common illnesses and injuries, and order X-rays, lab tests and other diagnostic tests. They can also refer patients to specialists.

Right: The premier chats with nursing students as they practise on a mannequin

Sitting down to聽begin the round table, McGuinty was greeted by Lesley Beagrie, associate dean of professional & global programs in the School of Nursing in 91亚色's Faculty of Health. Beagrie thanked the premier for the funding that has made both the Nursing Resource Centre and programs such as the second-year entry and internationally educated BScN programs possible.

Following Beagrie's welcoming remarks, the premier opened the round-table discussion. 鈥淚 want to take this opportunity to thank the students for pursuing, with passion, a career in nursing as it is a calling,鈥� he said. He聽described聽nursing as聽a profession that cares just not for patients but for mothers, fathers, children, siblings, neighbours聽and friends. "These aren't just any people, they are really important to all of us," he said.

McGuinty聽spoke with reverence of the knowledge and skill required by nursing professionals and how far nursing has come since 1949, when his mother was a nurse, eliciting a laugh as he recounted a story about a colleague of his mother's聽who聽forgot to cut up a patient's grapefruit and was required, as punishment, to聽write out 500 times how she would not forget to cut聽up a grapefruit in the future.

The Ontario premier then聽talked about his government's vision for health care and the important role nursing professionals would play in bringing that vision to reality. "The first thing our government did was to make sure that there聽are more of you. As of today, we are up to 10,700 more nursing positions in Ontario," he said.

The government, said McGuinty, through a program聽based on best practices,聽is now allowing nursing professionals to conduct tests, including those聽to detect colorectal cancer. Nurses will also be able to聽work as surgical first assistants and in long-term care emergency mobile teams. He reiterated his聽enthusiasm for nurse practitioner-led clinics:聽鈥淥ntario has the first nurse practitioner-led clinics in North America,鈥� said McGuinty, 鈥渨ith 11 at various stages in terms of being聽phased in and today聽the government issued an announcement for the next 14 clinics. So there will be a total of 25 such clinics in Ontario.鈥�

Above: McGuinty, centre, addresses nursing students gathered for聽a round-table discussion

"Nurse practitioners in Ontario will now be able to communicate a diagnosis, order diagnostic tests such as an MRI聽or CT scan, cast a fracture and prescribe medications," he said. "We are also talking about permitting our nurse practitioners to admit and discharge patients into and from a hospital, and introduced a new package of reforms that will be important to nurse practitioners. Up to聽now,聽hospitals have been required to seek advice on health issues聽exclusively from an all-physician advisory committee. Now we are going to ensure that nurses and other health professionals can聽provide that advice on health as well."

The innovations are required, said the premier, to help combat the rising cost of health care in Ontario. The cost has moved from a figure of 32 cents聽for every program dollar spent by the government 20 years ago, to a current cost of 46 cents per dollar, and is estimated to reach 70 cents of every program dollar spent in 12 years if action is not taken, diverting money from other critically needed areas including infrastructure, schools, environmental protection and services.聽The nurse practitioner-led clinics and聽reforms to聽reduce costs of prescription drugs in the province are two such measures aimed at reducing exploding health-care costs.聽"Such clinics and nursing education programs form an integral part of the province鈥檚 Open Ontario Plan created to strengthen public health care," said the premier.

Left: Student Thomas McCormick聽talks about why聽he decided to become a nurse and of his plan to travel to a remote community in northern Ontario to work in a community clinic

Following his comments, McGuinty opened the discussion to students, hearing more about why they had chosen the profession. For master's student Deana Ruddell-Thomson,聽the experience of watching family and friends聽cope with illness caused by tainted water during the Walkerton聽tragedy more than 10 years ago solidified her desire to study nursing.

Fourth-year BScN student Crystal Van Leeuwen said, "Nursing chose me. The moment when I knew when I聽was going to聽enrol in nursing聽came when I was volunteering in northeastern Thailand working with children with HIV and I held an eight-year-old girl who was the size of an average three-year-old Canadian child. She was going to die聽because she did not have equal access to affordable medications聽and I聽knew I needed to join a profession that would advocate for patient rights聽as well as health."

Another student, Thomas McCormick, spoke about his plans to聽travel to a聽remote community in northern Ontario to work in a clinic, while another talked about coming to Canada from Russia where she had worked as a nurse and how she was delighted to be able to continue her profession through her enrolment in the BScN for internationally educated nurses.

At the end of the round-table discussion, Shoukri thanked McGuinty for visiting 91亚色 and presented him with a copy of 91亚色: The Way Must be Tried by 91亚色聽 Professor Emeritus and University historian聽Michiel Horn. "Thank you very much for choosing 91亚色 to kick-start Nursing Week," said Shoukri. "We see you as the champion of postsecondary education and the champion of health care. We thank you for being that champion and we are committed to working with you to improve both postsecondary education and health care in Ontario."

Right: The premier is presented with a commemorative copy of 91亚色: The Way Must be Tried by 91亚色 President Mamdouh Shoukri

The premier responded that while he had spoken to everyone, "there is one group I would like to give special thanks to and that group is the teachers who are here today. It is not just the substantive subject matter that you transmit to your students, it is also how you do it and how you conduct yourselves. Your patience, understanding and commitment transcends time. Thank you all."

By Jenny Pitt-Clark, YFile editor.

Republished courtesy of YFile鈥� 91亚色鈥檚 daily e-bulletin.

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Faculty and graduate students are invited to find out how 91亚色 Libraries can help make their research available to the world through . Join the science librarians at Steacie Science & Engineering Library at聽4:30pm and listen to guest speakers, including Lesley Beagrie, associate dean of professional & international programs in the Faculty of Health; Gordon Flett, associate dean of research & graduate education聽in the Faculty聽of聽Health; and biology University Professor Ron Pearlman of the Faculty of Science & Engineering. Pearlman has worked extensively with the Canadian Institutes of Health Research (CIHR) in encouraging faculty to support open access (OA) publishing.

Above: A screenshot of a listing of some of the open access life science journal articles in PMC Canada

On April 28, the National Research Council鈥檚 Canada Institute for Scientific & Technical Information in partnership with the CIHR and the US National Library of Medicine, launched PubMed Central (PMC) Canada.聽PMC Canada enables CIHR-funded researchers to deposit their peer-reviewed articles for global exposure online along with content from PMC US and UK PubMed Central.

Benefits of PMC Canada:

• It has higher citation numbers than traditional journals.
• International exposure will put 91亚色 research on the global map.
• 91亚色 researchers already have over 300 entries in PubMed.
• Health researchers worldwide will be able to access CIHR-funded research.
• Links to the free full-text publication will speed up the grant review process.

The Problem: Tackling the World鈥檚 Health Issues

While much funding has been dedicated to basic and applied (clinical) research, there has not been a process to ensure that the findings are made available to policy-makers and practitioners so that people and institutions can benefit from the research. Emerging trends require that research agendas not only involve the creation of knowledge, but also a plan to facilitate the use of that knowledge, otherwise known as .

Above: A screenshot of PubMed Central Canada on the 91亚色 Libraries Web site

A Solution: Open Access

The emphasis on knowledge translation has driven the groundswell of interest in OA publishing in recent years. The scholarly community and CIHR believe that greater access to research publications and data will promote the ability of researchers in Canada and abroad to use and build on previous knowledge to address today鈥檚 health challenges. Only when research findings are widely available can evidence be translated into policies, technologies, health-related standards and practices, and new avenues of research.

91亚色 Libraries initiated in 2005. Librarians offer and and meet with researchers to encourage them to make their research available through , 91亚色's repository of research.

Increasing 91亚色鈥檚 Research Impact

CIHR, along with a growing number of granting agencies, has adopted an requiring that the results of all CIHR-funded projects are made freely accessible online as of Jan. 1, 2008. Grantees may set up an account to facilitate access to their research publications through PMC Canada. 91亚色 researchers already have over 300 entries in PubMed, and soon all CIHR-supported researchers will be involved in the endeavour. Some publishers already deposit in PMC Canada.

For more information, visit the Web site or the Web site.

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