Today, U of T researchers received over $7.4 million in research grants from the Canadian Institutes of Health Research (CIHR) to improve primary health care for Canadians and people around the world.

Professors in the Department of Family and Community Medicine (DFCM), Institute of Health Policy, Management and Evaluation (IHPME) and Dalla Lana School of Public Health (DLSPH) are leading international research teams that will develop innovative solutions for managing and preventing chronic disease and access issues for vulnerable populations.

DFCM Vice-Chair and Professor Dr. Eva Grunfeld is leading the Canadian Team to Improve Community-Based Cancer Care along the Continuum (CanIMPACT) project. The $2.5 million project tackles issues that cancer patients and their families face when transitioning between community-based care with their family doctor and hospital-based care with cancer specialists along the entire cancer journey.

“By setting-up a patient advisory committee, our team of researchers, family doctors, nurses, cancer specialists and policy makers are improving care over the cancer journey, from diagnosis to survivorship,” says Grunfeld, noting the grant provides five years of stable funding for CanIMPACT —  the first project of its kind in Canada. 

IHPME Professor Walter Wodchis is leading an international team with New Zealand collaborators — led by Professor Toni Ashton from the University of Auckland and $1.2 million from the New Zealand Health Research Council — to find new ways to care for seniors with complex needs.  Wodchis and his team are analyzing health policy and consulting with care providers and caregivers to design an effective model of community-based primary care for seniors.

“Older adults with complex care needs represent the greatest challenge and opportunity for improving the health care delivery system — costs are high and care is fragmented, duplicative and burdensome to health care providers, patients and caregivers,” says Wodchis, who is an international expert in health economics and recipient of a $2.5 million CIHR grant.

“Our team is looking at successful models of integrated care for this population and find ways to put them into action across Ontario, Quebec and New Zealand.”

Also collaborating with international researchers is DLSPH Professor Kue Young who is using a $2.4 million CIHR grant to transform primary care for people living in remote northern communities through a Circumpolar Health System Innovation Team.

“Our team is looking at the patient’s health journey to ensure the right care is received at the right time,” says Young, noting that the team is consulting with international circumpolar communities for advice as well as building research capacity in the North.

When announcing the $29-million in funding for 12 research teams, The Honourable Leona Aglukkaq, Minister of Health, said:

“Community-Based Primary Health Care is the heart of our health care system.  Our Government understands that, for most Canadians, primary health care is the most frequent point of contact with the health care system, and we are committed to strengthening this front line of care.  I am particularly pleased that the teams we are supporting today will also focus on ways to improve access for those most vulnerable among us.”

It’s the part of our body that controls what we think, the ways we move and how our other organs function. Though we know the brain plays an important role in our day-to-day life, there’s still a lot to learn about how it works.

 Sonia Sugumar is excited to help unlock those mysteries.

“I feel like it’s still one part of our human body that we have a very limited understanding of,” she says.  “We still know relatively little about the brain compared to what we know about the rest of the body.”

Sugumar is completing a master’s degree in Physiology through the University of Toronto’s Collaborative Program in Neuroscience, which includes graduate students from 15 departments in six Faculties at the University of Toronto. 

“[The program] really helps bring us all together,” says Dr. Peter L. Carlen, Sugumar’s supervisor, and a Professor in the Faculty of Medicine’s Departments of Medicine (Neurology) and Physiology. “We’ve got an enormous reservoir of neuroscience talent across the university, and we need something to pull us together and this program does it.”

Carlen is also the Senior Scientist in the Division of Fundamental Neurobiology at Toronto Western Research Institute.  His lab is the site of several research projects, including work on the cellular mechanisms and nervous system communications in epilepsy, exploring what happens during transition into seizure.

Sugumar is involved in another project within Carlen’s lab, and is exploring the ways low blood glucose levels can affect electrical activity within the brain to cause hypoglycemic seizures, which can be the result of an insulin overdose in people with diabetes.

Using mice, the lab is looking at the role of an artificial cerebral spinal fluid composition, which bathes the brain.  The group is exploring the various components that make up this fluid and how they affect the brain.

In particular, Sugumar is adding to what is known about gap junctions, which are “bridges” between brain cells that allow the passage of electrical signals in the form of calcium or sodium ion movement, generated by small molecules like glucose.  She’s zeroing in on how the absence or presence of these “bridges” can affect brain activity in the presence of very low blood glucose levels.

It’s an area that’s been well-studied in the context of other medical conditions such as epilepsy and ischemic stroke.

Sugumar is passionate about this field of study.  She became interested in neuroscience during her undergraduate studies. A summer job at the National Research Council in Ottawa allowed her to gain valuable microscopy techniques that led her into Carlen’s lab.

“The aspect of just how much there is left to learn really drew me in to neuroscience,” says Sugumar.

With just a short time left before she completes her degree, Sugumar plans to publish her findings in the near future. She’s confident that was she’s researching today could become a building block for new developments long into the future. 

“Even the smallest contribution can have the potential to make a huge difference.”
 

The Heart and Stroke Foundation has announced a $300 million initiative to support cutting-edge heart and stroke research at leading health institutions across the country. The funding initiative is the largest research commitment in the organization’s 60-year history. It will accelerate the progress of the Heart and Stroke Foundation’s goal of reducing Canadians’ rate of death from heart disease and stroke by 25 per cent by 2020.

The University of Toronto, as a member of the Heart and Stroke Foundation Research Leadership Circle, will receive a landmark $30 million in research funding over the next 10 years. The commitment will strengthen the extraordinary network of U of T faculty who are already pursuing breakthroughs in cardiovascular research, teaching and clinical innovation.

The University’s Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, for example, has among its members more than 90 faculty researchers who are making vital contributions to cardiovascular science and clinical care, such as solving genetic mysteries in heart development, developing new diagnostic tests for heart failure, engineering replacement parts for damaged hearts and creating new life saving treatments.

The University of Toronto is also home to world-class strengths in the rapidly evolving field of transplant research, where advances in stem cell biology, cloning, gene therapy and tissue engineering are creating unique opportunities to treat and regenerate damaged organs, including the heart.

“The new commitment from the Heart and Stroke Foundation will provide U of T with a stable source of funding for cardiovascular research,” says Professor Michael Farkouh, Director of the Heart & Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, and cardiologist at University Health Network’s Peter Munk Cardiac Centre.

This will allow us to build on our discoveries and ensure our research is translated into better health care outcomes for Canadians who are confronting the threat of heart disease and stroke.”

The Research Leadership Circle also includes U of T-affiliated hospitals including the Hospital for Sick Children, Mount Sinai Hospital, St. Michael’s, Sunnybrook Health Sciences Centre and the University Health Network. These institutions, together with U of T, form the largest cardiovascular research network in the country.

“Simply put, there’s an urgent need to save more lives faster and that’s why the Foundation has brought together the Research Leadership Circle,” says David Sculthorpe, CEO, Heart and Stroke Foundation of Canada. “This $300 million commitment will allow our partners an unprecedented ability to plan major research projects, foster greater collaboration and attract even more of the world’s best researchers within and outside of Canada to fight these insidious diseases.”

Heart disease and stroke account for almost 30 per cent of annual deaths in Canada. A Canadian dies from the diseases every seven minutes. They are also a major drain on the economy, resulting in more than $20.9 billion spent annually in physician services, hospital costs, lost wages and decreased productivity.

Since 1952, the Heart and Stroke Foundation has provided more than $1.35 billion to heart and stroke research — second only to the federal government. However, this is the first time the Foundation has made an up-front commitment to support long-term research planning. The Foundation’s traditional merit-based peer-reviewed granting process will continue in tandem with the new funding initiative.

“The University of Toronto is thrilled to be part of the Heart and Stroke Foundation Research Leadership Circle,” says Farkouh. “Working with our institutional partners, we look forward to meeting the Foundation’s goal of significantly reducing the impact of heart disease and stroke in Canada.”

For more information about the Heart and Stroke Foundation Research Leadership Circle, click here.

For Dr. Gillian Einstein, it’s a thrill to know her work on women’s brain health will help people make more informed decisions about their bodies.

“It’s really what I always wanted to do. I always wanted to work on scientific problems that would make a difference,” she says.

Einstein is an Associate Professor with the University of Toronto’s Department of Psychology and the Dalla Lana School of Public Health.  She is also the Director of the Collaborative Graduate Program in Women’s Health.

Her lab is exploring what happens to cognition in women who carry specific mutations to the genes, BRCA1 and 2, and have had their ovaries removed in a procedure known as an oophorectomy. This leaves a woman’s body unable to produce one critically important estrogen, 17-beta-estradiol.

BRCA1 and BRCA2 are DNA repair genes, but when they contain mutations, they can be linked to increased rates of breast and ovarian cancers. Some women who learn they carry these mutations choose to have their ovaries removed to reduce their risk of cancer.

But, Einstein explains, there can be other consequences.

Earlier research has found that women who’ve had their ovaries removed faced a higher incidence of Alzheimer’s and Parkinson’s dementias than women who still had their ovaries.

Now, Einstein is trying to find out why.

Her research has involved three groups of women: a group that carries the BRCA mutation and have kept their ovaries, a group that carries the mutation and have had their ovaries removed, and a group of similarly aged women who aren’t carriers of the gene mutation.

To gather the information, the lab is recruiting women one to eight years after surgery and testing them three times in the following years.  This will generate data spanning a decade.

The research is ongoing, but preliminary findings reveal that following ovary removal, the ability to remember words declines as time passes. Logical memory, which can determine how well a person generally remembers things, may also be affected in some people.

Einstein expects to have some definitive results by the end of 2014.

The project will soon allow Einstein to recruit women prior to their surgeries, and to test them before and after the operation as well as a few years later. This will establish better benchmarks by which to compare the results. Einstein will also be collaborating with the Rotman Research Institute at Baycrest to do brain imaging as part of her research.

“I’d very much like women who are electing to have ovaries removed — for very good reasons I might add — to have a full sense of what is going to follow,” says Einstein. “They should know that while it will decrease their risk of ovarian cancer, there may also be some cognitive declines.”

She adds that removing the ovaries can also have implications for bone and heart health, as well as the immune system. Einstein’s hope is for women and doctors appreciate that removing the ovaries doesn’t only affect the reproductive system, but the entire body.

“Estrogen is an incredible molecule, and it does amazing things in both men and women’s bodies,” says Einstein.  “I think the women with the BRCA mutation are making an enormous contribution to our understanding [of estrogen].”

U of T Medicine’s Brain Health and Neuroscience Network spans nine hospitals, 250 scientists and includes $98-million in research funding.  To learn more about the Network, click here.
 

University of Toronto Professor Galit Kleiner-Fisman and her team recently launched a unique website — Live Well With Parkinson’s — which features the information Parkinson’s patients need to avoid conflicts between diet and medication.

“For patients with Parkinson’s, knowledge is empowerment and it is crucial for being able to live well with the disease,” says Kleiner-Fisman, an assistant professor of medicine at U of T, neurologist at Baycrest, and medical director of the hospital’s Jeff and Diane Ross Movement Disorders Clinic.

“Unfortunately, many patients have some fundamental gaps in their knowledge about symptom management, resulting in poor symptom control.”

Kleiner-Fisman points to the drug Levodopa as an example. It’s one of the most commonly prescribed medication to control tremors, rigidity and slowness of movement. However, it can be less effective when it interacts with protein-rich foods.

“Some people taking the medication need to follow a protein redistribution diet,” she says. “They need to control what and when they eat. Avoiding nutritional mistakes can be very difficult because many patients don’t have all the facts about protein-rich foods.”

To create a website that offers a holistic recipe for success, Kleiner-Fisman enlisted the help of her team at the Assistive Technology Clinic and culinary students from George Brown’s Food Innovation and Research Studio (FIRSt). Together, they developed recipes and meal plans to make following a protein redistribution diet simple, healthy and appetizing.

“When you have the correct information about Parkinson’s you can adapt rather than feel overwhelmed,” says Keith Goobie, a Parkinson’s patient in the Jeff and Diane Ross Movement Disorders Clinic. “The information I’ve received from Dr. Kleiner-Fisman has been empowering.  I hope this website will enable more people with Parkinson’s to benefit from the same level of empowerment.”

Visit livewellwithparkinsons.com to learn more.

A world-renowned U of T cancer researcher has discovered a new class of targeted cancer drugs — a major breakthrough that could revolutionize cancer treatment.

Professor Tak Mak of the Department of Immunology in U of T’s Faculty of Medicine in collaboration with Dr. Dennis Slamon at the University of California, Los Angeles developed CFI-400945, a new drug that effectively inhibits the growth of breast and ovarian cancers, as well as colorectal, glioblastoma, lung, melanoma, pancreatic and prostate cancers. The new drug is based on their research of PLK4, a target enzyme that plays a crucial role in cancer cell division.

“We have been able to progress this project from our initial scientific observations through the complex stages of drug discovery and development to the point where we will shortly be able to test a drug in patients,” said Mak, also appointed to the Department of Medical Biophysics and Director of The Campbell Family Cancer Research Institute at the Princess Margaret Cancer Centre.

“It is extremely rare for an academic group to have discovered and advanced a novel “first-in-class” drug candidate to this level, and it would not have been possible without the fundamental support provided by donors,” Mak continues.

Mak and Slamon submitted an Investigational New Drug application to Health Canada and the Food and Drug Administration for CFI-400945, and, following a successful regulatory review, look forward to entering the clinical trial phase in the coming months.

“I truly believe in this important discovery and its therapeutic potential for cancer patients,” said Slamon, best known for his discovery and development of Herceptin, a targeted breast cancer drug developed in the late 1990s that had a major impact on breast cancer survival rates.

HIV prevention programs for female sex workers in India reduce rates of syphilis, HIV and other sexually transmitted infections (STIs), a University of Toronto study has found. 

About two million Indians are infected with HIV, mostly in the southern states of Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The study, led by Professor Prabhat Jha from U of T’s Dalla Lana School of Public Health and St. Michael’s Hospital’s Centre for Global Health Research (CGHR), examined the impact of prevention among female sex workers whose contact with male clients contributes substantially to new HIV infections in the general population. The virus is then spread to the wives and other sex partners of these male clients. 

“We not only have to prevent HIV, but also other infections like syphilis. Prevention among sex workers can reduce various infections, and prompt treatment of sexually transmitted infections is particularly important,” said CGHR’s Paul Arora, the lead author.

The peer-based prevention programs provided condoms and treated STIs among sex workers and their clients in addition to other activities.  The authors examined data from 868 prevention projects — serving about 500,000 female sex workers — implemented between 1995 and 2008.  They found that reaching sex workers through prevention programs decreased HIV and syphilis infection rates among young pregnant women tested routinely at government prenatal health clinics. 

Other findings included:

• Levels of HIV fell by 40 per cent and the levels of syphilis fell by 70 per cent among pregnant women (who represent new infections in the population) between 2003 and 2008.
• Each additional sexually transmitted infection treated (per 1000 people) reduced the annual risk of HIV infection by two per cent and reduced the annual risk of syphilis infection by 11 per cent.
• Increased funding, outreach, treatment of STIs and condom distribution reduced syphilis infections, but only STI treatment significantly reduced HIV infections.
• There was no difference on the impact on HIV or syphilis infection between the Gates Foundation- funded projects or the NACO-funded projects, even though the per person cost of the Gates programme was about five times that of NACO.

"This vital study is a reminder that governments must invest in prevention, and that even modest amounts of funding that reach the most at risk groups can yield big reductions in HIV and other infections" added Professor Peter Piot, Director of the London School of Hygiene and Tropical Medicine, UK, and former Director of UNAIDS, who was not involved in the study.

The study was supported by The Bill and Melinda Gates Foundation and the Canadian Institutes of Health Research. The study will be published on June 16 at 8pm EST in BMJ Open. Additional information can be found at www.cghr.org.

Media Inquiries

Professor Prabhat Jha will be in India and available for media inquiries on June 17 and 18. 
Mr. Paul Arora is also overseas, but available for interviews by phone or Skype.

For Indian media inquiries, please contact Prabha Sati (+91 971 196 4550; satip@smh.ca). For all other media inquiries, please contact Leslie Shephard (416-864-6094; ShepherdL@smh.ca) or Nicole Bodnar (416-978-5811; Nicole.Bodnar@utoronto.ca).

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About The Dalla Lana School, University of Toronto

The Dalla Lana School of Public Health (DLSPH) is a regional and global leader in public health education, research and service, with one of the largest concentrations of academic population and public health researchers in Canada and more than $30 million in research funding each year.

Dr. Catharine Whiteside, Dean of the University of Toronto Faculty of Medicine and Vice Provost, Relations with Health Care Institutions, today announced that seven of Toronto’s leading research organizations have joined together in an unprecedented global alliance of more than 70 organizations engaging over 40 countries around the world. The alliance aims to set new, unified standards for managing and sharing of genomic and clinical data to enable rapid progress in biomedical research and to advance human health.

The past decade has brought about an explosion of genomic data in medical research. But currently much of this data is collected and analyzed in isolation – by disease, by country, or by institution - limiting its impact. The alliance aims to bring together ethics, privacy, medicine, research and technology to set new, unified standards that will allow data across the world to be shared in a responsible, ethical manner. A standardized system will allow for the aggregation of data and help researchers worldwide collaborate to tackle more complex problems with more efficiency.

“To realize personal, genomic-based treatments for disease, we must pool expertise and break down institutional barriers,” says Dr. Whiteside. “By integrating U of T’s thriving community of researchers, teachers and clinicians, this alliance will have a powerful impact on health locally and globally.”

The seven University of Toronto-affiliated organizations participating in the alliance are the Samuel Lunenfeld Research Institute at Mount Sinai Hospital, Sunnybrook Health Sciences Centre, The Hospital for Sick Children (SickKids), University Health Network, University of Toronto and the Ontario Institute for Cancer Research, which also serves as the Secretariat for the International Cancer Genome Consortium.

“International cooperation is essential to make personal medicine a reality,” says Dr. Stephen Scherer, Director of the University of Toronto’s McLaughlin Centre and The Centre for Applied Genomics at SickKids. “The alliance will create a robust framework, enabling scientists to collaborate and bring treatments to patients sooner.”

“Mount Sinai Hospital’s Samuel Lunenfeld Research Institute is proud to be a founding member of this global alliance. An alliance of this scope will be instrumental in resolving some of the major hurdles to bringing new genomics knowledge and technology into medical practice and will ensure timely translation of genomics discoveries into improved population health,” says Dr. Katherine Siminovitch, Director, Personalized Genomics and Innovative Medicine at Mount Sinai Hospital who has developed a genetic test for a rare and usually fatal immune deficiency disorder called Wiskott-Aldrich Syndrome. Dr. Siminovitch has also identified gene variants associated with risk for rheumatoid arthritis and other debilitating autoimmune diseases.

“Our collective understanding of human biology has never been better positioned to facilitate its application toward understanding the genetic basis of health and disease,” said Dr. Michael Julius, Vice-President, Research of Sunnybrook Health Sciences Centre. “The delivery of precision, individualized medicine is within our grasp, and the inception of the Global Alliance will be a critical enabler of achieving the goal responsibly.”

“University Health Network is pleased to join the Global Alliance,” said Dr. Benjamin Neel, Director of the Ontario Cancer Institute – the research arm of the Princess Margaret Cancer Centre.  “As an organization which is now offering personalized cancer medicine through the IMPACT and COMPACT studies, we see cooperation around the world on genetic studies as an important direction for all research facilities. In our early work with IMPACT – and with our capabilities with clinical sequencing of genes – we have seen the resulting information on individual patients change approximately 30 per cent of the treatment courses for those enrolled in this clinical trial. This study provides the only ongoing clinical sequencing in Canada with results delivered to patient medical records.”

“At present, it is generally not possible to predict which changes in DNA sequence lead to clinical consequences. Only by comparing each personal genome sequence to a large repository of other such data can robust patterns and relationships be identified,” said Dr. Tom Hudson, Chairman of the Executive Committee of the International Cancer Genome Consortium, and President and Scientific Director of the Ontario Institute for Cancer Research. “The stakes are high, because if we get it right we can create new opportunities to define diagnostic categories, streamline clinical trials, and match patients to therapy. We want to make sure this is done in a global manner, and with the highest standards for ethics and privacy.”

Brian Li joined hundreds of Faculty of Medicine students in celebrating a major milestone at yesterday’s convocation ceremony.

Li is one of 218 MD students who donned the traditional cap and gown for convocation. More than 12,000 students from across the University of Toronto will be doing the same during multiple ceremonies this June.

“I’m very excited to graduate, but even more excited for my residency and the new learning opportunities yet to come,” says Li, who will be pursuing his internal medicine residency at the University of Toronto.

Cardiology is Li’s passion and he’s ready for all the opportunities and challenges that come with residency.

“I learned amazing teaching and clinical skills from some of the world’s leading experts here at U of T Medicine.  I now have a strong foundation for residency and beyond,” Li says.

While working with mentor and interventional cardiology fellow at Sunnybrook, Dr. Brian Courtney, Li utilized his engineering background and developed an award-winning imaging catheter that helps detect heart attacks.

“The minimally-invasive device combines ultrasound and optical laser technology to better visualize and characterize coronary plaques, allowing us to identify vulnerable regions that could cause heart attacks,” Li explains.

Li is enthusiastic about the future and fondly reflects on the relationships he’s made at U of T.

“I had a great time during clerkship in my third and fourth years. I’m going to miss my classmates and being part of Daffydil — the student run charity musical production — the most. I’m extremely lucky to be part of the U of T Medicine community.”

A national collaborative leadership education partnership between the University of Toronto, University of British Columbia, Northern Ontario School of Medicine, Université Laval and Queen’s University, has received $2.7 million over three years from the Ontario Ministry of Health and Long Term Care (MOHLTC).  In addition to the substantial support from the five University partners and in kind contributions of UBC and Université Laval, this grant facilitates international recognition of innovation in health leadership program development across Canada and the world.

The Canadian Interprofessional Health Leadership Collaborative (CIHLC) was chosen by the U.S. Institute of Medicine’s (IOM) Board on Global Health as one of four innovation collaborative projects from around the world. The CIHLC will grow and pilot “leadership mobilization” ideas, outlined in the Lancet Commission Report, Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World.  CIHLC’s vision is collaborative leadership for health system change to globally transform education and health.

“We are very grateful to the Province of Ontario for supporting this innovative project and for their acknowledgement that “collaborative leadership” is necessary to make partnerships work, for traditional leaders to be more participatory and inclusive, and for shared leadership to be taught to manage complex enterprises” says Dr. Sarita Verma, CIHLC Co-Lead.

In the 21st century, health systems have become so complex that they cannot be managed effectively by a few traditional leaders. Therefore, the CIHLC will develop, implement, evaluate and disseminate an evidence-based and commercially viable collaborative leadership education programs. Targeted at emerging leaders in health care, the program will define and confer the competencies required to lead system change and confront complex health challenges.

The leads for the five-university collaborative include:

• Sarita Verma, Deputy Dean, Faculty of Medicine, University of Toronto
• Maria Tassone, Director, Centre for Interprofessional Education, University of Toronto
• David Marsh, Associate Dean, Community Engagement, Northern Ontario School of Medicine
• Sue Berry, Executive Director, Integrated Clinical Learning, Northern Ontario School of Medicine
• Margo Paterson, Professor, School of Rehabilitation Therapy, Queen’s University
• Lesley Bainbridge, Director, Interprofessional Education, Faculty of Medicine University of British Columbia
• Emmanuelle Careau, Professor, Rehabilitation Department, Université Laval

“The CIHLC sees collaborative leadership as a critical enabler of patient-centred and sustainable, publicly-funded health care. Every team member in an organization brings unique skills, experiences, and perspectives that should be effectively utilized.  No one lens can attend to the complex patient and systems issues facing us as a society,” adds Maria Tassone, CIHLC Co-Lead.