Kendra Hunter

The graduate-level course, which is open to all ��˾��ֱ�� students, is being offered by the department of mechanical and industrial engineering (MIE) in the Faculty of Applied Science & Engineering. MIE1724: Additive Manufacturing in Engineering Applications focuses specifically on the rapidly evolving and lucrative field, which has applications for numerous sectors of the economy.

The course is the creation of alumnus Ali Radhi, who wanted to provide a graduate-level specialized class that looks at the process of designing and building cost-effective and timely products using novel materials and hardware.

Radhi recently spoke to writer Kendra Hunter about the new course and the importance of preparing today’s students for the design and fabrication of complex structures.

What inspired you to create this course?

At MIE, I have been involved in the design of lightweight structures and saw there was room to further bridge the fields of materials and manufacturing through a new course. A recent trend in 3D printing is to produce complex structures using materials with properties not usually found in nature, such as invisibility cloaks, and I wanted to address this while giving singular focus to the field of additive manufacturing, 3D printing and their respective applications. Associate Professor Tobin Filleter’s MIE1744: Nanomechanics of Materials provided inspiration in expanding this area of knowledge. From there, MIE1724 took shape.

 What can students expect from this course?

The course introduces various types of additive manufacturing approaches, including multi-material 3D printing, micro/nano additive manufacturing and 3D bioprinting. MIE1724 is also designed to show the limitation of selected additive manufacturing methods. Characterization of additive manufacturing parts is included as a major course outcome. It helps students to integrate design for additive manufacturing aspects in industry product fabrication.

Students get to learn about new 3D printing technologies and how they are applied to solve problems in security, automation and more.

The course will first introduce the concept of 3D printing and then will move into computer-aided design (CAD) for additive manufacturing. Currently, students can request parts to be 3D printed through the Myhal Centre’s fabrication facility. Once it is safe to do, they will be able to receive training to use the facility for their own education and research.

How does this course benefit degree and career options?

3D printing is now the primary method of prototyping. More recently, it became the sole method for end-use part production for highly complex structures and/or material content. Dedicated post-secondary education in 3D printing helps fill the talent gap in additive manufacturing as global revenue from these technologies has jumped from $4 billion to $13 billion between 2014 to 2018.

Additive manufacturing shortens design and production processes by enabling companies to streamline prototyping activities, alter supply chains and evolve end-product manufacturing. The market is growing at a rapid pace and people with a specialization in additive manufacturing will be in demand.

Did you design MIE1724 strictly as an engineering course for engineering students?

No, in fact this course is open to all ��˾��ֱ�� students. 3D printing is of great interest to many fields such as medicine, architecture and dentistry. The course is structured to highlight the technology’s potential, process and applications in those fields and much more. The course also addresses unique fields, such as textiles and cosmetics, and how this technology can be applied. Additionally, the areas of information science, education and graphic design also benefit with over 250 applications of additive manufacturing that can be incorporated into their daily use of technology.

How did your PhD studies at MIE help you develop the skills to create MIE1724?

The PhD program provided a lot of exposure to state-of-the-art fabrication technologies. 3D printing was one of those avenues and I took part in design projects and competitions that employed such technologies within the facilities at ��˾��ֱ��. Furthermore, the teaching assistant and instructor opportunities from the university helped me to identify the knowledge gap in 3D printing from ��˾��ֱ��’s broad list of advanced courses. During my PhD studies, collaboration with fellow research groups aided my own research through sharing of knowledge with my network as well as training in high- tech research facilities.

MIE1724 was inspired by Associate Professors Filleter’s and Eric Diller’s research – both were helpful and supportive in providing insights for a proper scope and delivery for the course. Professor Murray Thomson, who is associate chair of graduate studies for MIE, provided support to address student expectations and Maximiliano Giuliani, senior facility supervisor at the Myhal Centre for Engineering Innovation & Entrepreneurship, provided input on expected knowledge and training for students before using his facilities for 3D printing.

��˾��ֱ�� researchers propose new weapon in the battle against food-borne bugs: Cooking oil

Christopher.Sorensen — Mon, 30 Jul 2018 19:02:16 +0000

��˾��ֱ�� researchers propose new weapon in the battle against food-borne bugs: Cooking oil

Christopher.Sorensen Mon, 07/30/2018 - 15:02

Cutline

��˾��ֱ�� researcher Tarek Awad shows two samples: a stainless steel surface treated to trap simple cooking oil (left) and an uncoated surface (photo by Liz Do)

Kendra Hunter

Topic

Global Lens

Faculty of Applied Science & Engineering

Food

Materials Science

Research & Innovation

University of Toronto researchers have a simple solution for food manufacturers battling nasty food-borne illnesses in their industrial plants: cooking oil.

Many foods produced on an industrial scale include raw ingredients mixed together in enormous stainless steel machines that can be difficult to clean. With repeated use, equipment surfaces get minute scratches and grooves, providing bacteria and biofilms the perfect place to hide. Surface-trapped food residue and bacteria then increase the risk of contamination from micro-organisms such as salmonella, Listeria and E. coli.

But Ben Hatton, an assistant professor in ��˾��ֱ��'s department of materials science and engineering, and fellow researchers Dalal Asker and Tarek Awad believe they have an answer that's as simple as it is effective. They propose trapping a thin layer of cooking oil at the metal surface to fill in microscopic scrapes, cracks and fissures, creating a barrier to bacterial attachment.

“Coating a stainless steel surface with an everyday cooking oil has proven remarkably effective in repelling bacteria,” says Hatton who collaborated on the project with AGRI-NEO, an Ontario seed processing company looking for a solution to a common problem in the industry.

“The oil fills in the cracks, creates a hydrophobic layer and acts as a barrier to contaminants on the surface.”

Food particles can accumulate on an untreated stainless steel surface, at left, increasing the risk of contamination in food production facilities. The oil-treated surface, at right, repels material (video by Liz Do)

The team, which researches cheaper, safer and more effective ways to prevent bacteria thriving inside these machines, found that this solution reduced bacterial levels inside the industrial equipment tested by one thousand times. Their work was recently published in the journal ACS Applied Materials & Interfaces.

This simple and cost-effective alternative builds on the Slippery Liquid-Infused Porous Surfaces (SLIPS) principle, which was initially developed at Harvard University to trap lubricant layers into a surface micro-structure and create slippery, non-wetting and non-adhesive properties. Cooking oils such as olive, corn or canola also provide a safer option for cleaning food-processing equipment than the harsh chemicals and disinfectants that are typically used. The sheer size of the machines makes it harder for cleaning materials to do a thorough job, and leftover bacteria can build up resistance to the cleaning agents. Hatton’s method of filling the scratches with oil prevents bacteria from settling and essentially cleans the surface without leaving chemical residues on the stainless steel surface.

“Contamination in food preparation equipment can impact individual health, cause costly product recalls and can still result after chemical-based cleaning occurs,” says Hatton. “The research showed that using a surface treatment and a cooking oil barrier provides greater coverage and results in 1,000 [times] less bacteria roaming around.”

The Hatton research group continues to test new combinations of oils, foods and biofilm types to increase the efficiency of the bacteria barriers. They will also explore the possilbility of using this method in developing countries to minimize bacterial infection and improve mortality rates.

The research was supported by the Natural Sciences and Engineering Research Council of Canada (NSERC) and the Canada Foundation for Innovation.

��˾��ֱ�� students win international clean energy competition with sustainable yacht design

noreen.rasbach — Mon, 25 Jun 2018 19:02:33 +0000

��˾��ֱ�� students win international clean energy competition with sustainable yacht design

noreen.rasbach Mon, 06/25/2018 - 15:02

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From left, Professor Steven Thorpe, Bryan James, Jessica MacInnis, Matthew Chen and Yuri Savguira – winners of the global 2017-2018 Hydrogen Student Design Contest (photo courtesy of Steven Thorpe)

Kendra Hunter

Topic

Global Lens

Faculty of Applied Science & Engineering

Global

Graduate Students

Research & Innovation

Undergraduate Students

A team from University of Toronto's Faculty of Applied Science & Engineering has won an international clean energy design competition. Its design for a sustainable recreational boating system, dubbed Motion+, took first place at the global 2017-2018 Hydrogen Student Design Contest, an annual competition organized by the Hydrogen Education Foundation in Washington, D.C.

The team's winning entry comprises a hydrogen-fuelled amphibious motor boat named the Hydronautic+ and its companion refuelling station fHuel+. It is based on the idea of using off-peak renewable energy to turn water into hydrogen that can replace gasoline as the power source for the vessel. It offers a sustainable, noise-free and emission-free alternative for the boating industry.

The project grew out of MSE458/MSE1058 Nanomaterials in Alternate Energy Systems, a course taught by Professor Steven Thorpe, a professor in the department of material sciences and engineering, that is taken by fourth-year undergraduates and graduate students. The Motion+ team members are Jessica MacInnis, a master's of engineering candidate, Yuri Savguira, a PhD candidate, Matthew Chen, a master's candidate, and Bryan James, a former ��˾��ֱ�� student who is now a PhD student at the University of Florida.

“Our team took a design developed in the classroom and presented it against global competitors,” says MacInnis, who managed safety and regulations for the yacht and refuelling station design. “To win first place was a thrill and came as a result of our team designing a practical solution to current boating challenges”

One of 33 worldwide teams competing for the top prize, Motion+ presented their concept at the Department of Energy Annual Merit Review in Washington D.C. Their focus on the marine industry demonstrated a unique perspective that impressed the judges. The new design allows for the enjoyment of boating without harming lake ecology or surrounding wildlife.

Throughout the course and the many design sessions that followed, the team took advantage of the resources in the technology-enhanced active learning (TEAL) classrooms that have been piloted in the Sandford Fleming building since 2014. TEAL rooms are also a major feature of the recently opened Myhal Centre for Engineering Innovation & Entrepreneurship.

The TEAL model provided a dynamic environment where the team could design their product and develop a business proposition. There they came up with the critical amphibious features enabling the craft to refuel on land, an elegant solution that addressed a number of challenges around hydrogen access.The combination of classroom learning, design concept, innovation and entrepreneurship turned a course project into a first-place win for the team.

“TEAL gave our team the right environment to create an award-winning concept and design,” says Savguira, the team’s project manager. “Our win in Washington showcases the opportunities that learning spaces like this can offer students.”

��˾��ֱ��'s Andrew Forde to perform new composition inspired by Glenn Gould

noreen.rasbach — Tue, 06 Feb 2018 18:54:31 +0000

��˾��ֱ��'s Andrew Forde to perform new composition inspired by Glenn Gould noreen.rasbach Tue, 02/06/2018 - 13:54

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Andrew Forde will perform The Ideas of North on Friday at Koerner Hall (photo by Markus Staley)

Kendra Hunter

Topic

Our Community

Black History Month

Faculty of Applied Science & Engineering

Graduate Students

Andrew Forde, a PhD candidate in the Faculty of Applied Science & Engineering who is also a musician, entrepreneur and philanthropist, strives to challenge the status quo with his projects.

Now, the multi-talented artist is debuting a new musical composition he designed to reflect modern Canada. Called The Ideas of North, the concert will be performed on Friday at Koerner Hall.

Inspired by Glenn Gould’s iconic 1967 CBC radio broadcast The Idea of North, Forde decided to create a project about embracing something classic and wrapping it in a modern quilt of voices and instrumentation. Half a century later, Forde recognized that many of the original themes were still relevant to contemporary Canada.

“By using Gould's legendary radio documentary as the backdrop, I want to reimagine the North for a 21^st-century, pan-cultural Canada,” says Forde. “I want to extend my search of self, of community, of those whose perspectives remain untold, and to take the lead from our Aboriginal sisters and brothers and share our collective stories.”

Forde began composing The Ideas of North nine months ago, and conceived of the work as unfolding in three parts, like a concerto. He reached out to friend and Juno-winning musician and performance artist Shad to write the lyrics.

“The Shad we hear on this song is nothing like the Shad of past,” says Forde. “We discussed the philosophy of the track extensively, and what it was meant to conjure, what message we wanted to get across. Like Gould, Shad created a performance like we have never experienced from something as familiar as rap.”

Read a CBC story about Forde's The Ideas of North

Born and raised in Toronto by parents who arrived from the Caribbean, Forde grew up immersed in the city’s multiculturalism. He started studying violin as a child, a passion he maintained throughout his studies in ��˾��ֱ�� Engineering. This balance between arts and engineering strengthened both abilities, he says – the rigour and wonder he found in engineering influenced his music, and the creativity of his compositions enriched his engineering design thinking.

“I can create compositions methodically, by picturing where it is I want to end up, what I want the listener to feel, and then constructing harmonies and melodies that deliver on that promise,” says Forde. “It’s a ‘first principles’-based approach every time I write something new, and I am sure that it comes from the engineering side of my being. I can truly think outside the box because the box itself does not exist.”

Read about other Black History Month events

This multi-faceted approach, along with Gould’s initial work, led to the creation of The Ideas of North. The performance is collaborative, interactive and communicates a responsibility to shift consciousness, to instigate conversation, and to have safe opportunities to reconcile differences, says Forde.

When he takes to the Koerner Hall stage on Friday, he will bring Iskwé, an Indigenous singer-songwriter, and teenage trumpeter and pianist William Leathers, along with Shad, who will appear via a video recording.

Tickets for The Ideas of North are available online and through The Royal Conservatory of Music.

��˾��ֱ�� researchers develop new way to fill cavities that could reduce further decay

noreen.rasbach — Tue, 06 Feb 2018 05:00:00 +0000

��˾��ֱ�� researchers develop new way to fill cavities that could reduce further decay

noreen.rasbach Tue, 02/06/2018 - 00:00

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Collaborating for the research are (from left) Assistant Professor Ben Hatton, Associate Professor Yoav Finer and PhD candidate Cameron Stewart (photo by Yodit Tedla)

Kendra Hunter

Topic

Our Community

Faculty of Applied Science & Engineering

Faculty of Dentistry

Institute for Biomaterials and Biomedical Engineering

Research & Innovation

When patients go to the dentist to fill a cavity, they’re trying to solve a problem – not create a new one. But many dental patients get bad news: Bacteria can dig under their tooth-coloured fillings and cause new cavities, called recurrent caries.

Now, a collaboration between researchers in the University of Toronto's department of materials science & engineering, Faculty of Dentistry, and the Institute of Biomaterials and Biomedical Engineering (IBBME) has resulted in a novel way to minimize recurrent caries.

In a recent paper published in the journal Scientific Reports, Assistant Professor Ben Hatton of the Faculty of Applied Science & Engineering, Associate Professor Yoav Finer of the Faculty of Dentistry and PhD candidate Cameron Stewart of IBBME tackled the issue and proposed a novel solution: a filling material with tiny particles made by self-assembly of antimicrobial drugs, designed to stop bacteria in its tracks.

These particles may solve one of the biggest problems with antibacterial filling materials: How do you store enough drug within the material to be effective for someone’s entire life?

“Adding particles packed with antimicrobial drugs to a filling creates a line of defence against cavity-causing bacteria,” says Hatton. “But traditionally there’s only been enough drug to last a few weeks. Through this research we discovered a combination of drugs and silica glass that organize themselves on a molecule-by-molecule basis to maximize drug density, with enough supply to last years.”

This discovery of using antimicrobials that self-assemble means the team can pack 50 times as much of the bacteria-fighting drugs into the particles.

Interested in publicly funded research in Canada? Learn more at ��˾��ֱ��’s #supportthereport advocacy campaign

“We know very well that bacteria specifically attack the margins between fillings and the remaining tooth to create cavities,” says Finer. “Giving these materials an antimicrobial supply that will last for years could greatly reduce this problem.”

Looking ahead, the research team plans on testing these new drug-storing particles in dental fillings, monitoring their performance when attacked by bacteria and saliva in the complex environment inside their mouths.

Hatton says the researchers are still far from testing on patients, but the Faculty of Dentistry “has a well-established program for the development and testing of dental materials and procedures. The immediate next steps after in vitro material testing will be to test cavities in an animal model to prove safety and efficacy.”

The research was funded by the National Institutes of Health, Canadian Institutes of Health Research, Canada Foundation for Innovation: John R. Evans Leaders Fund and the Ministry of Research and Innovation Ontario Research Fund.

Read the research in Scientific Reports

Understanding postpartum depression

sgupta — Mon, 12 Aug 2013 14:11:54 +0000

Understanding postpartum depression sgupta Mon, 08/12/2013 - 10:11

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Many mothers do not seek help due to perceived stigma around postpartum depression (photo by Seema Krishnakumar via Flickr)

Kendra Hunter

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Kendra Hunter

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Officially, what caused the deaths of Winnipeg mother Lisa Gibson and her two children are under review but there is a likely possibility that postpartum depression played a role.

Despite growing awareness, there is still a stigma around the condition, which affects approximately 13 per cent of mothers in the first 12 weeks after the birth of a baby and about eight per cent of mothers after the first year.

The Lawrence S. Bloomberg Faculty of Nursing’s Professor Cindy-Lee Dennis, an expert in the field of detecting, treating and preventing postpartum depression, discusses postpartum depression with ��˾��ֱ�� News.

What are the ranges of postpartum mood disorders?

There are different postpartum mood disorders. Some mothers will experience “baby blues” – a very common, transient condition that often resolves on its own. On the other end of the spectrum is postpartum psychosis, which affects less than one per cent of mothers and often occurs within the first couple of weeks postpartum. However, it’s a very serious condition that often requires hospitalization due to significant symptoms such as hallucinations. Another mood disorder that may occur after childbirth is postpartum depression where symptoms range in severity from mild to severe.

For mild depressive symptoms, peer support from mothers groups or non-directive counselling from a public health nurse might be beneficial. Mothers with moderate depressive symptoms often require some form of psychotherapy such as interpersonal psychotherapy and cognitive behavioural therapy and antidepressant medication may be prescribed. Mothers with severe depressive symptoms will frequently require antidepressant medication along with an appropriate therapy.

Is the number of children a mother has a risk factor for postpartum depression?

Postpartum depression is not related to the number of children. However, there are some very strong risk factors that women and their family members should be aware of. If the mother has experienced depression independent of childbirth then she is at risk for another depressive episode with the birth of a baby. Depression and high levels of anxiety during the pregnancy are also risk factors for postpartum depression.

There are also a number of psychosocial variables that place a mother at risk to develop this condition. For example, if a mother lacks social support and feels she has no one to talk to she is more likely to develop depression. A poor marital relationship and a number of “life stressors” or high levels of child care stress also place a mother at risk. Based on the evidence around life stressors, research clearly indicates that if a mother is young, low income, single, or an immigrant she is more likely to develop postpartum depression.

If a mother thinks she has postpartum depression, what should she do?

If a mother thinks she may be experiencing depression she can go online and answer the 10 Edinburgh Postnatal Depression Scale questions. If her score is greater than nine, then she may be experiencing postpartum depression and she should speak with her family physician or a public health nurse who will complete a more detailed assessment and discuss available treatment options. These two resources are an excellent way to begin accessing effective treatment.

In your career studying postpartum depression, have there been improvements in the detection of this condition?

Many mothers think that the symptoms they are experiencing are just a normal response to the stress of having a new baby. If that is the case, they often do not recognize that they are experiencing depression and they do not seek help. However, for some mothers they do recognize that something is wrong but they do not seek help for various reasons including the perception of stigma around postpartum depression.

Society has constructed the role of what a “good mother” is and there’s a perception that being a good mother and being depressed or having a mental illness are at odds. Although this is often not the case, some mothers are very reluctant to admit they may be experiencing depression. To increase detection and treatment, we are strongly encouraging health professionals who are in contact with mothers in the postpartum period to be aware of postpartum depression and to administer the Edinburgh Postnatal Depression Scale if they suspect a mother may be experiencing this condition.

What areas of postpartum depression are you currently researching?

I just received CIHR funding to conduct a study to examine the impact of parental depression in the first two years of a child’s life with a focus on understanding how maternal depression, paternal depression, and dual parental depression affects infant development outcomes. We will also study the prevalence, course, and relationship between maternal and paternal depression. The results will assist in developing innovative and effective targeted interventions for parents based on whether the family has one or two parents with postpartum depression and whether the depressed parent is the mother or the father.

International experts have clearly identified parental depression as a major childhood adversity and shown that effective interventions to address this condition are one of the most important public health preventive strategies we can implement to reduce the long-term negative developmental outcomes among children. Our study will inform the development of effective parental depression interventions with the aim of preventing poor child outcomes.

Kendra Hunter is a writer with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto.

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Dr. Arlene Bierman brings geriatrician expertise to Congressional Fellowship Program

sgupta — Wed, 24 Jul 2013 10:48:27 +0000

Dr. Arlene Bierman brings geriatrician expertise to Congressional Fellowship Program sgupta Wed, 07/24/2013 - 06:48

Kendra Hunter

Author legacy

Kendra Hunter

Topic

Bloomberg Nursing professor Dr. Arlene Bierman, an authority on care for older adults with chronic illness, is taking her expertise to Congress.

Bierman has been accepted into the Atlantic Philanthropies Health and Aging Policy Fellows Program. The prestigious year-long opportunity is designed to equip experts with policy experience and networking connections while helping the United States government develop and implement evidence-based health policies.

As a Fellow, Bierman is working in the United States Department of Health and Human Services (HHS) Office of the Assistant Secretary of Health (OASH), collaborating with the National Institute of Aging and collaborating with the Center for Medicare and Medicaid Innovation. She is also working in the office of Congressman Jim McDermott, ranking member of the House Ways and Means Health Subcommittee, on issues related to Medicare reform.

Writer Kendra Hunter spoke with Professor Bierman, who specializes on the health of socio-economically disadvantaged older adults and the inequities in health care that they experience, about this appointment.

What is the Health and Aging Policy Fellows Program?
We can’t deliver effective care to older adults without large-scale health system transformation and this program, established in 2008, was created to address this growing concern. An estimated 71 million Americans will be 65 and older by 2030, and there is urgency to develop and implement innovative models to care for this population, many of whom will have complex health problems and rely heavily on the health care system.

Equally important is the need to promote and foster active aging and reduce the burden of illness among aging populations. The Fellows Program is integrated with the American Political Science Association (APSA) Congressional Fellowship Program – the oldest and most prestigious congressional fellowship in the U.S. The opportunity to participate with an interdisciplinary group of peers on tackling the critical health and aging policy issues currently facing the U.S., and by extension Canada, is a great honour.

What are you working on for the duration of your Fellow Program?
I’m at the start of a six-month sabbatical to the U.S. to work more intensely on my Fellowship projects and placements. At the HHS Office of the Assistant Secretary of Health (OASH), I am working on developing strategies to achieve the objective of the Multiple Chronic Condition initiative. My focus is on the role of health information technology in improving quality and outcomes of care for people with multiple chronic conditions. This includes patient engagement, quality improvement, clinical decision making, and population health management.

Collaborating with the Center for Medicare and Medicaid Innovation (CMMI), I am involved in the implementation and evaluation of the Comprehensive Primary Care Initiative, a multi-payer demonstration of a medical home model in 500 primary practices in seven states. In the office of Congressman Jim McDermott, I have the opportunity to learn more about the policy process.

What have been a few of the highlights so far?
As part of this program, I’ve had the opportunity to meet with top officials, sit in on Congressional meetings and learn the intricacies of both the U.S. and Canadian legislative process. The level of exposure has been phenomenal and provided me with new insights on how to effectively translate research to policy in order to improve both population health and health care delivery.

The program affords Fellows the opportunity to participate a week-long Canadian Parliamentary Exchange to get a cross-border perspective on a wide range of policy issues. The exchange provides a better understanding the differences in the policy process and governance between the two countries. We met with leaders from each political party including Stéphane Dion, Thomas Mulcair and John Baird, and received valuable one-on-one interactions with the people shaping Canada’s health care policies. This experience on Parliament Hill and meeting the senior-level officials with my American colleagues has been one of the highlights of the year.

Can Canada learn from the U.S.?
Canada can learn a great deal from the U.S. and the U.S. can learn a great deal from Canada. While Canada has universal access to health care, and the U.S. has yet to achieve universal coverage both countries face similar challenges in the need to improve quality, value and efficiency of care. Both countries need to redesign their health systems to improve chronic disease prevention and management and to care for the growing number of people with multiple chronic conditions. We can accelerate learning from drawing on the respective experiences in each country to work towards these goals. There is also opportunity for scientific exchange on the methods of implementation science, performance measurement, and quality improvement.

It’s a very interesting time in U.S. health care and the potential for cross-border learning and knowledge exchange between the U.S. and Canada has never been greater.

Kendra Hunter is a writer with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto.

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How to improve health care safety in the home

sgupta — Fri, 12 Jul 2013 15:33:45 +0000

How to improve health care safety in the home sgupta Fri, 07/12/2013 - 11:33

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Roughly half of the adverse events such as falls or injuries experienced by users of home health care are preventable, says Professor Emerita Diane Doran

Kendra Hunter

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Subheadline

��˾��ֱ�� nursing expert releases first guidelines

More than one million Canadians receive health care services in the home and new research from the University of Toronto shows that each year 10 to 13 per cent experience an adverse event, such as an injury or medication problem.

Lawrence S. Bloomberg Faculty of Nursing’s Professor Emerita Diane Doran has released Safety at Home: A Pan-Canadian Home Care Study through the Canadian Patient Safety Institute (CPSI). Doran, along with co-lead researcher Régis Blais of Université de Montréal, spent two years looking at the prevalence, magnitude and risk of incidents in home care across Canada.

Writer Kendra Hunter asked Doran about the findings and the safety recommendations from this study, the first of its kind in scope, and what this means for the future of home care and an aging population.

Why is this research important?
Ageing in Canada is reaching unprecedented levels in our country and, with people more determined to stay in their homes, it’s important that we study the home care model and how it’s working. We know that in 2011, there were 1.66 million Canadians receiving home care services and this number is expected to almost double to 2.78 million by 2036. Currently we know that 70 per cent of home care clients are over 75, mostly female with 20 per cent having a dementia related diagnosis such as Alzheimer’s.

With figures already this high, changes are needed in home care to accommodate this swell of clients and minimize risk.

What did your research uncover?
Namely that four out of every 100 clients admitted to home care experience an adverse event, such as a fall, infection, medication-related or other injuries, and that approximately 50 per cent were judged preventable. We determined that harmful incidents in home care could result from inconsistencies in care planning and delivery, poor standardization of processes and medication packaging, to name a few.

The consequences of these adverse events meant an increase in using health care services, disability or death.

How does this affect clients and families?
One of the main issues we uncovered was a high level of caregiver distress. As it stands, caregivers and clients have to deal with a patchwork of services due to the way the system was designed. Home care in Canada is defined as an “extended health service,” and is therefore not an insured health service under the Canada Health Act. Each province and territory administers its own publicly funded home care programs and services and they vary in terms of levels of coverage, eligibility criteria and funding. Some provinces and territories contract out a portion of their home care service to private agencies, so caregivers and clients have the additional task to manage a variety of care providers, from different agencies, in their homes all providing a separate, but yet related service.

Another very understandable issue that arises is that many clients don’t want to admit they need help or that something is wrong, for fear of being told they can no longer live independently. As a result, an adverse event can occur, which could leave the client in a position where they have no choice but to go into long-term care.

Is home care more hazardous than institutional care?
Home care is, in fact, safer for most patients than hospital stays. To put the findings in context, we found the rate of adverse incidents in home care to be 4.2 per cent.

A landmark national study by Baker, Norton, and colleagues published in the Canadian Medical Association Journal, entitled “The Canadian Adverse Events Study,” found that 7.5 per cent of patients experienced adverse events in hospitals. Most patients stay in hospital less than a week, while many people receive home care for months or years.

What can be done to make home care safer?
Some of the recommendations we’ve put forward are:

Better communication across the board, between health care teams, health care facilities, with the clients, with their families – all of that is needed in order to ensure consistency of care delivery.
Provide support for caregivers to give them better training, the opportunity for counselling, needs assessments, so they can manage the complexities and sometimes stressful elements of this care.
Build integrated, interdisciplinary health care teams.
Use a standard assessment tool to identify clients at risk and so that caregivers can know what signs to look for to identify if a client is declining.
Provide opportunities and incentives for collaboration among health care sectors to find collaborative ways to ensure the best care possible.

Kendra Hunter is a writer with ��˾��ֱ��'s Lawrence S. Bloomberg Faculty of Nursing.

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Nursing dean to become vice-provost of academic programs

sgupta — Fri, 21 Jun 2013 10:16:02 +0000

Nursing dean to become vice-provost of academic programs sgupta Fri, 06/21/2013 - 06:16

Kendra Hunter

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In 2005, Professor Sioban Nelson moved from Australia to the University of Toronto to take over the role of dean at the Lawrence S. Bloomberg Faculty of Nursing.

Beginning August 1, 2013, Professor Nelson begins a new role at ��˾��ֱ��, directing academic standards, policy and planning for the University as vice-provost (academic programs).

Over her two terms as dean of Bloomberg Nursing, Nelson has significantly increased the profile of the Faculty throughout the University and with numerous community and professional partners. Her leadership has been instrumental in building the global reputation of the Faculty and widening the network of international partners and collaborators.

Writer Kendra Hunter spoke with Nelson about the move to Simcoe Hall.

Leaving Australian summers for Canadian winters would be a tough switch for most—what attracted you to the University of Toronto when you first took the role of dean?
What I found so compelling was the opportunity to take a truly excellent Faculty to the next level. Opportunities like that are pretty rare. We have such outstanding students and we do such wonderful research—I felt my job was to help the Faculty see how fantastic it was, to own it, and to set new benchmarks for the discipline and for ourselves—and to communicate that message in everything we do. A dream job really.

What are you most proud of during your time as dean of Bloomberg Nursing?
There are many things we've accomplished together as a faculty so it's hard to choose. I'm very proud of the community we've created around us, building strong connections with the teaching hospitals, with our alumni and with the broader professional community. I think the practice-university divide feels pretty seamless these days and that is critical for a professional faculty. It's been an effort but it’s been very rewarding for everyone.

How has your role as dean prepared you for the vice-provost role?
Ask me in a year.

What are you looking forward to accomplishing as vice-provost?
I'm not sure about what I can accomplish but I am very excited about how much I'm going to learn about the whole University. The health sciences world is big and complex and took a lot of getting to know. I expect every other sector of the University will be equally mystifying and I'm really looking forward that.

Have you adapted to the Canadian winters yet?
Well I complain like everyone else when it’s very cold or when winter has overstayed its welcome—so I guess I’m acclimatized. I’ve lived in many different climates—from equatorial to Toronto and everything in between. I do love the big seasonal shifts here and the very different rhythm of life we have across the year.

Kendra Hunter is a writer with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto.

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��˾��ֱ�� Nursing professor advises Toronto city council as it strengthens health care for medically uninsured

sgupta — Mon, 13 May 2013 15:49:21 +0000

��˾��ֱ�� Nursing professor advises Toronto city council as it strengthens health care for medically uninsured sgupta Mon, 05/13/2013 - 11:49

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Professor Denise Gastaldo provided research evidence to Toronto city council for the landmark decision (photo by Rebecca Baran)

Kendra Hunter

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Kendra Hunter

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Professor Denise Gastaldo shared research, expertise for the major decision

Toronto city council addressed the needs of the medically uninsured and voted 21 to 7 in favour of increasing help for those without Ontario Health Insurance Plan (OHIP) coverage on May 9.

In the recommendations presented to council, Bloomberg Nursing associate professor, Denise Gastaldo, strengthened the case for affordable, accessible health care through inclusion of her research findings on Latin American Undocumented Workers in the Greater Toronto Area.

As one of the few academics invited by the Board of Health to participate as a key informant in the report, Gastaldo’s research contributed to the need for improvements at the program and policy level.

She speaks with ��˾��ֱ�� News about what this decision means for health care in Toronto.

Why is access to health care an issue we need to discuss in Toronto today?
There is an assumption that everybody who resides in Ontario has OHIP. If you are a recently arrived landed immigrant or an undocumented worker in the GTA, you have no right to health care. Even in case of severe illness, my research participants have delayed seeking help, were turned down or were charged expensive amounts for health care; much more than what is charged to OHIP. When you don’t have OHIP, it is very hard to access preventive services and hospitals can charge any amount for emergency care. For instance, I know of someone in his 20s who was still in his three-month uninsured period as landed immigrant and he fainted in class. After three days in a downtown Toronto hospital he had to self-discharge because his bill was already over $14,000. Very few can afford a cost like that and if you’re in a precarious employment situation with poor wages and no safety net, expenses like that are impossible to pay back.

What do you think about the Toronto Board of Health report that city council voted on?
I am encouraged by city council’s decision to find meaningful solutions to the health needs of Torontonians who can’t access OHIP. Toronto Public Health and the Board of Health should be congratulated for their courage and vision. Toronto prides itself on being a global city and as such, can no longer look for one-dimensional solutions for the complex global issues that impact its citizens regardless of status. We need to engage with new alternatives, thinking about occupational citizenship and health for all.

What was your contribution to the Board of Health recommendations that were presented to city council?
I was a key informant during the report development and my research report on undocumented workers residing in the GTA and the health issues they face. This evidence was used to create recommendations as to why we need to provide health care to this segment of the population and were put forward by the board.

Some people argue that the cost is too much for the Toronto taxpayer, is this true?
This is a misconception that looked at from a short-term perspective, the answer would appear to be “yes” but in the long term, the answer is a resounding “no.” There are three things we have to have in mind: first, prevention is much cheaper than treatment of severe conditions. Providing pre-natal care and a safe birth is far cheaper than treating a sick mother and baby; ensuring safe working conditions is cheaper than treating injured workers. Second, presently people delay seeking care because it’s too expensive or they are afraid of deportation. Third, to regularize the status of people who are living and working here for years is a pathway to increase tax revenues from both employers and employees. The report proposes to address issues at the federal and provincial level, to discuss a formula of affordable (OHIP-like fee) care for those who can pay, and a better system to support clinics and community health centres that presently offer services for refugees, migrants and non-status residents. If we do nothing, it will cost us much more and a lot of unnecessary suffering and discrimination will occur. Toronto now has the opportunity to lead global cities by being an example of a health promoting, fair-minded city.

Kendra Hunter writes for the Lawrence S. Bloomberg Faculty of Nursing.

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