The Role of Religion and Spirituality in the Care of Patients in Family Medicine

Aims: This thesis explored patients’ perspectives on discussing their religious and spiritual beliefs with their family physicians and family physicians’ behaviours in discussing patients’ religion and spirituality. Methods: This thesis examined the role of religion and spirituality in patient care in family medicine using qualitative and quantitative methodologies including in-depth interviews of patients and a survey of family physicians. Findings: The majority of participants believed that religion and spirituality was important in patient care in family medicine. Barriers and facilitators were identified to the integration of religion and spirituality into patient care. Both studies identified physician comfort level as a barrier and medical education as a potential solution. Conclusions: The majority of participants believed that patients’ religious and spiritual beliefs were important to know, but identified comfort level as a barrier to asking. Medical education on religion and spirituality in patient care is important to increasing physician comfort level

Preceptor engagement in distributed medical school campuses

Background: There is increasing interest in distributed medical campuses and engagement of physicians in these communities.  To date, there has been suboptimal recruitment of physicians to participate in medical education at distributed campuses.  The purpose of this project was to identify barriers to engagement in medical education by community physicians in the geographical catchment of the Waterloo Regional Campus of McMaster.Method: In-depth, semi-structured, qualitative interviews were conducted with physicians not involved in teaching. Interview recordings were transcribed and analyzed using a closed-loop, iterative coding methodology and thematic analysis was performed.  Interviews were conducted until thematic saturation was achieved.Results: Six interviews were conducted and coded.  Nine key themes emerged: academic centre versus distributed sites, interest in teaching, financial considerations, administrative barriers, medical experience and knowledge currency, practice environment and schedule, training on teaching, setting up systems for learners in distributed campus settings, and student engagement and medical learner level.Conclusions: Barriers to engagement in teaching primarily focused on differences in job structure in the community, administrative barriers both at the hospital and through the medical school, and lack of knowledge on how to teach.  As medical schools look to expand the capacity of distributed campuses, misperceptions should be addressed and opportunities to improve engagement should be further explored

Interprofessional Management of Allergic Conjunctivitis: A Proposed Algorithm for Canadian Clinical Practice

Ocular allergies affect a large and increasing number of people in North America. Canada’s statistics are likely to mirror those of the U.S., where up to 40% of the population is affected by ocular allergies. The symptoms and signs of ocular allergies can greatly affect productivity and have a dramatic effect on overall quality of life (QoL). Over the years, many effective treatments have been developed for the management of ocular allergies. For allergic conjunctivitis, topical ophthalmic agents include antihistamines, mast-cell stabilizers, dual-activity agents, steroids, nonsteroidal anti-inflammatory drugs, and other immune-modulating drugs. Oral antihistamines are commonly chosen by patients for all forms of allergy, including allergic conjunctivitis. This review provides a summary of the forms of ocular allergy, with a particular focus on the symptoms and signs, diagnosis, current treatment options, and impact on QoL. More importantly, through multidisciplinary collaboration, a simplified treatment algorithm is proposed for Canadian clinical practice. This algorithm provides practitioners the best possible management strategies based on an individual patient presentation, thereby maximizing treatment efficacy and minimizing the effects on tasks of daily living and QoL

Gestion interprofessionnelle de la conjonctivite allergique: Algorithme proposé pour la pratique clinique canadienne

Les allergies oculaires touchent un nombre important et croissant de gens en Amérique du Nord. Les statistiques du Canada sont probablement analogues à celles des États-Unis, pays où jusqu’à 40 % de la population souffre d’allergies oculaires. Les symptômes et les signes de ces allergies peuvent avoir un effet considérable sur la productivité et la qualité de vie en général. Au fil des ans, on a mis au point de nombreux traitements ef caces pour la prise en charge des allergies oculaires. Dans le cas de la conjonctivite allergique, les agents ophtalmiques topiques comprennent les antihistaminiques, les stabilisateurs mastocytaires, les agents à double activité, les stéroïdes, les anti-inflammatoires non stéroïdiens et d’autres médicaments à modulation immunitaire. Les patients choisissent souvent des antihistaminiques oraux pour toutes les formes d’allergie, y compris la conjonctivite allergique. Nous récapitulerons ici les formes d’allergies oculaires en mettant particulièrement l’accent sur les symptômes et les signes, le diagnostic, les options de traitement actuelles et l’incidence sur la qualité de vie. Plus important encore, nous proposerons, grâce à la collaboration multidisciplinaire, un algorithme de traitement simplifié pour la pratique clinique au Canada. Cet algorithme fournit aux praticiens les meilleures stratégies de gestion possibles fondées sur la présentation individuelle du patient et propres à optimiser l’efficacité du traitement et à réduire au minimum les effets sur les tâches de tous les jours et la qualité de vie

MicroRNAs in cardiac arrhythmia: DNA sequence variation of MiR-1 and MiR-133A in long QT syndrome.

Long QT syndrome (LQTS) is a genetic cardiac condition associated with prolonged ventricular repolarization, primarily a result of perturbations in cardiac ion channels, which predisposes individuals to life-threatening arrhythmias. Using DNA screening and sequencing methods, over 700 different LQTS-causing mutations have been identified in 13 genes worldwide. Despite this, the genetic cause of 30-50% of LQTS is presently unknown. MicroRNAs (miRNAs) are small (∼ 22 nucleotides) noncoding RNAs which post-transcriptionally regulate gene expression by binding complementary sequences within messenger RNAs (mRNAs). The human genome encodes over 1800 miRNAs, which target about 60% of human genes. Consequently, miRNAs are likely to regulate many complex processes in the body, indeed aberrant expression of various miRNA species has been implicated in numerous disease states, including cardiovascular diseases. MiR-1 and MiR-133A are the most abundant miRNAs in the heart and have both been reported to regulate cardiac ion channels. We hypothesized that, as a consequence of their role in regulating cardiac ion channels, genetic variation in the genes which encode MiR-1 and MiR-133A might explain some cases of LQTS. Four miRNA genes (miR-1-1, miR-1-2, miR-133a-1 and miR-133a-2), which encode MiR-1 and MiR-133A, were sequenced in 125 LQTS probands. No genetic variants were identified in miR-1-1 or miR-133a-1; but in miR-1-2 we identified a single substitution (n.100A> G) and in miR-133a-2 we identified two substitutions (n.-19G> A and n.98C> T). None of the variants affect the mature miRNA products. Our findings indicate that sequence variants of miR-1-1, miR-1-2, miR-133a-1 and miR-133a-2 are not a cause of LQTS in this cohort

Mammalian microRNAs: a small world for fine-tuning gene expression

The basis of eukaryotic complexity is an intricate genetic architecture where parallel systems are involved in tuning gene expression, via RNA-DNA, RNA-RNA, RNA-protein, and DNA-protein interactions. In higher organisms, about 97% of the transcriptional output is represented by noncoding RNA (ncRNA) encompassing not only rRNA, tRNA, introns, 5′ and 3′ untranslated regions, transposable elements, and intergenic regions, but also a large, rapidly emerging family named microRNAs. MicroRNAs are short 20-22-nucleotide RNA molecules that have been shown to regulate the expression of other genes in a variety of eukaryotic systems. MicroRNAs are formed from larger transcripts that fold to produce hairpin structures and serve as substrates for the cytoplasmic Dicer, a member of the RNase III enzyme family. A recent analysis of the genomic location of human microRNA genes suggested that 50% of microRNA genes are located in cancer-associated genomic regions or in fragile sites. This review focuses on the possible implications of microRNAs in post-transcriptional gene regulation in mammalian diseases, with particular focus on cancer. We argue that developing mouse models for deleted and/or overexpressed microRNAs will be of invaluable interest to decipher the regulatory networks where microRNAs are involved

The Promoter of the pri-miR-375 Gene Directs Expression Selectively to the Endocrine Pancreas

microRNAs (miRNAs) are known to play an essential role in controlling a broad range of biological processes including animal development. Accordingly, many miRNAs are expressed preferentially in one or a small number of cell types. Yet the mechanisms responsible for this selectivity are not well understood. The aim of this study was to elucidate the molecular basis of cell-specific expression of the pri-miR-375 gene, which is selectively expressed in pancreatic islets, and has been implicated both in the development of islets, and the function of mature pancreatic beta cells. An evolutionarily conserved 768 bp region of DNA upstream of the pri-miR-375 gene was linked to GFP and luciferase reporter genes, and expression monitored in transgenic mice and transfected cultured cells. Deletion and targeted mutagenesis analysis was used to evaluate the functional significance of sequence blocks within the upstream fragment. 5′-RACE analysis was used for mapping the pri-miR-375 gene transcription start site. The conserved 768 bp region was able to direct preferential expression of a GFP reporter gene to pancreatic islets in transgenic mice. Deletion analysis using a luciferase reporter gene in transfected cultured cell lines confirmed the cell specificity of the putative promoter region, and identified several key cis-elements essential for optimal activity, including E-boxes and a TATA sequence. Consistent with this, 5′-RACE analysis identified a transcription start site within this DNA region, 24 bp downstream of the TATA sequence. These studies define the promoter of the pri-miR-375 gene, and show that islet-specific expression of the pri-miR-375 gene is controlled at the transcriptional level. Detailed analysis of the transcriptional mechanisms controlling expression of miRNA genes will be essential to permit a comprehensive understanding of the complex role of miRNAs such as miR-375 in developmental processes

Mammalian MicroRNA Prediction through a Support Vector Machine Model of Sequence and Structure

BACKGROUND: MicroRNAs (miRNAs) are endogenous small noncoding RNA gene products, on average 22 nt long, found in a wide variety of organisms. They play important regulatory roles by targeting mRNAs for degradation or translational repression. There are 377 known mouse miRNAs and 475 known human miRNAs in the May 2007 release of the miRBase database, the majority of which are conserved between the two species. A number of recent reports imply that it is likely that many mammalian miRNAs remain to be discovered. The possibility that there are more of them expressed at lower levels or in more specialized expression contexts calls for the exploitation of genome sequence information to accelerate their discovery. METHODOLOGY/PRINCIPAL FINDINGS: In this article, we describe a computational method-mirCoS-that uses three support vector machine models sequentially to discover new miRNA candidates in mammalian genomes based on sequence, secondary structure, and conservation. mirCoS can efficiently detect the majority of known miRNAs and predicts an extensive set of hairpin structures based on human-mouse comparisons. In total, 3476 mouse candidates and 3441 human candidates were found. These hairpins are more similar to known miRNAs than to negative controls in several aspects not considered by the prediction algorithm. A significant fraction of predictions is supported by existing expression evidence. CONCLUSIONS/SIGNIFICANCE: Using a novel approach, mirCoS performs comparably to or better than existing miRNA prediction methods, and contributes a significant number of new candidate miRNAs for experimental verification

This is Research: Moscou, Bains, Lee Poy, and Cornwall: Vaccin8 for the Culture

Vaccin8 for the Culture is a Toronto GTA grassroots community-based collaboration between SolidBlack! — a collective comprised of Ontario College of Art & Design University (OCADU) Black assistant professors and the Jamaican Canadian Association. In this collaboration, OCAD U professors are engaging Black youth (ages 14-29 years) in the co-design of a public health campaign to promote COVID-19 vaccination within the Toronto GTA Black community. Black youth participating in the Vaccin8 for the Culture project are designing posters and other campaign materials that celebrate Black art, storytelling, and dance to promote vaccination and protect Black health, Black lives Black love, Black joy and Black culture! The project is funded by the Public Health Agency of Canada. Visit the project website at https://solidblackcollective.com/ The image selected to represent this project is a poster of the posters designed by project youth. Poster designs: Kyla Gilbert, Alexis Henry, Abdulkadir Nur, Anara Osbourne, Arianna Osbourne, Deshae Robinson, Joshua Spencer, and Andres Navas Suarez. Instagram @solidblackcollective Twitter - @solid_Black