Raw Talk Podcast

#96: Genetic Testing: What it Means for Families and the Future

The Human Genome Project -- to sequence all genes in human DNA -- took over a decade and about $5 billion dollars to complete. Today, we can get the same results in 2 months for about $5000, or even over a weekend if we really need it. As a result, more and more people have access to genetic testing. For many families affected by inheritable conditions, these tests can be invaluable. But is this the precision medicine revolution we've been promised? In this episode of Raw Talk Podcast, we gather experts in genetic testing and genetic counselling to find out. We'll explore what genetic testing really looks like, what the results can mean for families, and learn about the growing field of genetic counselling. First, we spoke with Dr. Raymond Kim, medical geneticist at the University Health Network, who told us about the history and future trajectory of medical genetics. We also sat down with genetic counsellors Stacy Hewson and Laura Zahavich, who direct and lecture for the genetic counselling master's program here at the University of Toronto; they shared with us their challenging but rewarding experiences supporting families to order, interpret, and process genetic tests. Finally, we heard from Huntington's Disease researcher and carrier Dr. Jeff Carroll, who shared his story with genetic testing personally and while family planning. We hope to shed a light on the exciting fields of medical genetics and genetic counselling, and the growing number of genetic tools that might truly revolutionize healthcare as we know it.

Written by: Adrine de Souza

Dr. Raymond Kim - Webpage
Stacy Hewson - Webpage
Laura Zahavich - Webpage
Dr. Jeff Carroll - Webpage
University of Toronto MSc in Genetic Counselling Program
Article - Prioritizing diversity in human genomics research
gnomAD: Genome Aggregation Database
Raw Talk Podcast - Season 5 Listener Survey

#95: Live or Be Alive: Medical Assistance in Dying

Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 under Bill C-14 after decades of public dialogue and debate. This episode takes a deep dive into MAiD, the death and dying experience, and what these mean to patients, families, care providers, and others involved in the health system. We had the pleasure to sit down with and learn from Sally Bean, Director of Policy and Ethics at Sunnybrook Hospital; Dr. Madeline Li, Psychiatrist and Lead of the Psychosocial Oncology Division, Princess Margaret Cancer Centre; Dr. Ahmed Al-Awamer, Palliative Care Physician and Director of Postgraduate Medical Education, University Health Network; and Steve Legere, a patient diagnosed with incurable cancer who has been approved for MAiD, and his partner, Christine Legere. Each of these individuals takes us through a different aspect of living and dying at the end of life and how MAiD has impacted their respective lives and professional roles.

Written by: Larkin Davenport Huyer

Canada's new medical assistance in dying (MAID) law
Madeline Li's Maclean's article
Article: Medical Assistance in Dying - Implementing a Hospital-Based Program in Canada

#94: Child Maltreatment: Healing and Breaking the Cycle

For many people, childhood memories hold a special place in our hearts. Childhood experiences also impact our journey through life, shaping our personality, relationships, and conceptions of right and wrong. But not all childhood memories are bright, and many children suffer significant trauma through maltreatment by family members or other trusted adults. In this episode, we explore the difficult topic of child maltreatment with the help of our esteemed guests. First, Dr. Tracie Afifi, a Professor in Community Health Sciences at the University of Manitoba, describes the scope of child maltreatment in Canada, and describes intervention and prevention strategies. Next, Dr. Robert T. Muller, a Clinical Psychologist, Professor of Psychology at York University, and bestselling author on trauma therapy, tells us about the goals, pitfalls, and successful strategies in psychotherapy for patients with childhood trauma. Finally, Dr. Katreena Scott, an Associate Professor and Clinical Psychologist at the University of Toronto, explores the complex familial contexts in which child maltreatment can arise, and describes the unique intervention program she and her team have pioneered to help break the cycle.

Written by: Tsukiko Miyata

Local Children's Aid Societies (Ontario)
Profile - Dr. Tracie Afifi
Profile - Dr. Robert T. Muller
Profile - Dr. Katreena Scott
Book - Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth
Book - Trauma and the Avoidant Client: Attachment-Based Strategies for Healing
Caring Dads
Adverse Childhood Experiences
Global look at Child Maltreatment (WHO)
Child Maltreatment in Canada
Indigenous people and Child Maltreatment

#93: The Future of Antibiotics

Since their discovery in the 1920's, antibiotics have allowed the field of medicine to make leaps and bounds in innovation. The ability to treat bacterial infections reliably and effectively have made transplant surgeries, cancer chemotherapy, and treating what were once considered deadly infections, like pneumonia, a routine part of our health care. However, antibiotic resistance can occur when the bacteria being targeted change in response and render the antibiotic ineffective. Antibiotic resistance is a global threat and there are concerns that by the year 2050, antibiotic resistant infections could cause more than 10 million deaths annually. In this episode, we explore the drivers of antibiotic resistance around the world and speak to researchers tackling this issue through their research on innovative therapies and solutions. First, Dr. Thomas Van Boeckel explains the major driving forces and global trends in development of antibiotic resistance and system wide policy level changes required to tackle the threat. Dr. Erin Duffy takes us through the innovative work being done at CARB-X, a non-profit initiative to accelerate research in the field globally. Finally, Chidozie Ojobor from the University of Toronto, talks to us about his research on tailocins, a promising new technology he is researching for combating antibiotic resistant bacteria.

Written by: Anam Islam

CDC antibiotic resistance threat report, 2.8 million AR cases each year in the USA
Global trends in antimicrobial resistance in animals in low- and middle-income countries
Dr. Van Boeckel's university profile page
Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations
CARB-X portfolio
Davidson Lab at UofT

#92: Producing and Pricing Drugs in Canada

Pharmaceutical drugs are a pillar of modern healthcare - from preventative medicines to life-saving therapies. We therefore rely on pharmaceutical companies to discover, develop, and deliver new drugs to patients in need. We know that this process is both risky and expensive, but does that justify the drug prices we see in Canada today? Who decides what’s a fair drug price anyways? And what is the role of academic science in this whole operation? Join us as we answer these questions and more, with our expert guests: Dr Alison Symington, consultant with Life Sciences Ontario, describes the process of drug discovery and the relationships between academia and industry. Dr. Wong-Rieger, President and CEO of Canadian Organization for Rare Disorders, describes the challenges faced by individuals with rare diseases. Dr. Nigel Rawson, Senior Fellow with the Fraser Institute, introduces us to the Patented Medicine Prices Review Board and their upcoming changes. Finally, Dr. Joel Lexchin, Emergency physician at the University Health Network and Canadian drug policy expert, explains some of the challenges to setting fair drug prices in Canada.

Written by: Adrine de Souza

Profile - Dr. Alison Symington
Profile - Dr. Durhane Wong-Rieger
Profile - Dr. Nigel Rawson
Profile - Dr. Joel Lexchin
Patented Medicine Prices Review Board (PMPRB)
Proposed PMPRB changes
Canada Pharmacare Act (Bill C-213)
Canadian Organization for Rare Disorders (CORD)
Innovative Medicines Canada
Article - academic vs industry for drug discovery
Drug Discovery @ U of T

 

#91: Social Determinants of Health: Care beyond the Clinic

Many factors including income, food security, or housing can have a huge contribution to our health. These are known as the social determinants of health (SDoH). In this episode, we discuss some common SDoH, how they impact our health, and what some leading physicians are doing to tackle the issue. Our guests, Dr. Andrew Boozary, Dr. Andrew Pinto, and Dr. Kate Mulligan discuss topics such as, the teaching of SDoH in the medical curriculum, how the SDoH have been exacerbated with the COVID-19 pandemic, as well as current and future efforts to address the SDoH and decrease the associated health disparities. All of our guests are actively working to change our health system and the way we provide care to improve the health disparities we see in Toronto, Ontario, Canada, and beyond.

Written by: Larkin Davenport Huyer

Dr. Andrew Boozary's Twitter
Dr. Kate Mulligan's Twitter
Dr. Andrew Pinto's Twitter
Upstream Lab
Social Medicine at UHN as reported by Toronto Star
Public Health Ontario's report on SDoH in COVID19

#90: Anti-Black Racism in Healthcare

Like so many institutions, anti-Black racism continues to pervade the healthcare system—rarely in overt, obvious ways, but in ways that undeniably lead to worse health outcomes for Black communities. In this episode, we discuss the uncomfortable truths of anti-Black racism in healthcare, and what we can do about it. We hear from Dr. Sean Wharton, Medical Director of the Wharton Medical Clinic, Internist, and Adjunct Professor at McMaster University and York University, about his experiences in the healthcare system, as a trainee, physician, and researcher. He discusses the roots of racist systems, and the impacts of subconscious biases on both the provision and receipt of patient care. As the founder of the Black Medical Students’ Association, he describes how the unique needs of different trainee and patient populations must be recognized and addressed if we hope to provide equitable care. We also spoke with Jessica Goncalves, a nursing student and the first Black President of the Nursing Undergraduate Society at the University of Toronto. She tells us about the labelling that begins long before members of the Black community enter health professions, and the importance of diverse representation within such professions. We hope that you are inspired—as we are—by our guests, to continue conversations, advocacy, and actions in the pursuit of health equity.

Written by: Rachel Dadouch

Dr. Wharton - Wharton Medical Clinic
Dr. Wharton - Feature UofT Temerty Faculty of Medicine
Dr. Wharton - Inaugural Lecture in Black Health for City-Wide Medical Grand Rounds
Jessica Gonclaves - President of the Nursing Undergraduate Society
Resource - The Implicit Project
Article - The Effect of Race and Sex on Physicians' Recommendations for Cardiac Catheterization
Resource - Anti-Racism Resources
Article - For our White Friends Desiring to be Allies
Book - So You Want to Talk About Race by Ijeoma Oluo
Book - How to be an Antiracist by Ibram X. Kendi
Book - Black and Blue: The Origins and Consequences of Medical Racism by John Hoberman
Event - Black Physicians Association of Ontario Annual Health Symposium (Feb 27, 2021)
Organization - Black Physicians of Canada
Organization - U of T Black Medical Students Association

 

#89: Vaccines: Making History

Vaccine technology has come a long way in terms of safety and understanding the underlying immunological principles. The first vaccine that was made was against smallpox in the late 18th century. Since then, vaccines have become the key tool in fighting against infectious diseases that have affected humans for centuries, including chickenpox, measles, and polio. But as the world prepares for the largest mass vaccination campaign in history with the COVID19 vaccines, there are many people that are somewhat hesitant about the vaccination process but are curious to learn more. The emergence of mRNA vaccines has allowed for the fastest development of a vaccine in history and could be a sign of what's to come in the future. In this episode, we talk about the COVID19 mRNA vaccine with the co-founder of Moderna, Dr. Derrick Rossi and about how mRNA can be used in personalized cancer vaccines with Providence Therapeutics' Chief Development officer, Dr. Natalia Martin Orozco. We look back at the history of vaccine development with Dr. Christopher Rutty. Finally, We also speak with Dr. Nicole Charles to explore the complexity of vaccine hesitancy in marginalized communities.

Written by: Yagnesh Ladumor

Connaught Labs at UofT
History of Vaccination virtual exhibit
Dr. Charles' book - Suspicion. Vaccines, Hesitancy, and the Affective Politics of Protection in Barbados
Seminal paper from the Rossi Lab about Modified RNAs
Providence Therapeutics

 

#88: Tuberculosis: The Forgotten Pandemic

Tuberculosis (TB) is a bacterial infectious disease that affects millions of people globally every year. Despite being one of the oldest infectious diseases in humans, control of the epidemic through treatment and vaccination has remained out of reach. In today’s episode, we learned about what makes TB so difficult to control, from immunology to stigma. First, Dr. Jun Liu, a Professor in the Department of Molecular Genetics at University of Toronto, guides us through current knowledge on TB and discusses the difficulties and advances in developing TB vaccines. Next, Dr. Amrita Daftary, a Professor in the Department of Global Health at York University, explains the process of diagnosing and treating TB, and later highlights challenges that patients with TB may face while accessing care. Finally, Dr. Sarah Fortune, the Director of TB Research Program at Harvard T. H. Chan School of Public Health, helps us understand how TB drug resistance can arise, and why TB-HIV co-infection poses such a challenge. The fight against TB continues every day, by millions of patients, healthcare providers, and researchers alike. Join us as we learn about this forgotten pandemic.

Written by: Tsukiko Miyata

Dr. Jun Liu - profile
Dr. Amrita Daftary - profile
Dr. Sarah Fortune - profile
What is DOTS? - report
Paul Farmer on Partners in Health, Harvard-Haiti, and making the lives of the poor the fight of his life
TB Personal Stories
Vaccine Preventable Diseases

#87: Water: Access, Equity and Greater Impacts

It's only natural to be curious about the most essential need for human health and survival: water. In this episode, we learn about clean water, recognizing the drastic difference in water security between communities and what can be done about it. We spoke with Dr. Jay Famiglietti, a hydrologist at the University of Saskatchewan, about water infrastructure in terms of freshwater availability, climate change, and the value of federal oversight and science communication. Dr. Madjid Mohseni, professor in Chemical and Biological Engineering at the University of British Columbia and Scientific Director of RES'EAU, shares his expertise in water quality and technologies, and his efforts to facilitate safe drinking water access. He emphasizes collaboration with Indigenous communities and the importance of water operators, echoed by John Millar, the founder of Water First. John delves into the training and education for Indigenous community members, as an essential way to combat water challenges on the ground. Currently, boil water advisories disproportionately affect Indigenous communities. We discuss environmental racism with Dr. Ingrid Waldron, Associate Professor at Dalhousie University and author of "There's Something In The Water". Dr. Waldron draws upon intersectionality in the context of environmental health inequities, and shares the impact of policy changes.

Written by: Rachel Dadouch

Dr. Jay Famiglietti's website
Dr. Famiglietti's podcast: Let's Talk About Water
Dr. Madjid Mohseni's profile
Dr. Ingrid Waldron's profile
Emerging trends in global freshwater availability (Nature)
RES'EAU Centre for Mobilizing Innovation's (RES'EAU)
59 long-term drinking water advisories
Water First
The ENRICH Project
Support Bill C-230