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St. Michael's goes to the Oscars® – Part 2

In the second of a three-part series, we connect St. Michael's researchers and clinicians to the Best Picture nominees

Toronto, February 24, 2011

On Sunday, February 27, the Academy of Motion Picture Arts and Sciences® will be handing out the Oscars® for the best of the best in cinema from Hollywood and around the world.

The 83rd Academy Awards® will feature 10 nominees for Best Picture.

What's the connection between St. Michael's and the Oscars®? Other than the fact that all our researchers, educators and clinicians are stars? Many of this year Best Picture nominations touch on physical or mental health issues that are treated or studied here at St. Michael's. We'd like to highlight some of that leading research and patient care in the days leading up to the 83rd Annual Academy Awards® on Sunday.

True Grit

In an adaptation of Charles Portis’ original novel, 14-year-old Mattie Ross (Hailee Steinfeld) enlists an aging US Marshal (Jeff Bridges) and another lawman (Matt Damon) in tracking down Tom Chaney, a hired hand who killed her father. The trio journey into hostile Indian territory where surprises unfold and a shootout ensues as they find their killer.

As one of Toronto's only trauma centres, St. Michael's serves as a vital resource. Trauma surgeons such as Dr. Najma Ahmed and her trauma team care for some of the most critically injured patients, including victims of gun violence. One-third of traumatic injuries seen at the hospital are intentional assaults or self-inflicted injuries. Within 20 minutes of receiving a trauma patient, Dr. Ahmed and her team have to collect medical information while identifying and managing any life-threatening conditions. Outside of the trauma room, Dr. Ahmed is studying risk factors for intimate partner violence and violence against children, and the risks of firearms in the home.

Toy Story 3

As their owner prepares to go to college, his childhood toys find themselves in a daycare with overeager toddlers who do not play nice. Eventually, they find their way into the care of a sweet little girl where they find themselves wanted and played with.

We asked St. Michael's pediatrician Dr. Michael Sgro, "Do toys make a difference in childhood development?"

"There are studies to show benefit from developmental toys, toys that encourage language development, toys involving imaginative play and toys that encourage social interaction," he said. "There is also evidence that toys and games that involve extended "screen time" have a negative impact on childrens' health and development. Many of the studies are indirect evidence."

He also told us that studies don't exist suggesting a single or particular toy is better for development than another toy. This is likely due to the complexity of development and that the type of stimulation, rather than the particular toy, is the fundamental aspect in childhood development.

The Social Network

The Social Network is a biographical drama about the founding of the social networking website Facebook by Harvard undergrad Mark Zuckerberg, a computer programming genius with no social skills, and the resulting lawsuits filed by his closest friend who provided the seed money and by classmates who claimed Zuckerberg stole their idea. More than 500 million people have joined Facebook since it was founded in 2004. Together, they spend more than 700 billion minutes a month in Facebook.

Facebook and other forms of social media are having an impact on healthcare. According to Statistics Canada, 80 per cent of Canadians use the Internet. Dr. Mike Evans, a family physician and director of the Health Design Lab at St. Michael's Hospital, said a large number of them are already using "Dr. Google" to get their health information – or to compare what their doctor tells them. "There is great information out there, but there is also lots of misinformation and people trying to sell you products," he said, Evans is currently testing an e-mail clinic. "It is also is a double-edged sword. It is a no-brainer in so many ways, as I can drive patients to the best resources out there for their problem post-visit, remind them to come in for screening, do e-referrals for physiotherapy and so on. On the other hand, I live in fear of patients flipping me an e-mail every time they get a cold or worry that they use it as diagnostic or emergency service – which is not how we are using the e-mail clinic."

Evans is surveying patients to see what services they would want from an e-mail clinic – such as a blog for people with a chronic disease like high blood pressure. He's also focusing on the best ways to maintain patient privacy and confidentially.

Evans e-mails podcasts of his weekend CBC show, "Evidence-Based Radio," to his patients. "We've just done shows on weight loss and a Valentine's Day show on the health effects of relationships and when I send these to my patients anecdotally I feel like I am improving my counseling and they get to review the information on their own time."

Evans said an e-mail clinic should be seen as an improvement to the clinician-patient relationship, not a replacement. For example, he recently met in the clinic with an 80-year-old woman who had been in the emergency department four times in a week. He got to know her and her family, who appointed one member to correspond with the doctor via e-mail. He was able to prevent any more emergency room visits and to cut her medications slowly over e-mail from 10 to one. Her husband has dementia, so she appreciated not having to come in all the time, yet she still felt connected and her social network, her wonderful family, felt in the loop and empowered." Dr. Evans believes that, "there are many challenges such as legal, privacy, usage rules, payment, and so on that we have to figure out, but it's time for medicine to adapt."