Author: UBC Abbotsford-Mission Family Practice Residency Program

Registration is now open for Okanagan Orchards, our annual faculty development and appreciation event, hosted by the UBC Family Practice Postgraduate Program.

This is a free virtual event on the afternoon of Friday, May 27^th, 2022. Register here!

This event is open to all preceptors and faculty from across the province, as well as administration and resident leads.

We look forward to bringing our team together virtually for an interactive afternoon of intimate discussions, small workshops, and prizes!

Feel free to share this invitation with colleagues at your site. Please let me know if you have any questions. We look forward to seeing you in May! 

Larissa McLean, BA, MHA  
Manager, Rural Education & Initiatives
Faculty of Medicine | Department of Family Practice, Postgraduate Program 
The University of British Columbia
larissa.mclean@ubc.ca
http://postgrad.familymed.ubc.ca 

Climate change has had a huge impact on many aspects of human health. Please join us for this free online accredited educational session where highly experienced and knowledgeable medical experts will answer your questions, share their experiences and recommend best practices in understanding and managing the significant health impacts of wildfire smoke.

May 4 (Wed) | 1830–2000 PDT | Webinar: Register here
Audience: family physicians, specialists and other health care providers.
Meet our panel:

• Dr. Courtney Howard, Emergency Physician, Clinical Associate Professor in the Cumming School of Medicine, University of Calgary
• Dr. Dharma McBride, Emergency and Family Physician 
• Dr. Emily Brigham, Respirologist, Legacy for Airway Health 
• Dr. Michael Hadley, Cardiology Fellow, Mount Sinai Hospital (New York)
• Dr. Sarah Henderson, Scientific Director in Environmental Health Services, BCCDC, Associate Professor, UBC School of Population & Public Health
• Moderator: Dr. Christie Newton, Family Physician, Associate Professor, Associate Head Education and Engagement, Medical Director UBC Health Clinic, UBC

“The story of Paxlovid starts back in 2003, when the first SARS outbreak took place in Asia. Looking to develop a medication that could stop its spread, Pfizer started researching drugs that could block the action of a viral protein called a protease, which is necessary for the virus to replicate itself inside the host cell. One advantage of a medication like this, compared to a vaccine, is that it attacks a vulnerability of the virus that doesn’t mutate in the same way that the spike proteins targeted by vaccines do. That means it’s likely to be equally effective against all variants.

Pfizer’s preliminary research didn’t get too far before SARS petered out. But when SARS-CoV-2 popped up, they put the idea back on the fast track, ultimately trying out more than 600 candidate compounds in test tubes. The most promising were then tested in animals before being winnowed down once more for human trials.

Pfizer started testing Paxlovid in September 2021, enrolling patients who were suffering from mild to moderate symptoms — meaning they hadn’t been hospitalized yet — and were at high risk of their symptoms turning severe, either due to being over 65 or having comorbidities like obesity or diabetes. Pfizer expected the study to last into 2022, but was able to end the trial early because the results were so spectacular. It reduced hospitalizations in those who caught COVID by 90 percent and eliminated deaths entirely. Among the thousand or so trial participants who took the drug, none died, versus seven people in the control group.”

What Happened to Paxlovid? The COVID antiviral arrived too late for the Omicron wave, but it remains a powerful weapon via The Intelligencer.

“Ukrainian teachers support the statement that creativity draws on both spontaneous
thought, originating from the default mode network, and on sustained cognitive control over those thoughts originating from a separate brain network (Beaty et al., 2015). Unfortunately, there is a lack of methods for systematic assessment of skills as critical thinking or creative thinking. In our opinion, integrating updated pedagogical methodology with creative techniques and interprofessionalism is a valuable approach for fostering students’ creativity and generating research skills. It is also compulsory to orient knowledge into the development of students’ systematic and logical viewpoint, scientific and theoretical beliefs, moral qualities, and active life position (Wiley & Jarosz, 2012).

It is necessary to mark that intensification of future doctor’s creative potential is performed through the formation of creative thinking, research skills, ability to interact with the information means, put and solve different tasks according to specific activities that may help in the formation and development of independence and cognitive research activities in the process of personal, specially organized student’s educational activities (Runco & Jaeger, 2012). Nevertheless, up-to-date training experience is not focused on the demands of contemporary society as: ‘we are currently preparing students for jobs that do not yet exist, to use technologies that have not yet been invented, and to solve problems that we don’t even know are problems yet’ (Darling-Hammond, 2008, p. 2).

Shaheen (2010) stated that for many developing countries, creativity remains neglected, whereas in developed countries, educational philosophy and goals rely on student’s enhancement of creativity and self-actualization. Consequently, we define creativity as both a talent and a skill that can be developed as an independent activity, which is closely connected with intellect, curiosity and analytical thinking.”

More on Creativity as an Essential Aspect in Medical Education via Creativity Studies.

“In this issue of The Lancet Digital Health, Xiaoxuan Liu and colleagues give their perspective on global auditing of medical artificial intelligence (AI). They call for the focus to shift from demonstrating the strengths of AI in health care to proactively discovering its weaknesses.

Machines make unpredictable mistakes in medicine, which differ significantly from those made by humans. Liu and colleagues state that errors made by AI tools can have far-reaching consequences because of the complex and opaque relationships between the analysis and the clinical output. Given that there is little human control over how an AI generates results and that clinical knowledge is not a prerequisite in AI development, there is a risk of an AI learning spurious correlations that seem valid during training but are unreliable when applied to real-world situations.”

Read more on Holding Artificial Intelligence to Account via The Lancet.

To all faculty and staff,

Nominations are now open for the 2022 Faculty of Medicine Awards.

This suite of Faculty of Medicine awards was recently refreshed in 2021 and includes several new awards which were launched last year with much success. These awards provide an expanded opportunity to acknowledge outstanding faculty and staff members who demonstrate exceptional contributions to the Faculty, and who are also dedicated to advancing our values and our vision of transforming health for everyone.

Please review the awards and nominations guidelines carefully and submit your nominations by Friday, June 10th. Recipients will be announced this summer, and the awards will be presented at our annual reception in the fall.

Sincerely,

Dermot Kelleher, MB, MD, FRCP, FRCPI, FMedSci, FCAHS, FRCPC, AGAF
Professor, Department of Medicine
Dean, Faculty of Medicine
Vice-President, Health
The University of British Columbia

Award Categories

For information on each award category and to download a nomination form, click on the links listed below.

• Applegarth Staff Service Awards
• Dean’s Staff Awards (three categories)*
• Clinical Faculty Award for Excellence in Clinical Teaching
• Clinical Faculty Award for Excellence in Leadership and Service*
• Clinical Faculty Award for Excellence in Mentorship*
• Clinical Faculty Award for Excellence in Research*
• Clinical Faculty Award for Excellence in Advancing EDI*
• Innovation in CME-CPD Award
• Distinguished Service to CME-CPD Award
• Awards for Excellence in Mentoring Early Career Faculty
• Webber Lifetime Achievement Award

*New award launched in 2021

“In this research note, we use data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to determine whether darker skin tone predicts hypertension among siblings using a family fixed-effects analytic strategy. We find that even after we account for common family background and home environment, body mass index, age, sex, and outdoor activity, darker skin color significantly predicts hypertension incidence among siblings. In a supplementary analysis using newly released genetic data from Add Health, we find no evidence that our results are biased by genetic pleiotropy, whereby differences in alleles among siblings relate to coloration and directly to cardiovascular health simultaneously. These results add to the extant evidence on color biases that are distinct from those based on race alone and that will likely only heighten in importance in an increasingly multiracial environment as categorization becomes more complex.”

More on New Evidence of Skin Color Bias and Health Outcomes Using Sibling Difference Models: A Research Note via Demography.

“Although anaphylaxis management recommendations depend on practice resources and proximity to emergency services, key components for medical clinics include a highly visible anaphylaxis protocol, regular rehearsals, appropriately maintained supplies, and a treatment log to record events.[3,19]

Clinic staff should be familiar with an anaphylaxis management protocol that is tailored to their office and incorporates input from staff members across multiple disciplines.[20] This protocol should feature flow charts for initial management of respiratory distress and hypotension/shock, and should include drug dosages, supplemental oxygen and intravenous fluid recommendations, and contact information for emergency medical services.[7] The importance of a protocolized approach to anaphylaxis care cannot be overstated because the rapidly evolving nature of anaphylaxis does not afford the time to look up information or recall memorized algorithms.[6] In one pediatric emergency department, implementing an anaphylaxis protocol enhanced anaphylaxis management by improving the rates of epinephrine administration and appropriate observation, and by reducing the rate of corticosteroid monotherapy.[21]

Guidelines strongly recommend regular anaphylaxis rehearsals; however, they do not specify the content or frequency of those events, but rather defer this to the discretion of the attending physician.[3,7,19] At the least, medical professionals should be able to quickly locate and assemble necessary supplies for administration, and roles for calling emergency services and treatment logging should be established.[3,19] Readily available supplies should be maintained, and their contents and expiry dates should be regularly documented.[3] Recommended anaphylaxis supplies are provided in the Box. Treatment logs should be readily accessible for documenting clinical events, vital signs, and medications/treatments administered.[7]”

More on In situ simulation training for in-office anaphylaxis preparedness via BCMJ.

“Children’s exposure to adverse experiences is much higher than we had once thought, with a global systematic review finding that a billion children a year are victims of violence. The past two years have tipped the balance of these scales against all children. Emergencies increase family violence and mental health distress. More than seven million children have lost a parent or main care giver to covid-19, and the global pandemic has exacerbated pre-existing inequalities and risks for childhood adversity. Parenting in war is violently undermined: in chaos and emergency, families face extreme, unanticipated challenges. We also know that adverse experiences are often unwittingly transmitted across generations.

On the positive side, we now have convincing evidence of how to increase protective factors for children. Parenting programmes have been found to be effective at supporting parents to be the good care givers that they overwhelmingly want to be. They prevent and disrupt the intergenerational transmission of violence and trauma and improve mental health for parents and children. When combined with economic assistance (“‘cash plus care”) they are even more effective. The research is now so strong—with 77 systematic reviews and more than 100 randomised trials in lower resource countries—that the World Health Organisation (WHO) is developing guidelines for parenting programmes. In doing so, parenting programmes parallel other public health interventions for children that are backed up by robust evidence, such as polio vaccines and antenatal care. In emergencies, families need evidence based support that is accessible, relevant, and simple.”

More on Ukraine’s children: use evidence to support child protection in emergencies via BMJ.

“Health for all will not be achieved if the current estimated 100 million people experiencing homelessness continue to be underserved. Actions by support workers, health workers, health administrators and health policy makers, legislators, and regulators is needed to improve access to self-care interventions among people experiencing homelessness.20

People experiencing homelessness must be engaged as part of the solution to improve access to quality health services and the uptake of self-care interventions. Support organisations working with people experiencing homelessness should involve people who have been homeless as peer educators to provide one-to-one support, reliable information on self-care interventions, and facilitate access to quality health services. For instance, the use of peer support has been shown to reduce drug and alcohol use and increase healthy behaviours. Additionally, support organisations, in partnership with health workers, need to engage directly with people experiencing homelessness, such as through group dialogues and individual support sessions to rebuild their trust, dignity, and self-esteem—both to overcome previous negative experiences of accessing healthcare and to prioritise self-care.

Health workers have a specific role in supporting people experiencing homelessness and their ability to self-care. Increasing the skills and competencies of health workers to provide non-stigmatising, trauma informed care for people experiencing homelessness is essential. A good model is the health worker training developed by Pathway, a UK charity that enhances care coordination for people experiencing homelessness admitted to hospital.”

More on Access to self-care interventions can improve health outcomes for people experiencing homelessness via BMJ.

More on a good model: Pathway. Healthcare for homeless people—what we do. 2019. https://www.pathway.org.uk/about-us/what-we-do/