An overlooked issue in medicine is the high rate of depression among people with other medical illnesses, according to a recent paper by U of T-affiliated co-authors including Dr. Joshua Rosenblat, a clinician-scientist at the Department of Psychiatry, and Dr. Paul Kurdyak, the director of Health Systems Research at the Centre for Addiction and Mental Health.

They reviewed articles related to depression among people with other medical illnesses, a condition which is twice as common for them than in otherwise healthy patients. The Varsity spoke with Rosenblat to learn more about the high rates of depression observed in patients with other medical illnesses, and how to best tackle the issue.

Causes of depression in patients with other medical illnesses

Rosenblat suggested three main sources of depression among people with other medical illnesses: biological, psychological, and social. Psychological and social triggers can include sadness driven by unfortunate circumstances, such as a serious medical diagnosis.

When considering biological sources, Rosenblat said, “A lot of things… can happen in your body biologically that can actually have a profound impact on the immune and cognitive systems.”

Inflammation, often caused by infection, autoimmune disorders, and cardiovascular issues, can release inflammatory signals that lead to depression. This is likely an evolutionary adaptation meant to reduce the spread of disease disincentivizing socialization through depressive symptoms.

Additionally, neurological disorders can also make the brain more susceptible to depression. As an example, half of all stroke victims will develop depression.

Impacts of depression on treatment

It is important to note that while illness can cause depression, depression can also give rise to illness. For example, depression often leads to changes in appetite, resulting in malnourishment or complications related to overeating.

Additionally, just as inflammation can trigger depression, so too can depression trigger inflammation, leading to the development of autoimmune disorders among patients. Depression can also cause harmful changes in behaviour, such as alcohol or tobacco use disorders, which may lead to other illnesses such as cancer, and can worsen pre-existing medical conditions.

Depression can have serious impacts on disease recognition. According to Rosenblat, there is an increased risk of a false link between symptoms of neurological disorder or medical illness. For example, a patient with diagnosed anxiety may also have an undiagnosed stomach ulcer, but their stomach problems may be dismissed as a symptom of anxiety.

The opposite is also true: a patient being treated for cancer might struggle with low energy caused by undiagnosed depression, but this may be dismissed as a symptom of cancer.

Diagnosing and treating depression

Depression is often not properly diagnosed among people with other medical illnesses. It is difficult to measure how often depression is under diagnosed, but Rosenblat estimates at least 25 per cent of cases are not diagnosed.

There are a number of reasons for this discrepancy. Primarily, patients and medical providers may feel uncomfortable discussing depression. In addition, there may be problems with the systems used to diagnose depression. Screening tools that are too specific may overlook some patients who have depression, while screening tools that are too sensitive may overwhelm the mental health system with some patients who do not have depression.

An overwhelmed medical system can also mean that patients who have issues more serious than their depression might not have time to discuss depressive symptoms. Rosenblat suggested a number of solutions to these diagnosis problems, including reducing stigma, as well as pairing highly sensitive and highly specific screening tools.

An example of paired screening tools might be a doctor asking, “Do you feel depressed?” and “Do you feel less motivated?” as sensitive tools. If the responses are affirmative, they would follow up with a test that asks about symptoms of depression, which is a specific tool.

Unfortunately, screening improvements do not necessarily lead to improvements in depressive symptoms. Many hospitals do not have adequate resources to treat depression. More investment into the mental health system, as well as better treatment education for medical providers would help.

According to Rosenblat, the current recommended treatment includes starting with less intense interventions, such as community engagement and socialization, and if those do not work, trying antidepressants and psychotherapy.

Next steps for depression research

What’s on the horizon of depression research? A number of more radical treatments, such as psychedelics — Rosenblant’s current focus of research — and the dissociative anesthetic ketamine have shown interesting clinical trial results. More research is generally needed for biological treatments of depression.

Lastly, Rosenblat suggested that future clinical trials should begin with stronger predictions, such as the potential side effects of a drug and the ways in which it will improve depression. This is different from previous methods, which simply gave a drug to patients and considered side effects and biological pathways in hindsight.

Depression is difficult to both discuss and study. Numerous changes, such as reduced stigma, better funding, and additional research need to take place to improve the diagnosis and treatment of depression.

For now, the results of this study demonstrate the importance of considering depression among people with other medical illnesses and how to best go about diagnosing and treating the disease.

If you or someone you know is in distress, you can call:

• Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566
• Good 2 Talk Student Helpline at 1-866-925-5454
• Ontario Mental Health Helpline at 1-866-531-2600
• Gerstein Centre Crisis Line at 416-929-5200
• U of T Health & Wellness Centre at 416-978-8030.

Content warning: discussions of suicide

What is the value of addressing social connectedness as a factor of mental health? To Michael Wager, it may be one of the best tools that students can use especially as the university battles a mental health crisis on campus.

Wager, a performance coach for athletes who works at the U of T-affiliated Toronto Western Hospital, spoke with The Varsity to share his experiences of mental health and discuss promising approaches to addressing the causes of mental health concerns.

The ABC model of mental health

An influential model in psychiatry is the biopsychosocial approach, which posits that biological, psychological, and social factors each influence resiliency — defined as one’s ability to adapt to stress and adversity.

To make the model more accessible to a general audience, Wager reframed it as the ABCs model of resiliency: attitude, biology, and community.

Psychological attitude refers to one’s outlook on the world, which includes whether you see the world through a positive lens and have an optimistic attitude. This represents the psychological factors of resilience. “If you can find a way to have a positive attitude, you can be more resilient,” said Wager.

A shift in psychological outlook could stem from psychotherapy, which comprises treatments for mental health conditions by talking with a mental health provider. It could also come from coaching, especially in the context of competitive sports, which could shift athletes’ mindsets.

“The ‘B,’ biology, is how can you hack your own biology to be more resilient,” said Wager. This corresponds to the biological factors of resilience, which suggests that biological abnormalities may be a cause of mental health conditions.

Prescription medication, such as antidepressants, could be a treatment option, along with medical procedures, including deep brain stimulation for severe cases. However, Wager noted that neurological changes can also take place due to physical exercise, as well as improving one’s nutrition by eating healthier food.

But the ‘C,’ community, could be the most important piece of the puzzle of resilience, noted Wager. Which corresponds to the social factors of the biopsychosocial model.

“There’s research out there that shows the more connected one is to their community, the better off they’re going to be in their own mental health journeys,” noted Wager. Joining a club, a sports team, or volunteering could be ways for students to find a community.

One major criticism of the biopsychosocial approach is that the boundaries of biological, psychological, and social factors are ill-defined: for example, it’s unclear whether a psychological factor can be a biological factor as well. However, this may be less important in the context of treatment.

“If you’re not sure where to start, just pick something, anything, that will help you make gains in one of those three areas,” said Wager.

Applying the model in his own life

Wager himself has grappled with mental health challenges and used the ABCs to address them.

“In university, I had a really tough time; I was depressed,” he said. “I failed my first year, got myself back together, worked in the restaurant industry for a couple of years, became a little more stable, and then finished a bachelor’s degree.”

He has further experienced depression following the loss of a friend due to suicide. “It made me more depressed, but it also made me more motivated to really try and make a contribution to this world and [raise awareness about mental health].”

Wager uses journalling to change his own psychology. “I have a great little journal that my friend made me, it’s tiny so I can carry it wherever I go,” he said. “So I will start my day by writing out 10 things I’m grateful for.”

To address his biology, Wager practices yoga, which has been linked to neurobiological changes that could help patients with depression. He has also spoken with a psychiatrist, who has prescribed him with medication to improve his mental health.

Finally, to broaden his community, he joined a volleyball team. “When I first moved here [to Toronto], I barely knew anyone,” he said. The team sport enabled him to have fun and get to know people he enjoyed spending time with.

“It’s so important if you’re going to perform in sports or in school or in life, you’ve got to have people in your corner,” he said, reflecting on the importance of social factors. “Whether you’re an athlete or not, you’ve got to have people in your corner, and that’s what I want to share.”

If you or someone you know is in distress, you can call:

• Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566
• Good 2 Talk Student Helpline at 1-866-925-5454
• Ontario Mental Health Helpline at 1-866-531-2600
• Gerstein Centre Crisis Line at 416-929-5200
• U of T Health & Wellness Centre at 416-978-8030.

Warning signs of suicide include:

• Talking about wanting to die
• Looking for a way to kill oneself
• Talking about feeling hopeless or having no purpose
• Talking about feeling trapped or being in unbearable pain
• Talking about being a burden to others
• Increasing use of alcohol or drugs
• Acting anxious, agitated, or recklessly
• Sleeping too little or too much
• Withdrawing or feeling isolated
• Showing rage or talking about seeking revenge
• Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention.

In 2016, the World Health Organization declared an international health emergency over the transmission of the Zika virus, which broke headlines for causing brain damage in infants.

Now, in 2019, a University of Toronto-affiliated study has investigated the outbreak of the Asian lineage of the Zika virus in Angola, with the goal of providing “the first cohesive insight into the introduction, circulation, and possible public health effects of Zika virus in Angola.”

The co-authors concluded that this subtype of Zika virus has been present in Angola, and that the transmission most likely originated from Brazil.

Why is the Zika virus so dangerous?

The virus has two distinct lineages: the African genotype and the Asian genotype. Researchers have detected the African genotype in Africa since the mid-twentieth century, according to the co-authors, but there is little data on the presence of the Asian genotype in Africa.

Until 2007, the Zika virus was only identified in 14 people in Africa and Asia. At the time, infection was believed to cause mild symptoms, such as a fever, headache, and rash. Since 2013, however, the Asian genotype of Zika virus has spread to locations in the Pacific Islands and the Americas, and has resulted in more than 800,000 suspected and confirmed cases of the disease.

The conditions in sub-Saharan Africa, where there is a mosquito population that can spread the disease and an appropriate climate for infection, means that the residents are especially susceptible to the disease. Research has also revealed that Zika virus is dangerous during pregnancy, as it can cause severe birth defects.

The investigation’s findings

The study’s findings suggest that either a single event introduced the Zika virus in Angola and continued until at least June 2017, or that there was a recurrent and later introduction of the virus belonging to a specific lineage present in Brazil. The co-authors believe that the virus “probably circulated in Angola for 17–28 months.” This implies that the outbreak was substantially larger than the small number of cases detected by the Angolan ministry.

In order to investigate the possible source of Zika virus in Angola, the co-authors analyzed the global incident of Zika virus infection and human mobility data. They considered two major factors as contributors to a high risk of exporting Zika virus to Angola, which were high local incidences of Zika virus and a high number of air passengers travelling to Angola.

To achieve this they determined the monthly number of passengers to Angola from countries who were reporting Zika virus outbreaks, based on the worldwide ticket sale of data from the International Air Transport Association, from 2015 to 2017. They also used surveillance data to estimate the average Zika virus incidence per person per week in each country.

What did the investigation reveal about emergence and spread of Zika virus?

Previous research has established the transmission of mosquito-borne viruses between Brazil and Angola through studies on the spread of chikungunya virus from Angola to Brazil in 2014. Angola and Cape Verde, the two African countries with confirmed Asian-lineage Zika virus, have regular air connectivity with Brazil.

Moreover, the co-authors found that Angola, out of all African countries, received the largest number of travellers from Zika virus-affected countries in the Americas.

The researchers concluded that Zika virus was most likely introduced to Angola from Brazil, according to data for human flight mobility and the global incidence of the disease. However, the possibility of spread to Angola from affected locations where genomic data are unavailable is not out of the question.

The study’s methods

In order to conduct their study, researchers undertook “a multi-component investigation into Zika virus and suspected microcephaly cases in Angola.”

They assessed surveillance data from the Ministry of Health in Angola in order to identify acute cases of Zika virus infection. The co-authors also screened samples from a separate 2017 study involving 349 people with HIV living in Luanda, Angola to expand the dataset. They sequenced Zika virus from three samples and performed an analysis to explain the origins and duration of the outbreak in Angola.

In addition, the researchers analyzed human air travel and data on the global outbreak of Zika to support findings about the geographical source of the introduced strain. They further assessed suspected cases of microcephaly, a birth defect characterized by abnormal brain development, notified to the Ministry of Health in Angola.

The co-authors also conducted an analysis of evolutionary relationships, called a phylogenetic analysis, that showed that the three Angolan Zika virus genomes that they analyzed had a common ancestor in June 2016, improving the understanding of the virus.

A better look st Zika outbreaks in Africa, noted the co-authors, is critical in order to safeguard the health of people living in the continent and across the globe.

Augmented reality could hold promise for improving surgical training, using the Osterhout Design Group (ODG) R-7 Smartglasses, according to a recent study conducted with the University of British Columbia (UBC).

A research team, which included Dr. Neil Chadha, a former fellow at The Hospital for Sick Children in Toronto, recruited staff surgeons and resident trainees to participate in the study at Vancouver General Hospital. Resident trainees used the ODG R-7 Smartglasses to perform a synthetic surgery for educational purposes in the temporal bone cadaver drilling laboratory .

Applying the use of Osterhout Design Group R-7 Smartglasses

One main aspect of the study involved the use of a device to create an augmented reality. For the research team, the decision to use the ODG R-7 Smartglasses was simple.

“The [ODG] already had partners doing research with the R-7 Smartglasses,” said Dr. Michael Yong, a resident physician at UBC’s Faculty of Medicine, and a co-author of the study, in an interview with The Varsity.

In terms of set-up, the research team further believed that the smart glasses would be suitable to the operating room due to their battery life and wear-ability. However, Yong noted that while the maximum two-hour battery life is not currently a concern, it could pose a challenge in the future during clinical situations.

The study’s design and results

The study was completed at Vancouver General Hospital with two supervisors and five resident trainees using the temporal bone cadaver drilling laboratory.

“The temporal bone-drilling lab is… something that every residency program in [otolaryngology, which concerns the ear, nose, and throat] has access to, and so it was an easy place for us to start,” said Yong. 

After the trials, the researchers collected comments and a completed survey from the supervisors and residents participating in the study. Many comments recognized the promise of augmented reality in advancing surgical training. However, they also noted areas of improvement with the techniques.

The strongest advantage of the smart glasses was their potential to communicate remotely and exchange editable images with other practitioners. Other reviews of smart-glasses technology have noted applications, including monitoring patient vitals remotely and review patient charts on the go.

Some of the suggested improvements of the teaching experience included better lighting with the glasses, reduced time for images to be processed, and the reduction of connectivity issues. One of the more notable suggestions was to avoid the temporal cadaver bone lab for such, due to drawbacks caused by drilling.

“When you’re drilling the skull, bone dust comes up into the air,” said Yong. “Usually we wear masks and protective goggles, but the R-7 glasses are not designed to be an industrial-grade protective goggles, and so, there’s openings on the sides of it and little spaces here and there, that allow for bone dust to come in.”

Further research is needed to make the use of this technology widespread. However, Yong remarked, “It’s just a matter of getting more institutions to do these kinds of feasibility studies, to do these kinds of tests and get some feedback as to how best we can adapt this rapidly-growing industry technology to surgery… in a useful and efficient matter.”

Content warning: this article contains mentions of suicide.

It’s exam season at U of T. This time of year, stress-buster events are a mainstay, ranging from immersive workshops to meditation techniques to plant potting.

They’re intended to help students take their minds off their worries. However, in the context of the mental health crisis at U of T, they are also a common target of criticism. The general consensus seems to be that these events are attempts by the administration to address the needs of a struggling student population in the most superficial way possible.

Metaphors abound: damming a river with a coffee filter, or launching a Saturn V rocket with Mentos and Coca-Cola. At protests, on social media, in classrooms, and in ordinary conversations, students have been clear: these events simply aren’t enough — they don’t even come close.

However, for many students, stress-buster events can be a helpful way of letting off steam during a demanding and isolating period. Combined with appropriate outside treatment, they can also help students struggling with more severe issues engage with others and combat loneliness. It’s also notable that many stress-busting initiatives are hosted by independent student groups, who are doing what they can to help struggling peers.

However, a critical assessment of these events illuminates the need for holistic mental health reform, both at U of T and in our society at large.

Picking up the university’s slack

U of T students face punishing workloads, issues with mental health, an isolating campus culture, and inaction from the highest level of the university administration.

In this environment, the idea that our problems can be meaningfully addressed by spending an hour planting a succulent feels insensitive and misinformed at best. At worst, these events seem outright negligent — not because they are harmful, but because they exist within a context characterized by the university’s failure to provide effective and accessible mental health services.

This is exemplified by one student’s comment on the How Many Lives? website, which features anonymous testimony on mental health at U of T: “I’m tired of asking for help and being referred to a session to make DIY bath bombs.”

Indeed, many students need more than arts and crafts and a therapy dog — they need a therapist. But when they turn to Health & Wellness, they can experience unjustifiably long wait times, exhausting bureaucracy, and punitive policies. In the face of this, it is ultimately up to student organizations to fill in the gaps of support.

One such example is Healing Hearts Through Art (h2art). Following the third apparent suicide at the Bahen Centre for Information Technology within two years, h2art was launched in October by Christeen Salik. The group was created in order to facilitate art-based healing opportunities for students.

In an interview with The Varsity, Salik remarked that, though she had always been open about her mental health, she found that art was the only avenue through which she could heal and express the complex feelings that arose after the apparent suicide in March. Art, she reasoned, could also help students without the English-language skills to comfortably communicate with a counsellor, and students who are more comfortable with non-verbal communication.

Salik observed that the university seems “fragmented” on mental health. She called for increased funding for mental health services, as well as for greater collaboration between Health & Wellness, colleges, faculties, and student groups — though she was quick to note that ultimate responsibility falls on the university.

Salik also mentioned that she knew many student activists who have had to take breaks this semester after “pouring themselves” into their activism.

“We’re obviously picking up the slack right now,” she said.

A fundamental lack of resources

StrengthIN is another student group that has grown from the mental health crisis. This student organization works to help students develop practical strategies to maintain their mental health. Originally founded to facilitate mental health workshops for high school students, it has recently begun to host workshops and stress-buster activities on-campus.

I recently attended an event facilitated by the organization: a Harry Potter-themed mental wellness workshop. As the soundtrack of the films played in the background, attendees were seated around tables in the Hart House East Common Room. The event’s facilitators encouraged us to share our experiences with mental health and coping, as well as techniques to combat stress and broader pressures on our mental health.

Later, I sat down with two of the event’s organizers: Zara Mian, an event coordinator, and Kyla Trkulja, StrengthIN’s secretary. They explained that the group does what it can and tries to stay focused on combatting loneliness among students while enhancing students’ coping techniques.

Trkulja spoke about how her past experiences mobilized her to join StrengthIN. She lives with depression and anxiety, and tried to access counselling through the Health & Wellness Centre last year when she experienced a relapse.

Although she arrived at the centre during a moment of crisis, she was quickly sent away with instructions to come back with a doctor’s referral. She claims that when she acquired one, Health & Wellness took a month to send her an automated email indicating that she could book an appointment. The next available appointment? Four months away.

When the opportunity arose to help StrengthIN facilitate mental health workshops for students, Trkulja jumped at the chance. She commented, “We need as many resources as we can get.”   

Both Mian and Trkulja agreed that administrative inaction has put a weight on the shoulders of student groups like StrengthIN.

“They do put like a burden on groups like ours,” said Mian.

This is ultimately a responsibility that they cannot shoulder alone. Providing comprehensive care cannot start and end with stress-buster events and workshops alone.

“[StrengthIN is] realistic [about] what we can do,” said Mian. “We’re not mental health professionals.”

“We need to change everything”

Ramata Tarawaly is the Associate Director of Community Wellness at Trinity College, a role which encompasses two broad portfolios: working to connect individual students struggling with mental illness with supports like counselling, and promoting well-being throughout the college’s community.

Tarawaly told me that she sometimes gets critical feedback from students who ask why the college invests in wellness and stress-buster events when they are not appropriate remedies for severe mental health issues.

“That’s not their intention,” she said. “I think that’s why we need multiple different targets in terms of promoting good mental health [and] engaging with people who are experiencing mental illness. The programming is one aspect of more of a community approach.”

She noted that easily accessible programs like stress-buster events can actually help support the treatment and goals of students struggling with mental illness.

“Students that are having [issues with] anxiety, depression, or stress have… reported to me that [stress-busters and community building events] are helpful,” she said.

Furthermore, she told me that Trinity’s approach to wellness programming has been attentive to the needs of the students that she works with. This year, the college has been increasingly oriented toward activities that require less overt socialization after students expressed that social anxiety was a barrier to attendance.

She noted that, “You don’t have to socialize, but you’re in a social space.”

As conversations surrounding mental health have become more prevalent, Tarawaly has noticed a positive trend of students actively indicating their needs, critiques, and recommendations to the administration.

“We’ve worked really hard to meet those needs and be responsive,” she said.

Tarawaly’s position is a model that could be usefully applied across the university. Her position is a centralized role with the resources and capacity to support mental health at U of T by working with various entities such as students, Health & Wellness, community advisors, and the wider college administration.

However, the resources and funding available to the university and community as whole makes it difficult to replicate this role. A registered nurse, Tarawaly is no stranger to interacting with health care systems and thinking about the overarching remedies that must be made to better them.

“We need to change everything,” she said.

The dangers of a partial fix

Although the overwhelming lack of available institutional mental health resources has led to student groups running stress-buster events, it still must be acknowledged that these events are not sufficient and sustainable support structures for students.

Lucinda Qu, one of the founding members and organizers of the student group called the UofT Mental Health Policy Council, emphasized the importance of developing “continuums and networks of care.” This would necessitate improved coordination of mental health strategies, services, and resources across levels of administration, ranging from leaders of mental health programs to professors, as well as improved communication between the administration and students.

For Qu, the prevalence of stress-busters and student perceptions of administrative inaction on mental health is connected to a broader phenomenon.

“A certain proportion of U of T’s resources could, and perhaps should, go toward the implementation of stress-busters,” she said. However, she also believes that the university relies too heavily on the promotion of stress-buster events and interventions, as opposed to meaningful strategies to address the root causes of mental illness on campus and to provide adequate support for individuals struggling with a mental illness.

In addition, the mindfulness that’s often practiced at stress-buster events is not comprehensively enough on its own in order to address the prevalence of mental illness on campus. Some events that teach meditation methods can actually be detrimental to student health.

According to a 2014 study in Future Medicine, the practice of mindfulness through meditation can trigger side effects such as panic attacks, dissociation, or suicidal feelings.

That means that students who lack this information beforehand may attend stress-buster events that advocate for mindfulness or meditation and come out feeling worse than before, which has the potential for serious emotional harm.

A path forward

Though they are an easy target of criticism — much of which is warranted — stress-busters aren’t all bad. In fact, their prevalence and pitfalls are largely visible symptoms of a deeper systemic issue: U of T’s lack of meaningful action on mental health. Intentionally or unintentionally, stress-busters have ended up helping to fill the void that has been left behind.

The experiences of student groups, activists, and even some administrative staff are instructive. Across the board, those interviewed agreed that more funding, better coordination amongst staff and between staff and students, centralization of a mental health mandate, and clear pathways to comprehensive care are needed.

If U of T provided extensive, easy-to-access mental health care and undertook academic, cultural, and financial changes to reduce the burdens shouldered by students, then stress-buster events would function as they are intended to. They could be fun, helpful ways to ease stress, lighten moods, and connect with others during stressful times.

However, right now, stress-buster events serve as an inadequate stopgap intended to help keep the student population afloat, many of whom are struggling in the absence of institutional support. The abilities of stress-busters are limited, which is largely recognized, but they do what they can.

“If we can help one person [who is] struggling,” Trkulja said, “then I feel that all the effort is worth it.”

If you or someone you know is in distress, you can call:

Canada Suicide Prevention Service phone available 24/7 at 1-833-456-4566

Good 2 Talk Student Helpline at 1-866-925-5454

Ontario Mental Health Helpline at 1-866-531-2600

Gerstein Centre Crisis Line at 416-929-5200

U of T Health & Wellness Centre at 416-978-8030.

Warning signs of suicide include:

Talking about wanting to die

Looking for a way to kill oneself

Talking about feeling hopeless or having no purpose

Talking about feeling trapped or being in unbearable pain

Talking about being a burden to others

Increasing use of alcohol or drugs

Acting anxious, agitated, or recklessly

Sleeping too little or too much

Withdrawing or feeling isolated

Showing rage or talking about seeking revenge

Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. If you suspect someone you know may be contemplating suicide, you should talk to them, according to the Canadian Association for Suicide Prevention

It’s that time of year again. As lecture halls fill with sounds of coughing, sneezing, and sniffling, courtesy of students who refuse to cover their germ-laden mouths in class, you can be sure that flu season is upon us.

As a child, I dreaded going to the doctor and getting stabbed in the arm with an obnoxiously long needle — and honestly, I still do. However, one thing I do appreciate is how easy it is to go in to my local walk-in clinic and get vaccinated. This ease of access — a privilege that many do not have — saves me tons of time.

The availability of immunizations on campus is a huge step toward establishing health care that is both equitable and accessible.

For commuter students like myself, the act of getting a flu shot has become an afterthought. When I’m commuting an hour and a half to get to class, where I’ll be from 9:00 am to 5:00 pm, when will I find the time to get a flu shot?

However, this November, I was able to get my flu shot after just a two-minute walk to Sidney Smith Hall. Instead of having to miss a lecture — or worse yet, a tutorial quiz — I was immunized in just a few minutes.

While the university has taken a step in the right direction, there are still a number of ways that administration can improve the availability and awareness of these programs.

For example, the lack of advertising was astounding. I only heard about the flu shots through word of mouth, which, given the university’s resources, is not a very effective method for conveying this information.

U of T should further utilize online resources such as social media posts to communicate these beneficial programs to students. As of the time of writing, U of T’s Instagram account has roughly 105,000 followers. By amplifying the presence of on-campus immunizations, U of T could foster a larger turnout for next year. Increasing the total number of students who are able to get their flu shot ultimately helps the entire school community.

Moreover, in-person advertising, such as an information booth outside Sidney Smith Hall, would also increase general awareness of these vaccination areas.

Additionally, in order to increase ease of access for students living in residence, it would be specifically helpful to have immunization centres inside colleges. It’s important to keep in mind that these are students who might be taking responsibility of their own health for the first time ever. Personally, if St. Michael’s College hosted pop-up immunization stations at Brennan Hall, I would certainly take advantage of this opportunity.

Bringing accessible health care to the student body, rather than expecting students to access it outside of campus, has been a positive development for U of T students, especially commuters. Moving forward, we must continue to expand these efforts, not only through increased advertising, but also by diversifying the locations of on-campus flu shots beyond just a few near the centre of campus.

Vaccinations are crucial in ensuring that student health is maintained. Complications that arise with failing health impede physical wellness and academic functionality. Ensuring that students are able to prevent illnesses in a free and accessible manner gives everyone more time to study for those awful finals that are coming up.

Angad Deol is a first-year Life Sciences student at St. Michael’s College.

Although each university is challenging in its own way, and each student may experience these challenges differently, I think we can all sympathize with how daunting and tedious our studies at U of T can be.

The culture of academic excellence at U of T — fueled by demanding professors, competitive students, and threats of grade deflation — becomes a huge component of our lives from the very first step we take on campus.

When you take into account assignments, midterms, and of course, readings, our studies may almost become as demanding and time consuming as full-time jobs.

This being the case, I think that many people ignore the importance of choosing the right subjects to study and how significant this decision may be to their university experience.

People often feel pressured to take certain pathways to success, even though these paths may not necessarily lead to positive experiences or even financial stability. When choosing courses, we need to sincerely consider our interests and our ability to perform in these positions.

Many people choose areas of study that are traditionally thought of as high-paying and secure, even if they do not enjoy doing the work. This might be great if you develop a love for what you study or show great skills in your work, but it may also be damaging if you’re forcing yourself into a field that you don’t find fulfilling.

I believe that choosing to study something you will not enjoy can only worsen the anxieties associated with a challenging academic culture.

At U of T, most programs — even those with rigid and unalterable requirements — give students the ability to take a number of elective courses. Electives are a great opportunity to explore other subjects, and to indulge interests beyond your field of study.

In fact, many people often find themselves gravitating toward areas of study related to their elective choices. The flexibility of U of T’s degree programs allows students to take extra years to complete degrees, especially if they choose to switch majors halfway through their program.

For instance, when I enrolled at U of T, I had no idea how much I would enjoy studying philosophy. Instead, I chose to study social sciences. I was taking courses in five different departments when I enrolled in an introductory philosophy course by chance.

I soon came to realize that I really love the subject, and I am relatively good at studying it. I decided to take more philosophy courses, and eventually became a philosophy specialist.

This was one of the best decisions I’ve ever made. Studying something that I love makes me enjoy the journey and tolerate the challenge. If it wasn’t this easy and convenient to experiment in courses from different departments, I might be studying something that I do not enjoy as much and, consequently, feel less enthusiastic about school.

I believe that when we find and study something we truly enjoy — even if only as a minor or a single course we are interested in — U of T may become less challenging.

So do not be afraid to enroll in different courses. You might find your passion where you least expect it to be, like I did. In turn, you may find U of T’s academic environment less toxic, more enjoyable, and more endurable — a challenge that you might even enjoy.

Efe Akan is a third-year Philosophy student at St. Michael’s College.

For years, the cause of the genetic link between Parkinson’s disease, Crohn’s disease, and leprosy has largely remained a mystery. However, a recent U of T-affiliated research effort has made significant strides by demonstrating that the cause seems to stem from inflammation.

Dr. Bojan Shutinoski, the first author of the study published in Science Translational Medicine at The Ottawa Hospital, explained to The Varsity that the gene in question, LRRK2, has been previously studied in relation to Parkinson’s and neuronal function. Shutinoski worked with co-authors, including Dr. Juliana Rocha of U of T, to complete the study.

Parkinson’s is caused in part by a lack of dopamine, which is produced by some neurons. This would suggest that the gene influences the neurons’ health. However, the study is the first to link a mutation in the gene to the immune system’s function.

The mutation in question is named ‘p.G2019s,’ and was linked by the study to an increased risk for developing Parkinson’s disease, Crohn’s disease, and leprosy. The risk stems from the mutation’s ability to cause the immune system to become hyperactive during periods of infection, which leads to high levels of inflammation.

The study’s design

Mice carrying the mutation, as well as ‘wild-type’ mice without the mutation, were infected with Salmonella typhimurium — a strain of bacteria that can cause sepsis.

Another experiment in the study infected mutated mice with a virus limited specifically to the peripheral system — the nervous system outside of the brain and spinal cord — and the mice were then compared with wild-type infected mice.

The analysis demonstrated that mice expressing the mutation were better able to control infection with higher levels of inflammation than the wild-type mice. However, this inflammation can be damaging.

The impact of inflammation on disease development

Inflammation specifically leads to an increased production of reactive oxygen species (ROS) in the brain, which can damage cell structures in high concentrations. These species damage or even destroy the neurons that produce dopamine, strengthening the link to Parkinson’s.

According to Shutinoski, one unique discovery from this experiment is that even in mice infected with the bacteria that did not infect the brain, inflammation still had an impact on the brain.

Another interesting finding of this study is that female mice with the mutation were found to have higher levels of inflammation than male mice. Similarly, in humans, Parkinson’s generally affects more men than women.

However, when Parkinson’s in humans is linked to p.G2019s, the opposite is true, and women have higher rates of the disease. This correlates with the findings in mice, yet the differences between the sexes are still open questions in science.

Applications of the study

Shutinoski suggested two clinical applications from this enhanced understanding of LRRK2. Primarily, since the LRRK2 gene produces an enzyme named dardarin, there are specific inhibitors that could hamper its activity.

However, more work must be done to ensure that the inhibitors are exclusive to the enzyme — otherwise, inhibiting other similar enzymes could harm the immune system response. Additionally, the regulation of ROS production could yield positive results in patients with increased inflammation, as a decrease in ROS could lead to healthier neurons and more regular dopamine production.

There is still much to learn about LRRK2, Parkinson’s, and inflammation, and this study has opened up a wide range of questions for researchers to tackle in the future.

One final aspect of this study is that it was a collaborative effort across several research groups. The main group working with LRRK2 worked with Crohn’s researchers in the local area.

To Shutinoski, the teamwork of the researchers was crucial to the study’s success.

“Science thrives in collaboration,” he said. “Our paper is… proof that collaboration works.”