Hamilton Health Sciences: We Are Explorers

Redefining “Research”

By Ted Scott, Acting Vice President Research & Chief Innovation Officer, @Chief_Innovator 

The dictionary definition of “researcher” is painfully self-explanatory: “someone who conducts research.” Based on my experience at Hamilton Health Sciences over the last few years, this description does no justice.

The word “research” itself has attracted a certain connotation that invokes images of anonymous individuals in lab coats analyzing samples in whitewashed, sterile rooms in the pursuit of some far-off, seemingly impossible discovery. Sure, some discovery happens that way. But, so often, it’s so much more than that.

At HHS, our researchers are so much more than people in lab coats. They are innovative, strategic, highly creative minds who translate complex data into new knowledge. Many of our researchers are also healthcare providers. Every day, they work alongside the patients who are the inspiration for their research pursuits. Their “labs” are patients’ rooms, clinics, and operating theatres. Every day, they’re on the front lines of our healthcare system, asking questions and solving problems. Their roles span the entire spectrum of healthcare professions: they’re surgeons, pediatricians, physiotherapists, nurses, students. They’re also our neighbours, friends, family members and, sometimes, they’re patients, too.

In my short time at HHS, I’ve learned that our researchers are also some of our community’s top innovators and collaborators. They’re forming networks across our city and region that are aimed at improving the way we provide healthcare, applying technology and expertise to make our healthcare system better. And, most importantly, their work has immense, tangible impact. Beyond the lab and the computer database, our nearly 2,000 researchers and research staff are discovering and implementing new knowledge that’s changing the way we care for people, in real-time.

For example, they’re testing in-home technology that our nurses and doctors can use to monitor patients once they go home after heart surgery. They’re working with tech innovators to find better ways of predicting outcomes for cancer therapies, so patients can make better decisions around their treatment options. They’re trialling the latest therapies to help make life easier for kids with chronic diseases, like IBD.

This is just a sampling of the research happening at our hospitals, right now. It wouldn’t be possible without our researchers and research staff who are unwavering in their pursuit of making life better for people in our community, across our country, and around the world.

I admire their persistence, their patience, and their will to keep exploring, even when the answers aren’t clear. And especially when competing commitments – of being doctors, nurses, allied health professionals, students – are as demanding as they are in our very busy health system.

It’s this insatiable drive to know the unknown that I believe better defines a researcher, no matter how big or small the issue at hand.

At HHS, we’re redefining what “research” means to our community, and to the world.

We’re not just researchers. We are explorers. It’s in our DNA.

Read about Explorers at Hamilton Health Sciences:

BLOG: Creating a new treatment option

 

BLOG: The stubborn pursuit of “Why”

      

For more, visit WeAreExplorers.ca 

#WeAreExplorers #onHWS

 

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Hamilton Health Sciences is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.

 

 

Canadian First: SickKids and Sinai Health System repair spina bifida in-utero

In a Canadian first, a team from Mount Sinai Hospital and The Hospital for Sick Children (SickKids) has repaired a form of spina bifida in a fetus at 25 weeks gestation. The baby’s mother, Romeila Son, recovered very well from surgery, and a bouncing baby girl, Eiko, weighing 2.45 kg, was born on August 19 at 36 weeks gestation at Mount Sinai Hospital. Since her birth, Eiko has needed no further intervention for this usually debilitating condition. This is the first case in Canada where the mother has not had to travel to the United States for this specialized surgery.

Dr. Greg Ryan heads Canada’s largest and most experienced fetal therapy program at Mount Sinai Hospital and Dr. James Drake heads Canada’s largest and most established neurosurgical centre for the postnatal repair of spina bifida at SickKids. Working in collaboration with colleagues from Vanderbilt University in Nashville who pioneered the procedure, a team of 24 clinicians led by Drs. Ryan and Drake successfully carried out the 2.5 hour in-utero procedure at Mount Sinai on June 4, 2017.


From left: Dr. Michael Apkon, President & Chief Executive Officer, SickKids; Dr. Paige Church, Head of spina bifida clinic at Holland Bloorview Kids Rehabilitation Hospital; Dr. James Drake, Head of Neurosurgery, SickKids;  Premier of Ontario, Kathleen Wynne; Dr. Greg Ryan, Head of Fetal Medicine program, Mount Sinai Hospital; Romeo Crisostomo, Eiko’s dad; Romeila Son, Eiko’s mom; baby Eiko Crisostomo; Dr. Mathew Sermer, Obstetrician and Gynaecologist-in-Chief, Sinai Health System; Dr. Gary Newton, President and Chief Executive Officer, Sinai Health System.

What is spina bifida?

Myelomeningocele is a form of spina bifida, affecting approximately 120-150 babies in Canada each year. It is caused when the spinal column fails to close early in fetal development, causing permanent damage to the baby’s spinal cord and nervous system.

Babies with spina bifida can have varying degrees of paralysis of their lower limbs and many will need mobility supports such as leg braces, crutches or wheelchairs. Over 80 per cent of children with spina bifida will require a shunt to be inserted to relieve pressure on their brain, which must remain in place for their entire life, and some affected children will have a negative neurocognitive outcome. Between 15-30 per cent of children with spina bifida do not survive into adulthood and less than 50 per cent live independently as adults. A third of adults with spina bifida require substantial lifelong daily support. The emotional, social and financial impact for these affected individuals, their families and society as a whole, is enormous.

Better treatment option for babies

The Management of Myelomeningocele Study (MOMS), a groundbreaking trial published by Vanderbilt University, Children’s Hospital of Philadelphia and the University of California, San Francisco, in the New England Journal of Medicine in 2011, showed that, in babies who underwent the in-utero procedure:

  • Brain malformations were reversed by one-third
  • The need for walking aids or a wheelchair was halved
  • Their need for brain shunts was reduced by half

Consequently, the Society of Obstetrics and Gynaecologists of Canada (SOGC) now mandates that any pregnant woman whose fetus has spina bifida must be counselled about this treatment option.

“Although fetal surgery will not be appropriate for all fetuses with spina bifida, it is extremely encouraging that, for some, it may preserve neuromotor function, reverse brain herniation and reduce their need for a brain shunt,” said Dr. Greg Ryan, head of the fetal medicine program at Mount Sinai Hospital, part of the Frances Bloomberg Centre for Women’s and Infants’ Health. “However, it also entails some maternal and fetal risks, particularly that of premature labour, which must be carefully balanced.”

“We regularly see children who have been affected by spina bifida at SickKids,” said Dr. James Drake, head of the division of neurosurgery and senior associate scientist at SickKids. “It is my hope that our capacity to perform this in-utero surgery here in Toronto will mean that we can optimize their clinical outcomes, and reduce the degree of medical challenges these children will face.”

Collaboration counts

“I am extremely proud of the collaboration between Mount Sinai Hospital and SickKids – which has resulted in a terrific outcome for this baby girl,” said Dr. Ryan.”Having this kind of clinical capacity here in Ontario will really change the range of options available to parents who have been given a diagnosis of spina bifida during pregnancy.”

“I would like to congratulate everyone at Mount Sinai Hospital and SickKids who teamed up to perform Canada’s first in-utero spina bifida surgery,” said the Honourable Kathleen Wynne, Premier of Ontario. “The incredible story of baby Eiko’s journey into this world shines a bright light on our world-class health care professionals. They’re talented, innovative, and making life better for people in this province — starting even before they’re born. Congratulations to little Eiko and her family. I wish them a healthy, happy future.”

Mount Sinai Hospital and SickKids recently collaborated on another in-utero surgical first, repairing a congenital heart defect called transposition of the great arteries, in May, 2017. The team from SickKids and Mount Sinai Hospital is Canada’s only provider of fetal surgery.

Read the original press release of this Canadian First here.

*Feature photo: From left: Premier of Ontario, Kathleen Wynne; Dr. James Drake, Head of Neurosurgery, SickKids; Romeo Crisostomo, Eiko’s dad; baby Eiko Crisostomo; Romeila Son, Eiko’s mom; ; Dr. Greg Ryan, Head of Fetal Medicine program, Mount Sinai Hospital.

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SickKids and Sinai Health System are two of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.

HIV care that’s made for women

Women are one of the fastest growing populations at risk for HIV infection and they have worse clinical outcomes than men do.

Dr. Mona Loutfy, a senior scientist at Women’s College Research Institute, is developing HIV care designed especially for women’s needs to close the health gaps they experience.

Dr. Loutfy leads the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS), a national study funded by the Canadian Institutes of Health Research. The study’s goal is to help women with HIV be as healthy as they can be in every way.

Study findings have shown that women in Canada receive good treatment for their HIV but their overall women’s health needs — including pregnancy planning, Pap testing, mammograms and mental health care — are often overlooked. To find and address these gaps, Dr. Loutfy engages women with HIV and their communities to ensure their concerns drive her research questions.

“When we set out to look at what we thought as researchers, were the most important topics, we thought it was going to be all about delivery of HIV care. What came out was actually a bit different.”

The study found that 64 per cent of the women had experienced violence in childhood and 80 per cent had experienced violence in adulthood. Half of the women had depressive symptoms. Isolation and poverty were also significant issues in the community.

“I feel that the care needs to be a little bit different,” Dr. Loutfy says.

She is working to create a new model of care that is women-centred, meaning focused on optimizing the overall health of women with HIV in Canada, particularly those at a higher risk, such as Indigenous women and trans women.

For women like Evana Ortigoza, a Community Advocate with Dr. Loutfy’s Trans Women HIV Research Initiative, the effort is very important. Evana is a trans woman who has lived with HIV for 17 years.

“The research they’re doing here is for trans and women, women with kids and women in all their diversity; it’s amazing. We are not alone,” she says. “Everywhere I go, Women’s College is there to make sure that women are protected.”

Watch the video above to learn more about Evana and Dr. Loutfy’s research, and visit report2017.womensresearch.ca to learn more about research at Women’s College Research Institute at Women’s College Hospital.

 

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Women’s College Hospital is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.