Health and Community Leaders Talk: Allison Sekuler

By Allison Sekuler, vice-president, research, at Baycrest Health Sciences and Sandra A. Rotman Chair in Cognitive Neuroscience (@asek47)

What does health research mean to you?

Health research, specifically aging and brain health research in my role at Baycrest, means discovering the ways in which our brains function, how our brains change with age, and then linking the fundamental mechanisms of neural processing to new innovations that enhance care and add life to years for older adults.

Health research is not an individual endeavour, it’s a team sport. To fully understand aging and brain health, we need to bring together people from a diverse range of backgrounds and disciplines, each of whom contributes a different perspective and skill set to the problem at hand. One of the most pressing problems to solve in aging and brain health and one that is a focus for me in my new role, is the looming public health crisis in dementia.

Fifty million people around the world live with dementia and that number is expected to grow to 82 million within the next 12 years. In Canada alone, it’s been estimated that over 200 new cases of dementia are diagnosed every day on average, although many people remain undiagnosed, without access to treatment or care. The annual cost of dementia care in Canada has exceeded $10 billion, but the cost to those living with dementia, and to their caregivers and loved ones, is so much greater.  Research addressing the problem of dementia needs to tackle a number of fronts: detection, prevention, and treatment.

The research at Baycrest, in our world-renowned Rotman Research Institute for cognitive neuroscience, covers a broad spectrum, from solving the mysteries of the aging brain to improving evidence-based care practices at the bedside and creating cutting-edge technologies to enhance the aging experience.

Our fundamental research is complemented by the Baycrest-led Centre for Aging + Brain Health Innovation (CABHI). CABHI is a first-of-its-kind partnership of healthcare, science, industry and government that provides support to develop, test, and disseminate novel solutions addressing unmet needs in brain health and seniors’ care, and to create a culture of innovation within the long-term care sector.

With CABHI’s support, we are transforming our gold-standard workshops, the Memory and Aging Program and Goal Management Training, into interactive, evidence-based, brain-training products that will be available to anyone in the world with an Internet connection. Through these programs, older adults and individuals affected by brain injuries learn how to boost their memory and mental performance, helping them complete everyday tasks. Our researchers also are testing new ideas for early diagnosis and intervention of dementia, and developing approaches to better support caregivers.

As Baycrest celebrates its centennial in 2018, we’re reflecting on how combining care with fundamental research has led to many critical brain health and aging discoveries and looking forward to contributing many more innovations to help people live long and live well.

How does health research contribute to a healthier, wealthier, smarter Ontario?

The aging brain holds many secrets. By working together, we can understand, protect, and enhance brain health throughout our lifetimes. But we can’t do it all alone.

As one of the most research-intensive hospitals in Canada, Baycrest partners with various institutions in Canada and across the globe. With support from the Government of Canada and Brain Canada, we launched Canada’s first cross-institutional memory clinic, which will allow researchers to speed up the pace of dementia research. Baycrest’s Sam and Ida Ross Memory Clinic is the initial pilot site for the Toronto Dementia Research Alliance (TDRA) database, merging big data and neuroscience, enabling information to be shared across institutions, and bringing researchers closer to discovering effective treatments for Alzheimer’s disease and other dementias.

Our scientists also lead an international team of researchers from 12 sites across three continents developing The Virtual Brain, which combines neuroimaging with the power of artificial intelligence to enhance diagnosis and provide personalized treatments based on brain simulations. Through The Virtual Brain, Baycrest’s and Ontario’s research influence has spread, with more than 10,000 installations of the software around the world. Through our work, Baycrest researchers are dedicated to helping all adults live out their years in comfort and wellness, with a healthy body and mind.

 

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Read more Health and Community Leaders Talk blog posts on our Healthier, Wealthier, Smarter site and share your insights on Twitter with the hashtag, #onHWS. To learn more about how health research makes Ontario healthier, wealthier, and smarter, check out our website and our other blog posts and videos.

ARTIC + Quality Standards: Spreading Quality Care

By Dr. Joshua Tepper and Michelle Noble

Earlier this year, Globe and Mail health writer André Picard wrote a column about innovation in health care. “One of the most frustrating traits of the Canadian health-care system is its failure to recognize and embrace success,” he began. “Imagine if we took all our successful local innovations and pilot programs and actually implemented them on a larger scale,” he wrote later.

In Ontario, spreading innovation in health care is not something to be imagined. It is actually taking place.

ARTIC (Adopting Research to Improve Care) is a partnership between Health Quality Ontario and the Council of Academic Hospitals of Ontario (CAHO), and is one of the only Canadian programs focused exclusively on accelerating the spread of proven health care.

In the past year alone, ARTIC has improved the health of Ontarians by:

  • Expanding the use of primary care Memory Clinics by supporting the implementation of 17 clinics in rural, remote and underserviced communities across Ontario to improve care for patients with memory problems associated with dementia. They provide training for family medicine teams and professionals, meaning patients can receive appropriate care closer to home.
  • Reducing emergency room visits and improving care and the patient experience for up to 2,000 patients annually with opioid or alcohol addiction by supporting META:PHI (Mentoring, Education, and Clinical Tools for Addiction: Primary Care-Hospital Integration). The program has developed rapid access addiction medicine clinics in seven communities where opioid supports are much needed. They integrate care received in emergency departments and hospitals, primary care and front-line community services, enabling patients to seamlessly transition to a rapid access clinic and then, once stable, to a primary care provider. ARTIC and the Ministry of Health and Long Term Care are now supporting the further expansion of the clinics in communities across Ontario.
  • Expanding the use of a proven new tool that provides patients with clear and easy-to-understand instructions to help them manage their care after being discharged from hospital. A report by Ontario’s Avoidable Hospitalization Expert Panel in 2011 found communication of discharge instructions by hospitals to patients was often poor, in part because patients did not understand medical terms or were too stressed at the time of discharge to absorb critical information. Co-developed by patients and health care providers, PODS (Patient Oriented Discharge Summary) is being adopted in 27 hospitals and will benefit approximately 50,000 patients in the first year of its expanded use. If you are interested in adopting PODS at your hospital, contact ARTIC.

ARTIC will continue this important work in 2018. ARTIC has just issued a new call for proposals for high-impact clinical interventions or practice changes that are proven to work and are ready to spread across the province.

What is unique about this year’s call is that proposals are being sought for proven interventions or practice changes that align with Health Quality Ontario quality standards. Quality standards outline for clinicians and patients what quality care looks like and focus on conditions or topics where there are large variations in how care is delivered, or where there are gaps between the care provided in Ontario and the care patients should receive.

Based on the best available evidence, the standards are intended to enable critical conversations between patient and health care professional by providing them with tailored guidance to make them more comfortable and knowledgeable about the relevant condition.

To date, quality standards are been developed for a wide range of conditions including dementia, heavy menstrual bleeding, hip fracture, major depression, palliative care, opioid prescribing for both acute and chronic pain, and for the treatment of opioid use disorder.

To be eligible for ARTIC funding, proposed clinical interventions or practice changes must have already been proven and successfully implemented in at least one site, and must have involved patients and families in the development of the initiative and plans for its future spread. How patients are involved is a key criteria in assessing project proposals.  If you have or know of an intervention that’s ready to be spread across Ontario, we encourage you to apply.

As André Picard noted in his article, too often successful health innovations are piloted at one organization but never spread further. ARTIC is solving that problem by successfully seeding innovative projects in communities across Ontario, thereby providing quality care to patients and families.

 

Dr. Joshua Tepper is President and CEO of Health Quality Ontario and Michelle Noble is the Executive Director of the Council of Academic Hospitals of Ontario.

 

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Can computers help unlock the mysteries of the brain?

This story was originally published by Sean O’Malley, Senior Media Relations Specialist and co-host of the CAMH Podcast, on the CAMH website

There is perhaps no better way to illustrate how much the world of mental health research has changed in the 20-year history of CAMH than to look at the work being done today by Dr. Sean Hill’s team at the Krembil Centre for Neuroinformatics.

Consider what happened in 1997, the year before CAMH was created. That was when Deep Blue, a supercomputer created by IBM, defeated the world’s best chess player Gary Kasparov, marking a seminal event in the history of our relationship with technology. Today, the free chess app on my smart phone could probably beat Deep Blue.

For fans of the dystopian Terminator movie franchise, Deep Blue’s victory over Team Human signaled the beginning of the end for humanity as we know it.

But for young scientists like Dr. Hill, it raised the same question he had been asking since he tried his first PC at the age of eight: how much smarter could we make these machines? Could we make them smart enough to unlock the mysteries of the brains of the people who created them?

CAMH podcast with Dr. Sean Hill neuroinformatics
Dr. Sean Hill, Director of CAMH’s Krembil Centre for Neuroinformatics and CAMH podcast co-hosts Dr. David Goldbloom and Sean O’Malley discuss the past, present and future of neuroinformatics.

Yes, Dr. Hill began coding when he was eight, inspired by something called a TRS-80 that his older brother’s high school had purchased at a local Radio Shack and let his brother bring home to their family farm in rural Maine.

“In the winter when it was cold and dark…there was this whole new world you could discover in a box,” says Hill. “To me it was an opportunity to be incredibly creative.”

From a neuroscience perspective, the answer to 8-year-old Sean Hill’s question about computers and the brain increasingly appears to be ‘yes’ in a way we could only have imagined in CAMH’s early days. And that could have profound implications for how we diagnose and treat mental illness in the future.

“We saw in 2005 that by 2025, a supercomputer would be built that could simulate brain circuitry the scale of the human brain,” says Dr. Hill in the latest episode of the CAMH Podcast.

That prediction ended up being off but not by much – that supercomputer is now expected to be ready in the next two years.

Just in time for Dr. Hill to apply that technology breakthrough to his work at CAMH.

After devoting much of his career to this intersection between computers and neuroscience, most recently at the prestigious Blue Brain Project in Switzerland, what most excites Dr. Hill about coming to CAMH is that he can now apply the theoretical power of big data to the flesh and blood world of patient care.

 

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Healthy Aging: 100 Years of Research and Care at Baycrest

“I just plough through, that’s something I learned from my mom. Just plough through,” says Barbara Schechter, a young caregiver featured in CBC’s recent documentary, The Caregivers Club, which takes an intimate and compassionate look at the lives of four caregivers and their loved ones living with dementia. The families are also part of the Baycrest Health Sciences community in Toronto.

With three young children and a full time job, Barbara is also a caregiver for her mother. “The only thing that gets you through the day is how you’re going to manage and how you’re going to make your mom safe,” says Barbara in the documentary.

There are currently 564,000 Canadians living with dementia, and that number is expected to double by 2031. As Canada’s population ages, more and better care is needed.

Baycrest Health SciencesThat’s what drives the researchers at Baycrest Health Sciences.

Baycrest is ranked as one of the most research-intensive hospitals in Canada and is a member of the Council of Academic Hospitals of Ontario, which represents Ontario’s research hospitals. Research hospitals play a unique and vital role in Ontario’s health system, providing advanced patient care services, training the healthcare workforce, and conducting leading-edge research to discover tomorrow’s care today. They generate the expertise and evidence to drive change as system leaders, building a healthier, wealthier, smarter Ontario.

And Baycrest is doing just that. Its Rotman Research Institute is among the world’s top research institutes in cognitive neuroscience.  The Centre for Aging and Brain Health Innovation, led by Baycrest Health Sciences, helps to accelerate brain health and aging solutions. Together, Baycrest is advancing dementia care for patients locally and globally, discovering better ways to diagnose, prevent and treat dementia and other brain disorders.

Research at Baycrest is part of a continuous cycle, where foundational brain research leads to clinical testing, which leads to innovations supporting healthy aging, which leads to more questions about the fundamental mechanisms of the brain.

Is my memory normal? At-home assessments and iPad apps  

Early detection and prevention of memory problems and cognitive impairment is a major area of focus at Baycrest. Cogniciti, a digital health company led by Baycrest researchers, is empowering adults to assess their memory in the comfort of their own homes. Free, private and clinically researched, the digital brain health assessment has helped more than 60,000 adults answer the question, “Is my memory normal or should I see my doctor?”

Test-takers age 40 and up solve a series of evidence-based puzzles, including shape matching, face and name matching, and a number-letter alternating test. Based on performance, they receive a memory report and may be advised to connect with their family doctor for next steps in care.  Through the brain health assessment, Cogniciti provides researchers access to a rich pool of interested volunteers to help advance memory research.

Another initiative accelerating research into Alzheimer’s and dementia treatments is Baycrest’s work with the Toronto Dementia Research Alliance (TDRA). The Sam and Ida Ross Memory Clinic at Baycrest is the initial pilot site for the newly developed Toronto Cognitive Assessment (TorCA), which utilizes an iPad to capture anonymous patient information and pools it onto a secure, research recruitment database that will be shared amongst TDRA memory clinics. This data will allow scientists to widen their pool of research subjects and easily identify and recruit consenting subjects who match the criteria for their dementia studies.

The TorCA is a sensitive tool that can identify patients at risk of dementia earlier. The assessment not only informs research on detection of memory-related conditions, it also saves costs for the health system and saves patients from having to pursue unnecessary cognitive tests.

Currently, Ontario patients concerned with cognitive impairment receive assessments from specialists. The TorCA iPad app is a game changer, allowing any health care professional to assess patients upfront and determine whether they need to pursue a more lengthy and resource intensive neuropsychology exam. The hope is that this tool will soon be clinically available across TDRA hospital sites within Toronto – and beyond— free of charge.

Getting a glimpse into a brain with dementia

What if you could detect the minute changes that occur in the brain Alzheimer's transcranial stimulationover the course of a person’s life? Researchers at Baycrest are getting the chance to do just that by using magnetic resonance imaging (MRI) to study the aging brain, including brains with very early dementia.

Cognitive tests, similar to the Toronto Cognitive Assessment, led Dr. Rosanna Olsen and her team to wonder whether physical differences could be detected in the brains of healthy adults who scored poorly compared to those who scored well.

Her cross-sectional study found that people who scored lower on cognitive tests had a smaller “memory region” of the brain – the same region that is first affected in Alzheimer’s disease. This finding has allowed researchers to use both memory region brain measures and low cognitive test scores as biomarkers (a biological flag) for Alzheimer’s disease, which is a big step forward for the detection and prevention of dementia.

Innovative treatment for older adults with depression and Alzheimer’s disease

Up to 70% of people living with Alzheimer’s disease also suffer from depression, which does not typically respond to standard antidepressant treatments. Dr. Linda Mah and Dr. Jed Meltzer are using a non-invasive procedure called transcranial magnetic stimulation (TMS) to reduce symptoms of depression in older adults with Alzheimer’s.

TMS uses magnetic fields to stimulate or inhibit neurons in the brain. Although TMS is approved as a treatment for depression, researchers are aiming to treat other neurologic and psychiatric conditions. Drs. Mah and Meltzer will evaluate the effects of TMS on both mood and memory in Alzheimer’s patients who also suffer from clinical depression. For Alzheimer’s patients, this could mean tapping into brain stimulation to treat their symptoms.

Patient and family care driving research

Research at Baycrest goes both ways. Not only is evidence informing how clinicians, occupational therapists, personal support workers and volunteers care for Baycrest clients, but researchers are also evaluating services to ensure high quality care and support.

Baycrest dementia arts therapyThe Road to Connection program is a great example of this. It’s an arts-based program that brings together caregivers and their partners with dementia for creative sessions and discussion. The program empowers dementia patients to tap into their creative skills while serving as a support group for caregivers.  On top of that, the program gives caregivers an opportunity to celebrate their partners through the art they have created and come away with a shared, meaningful experience.

“We could come back together at the end of the day with something for both of us,” said one caregiver participating in the program. “There aren’t many programs like this one that allow caregivers to meet and share without leaving loved ones behind.”

Baycrest researchers are evaluating the Road to Connection program with the hope of duplicating it across other sites within the Baycrest community and in Ontario.

Baycrest researchers have evaluated and helped redesign volunteer programs to improve resident engagement in Baycrest’s long-term care facility, the Apotex Centre. The Program for Leisure Engagement for Active and Spontaneous Experiences (PLEASE) is an evidence-based model that trains volunteers to work one-on-one and in small groups with residents, when they ask the simple question, “What do you want to do today?” The evaluation found that the PLEASE program enhanced the abilities and personhood of residents – more smiling, talking and engagement. Researchers are also exploring the use of volunteer visits to help older adults with dementia preserve or improve their thinking abilities.

This work helps long-term care homes incorporate cost-effective programs to improve care for residents with dementia and create new roles for volunteers working with older adults.

A century of excellence in complex care, research and training

The world’s population is aging rapidly, and Baycrest has the expertise to deliver proactive solutions. Now in its centennial year, Baycrest has spent 100 years pioneering the science of health and aging.

Baycrest provides compassionate, specialized care, conducts cutting-edge cognitive neuroscience research, commercializes innovative solutions, and trains the next generation of health care professionals with the skills needed to support and respond to the diverse and complex needs of older adults.

As a global leader, Baycrest’s work is contributing to a healthier, wealthier, and smarter future for Ontario and beyond.

 

Why does health research matter to us? We know that it generates new discoveries, better care, and greater efficiency all while contributing to our knowledge-based economy. That’s how it makes Ontario healthier, wealthier and smarter today. Investing in research hospitals will help us continue building a healthier, wealthier, smarter Ontario. Discover more health research and patient stories by signing up for our monthly newsletter or joining the #onHWS conversation on Twitter.

Group feature photo was taken during CAHO’s Healthier, Wealthier, Smarter Field Trip to Baycrest Health Sciences. Read our other Healthier, Wealthier, Smarter Field Trips here.

 

Research shows that preemie babies do better when families are involved in care

Dr. Karel O’Brien, with mother, Amy, whose twins were born at 23 weeks, 5 days.

An international study led by Sinai Health System researchers shows that a Family Integrated Care model of treating the tiniest and most fragile babies helps improve the wellbeing of both children and parents.

Neonatal intensive care units (NICU) in Canada, Australia and New Zealand adopted the Family Integrated Care model, developed at Mount Sinai Hospital by Dr. Shoo Lee, and found that it improved the wellbeing of both preemie babies and their parents compared to standard care:

  • Improved weight gain among preterm infants
  • Better breastfeeding
  • Reduced parental stress and anxiety

When Amy, a new mother of twins found herself in the Mount Sinai NICU with babies born at 23 weeks and 5 days, she felt scared and overwhelmed by how fragile the babies were. Still in the NICU after almost three months, she has found comfort in being part of the Family Integrated Care model. “It really allowed me to feel like a mother. Being with my babies all day, I know instinctively if something is wrong or what they need, and can report that to the doctors and nurses. They are getting stronger and stronger every day, and this model of care has made me believe that when I bring them home, I’ll be able to confidently care for them.”

The study was led by Mount Sinai Hospital researchers Dr. Karel O’Brien, neonatologist, and Dr. Shoo Lee, Chief of Pediatrics. Recently published in the prestigious journal, The Lancet Child & Adolescent Health, it involved nearly 1,800 infants born at 33 weeks gestation or earlier across 26 NICU units.

What is Family Integrated Care?

Family Integrated Care actively involves parents in the care of their newborns, including giving oral medicine, feeding, taking their temperate and taking part in ward rounds.

Mount Sinai supports parents in spending six hours a day, at least five days a week with their babies by providing them with a rest space and sleeping room, comfortable reclining chairs at the bedside and nurses trained in family support.

“Parents are too often perceived as visitors to the intensive care unit. Our findings challenge this approach and show the benefits to both infants and their families of incorporating parents as key members of the infant’s health care team, and helping parents to assume the role of primary caregiver as soon as possible,” says Dr. Karel O’Brien, who leads the Family Integrated Care Program at Mount Sinai.

Real impact for preemies and parents

“How care is provided to the family, not just the infant, has a positive effect on the wellbeing of both infant and family,” says Dr O’Brien. “Weight gain, breastfeeding and reduced parental stress and anxiety are all associated with positive neurodevelopmental outcomes, suggesting that integrating parents into the care of infants at this early stage could potentially have longer-term benefits.”

At 21 days, infants in the Family Integrated Care group had put on more weight and had higher average daily weight gain (26.7g vs 24.8g), compared to the standard care group. Additionally, parents in the Family Integrated Care group had lower levels of stress and anxiety, compared to the standard care group. Once discharged, mothers were more likely to breastfeed frequently (more than 6 feeds a day), compared to the standard care group (70% vs 63% ).There were no differences in rates of mortality, duration of oxygen therapy or hospital stay.

“The results of this trial are encouraging indeed. Not only is this an example of innovative care developed here in our hospital, it is an exceptional example of how a good idea can be shared across the country and around the world,” says Dr. Lee.  “This was truly a collaborative effort with participating NICU’s, parents, and the whole care team.”

Read more about this story in the media.

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Making Healthcare Smarter: Seeing Medical Ethics Differently

Lisa Boivin is a member of the Deninu Kue First Nation in the Northwest Territories. She paints image-based stories that explore the gap between medical and land-based Dene ethics. She is a graduate student at the Rehabilitation Sciences Institute at U of T’s Faculty of Medicine.

Lisa recently presented her art and her story at the 12th Annual Bloorview Research Institute Symposium, including her image above, called Holding Thunderbird. She also sat down with BLOOM, the digital magazine of Holland Bloorview Kids Rehabilitation Hospital, to share her story. Read the complete, original interview: Lisa Boivin paints stories about medical ethics beyond words.

BLOOM: Why did you study bioethics as an undergrad?

Lisa Boivin: I fell in love with the element of story—that ethics are held in the story of clinical narratives. As a bioethics student, we have all of this academic rhetoric around ethics. But I learned that the ethics are anchored in the story of the patient.

BLOOM: You mean that the most important ethics are found in a patient perspective?

Lisa Boivin: Yes. Clinical and personal hardship helped me to see ethics differently—things like informed consent. I had to read a lot of patient narratives to have a fundamental understanding of the sacred ceremony of informed consent. That’s both parties coming together with complete understanding of one another’s situation, and a balance in decision-making. And that’s something that’s hard to accomplish, for basic reasons. The patient isn’t a clinician, and doesn’t have the expertise that a doctor has in terms of the biology of what’s happening. But there’s also such a tremendous power imbalance between the two parties.

BLOOM: Can you describe your art?

Lisa Boivin: I came to know image-based storytelling through an inability to articulate academic thought from an Indigenous perspective. I’m not a classically-trained artist. I’ve only painted for three years. I’m a ‘60’s scoop survivor from two generations of residential school survivors.

One of my professors asked me to write a paper on colonialism. I couldn’t do it. So I painted it. The paintings are born out of necessity, and are a way to communicate Indigenous perspectives to non-Indigenous colleagues. The one featured above is called Holding Thunderbird.

BLOOM: Can you describe what it means?

Lisa Boivin: From my teachings, Thunderbird is a very powerful being, the carrier of knowledge and the conduit between the creator and the people. Thunderbird is also the carrier of justice. With that responsibility comes great frustration.

I don’t feel knowledgeable, I simply carry a knowledge that is unfolding in images I’m creating. I find myself frustrated often. Holding Thunderbird relates to me as a person who struggles in the academy, where I’m constantly expected to fit my Dene knowledge into a colonial format. That’s extremely oppressive and harmful to me.

There are times when bioscience research clashes with Indigenous research methodologies. This painting was created to thank a professor who was helpful to me at a residency. The woman holding Thunderbird is the professor and all the flowers represent her knowledge. She’s keeping Thunderbird from flying away, and comforting Thunderbird.

She’s the first person that’s never asked me to change or do anything that would be harmful to the Indigenous knowledge in the images. That residency provided me with a healing, and a security I had never known.

For me, the painting represents the notion that we all have our own knowledge and our own knowledge systems. And for us to grow, we need support from people who have power in our lives. It can be a professor, a clinician, or a leader in our community. But the idea is someone holding space for us, as we are.

BLOOM: This reminds me of how difficult it can be to talk about disability in a culture that doesn’t value it. It’s almost like I don’t have the words, sometimes, or I feel like I’m put on the defensive, in trying to convince people that there is value in a different way of living.

Lisa Boivin: This is the kind of damage that the medical model does to people with differences. What I’ve learned from my family is that an Indigenous perspective of wellness is much larger than the narrow perspective of the medical model. The medical model measures wellness as the absence of disease. From my Dene perspective, the measure of wellness is the ability to interact with the land.

My father had polio as an infant, and during his childhood he was seen as someone who was disabled. But when my father came home from residential school, he got on a dog sled. He became a champion dog racer and was no longer disabled. He didn’t consider himself disabled in any way. He just navigated the world differently.

I’m someone who has been diagnosed with a learning difference or cognitive disability. I have a different way of translating knowledge. I’m an image-based storyteller. There’s a reason I can’t interact with certain academic theories. The images came to life and were born out of necessity. If I could translate knowledge in an academic way, I would never have learned how to paint.

BLOOM: You spoke about your dad’s physical disability, and how through dog sledding, he was able. How do Indigenous people view intellectual disability or other types of disability?

Lisa Boivin: Any Indigenous person would want people to embrace who they are, or to create their own idea of wellness. My dad walked with a limp and had varying degrees of mobility, but that never affected his understanding of his wellness.

My wellness comes from an ability to interact with the land—to understand where I am in the world, and how I fit in and what my duties are. My duty is to be an image-based storyteller.

In the Navaho literature, they don’t present an idea of correcting behaviour. You are who you are, and you contribute where you can.

You move differently, you speak differently. The eight-year-old boy in me says: ‘You have a difference, you do different stuff.’

BLOOM: What do you hope to do in the future?

Lisa Boivin: I want to share information about Canada’s colonial history and how that creates clinical barriers between a clinician or therapist and a patient.

There are centuries of failed relationships between what would become Canadian institutions and Indigenous people. For hundreds of years, there’s broken promises, institutional racism and mistrust. And this still takes place in medicine today. I am horrified when I read stories in the media about Indigenous patients who die in ERs because they’re seen as drunk or drug-seeking. When an Indigenous patient sees that in a media story, it influences how they interact with a doctor.

Medicine has also been used as an instrument to remove Indigenous children from their homes, because it’s perceived that Indigenous parents can’t look after their children. This was certainly the case for my father, who had over a dozen surgeries to correct his mobility impairment.

I’d like to promote an understanding of a wider notion of wellness. As we spoke of earlier, the medical model is very simplistic. It’s the presence or absence of disease. There are wider models of wellness.

For many Indigenous people, the ability to interact with the land is a measure of wellness. An Indigenous worldview includes the land, animals, community and nature. An ability to contribute to community is central to wellness, and that can be any contribution.

I’m a health-care educator and I will continue using arts-based practice to educate about colonialism and how that exists in medicine.

 

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Holland Bloorview Kids Rehabilitation 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.

Alzheimer’s drug one step closer to reality after Krembil team signs major development deal

A research team at the Krembil Research Institute has inked a deal with a multinational pharmaceutical company that could speed development of a potential disease-modifying drug for Alzheimer’s disease.

French drug company Servier has announced a new strategic research partnership agreement with Toronto-based Treventis Corp. – a biotech company founded by Krembil Director Dr. Donald Weaver – to co-develop a promising new therapeutic treatment already underway at UHN.

“This is a very big deal,” said Dr. Weaver, a medicinal chemist, University of Toronto Professor, Canada Research Chair and neurologist who treats dementia patients at Toronto Western Hospital.

“Drug discovery is a tremendously competitive field and this partnership demonstrates the ability of Krembil and UHN to achieve a level of excellence on the world stage. It also helps cement our place as one of the leading neuroscience research facilities in Canada.”

As part of the collaborative agreement, researchers in Paris and Toronto will jointly develop compounds that target two key proteins known to play a role in Alzheimer’s disease. Those proteins, called tau and beta-amyloid, are believed to have a deleterious effect on brain function when they misfold.

“We all have these proteins in our brains. When they misfold they become toxic to brain cells. They kill brains cells,” said Dr. Weaver. “We have identified a class of compounds that we believe prevent beta-amyloid and tau from doing this.”

Dr. Weaver’s team has spent nearly two decades searching for a therapeutic strategy to slow or stop the neurodegenerative disease that affects more than 500,000 Canadians.  There are currently no disease-modifying drugs for Alzheimer’s on the market.

In 2013, Treventis was awarded $4.7-million in funding from the prestigious Wellcome Trust to investigate compounds, with the goal of designing a drug that can safely and effectively treat people with chronic neurological dementias, such as Alzheimer’s. Funding from the Wellcome Trust, a British-based independent charity, is extremely competitive, difficult to obtain and is traditionally awarded to researchers in the U.K.

“The Wellcome Trust funding allowed us to get to the point where we have a molecule that works, but needs some fine-tuning,” said Dr. Weaver. “Partnering with a major pharmaceutical company like Servier is the next logical step.”

Dr. Weaver is quick to also credit other funding agencies that have played a significant role in advancing the fundamental research to its current stage of applied drug discovery. Among the most generous contributors, he said, are the Alzheimer’s Society of Canada, Canadian Institutes of Health Research, Toronto General & Western Hospital Foundation, The W. Garfield Weston Foundation, BrightFocus® Foundation and Krembil Foundation.

For its part, Servier has indicated it is excited to partner with Treventis in taking this research to the next level.

“We very much hope that this new collaboration will allow us to answer the huge unmet patient need for disease-modifying treatment of Alzheimer’s disease, thanks to Treventis’ unique and innovative technology,” Christian de Bodinat, the company’s Director of the Center of Therapeutic Innovation in Neuropsychiatry, said in a statement.

“We are very excited to be part of one of the first programs employing a dual approach in this field.”

As part of the agreement, Servier will fund all research costs and maintain worldwide rights to develop and commercialize drugs advanced during the partnership.

Dr. Weaver and his team are thrilled to partner with one of the most innovative pharmaceutical companies in the world.

“I think it says that Servier has faith that we have a sound approach, excellent molecules and that there is a good foundation already in place,” said Dr. Weaver. “This allows us to optimize and fine-tune the molecule and perform more elaborate biological evaluations.”

Next steps for the research team include ramping up work in the laboratories at the Krembil Discovery Tower and JLabs, and attempting to identify a candidate for a Phase 1 clinical trial.

*Story originally published on UHN website here.

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University Health Network 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.

Patients + Research: Pamela Parker

Research and care at Canada’s first cardio-rheumatology clinic

Meet Pamela

Two years ago, Pamela Parker’s hands became cracked and sore, and she learned she had developed severe psoriasis and eczema.

Pamela Parker Women's College Hospital

After seeing a specialist, she learned the psoriasis was also in her joints, a condition known as psoriatic arthritis. She was referred to Dr. Lihi Eder, a rheumatologist and a scientist at Women’s College Hospital (WCH) who runs the psoriatic arthritis program at WCH. After sharing her family’s history of heart disease, Dr. Eder referred Pamela to the WCH cardio-rheumatology clinic, the first of its kind in Canada.

Research has shown that patients with rheumatic conditions, such as psoriatic arthritis and rheumatoid arthritis, are at a higher risk for heart disease and other cardiovascular complications. The new clinic is helping patients like Pamela manage their heart health, and ideally, prevent a serious cardiac event. Dr. Eder and Dr. Paula Harvey, the head of cardiology at WCH, jointly run the clinic and collaborate on research studies about the connections between joint health and heart health.

Pamela shared why she is grateful for her care and why she gives back by participating in research.

Could you tell us about your health story?

All of a sudden, it was May 2015, when my skin just went berserk and my joints just went berserk. I was getting married as well, and you are focused on your nails and hands. I thought — why would my hands go from normal to this, and my joints? That’s when I was referred to Dr. Eder. She is very thorough and very caring. She actually takes her time out of her day to call me personally, which does not usually happen with specialists. I found out I do have psoriatic arthritis on top of psoriasis and eczema. She said we need to treat this aggressively or I could end up being crippled.

How were you referred to the cardio-rheumatology clinic?

Dr. Eder said there was a correlation between psoriatic arthritis and heart disease. She asked if I had a family history. I do, my father passed away of a massive coronary and my sister has had a triple bypass. I was referred to the cardio-rheumatology clinic and they did tests, and I have elevated cholesterol, nothing major at this point. For me, it was so amazing to have access to a cardiologist at a stage where if there is an issue they will be on top of it, knowing my family history. Dr. Eder then asked if I wanted to join a combined study and I was happy to participate in their research.

Why did you decide to participate in research?

It is so important. Participating is minor compared to having a crippling disease that no one knows anything about. My kids, my grandkids, my great grandkids could end up with these conditions, and if studies could figure out the ins and outs and shortcuts to detect issues early, I am all for it!

 

Approximately 30% of the people with psoriasis will develop an inflammatory arthritis known as psoriatic arthritis. Learn more about the psoriatic arthritis rapid access clinic at Women’s College Hospital and discover patient resources.

 

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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Johnson at ejohnson@caho-hospitals.com, 416-205-1469, or direct message or tweet at us on Twitter at @CAHOhospitals.

Read more Patients + Research posts and share your own insights on Twitter with the hashtag #onHWS. To learn more about how health research makes Ontario healthier, wealthier and smarter, visit our impact page, and check out our other blog posts and videos.

The Next Generation of Top Research Talent

Ontario Research Hospitals make our province and our health system smarter by attracting, training and retaining the next generation of health care professionals. Carley Richards, a trainee at The Royal, shares her experience diving into mental health research.

Meet Carley Richards

Throughout her teenage years, Carley Richards struggled with feeling depressed.

It wasn’t until her second year of university that she was actually diagnosed with depression and attention deficit hyperactivity disorder (ADHD). She finally had a piece of paper, with a diagnosis, that proved it wasn’t just “in her head.”

It was a change that would have a huge impact on her academic career.

“The brain is like a big unknown body of water that we’re only just dipping our toes into,” says Richards. “I realized the more we learn about and understand the brain, the more we’ll be able to help people like me.”

The Gut and the Brain

Now working toward a master’s degree in neuroscience at Carleton University, Richards is a research trainee under the supervision of Dr. Marie-Claude Audet, a researcher at The Royal’s Institute of Mental Health Research (IMHR). She recently won a Graduate Student Research Award from the IMHR.

“Recent research has shown that people with depression have different bacteria in their digestive system than people without depression,” says Richards.

The goal of her research is to look at the microbiome of two different groups of people — those who have depressive symptoms and those who do not. She’s hoping to link trauma in a person’s life to changes in gut bacteria, and explore whether changes in gut bacteria are associated with depressive symptoms.

Life as a Young Researcher

“As a young researcher paying for my own education, I need funding to conduct my research, which means I need to apply for grants and scholarships,” she says.

“It can take a lot of time, and unfortunately for young researchers, there’s a lot of competition and rejection. It can be really tough to stay in research.”

The funding from the IMHR Graduate Student Research Award is helping Richards push her research project forward.

“When you’re stressed, your body releases certain chemicals,” she says. “I’m using this funding to purchase a lab kit that measures a specific binding agent that connects those stress chemicals to the bacteria in the gut.” By using this lab kit, it will be possible for Richards to measure those connections.

“We’re a long way from understanding the brain, but imagine if we could treat symptoms of depression by treating specific bacteria in your gut,” says Richards. “We’re not there yet, but it’s exciting to know I’m contributing to that possibility.”

The Graduate Student Research Awards are funded by The Royal’s Foundation. They fund research and education experiences for young researchers as they work to make a difference in the lives of people living with mental illness.

 

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The Royal Ottawa Health Care Group is one of Ontario’s 24 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.

Research Spotlight: Health Sciences North

Dr. Janet McElhaney and her team at Health Sciences North Research Institute (HSNRI) are working with Indigenous communities to promote healthy aging of Indigenous People in Canada.

On December 4th, 2017, MP Paul Lefebvre announced on behalf of Health Minister Ginette Petitpas Taylor and CIHR-IAPH, a $1.4 million funding investment for improving the health of Indigenous seniors.

This funding will support a project titled “Aging in Place: Promoting Healthy Aging for Indigenous People with Multiple Chronic Conditions”, led by HSNRI’S Dr. Janet McElhaney, Vice President of Research & Scientific Director and Dr. Jennifer Walker, Canada Research Chair of Indigenous Health at Laurentian University. Using Indigenous research methods, the project will explore caregiving experiences and patterns to better understand how communities can support Indigenous families living with multiple chronic conditions.

“The funding from CIHR will provide an opportunity for collaborative community-based research that will identify the needs of Indigenous older persons and develop interventions to address the health issues and barriers to care for older adults. It will allow us to work with communities and find innovative solutions while working to develop the next generation of researchers,” says Dr. Janet McElhaney, HSNRI’s Vice President of Research and Scientific Director.

This project is funded in partnership with First Nation communities in Northern Ontario and Saskatchewan to identify the needs of Indigenous older persons living with multi-morbidity; develop interventions to address health issues and barriers to caring for older adults; and evaluate the effectiveness of community-specific interventions to enhance “holistic health”.

The goal is to create a legacy of sustained partnerships that promote true reconciliation and together cultivate a way forward from colonization and intergenerational trauma to healthier aging.

 

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Health Sciences North 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.