Patients + Research: Joan Baillie

Meet Joan

Three years ago, Joan Baillie was diagnosed with Mild Cognitive Impairment (a condition that is likely to develop into dementia). She participated in a brain rehabilitation research study at Baycrest Health Sciences led by Rotman Research Institute senior scientist, Dr. Brian Levine, and learned strategies to improve focus and complete everyday tasks through his Goal Management Training intervention. Since her diagnosis, Joan continues to function well and enjoy life.

Joan Baillie Baycrest Research Toronto

Can you tell us a bit about yourself and your health story?

More than 20 years ago, I had a mini stroke (also known as a Transient Ischemic Attack (TIA), a condition when the brain’s blood flow is temporarily blocked) and made a full recovery. After I left my car running with the keys inside for two hours, I visited my family doctor about memory concerns. My doctor diagnosed me with Mild Cognitive Impairment and while researching the condition, I read that it could lead to dementia.

A year after my diagnosis, I saw an advertisement about a research study taking place at Baycrest. They were looking for people who experienced a mini stroke or TIA and could benefit from cognitive rehabilitation. I was accepted into the study which would help doctors learn more about the brain and the cognitive changes that may occur with a stroke or mini strokes. The hope is that this will help doctors learn how to best treat those with cognitive problems. This research helped me better understand my memory problems and handle changes that are taking place in my brain.

Short-term memory loss always remains a concern and I am very aware of the signs of dementia.

Why does health research matter to you?

The more the doctors know, the more they can do for you. It’s important that doctors have more knowledge because we are an aging population that is living longer.

The brain scans taken at the start of the study showed that I might have experienced many mini strokes which potentially led to my memory loss. With Dr. Brian Levine’s Goal Management Training, I learned many strategies to help with focus and memory and these allow me to live my life more productively.

How does health research contribute to a healthier Ontario?

I believe without health research we would still be contracting polio, dying from diabetes and not living our lives fully due to brain limitations. Every advance in medicine is the result of research. If research can help find a reliable treatment for those suffering from dementia and/or Alzheimer’s, or even help everyone live their lives to the fullest, then it is absolutely necessary for this research to take place.

The knowledge that is gained from health research will contribute to the future care and treatment of patients with similar problems. It will help medical professionals look after their patients in more productive and understanding ways. It will ultimately save the government many dollars as they will better understand what is needed to serve people who live with dementia or similar conditions. We are approaching a crisis stage because hospitals, nursing homes and the general public are struggling to accommodate those who are living with these diseases.

How can patients and families support, improve or empower health research?

The public should understand that it research is necessary if there is going to be any improvement in the care of people in the future. People should make themselves available for research in any area for which they are experiencing issues. It takes some of your time, but the results will benefit so many patients with dementia or Alzheimer’s. When I told people I was involved in a research study, they congratulated me for doing something positive. We can all do that by sharing our experiences and encouraging other people to become involved in research projects.

 

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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Bradt at ebradt@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.

HWS Field Trips: Sudbury

Research hospitals play a leading role in making Ontario healthier, wealthier and smarter. To demonstrate the world-class hospital-based research happening across our province, we took a field trip to Sudbury, where researchers at the Health Sciences North Research Institute are improving the health of northerners, growing the economy of Greater Sudbury, and cementing their reputation as an emerging centre of health care research.

This blog post features some of the highlights of our field trip – but we also live tweeted every minute! To take the full live-tweeted tour, scroll through our Storify story here.

STOP 1: Grand opening of the Walford research facility

Greater Sudbury is committed to health research, recognizing its value for the community and the local economy. This fact was underscored as we kicked off our HWS Field Trip at the grand opening of a new research laboratory, an expansion of Health Sciences North Research Institute (HSNRI) current space.

A large crowd of more than 80 people came out to support and celebrate this milestone of Sudbury’s health research enterprise. The diverse audience included Mayor Brian Bigger, local MPs Marc Serre and Paul Lefebvre, local MPPs Glenn Thibeault and France Gelinas, members of the Greater Sudbury Chamber of Commerce, local business representatives, researchers, patients, community members, and local media outlets.

New Walford research site Health Sciences North Research Institute   Dr. Janet McElhaney Health Sciences North Sudbury
At the Health Sciences North Research Institute, “research is patient care”. /// Dr. Janet McElhaney, Scientific Director of HSNRI, leads a tour of the new Walford research facility.

The new Walford site – a repurposed, red-brick elementary school – has been transformed into a modern, state-of-the-art medical research facility for HSNRI. It will provide researchers with an additional 14,000 square feet of research and laboratory space, helping to attract more bright scientific minds to the area.

Health Research Champions in Sudbury at Health Sciences North
Research champions and guest speakers from the Walford site grand opening, (L-R): Dr. Janet McElhaney, Vice President of Research and Scientific Director, HSNRI, Nicole Everest, Board Chair, HSNRI, MP Marc Serré, MP Paul Lefebvre, Karen Michell, former Executive Director, CAHO, Minister of Energy, Glenn Thibeault, Paulette Lalancette, Co-Chair of Northeast Cancer Centre Patient & Family Advisory Committee, Mayor Brian Bigger, City of Greater Sudbury and Greater Sudbury Development Corporation, Dr. Denis Roy, former President and CEO, HSNRI

There were nine guest speakers at the facility’s grand opening, including outgoing CEO of Health Sciences North and HSNRI, Dr. Denis Roy.

“When I arrived here in 2010, I spoke of Sudbury and HSN having the potential to become the ‘Harvard of the North’ when it comes to the academic health sciences,” said Dr. Roy. “It’s already happening. Since the time HSNRI was established five years ago, it’s grown from a team of 36 people to 90. This new facility will help HSNRI to continue attracting world-class talent, who see Sudbury as a viable place to do leading-edge work.”

Vice President of Research and Scientific Director of HSNRI, Dr. Janet McElhaney, also highlighted some of the current research underway, including flu and nicotine vaccines, new models of care for frail seniors, and more. “This is research being done in the north, by northerners, for the people of the north, with world implications,” said Dr. McElhaney.

Dr. Denis Roy remarks on Health Sciences North as Harvard of the North   Paulette Lalancette
Research saves lives. Research makes life better” – Dr. Denis Roy /// “Health research allows patients to dream about the future.” – Paulette Lalancette.

Paulette Lalancette, Patient Advisor and co-chair of Northeast Cancer Centre Patient and Family Advisory Council, also shared her story. Paulette was diagnosed with stage 4 malignant melanoma in 2009, when her son was just four years old. With no further treatment options available to her, she was provided comfort measures. Now eleven years later with her cancer in remission, Paulette has become a strong cancer research champion in Ontario’s north, recognizing its value in bringing hope to families like hers. “Research is monumental and allows me to dream of the future,” said Paulette.

Read Paulette’s blog post about her experience and perspective on the value of research.

STOP 2: Labs at the Ramsey Lake Health Centre

After the Walford Site grand opening, we spent the afternoon meeting scientists and learning about how their research is making a difference for the community.

Viruses, Antimicrobial Resistance and Lessons from Nature

We met Dr. Reza Nokhbeh, who joined the Health Sciences North Research Institute in 2012. Dr. Nokhbeh’s research is focused on developing alternative treatments that use bacteriophages – a type of virus that infects and attacks other bacteria (in Greek, literally, to devour bacteria). Medicine is facing a growing problem of antimicrobial resistance, where bacteria are becoming resistant to antibiotics. On top of that, antibiotics typically act as a blanket treatment rather than a targeted treatment, attacking all of our bacteria, whether it’s good or bad for our immune systems. Dr. Nokhbeh’s big question is, how can we fight harmful bacteria while protecting our good bacteria?


Dr. Reza Nokhbeh (centre) and his members of his research team, Cassandra Norton (left) and Megan Ross (right).

“Nature knows much more than us,” explained Dr. Nokhbeh. “How can we learn from nature to improve care?” His team is working on developing therapies that use the “phage” viruses to target and infect only the harmful bacteria. The team is starting to see success in the treatment of acne and other bacterial infections such as C. difficile.

Real-Time Personalized Medicine for Chemotherapy Management

When Dr. Amadeo Parissenti first began conducting cancer research, he was surprised at the number of patients who were not benefitting from chemotherapy. “Getting treatment right is critical,” explained Dr. Parissenti. “The harsh conditions of chemotherapy can actually train a tumour to become resistant. That means that if the chemo isn’t working, the cancer can actually become harder to treat with other methods.”


Healthier, Wealthier, Smarter: Dr. Amadeo Parissenti (right) used his research evidence to create a smarter intervention for chemotherapy, and is bringing it to market with HSNRI spin-off company, Rna Diagnostics.  

He set out to develop a tool that could determine the effectiveness of chemotherapy for individual patients – in real time. Dr. Parissenti launched a spin-off company to bring his new tool, the Rna Distruption Assay™, to market. This tool provides physicians and patients a real-time evaluation of how patients are responding to chemotherapy. If it’s working, the physician and patient can continue with confidence. If it isn’t, they work together to consider alternate therapies. It’s marrying personalized medicine with chemotherapy management.

“For patients, this means avoiding harmful side effects of chemotherapy that isn’t treating the cancer,” said Dr. Parissenti. “It also means that patients have a new opportunity to improve outcomes earlier on by switching to a more effective treatment.”

The RDA™ tool is undergoing validation testing in a recently launched international clinical trial, involving more than 500 patients with invasive breast cancer, scheduled to receive neoadjuvant chemotherapy, in 40 centers across North America and Europe.

STOP 2: Labs at the Walford Research Facility

Marijuana Research: Generating Evidence for Regulations and Policy 

With marijuana legalization on the horizon in Canada, it is important to understand the potential impact of smoking marijuana, including lung cancer risk – the leading cause of cancer-related death in Canada. Dr. Leslie Sutherland is researching cannabis inhalation to see how it interacts with human lung cells and determine the level of harm.

Dr. Leslie Sutherland, Health Sciences North
Dr. Leslie Sutherland (left) is researching the link between cannabis inhalation and lung cancer, helping to drive evidence-based policy in Canada.

“We are comparing the early changes that occur in lung cells exposed to tobacco versus cannabis,” explained Dr. Sutherland. “Right now, evidence in the literature suggests that those who smoke both cannabis and tobacco are at a higher risk for lung cancer than those who smoke only tobacco. We are trying to identify the molecular changes that drive this correlation.” Depending on the research findings, Dr. Sutherland hopes that her cannabis smoke exposure research will help inform medicinal marijuana prescription guidelines for physicians.

These findings could have a big impact on marijuana policy decisions, and Dr. Sutherland expects to publish the results of her research later in 2017.

Understanding the Interaction of Traditional Medicine and Cancer Treatment

Many cancer patients in Northern Ontario take natural products as part of their effort to fight cancer. Having lived and worked in Sudbury for over 20 years, Dr. Robert Lafrenie’s research on natural or traditional therapies for cancer is informed by his experience working with the members of the Indigenous community.

Dr. Robert Lafranie
Dr. Robert Lafrenie and his team are improving care for the Greater Sudbury community by studying the interactions between traditional medicines and cancer treatments including chemotherapy and radiation therapy.

“A lot of patients are using natural products or traditional medicines to either bolster standard cancer treatments or to minimize the side effects of chemotherapy or radiation therapy,” explained Dr. Lafrenie. “While this can be a benefit, it’s important to understand how those medicines might interaction with standard cancer treatment.”

Dr. Lafrenie’s team is investigating how compounds extracted from various plants used in traditional medicine might help treat cancer without producing unwanted side effects or negatively interact with other cancer therapies. With the findings from his research, Dr. Lafrenie hopes to build a guideline for patients and physicians, showing which natural medicines help or harm when interacting with chemotherapy or radiation therapy.

Research Supporting Regional Needs

At the grand opening of the Walford facility, Mayor Brian Bigger said: “By attracting and retaining top talent in Sudbury, we all benefit from health research discovery and innovation.”

The Sudbury community not only benefits from the research underway at HSNRI, it also informs the questions and supports the discoveries being made by the researchers. HSNRI’s research priorities have been strategically selected based on the health priorities of the region, and include Northern and Indigenous Health, Healthy Aging, Cancer Solutions, Infection and Immunity, and Personalized Medicine. We had the benefit of seeing the progress in these priority areas, and we want to thank our hosts at HSNRI for giving us the opportunity to see, first-hand, that research truly is patient care.

CAHO Field Trip Sudbury Health Sciences North
Research is patient care! Thanks to our hosts at HSNRI. We look forward to seeing how the new Walford research facility will help drive a healthier, wealthier, smarter Ontario.

 

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 to build a healthier, wealthier, smarter Ontario tomorrow. Discover more health research and patient stories by signing up for our monthly newsletter or joining the #onHWS conversation on Twitter.

Read our other HWS Field Trips here.

Patients + Research: Paulette Lalancette

Meet Paulette

As a Respiratory Therapist and Anesthesia Assistant, Paulette has experience with healthcare in Ontario. But her world changed when she was diagnosed with cancer. Now eleven years later with a bright and hopeful future ahead, Paulette has become a health research champion as the co-chair of the Northeast Cancer Centre Patient and Family Advisory Council at Health Sciences North in Sudbury.

Paulette Lalancette shares her struggle with cancer and the value of health research at Health Sciences North

Can you tell us a bit about yourself and your health story?

I worked in the healthcare system every day. I was a Respiratory Therapist and Anesthesia Assistant living in Toronto. While working with a Plastic Surgeon at the hospital, my arm began to bleed out. It was decided that a closer look would be necessary. It was confirmed that I had stage 3c Malignant Melanoma. It wasn’t diagnosed early on because it wasn’t a typical melanoma. It was amelanotic, meaning it was white instead of the typical black spot.

Once it progressed to stage 4, I was sent to Roswell Park Cancer centre in Buffalo, NY for Interleukin (IL-2) therapy. The Oncologist there explained to me that he believed the future of fighting cancer didn’t necessitate finding a cure but finding treatment to help people to live with cancer as a chronic disease. Research was the key. After two rounds of treatment new tumors continued to appear. I was told the treatment wasn’t working. Back in 2009, there were no other treatment options and so the decision was made to provide comfort measures. I was told that there were new therapies in research trials but nothing would likely be available for me in time.

The following months were expected to be difficult, but for inexplicable reasons the tumours receded. By 2012 it was declared that there was no longer evidence of disease. There is no explanation as to why the melanoma disappeared. My Oncologist was not convinced that it is related to the Interleukin treatment but for whatever reasons it has been eleven years and I am still here to tell my story, leading a healthy lifestyle and able to enjoy the experience of my child growing up.

Why does health research matter to you?

Research is important to me because in the end it gives me hope that I will meet my grandchildren one day. My son was four years old when I was diagnosed with cancer and he is now fifteen. I live with the reality that my cancer will likely return one day. I am hopeful for the research advancements that have and will provide new treatment options with fewer side effects as the day comes that I may need them.

How does health research contribute to a healthier Ontario?

I believe health research has a two-fold contribution.

First, it contributes to disease prevention and wellness promotion. Research helps understand what is causing diseases and ill health and what steps can be taken to avoid triggers. In general, people want to engage in activities that will prevent disease. Research provides the necessary evidence-based data to make concrete recommendations to help the population avoid ill health and achieve wellness without having to decipher fact from fiction on their own.

Second, if disease cannot be prevented, health research can help improve outcomes, safety and patient experience. Research allows us to move forward with the proper care based on carefully weighted evidence. Patients can be confident that leading edge health care is being provided across the province because of health research.

How can patients and families support, improve or empower health research?

Adding the patient voice and a face to research can provide a sense of pride to the researcher and to its many supporters. Showing the human face of research gives all involved a motivation to continue the support needed to keep health research moving forward. Researchers do not always have the opportunity to see the monumental impact that some of the smallest advancements make. Also, patients do not always have the opportunity to say thank you to a research team for enhancing their daily lives. Continued health research gives me peace of mind for the future.

 

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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Bradt at ebradt@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.

Research Spotlight: Providence Care Hospital

What does the new Providence Care Hospital (PCH) in Kingston mean for health research in Ontario and the CAHO community?

Providence Care is a proud member of the Council of Academic Hospitals of Ontario, and our new space is an asset to the research community in southeastern Ontario. The PCH design provided dedicated space for health research in a prime location: Kingston is within easy distance of both Ottawa and Toronto, and our hospital itself overlooks local parks and Lake Ontario.

Researchers have open areas suitable for collaboration at PCH and just steps from our in-house Health Sciences Library, which is an academic library accessed by health care providers across the region. In addition, each of the nine inpatient units has space on the unit for researchers and care teams to work together with patients and families.

What is the focus of research at Providence Care?

The top three areas of focus for researchers at Providence Care align with our Mission to enhance the quality of life for the people we serve.  Working hand-in-hand with our health care partners, Providence Care offers programs and services in the areas of ‘Aging, Mental Health and Rehabilitative Care.’ Our research streams are aligned to these themes as well.

From a strategic perspective, our focus areas are also aligned to the Queen’s University Faculty of Health Services, and in particular they are supported by the Division of Geriatric Medicine, Department of Psychiatry and Divisions of Geriatric and Forensic Psychiatry, Department of Physical Medicine and Rehabilitation, and the Schools of Rehabilitation Therapy and Nursing.

When you look at the full spectrum of research, from knowledge generation to translation and exchange, there is quite a lot going on at PCH.

First, with respect to knowledge generation, currently in Psychiatry and its subspecialties at PCH there are 37 active studies totaling $8.2 million. These include:

  • 3 CIHR studies (2.7m) – dementia, CT evaluation, drug efficacy in seniors
  • 6 OBI studies (2.2m) neurodegenerative disease and biomarkers in depression
  • 4 CAN-BIND studies (800K) biomarkers in depression
  • 11 pharma drug evaluation studies (600K)

When it comes to Knowledge Translation and Exchange, the Centre for Studies in Aging & Health at Providence Care focuses on education and training, capacity building, development of partnerships and linkages and the use of online education and information.

The Centre is supported by success in grant applications from agencies such as Health Force Ontario, The Ontario Research Coalition, and Ontario Senior’s Secretariat and the South East Local Health Integration Network.  Important current initiatives include continued involvement as one of three funded sites involved in the provincial Age Friendly Communities initiative and for the Ministry of Corrections, the development and dissemination of materials on Aging for the inmates and institutional care providers, staff and administration.

What’s next for research at Providence Care Hospital?

Looking ahead, since moving into the new hospital, we see health research activities growing in Southeastern Ontario.  This relates to the previously mentioned new space and expanded partnerships. These provide new opportunities for our research supporters to grow and develop on-site and with our acute care academic hospital partners contributing substantially to the development of an Integrated Research Institute comprised of the Queen’s University Faculty of Health Sciences, the Kingston Health Sciences Centre and Providence Care. We also are working hard to attract new researchers into contributing to developments  in care for seniors, people living with mental illness and people living with and/or recovering from illness or injury.  

 

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Providence Care Hospital is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more 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: Wayne Kristoff

I was diagnosed in June 2014 with Type 2 diabetes.  It was bothersome but not unexpected as I had been told by my family doctor that I was borderline diabetic for a while. My father was also Type 2 and my paternal grandmother had what was described as a “sugar problem” in the late 40’s and early 50’s.  From what has been discussed in our family, I believe that it would be called Type 2 today. At the time of my diagnosis, I was told that I would be on medication for the rest of my life.

Fast forward to mid-December 2015 and I was watching the news on CTV London when a story appeared on an upcoming Lawson Health Research Institute trial taking place at St. Joseph’s Health Care London to see if they could put Type 2 diabetes into remission for a period of time. I would do anything to make things better for my children and grandchildren and there was the possibility of managing my diabetes in another way. Also, with my background in education, I knew the value of research into finding better ways to do things.

Wayne Kristoff participated in a clinical trial at Lawson Health Research Institute for Type 2 diabetes remission

In early February 2016, I was asked to meet so that information could be gathered, expectations outlined, and generally discuss if the study was appropriate for me. Some of the expectations were that I would meet with a dietician, I would keep track of my weekly activity and steps, I would work at losing a minimum of 5% of my body weight, and I would follow the regimen to the best of my ability. I was quite eager to join the study so another appointment was established where I would have blood taken, have a check-up and be randomized, which was explained to me as whether I would be part of the control group or part of the test group.

At the next appointment, everything went well. For the next month I would have weekly visits to the clinic with telephone checks part way through the week. From late March until May, I would attend the clinic every two weeks with all the paper work completed such as a 3-day meal diary, food survey of things I ate over a year, steps, daily insulin dosage and blood testing. I have to say that the visits were a pleasure as they turned into both cheerleading and counselling.

When I went for the checkup in May, it was the end of the intensive drug therapy and I was told to start decreasing the dosage of insulin. Blood was taken for another A1C test and I was to receive a call when the results were back. I remember well where I was and what I was doing when I received the call on May 16 to tell me that the test was good and to stop all diabetic medication.

Wayne Kristoff participated in a clinical trial at Lawson Health Research Institute for Type 2 diabetes remission
Wayne shared his story at our Healthier, Wealthier, Smarter London Field Trip

Whatever the outcome in the future, I have had much more time drug-free than I ever expected when I was first diagnosed. At the end of the trial, I am still not taking diabetic medication and my family doctor will continue to monitor my progress. I am now aware that there are several options for me if and when I need to take medications again. I also have to say that my quality of life is greatly improved.  I have so much more energy than I had before the trial. Not feeling well almost constantly puts a damper on things that you want to do. In the course of this trial I have met some great people that I know are there to support me.

Research such as this at our hospitals is so important because it advances treatment options for patients. It gives the public a chance to see where money goes rather than just in some lab out of sight.  It puts every day faces on research.

In summing up, I feel very privileged to be part of this trial. I would encourage anyone who sees a trial that is appropriate for them to become involved.  Would I do it again?  In a heartbeat and I will certainly be looking for other ways to stay involved.

Read more about Wayne Kristoff and the REMIT study at Lawson Health Research Institute

 

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Add Your Voice

Want to add your voice to the Patients + Research blog series? Email or call Elise Bradt at ebradt@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.

Research Spotlight: CAMH

The brain, mental health and therapeutics
A new dietary kit, developed as a result of brain imaging research, reduced the baby blues in women after giving birth

Why is brain research so important in mental illness and addictions?

The story behind a new dietary therapeutic kit shows how a better understanding of the brain can lead to health benefits.

In a CAMH study by Dr. Jeffrey Meyer, published earlier this year, this dietary kit led to a dramatic drop in “baby blues” among women after giving birth. Postpartum blues are common among women, but when severe, substantially increase the risk of clinically diagnosed postpartum depression (PPD). Overall, PPD affects 13 per cent of new mothers and is the most common complication of child-bearing.

As with other forms of depression and mental illness in general, postpartum depression is caused by a combination of factors such as a person’s genetics, environment and experiences. Specific symptoms are due to biological changes in the brain’s complex networks and chemical neurotransmitters.

Brain imaging is one way to help unravel how these networks and chemicals are linked to mental health and illness. Dr. Meyer, a psychiatrist and neuroscientist, has led a number of major studies in this area. Dr. Meyer heads the Neuroimaging Program in Mood & Anxiety, part of the Research Imaging Centre in CAMH’s Campbell Family Mental Health Research Institute.

In an earlier study, Dr. Meyer’s group had shown a surge in the brain protein MAO-A in the early postpartum phase. MAO-A breaks down three brain chemicals that help maintain mood: serotonin, norepinephrine and dopamine. When these chemicals are depleted, it can lead to feelings of sadness. MAO-A levels peak five days after giving birth, the same time when postpartum blues are most pronounced. In another previous study, Dr. Meyer showed that this also resembles brain changes that last for longer periods in clinical depression.

Based on these findings, Dr. Meyer developed a nutritional kit with three supplements carefully selected to compensate for a surge in the brain protein MAO-A.

The kit includes tryptophan and tyrosine, which compensate for the loss of the three mood-regulating chemicals, as well as a blueberry extract with blueberry juice for anti-oxidant effects.  Dr. Meyer’s team had also tested and confirmed that the tryptophan and tyrosine supplements, given in higher amounts than people would normally get in their diet, did not affect the overall concentrations in breast milk.

The current study, administered by research fellow Dr. Yekta Dowlati, included 21 women who received the supplements and a comparison group of 20 mothers who did not. It was an open-label study, meaning the women knew they were receiving nutritional supplements. The supplements were taken over three days, starting on the third day after giving birth.

On day five after giving birth – when the baby blues peak – the women underwent tests to assess the kit’s effect on mood.  The testing included sad mood induction, which measured the ability to be resilient against sad events. The women read and reflected on statements with sentiments that expressed pessimism, dissatisfaction and lethargy, and then listened to a sad piece of classical music. Before and after this test, researchers measured depressive symptoms.

The results were dramatic. Women who were not taking the supplements had a significant increase in depression scores. In contrast, women taking the dietary supplements did not experience any depressed mood. The study was published in the Proceedings of the National Academy of Sciences (PNAS).

“We believe this is the first study to show such a strong, beneficial effect of an intervention in reducing the baby blues at a time when postpartum sadness peaks,” says Dr. Meyer, who holds a Canada Research Chair in the Neurochemistry of Major Depression. “Postpartum blues are common and usually resolves 10 days after giving birth, but when they are intense, the risk of postpartum depression increases four-fold.”

These effects need to be replicated in a larger sample in a randomized, controlled trial. Further study could assess the kit’s ability to reduce both the postpartum blues as well as clinically diagnosed postpartum depression.

While the potential will take time to be fully realized, the kit is an important example of how brain imaging studies have led to a new therapeutic method that has potential to help women after giving birth, and perhaps even prevent PPD.

“Developing successful nutrition-based treatments, based on neurobiology, is rare in psychiatry,” says Dr. Meyer. “We believe our approach also represents a promising new avenue for creating other new dietary supplements for medicinal use.”

 

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CAMH is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more 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.

 

 

 

Health and Community Leaders Talk: Karen Michell

By Karen Michell, outgoing Executive Director of the Council of Academic Hospitals of Ontario (CAHO)

Healthier, Wealthier, Smarter: My Reflections on the Value of CAHO Hospitals

For the past eight years as CAHO’s Executive Director, I’ve had the unique privilege of supporting the shared vision of Ontario’s research hospitals. And every day, I continue to be inspired by the significant value and leadership that they bring to our province by working together as a community.

During my first 30 days at CAHO, Dr. Bob Bell, now Ontario’s Deputy Minister of Health and Long-Term Care, told me that research is about hope. Over my years here, patients like Tina Ceroni, Gail Bellissimo, and Rick King have made that statement real for me by sharing their own stories of how research has given them hope, and frankly, changed their lives. It has been a true highlight of my time at CAHO to meet and learn from them and other patients, caregivers and families, whose stories have made an indelible mark on my understanding of the value of health research: that it is a necessity, not a luxury.

Read more Patients + Research stories

I’ve often said that my favourite part of this job is to meet the health researchers and scientists who transform the lives of our patients. From the first week on the job to the last, I’ve been fortunate to have been invited to spend time in our member hospitals, often taking tours of the world-class research institutes that they run. I never fail to come away with a sense of awe about the curiosity of the scientists, their perseverance, their keen observance of the micro and the macro, their willingness to allow the unexpected to surprise them, and take them on joyful journeys of discovery. I appreciate the policy-makers and funders who support a research environment that nurtures these scientists and provides a rich training ground for the next generation.

Finally, I have been grateful to the CAHO CEOs for being willing to take risks together. We often talk about the understandably risk-averse nature of health care. And yet I’ve found that the CAHO community is motivated to try new things in order to improve the health care system in Ontario and to make the most and best out of the investments that Ontarians have made in us and our hospitals. I saw this with the creation of the Adopting Research to Improve Care (ARTIC) Program to find ways to get the best research evidence to improve care for patients faster, and through CAHO’s willingness to work together as an Innovation Broker to clear the path into market for health care innovators.  I’m looking forward to watching how CAHO’s Innovation Broker role helps to foster a more innovative culture in health care, and encourage innovators to consider Ontario as a destination of choice.

Sharing these reflections helps me to realize anew that research hospitals truly do make Ontario healthier, wealthier and smarter. They do this, not just as part of a smart business plan, but because it is part of their mission and mandate – it is who they are. I’m honoured to have served as the Executive Director of CAHO, and to have had a front-row seat to the excellence and opportunity created for Ontarians by Ontario’s research hospitals.

As I move on from my role at CAHO, I am thrilled to continue supporting this community – and its vision of a Healthier, Wealthier, Smarter Ontario – in my new role as Vice President, Strategy at the Sinai Health System.

 

 

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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.

Research Spotlight: SickKids

A new review at SickKids suggests paediatricians should think twice before routinely testing for respiratory viruses

In 2014, more than 2,000 kids who visited SickKids Emergency Department with respiratory symptoms were given an invasive and uncomfortable nasopharyngeal swab test. This is when a doctor or nurse inserts a long swab into the nostril to the back part of the nose to collect a sample of cells. The swabs are sent to the lab to test for six common respiratory viruses, but the results come back the next day, often after patients have already been discharged from the Emergency Department. With no set process for communicating positive or negative results for this test, the results generally did not impact the child’s care.

With an increased emphasis on ‘choosing wisely’ and reducing unnecessary medical tests and therapies across the medical field, paediatricians at The Hospital for Sick Children (SickKids) say it is not good enough to ‘do’ these tests just because we ‘can’. The team examined the benefits and limitations for this specific type of test and reviewed the scientific evidence as to when it is actually helpful in improving patient care. The review, including their recommendations, is published in the July 3 advance online edition of JAMA Pediatrics.

“Just because a test is available doesn’t mean we should automatically order one.”

Most viral respiratory illnesses can be diagnosed clinically based on the child’s symptoms (for example, runny nose, cough, nasal and chest congestion), but with more sophisticated and sensitive tests available, frontline clinicians frequently order tests to identify the specific offending virus.

“While the number of testing options has grown rapidly, the same attention has not been given to deciding how and when these tests can add value to the care of our patients. Just because the test is available, doesn’t mean we should automatically order one, especially since we know that for the majority of healthy children the result will have no impact on their care,” says Dr. Jeremy Friedman, senior investigator of the review and Associate Paediatrician-in-Chief at SickKids.

The review describes some of the common rationales used to justify respiratory viral testing but found poor evidence to support these rationales. Unsupported rationale includes:

  • to reduce the number of lab blood tests and chest x-rays performed, as well as unnecessary antibiotic use
  • to reduce the length of hospital stay
  • to offer prognostic information on length of the illness, and a confirmed diagnostic label for the physician and the family
  • to reduce health care costs

The team emphasized that there are clinical scenarios where respiratory viral testing can inform treatment decisions and improve overall patient care and therefore should be seriously considered. These examples include children with compromised immune systems, those at risk for influenza-related complications, children admitted to intensive care units, and infants with fever younger than three months old.

Healthier, Wealthier, Smarter results

“We hope this review helps health care providers make better decisions and think twice before ‘checking the box’ for a nasopharyngeal swab on the list of possible investigations,” Dr. Peter Gill, lead author of the review and senior paediatric resident at SickKids.

As part of SickKids Choosing Wisely initiatives, SickKids has reduced nasopharyngeal testing for typical respiratory viruses in the Emergency Department by greater than 80 per cent since 2014.

 

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SickKids is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more 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: Kingston Health Sciences Centre

Kingston Health Sciences researchers tackling health equity issues world-wide

Four Kingston Health Sciences Centre researchers are combining their experience with disadvantaged populations, their relationships with institutions on three continents, and a novel approach to evidence-gathering to tackle health equity issues world-wide.

ARCH, a research collaborative for global health equity, grew out of the diverse yet complementary research interests of Kingston General Health Research Institute and Queen’s University researchers Drs. Heather Aldersey (Rehabilitation Therapy), Susan Bartels (Emergency Medicine), Colleen Davison (Public Health Sciences) and Eva Purkey (Family Medicine).

“Global health isn’t just international,” explains Dr. Davison, “it’s about advantage and disadvantage, and unequal access, and working at the structural and community level on things that can benefit the vulnerable in Canada, and around the world.”

In March, the ARCH group was awarded $449,000 from the Queen Elizabeth II Scholars Program (QES) to establish The Queen Elizabeth Scholars Network for Equity in Maternal and Child Health.

“The most vulnerable mothers and children are rarely prioritized in health research or health policy, especially outside the immediate delivery and neonatal period,” Dr. Purkey says. The network aims to address the inequities in access to health services in low- and middle-income countries, where six million children die before the age of five, and where maternal death rates are still 14 times higher than in developed regions.

To do this, the project will support the research, learning and advocacy skills of 17 PhD, postdoctoral and early career researchers from the University of Kinshasa (Democratic Republic of Congo), Institute of Social work and Social Science (Haiti), the Mongolian National University of Medical Sciences (Ulaanbaatar, Mongolia), and Queen’s University (Kingston). The trainees will take part in international exchanges to conduct research and community outreach aimed at understanding and reducing disparities in maternal and child health.

“We want to develop engaged, ethical and innovative global health researchers who can advocate for these vulnerable populations, and address these real-world issues,” says Dr. Aldersey.

To build their collective experience, the group will also contribute to a common, multi-country study looking at the factors that contribute to maternal and child health inequities. This research has the potential to be boundary-breaking through its use of SenseMaker®, an innovative data-collection tool for mobile phones and tablets.

“It’s an efficient tool that enables us to get a quick picture of people’s experiences and perceptions,” says Bartels, who recently led a team using the tool to study child marriage in Syrian refugee camps across Lebanon. “It allows people to tell their stories without feeling judged or guilty, and then use the tool to interpret their stories for us without the filter of our own biases.” (Using SenseMaker, the researchers captured 1400 stories from Syrian refugees in hard-to-reach places in just eight weeks.)

Algorithms within the tool enable both qualitative and quantitative analysis of these anonymous stories, providing researchers with data patterns and contextual factors to capture common themes and identify inequities, quickly, so that researchers can go back to the communities within weeks or a few months to gain further information and begin to find solutions to these problems.

“QES is just the beginning for ARCH,” say the four researchers. “We’ll be seeking other funding opportunities to continue this kind of research.”

 

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Kingston Health Sciences Centre is one of Ontario’s 23 research hospitals that contribute to a healthier, wealthier, smarter province. Read more 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.

HWS Field Trips: Holland Bloorview Kids Rehabilitation Hospital

Research hospitals play a leading role in making Ontario healthier, wealthier, and smarter. To demonstrate the world-class hospital-based research happening across our province, we took a field trip to Holland Bloorview’s research institute, where researchers are creating a world of possibility for kids and youth with disability and their families.

This blog post highlights only a fraction of the research we learned about on our field trip – but we also live tweeted every minute! To take the full live-tweeted tour, scroll through our Storify story here.

Patient Engaged Research

We kicked off our tour by meeting with Suzanne Jorisch, a family leader on the hospital’s Research Family Engagement Committee (RFEC) who is also a long-time health research champion. Suzanne’s son Wesley first came to Holland Bloorview in 2010 with a brain injury. It wasn’t long before Suzanne and Wesley started getting involved in research projects underway at Holland Bloorview. “They started performing miracles,” said Suzanne, “and their research has given me tremendous hope that my son will have new opportunities for his future.”

Since then, Suzanne has become a strong voice for the value of paediatric research at Holland Bloorview’s research institute – and a champion for partnership with patients, families and caregivers. Together with hospital leaders like Lori Beesley, a family-centred care specialist, she is working to support standards and processes for meaningful family-researcher partnerships.

“Patient engagement isn’t something that can be done off the side of your desk,” said Lori. “We need to embed it into our research culture and process.” In her over 20 years of navigating the Canadian developmental and disability health sector, Lori has fostered numerous partnerships between clients, families, and staff, using the principles of client and family-centred care. She also cared for her son Mitchell who has Fragile X Syndrome. At Holland Bloorview, Lori leads both the Family Leadership Program and RFEC. “The Research Family Engagement Committee is not only leading patient and family engagement in research at Holland Bloorview, but it’s creating best practices for organizations around the world.”

Research Family Engagement Committee Holland Bloorview
 “At Holland Bloorview, they don’t look through you, they look with you,” said Suzanne Jorisch of her experience being involved in research at Holland Bloorview. L-R: Karen Michell, Executive Director, CAHO, Suzanne Jorisch, Family Leader, Lori Beesley, Family-Centred Care Specialist.

STOP 1: PEARL and PROPEL labs

Making therapy fun: Our next stop focused on innovative solutions that improve mobility for kids with disabilities. We met Ajmal Khan and Alexander Hodge, two members of the PEARL (Possibility Engineering and Research lab) team who work with Dr. Elaine Biddiss to develop mixed reality therapy games and interactive play spaces that are accessible to young people of all abilities. Immersive and interactive mixed reality games like Botley’s Bootle Blast help to make reaching rehabilitation therapy goals fun. For example, one game might help to strengthen shoulder mobility, while another might focus on strengthening fine motor skills. And as a bonus, the games can be played at home with friends!

Botley's Bootle Blast at Holland Bloorview
L-R: Ajmal Khan, Research Manager, and Alexander Hodge, Game Developer, introduce Botley’s Bootle Blast, a mixed reality therapy game.

Ontario-grown innovation: Dr. Jan Andrysek and his team at the PROPEL lab (Paediatrics, Rehabilitation, Orthotics, Prosthetics, Engineering, Locomotion) developed and commercialized the All-Terrain Knee (AT-Knee). It’s a low-cost, high-functioning mechanical knee that’s already being sold in 21 countries by social enterprise, LegWorks. Post-doctoral student, Matt Leineweber explained that, compared to standard prosthetics, patients using the AT-Knee expend 40% less energy and have reported a reduced number of falls. The AT-Knee is a great example of how health research helps fuel our innovation economy and improve quality of life for patients in Ontario and beyond.

LegWorks AT-Knee demo at PROPEL lab at Holland Bloorview
L-R: Sam Shi, Masters Student, and Matt Leineweber, Postdoctoral Fellow, demo some of the innovations from the PROPEL lab

 STOP 2: ProFILE lab

Addressing weighty topics: Weight-related issues can be challenging for people to discuss openly with their doctors. It can be uncomfortable and emotional – especially when you’re managing other conditions. For children with disabilities, conversations about nutrition, physical activity and weight are important for maintaining a high quality of life. Interim vice president of research and scientist, Dr. Amy McPherson, and her team at the ProFILE lab (Promoting Fitness and Healthy Lifestyles for Everyone) are looking at how to better approach these tough conversations, so that kids, families and care providers can comfortably discuss how to best manage a healthy lifestyle.

Some evidence-based lessons gathered from the team’s research:

  • Start conversations early and discuss regularly
  • Include the right people in the conversation – kids, families or caregivers, care providers and others who may be relevant
  • Communicate trust and respect with active listening, open questions and a collaborative attitude

 Weight research at Holland BloorviewWeight research at Holland Bloorview 
L-R: Laura Hartman, Postdoctoral Fellow and Christine Provvidenza, Knowledge Translation Specialist, highlight their findings on fostering positive weight-related conversations between kids, families and care providers.

Read more from Dr. McPherson on healthy choices for kids with disabilities in Canadian Living.

STOP 3:  PRISM lab

A philosophy of strengths-based innovation: Researchers at the PRISM (Paediatric Rehabilitation Intelligent Systems Multidisciplinary) lab discover and evaluate innovative technology solutions that help kids with severe disabilities communicate and interact with the world around them. A guiding principle of their research is to let innovation start from a child’s strengths and asking how those strengths can be augmented to give the child a voice.

Fanny Hotze, Paediatric Assistive Technology Specialist, shows us how the Hummer works Alborz Rezazadeh and Rozhin Yousefi demonstrate EEG-based brain-computer interface technology.
L-R: Fanny Hotze, Paediatric Assistive Technology Specialist, shows us how the Hummer works /// PhD students Alborz Rezazadeh and Rozhin Yousefi demonstrate EEG-based brain-computer interface technology. 

The vocal cord vibration switch, also known as the Hummer, is a great example of this principle. It harnesses a non-verbal child’s ability to hum by translating vocal cord vibrations into binary control signals for computer-supported communication.

For other children, researchers are developing brain-computer interfaces that identify and communicate thoughts and intentions. PhD students Alborz Rezazadeh and Rozhin Yousef gave a live demonstration of how one such brain-computer interface can allow child with complex disabilities to interact with the world around them. By focusing his attention on a series of images on the computer screen, he gave commands that turned on lights, fans, music and more.

ScreenPlay Pit Stop!

In general, hospital waiting rooms can be a stressful experience for children and their families. Holland Bloorview has created the ScreenPlay – an interactive waiting room that is proven to reduce waiting room anxiety. Developed by scientist Dr. Elaine Biddiss and the PEARL lab team, ScreenPlay heralds the high-tech waiting room of the future.


Holland Bloorview’s President and CEO, Julia Hanigsberg, shows us how kids can generate, grow and shift colourful images on-screen when they step or wheel across the pressure-sensitive tiles.

STOP 4: Autism Research Centre

Self-managing anxiety: The Autism Research Centre (ARC) conducts research aimed at improving outcomes and quality of life for children with autism spectrum disorders (ASD) and their families. A highly diverse team (its expertise spans neurology, developmental pediatrics, psychology, psychometry, engineering, occupational therapy, speech and language pathology, and nursing) focuses on understanding the biology and symptoms of autism, developing novel interventions and investigating service delivery models.

Now in early commercialization stages, the Anxiety Meter is one such intervention, developed by scientists Drs. Azadeh Kushki and Evdokia Anagnostou. The app is designed to help kids with ASD better manage their anxiety by measuring their heart rate and converting it into a visual representation on a tablet and/or watch through the Anxiety Meter app.

Dr. Kushki and Stephanie Chow, Research Assistant at Holland Bloorview Autism Research Centre
“Kids with autism often don’t realize that they’re anxious,” explains Dr. Azadeh Kushki, scientist at the Autism Research Centre. “By helping them identify their anxiety, we can help them manage it.” (L-R, Dr. Kushki and Stephanie Chow, Research Assistant)

The Holli glasses are another example of cutting-edge innovation. They glasses interact with Google Glass technology to provide prompts and cues during social interaction, like ordering food in a restaurant. It holds the potential to complement traditional therapy and provide coaching over the long term.

Holli Glasses at Holland Bloorview Autism Research CentreHolli Glasses at Holland Bloorview Autism Research Centre
Harnessing Google Glass technology, the wearer sees prompts and responses on a tiny screen in the right corner of the glasses that aim to reduce anxiety and provide coaching during social interactions.

Read more about the Anxiety Meter, Holli and autism research at the Bloorview Research Institute in Today’s Parent.

STOP 5: Evidence to Care

Putting knowledge into practice: Using evidence-informed care is an expectation of all health care professionals in leading academic health sciences centers around the world, but it isn’t always easy to ensure that knowledge translation happens consistently.

The Evidence to Care team at Holland Bloorview, led by Dr. Shauna Kingsnorth, promotes knowledge translation by identifying the best available research evidence and developing strategies to influence care.

“We don’t want to reinvent the wheel,” said Dr. Shauna Kingsnorth, Manager, Evidence to Care. Holland Bloorview
“We don’t want to reinvent the wheel,” said Dr. Shauna Kingsnorth, Manager, Evidence to Care. “We want to package the existing evidence in a way that makes it accessible for clinicians and families.”

Case Study: 1 in 4 children with cerebral palsy experience chronic pain. The Chronic Pain Toolbox, developed by the Evidence to Care team, is an evidence-based best practice product to assist clinicians in their efforts to accurately assess chronic pain in children with disabilities, especially those with cerebral palsy.

At Holland Bloorview, we translate research into real life impact for kids and their families
HWS Field Trippers end their tour inspired by the health research underway at Holland Bloorview’s research institute and the impact it will have on kids and families today and tomorrow; locally and globally.

“At Holland Bloorview, we translate research into real life impact for kids and their families,” said President and CEO, Julia Hanigsberg.

After a morning of meaningful research and imaginative, boundary-pushing innovation, it’s clear that Holland Bloorview is serious about its mission to create a world of possibility. We want to extend our sincere thanks to our hosts at Holland Bloorview’s research institute and Holland Bloorview Kids Rehabilitation Hospital.

 

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 to build a healthier, wealthier, smarter Ontario tomorrow. Discover more health research and patient stories by signing up for our monthly newsletter or joining the #onHWS conversation on Twitter.

Read our other HWS Field Trips here.