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.

Patients + Research: Richard King

Meet Richard

Richard is one of hundreds of patient volunteers who have taken part in respiratory studies over the past 25 years with Dr. Denis O’Donnell, a world renowned researcher in Chronic Obstructive Pulmonary Disease (COPD) at Kingston General Hospital.

 Richard is one of hundreds of patient volunteers who have taken part in respiratory studies over the past 25 years with Dr. Denis O’Donnell, a world renowned researcher in Chronic Obstructive Pulmonary Disease (COPD) at Kingston General Hospital
Rick King at work in the dental lab he has managed for more than 45 years.
Photo: Matthew Manor (Kingston General Hospital)

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

I’m 70 years old and I’ve had lung disorders since I was three. It started as asthma, but now it’s Chronic Obstructive Pulmonary Disorder (COPD), which was diagnosed in 1994. I’ve been under the care of a respirologist since the early 1970s. I’ve gone through different levels of this disease, and it’s gotten worse over time. The problem is, air gets trapped in your lungs and it can’t get out, making it difficult to get new air in.

I’ve been under the care of Dr. Denis O’Donnell at Kingston General Hospital for the past two decades, and I’ve taken part in a number of his studies. He really has revolutionized my life. I’ve been part of a study to try out new inhalers with a new delivery system.

Dr. O’Donnell is a very kind and caring physician, always trying to read behind the lines, trying to find out why things happen. I’ve gone through seven decades of breathing disorders, and now I’m at a point where although I have limitations in my ability to perform physical activities, I still strive to live a normal life. The breathlessness is always with me but I have found that by pushing myself and exercising faithfully (which takes dedication) I can do almost do whatever I want!

Why does health research matter to you?

My belief has always been, we should give back. It’s why I’ve given my time to assist in research. Research matters to me because if there wasn’t research going on, there’d be no drug development, and a lot of people wouldn’t have the quality of life that we have now.

When I was little, many times I’d have to sleep upright in a rocking chair because I couldn’t breathe. Nowadays inhalers give your lungs an opportunity to open up your airways. You’re able to go for a walk or live a relatively normal life. When I see a doctor bending over backwards to find answers to benefit his patients, I recognize that are a lot of positives for us, and it’s our responsibility to help them answer the questions that lead to better treatments and better quality of life.

How does health research contribute to a healthier Ontario?

Research has helped me to have a better quality of life – I’m still going into the dental lab (which I managed for more than 45 years) three days a week as I move toward retirement– but it also helps the lives of all the people in Ontario. And it helps people around the world, so the impact of this Ontario-based research is global.

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

Without the patient volunteers, doctors wouldn’t be able to do the research, so the patient voice is important. The problem is, there’s not a lot of public knowledge about respiratory disease. For example, people with my problem, as long as we’re sitting still, nobody knows we have a problem. But as soon as we become active it’s an issue. You should be able to do all those kinds of things, walking, going up and down stairs, playing football with your grandson… you should be able to enjoy all aspects of life. That’s what the miraculous new drugs are doing for us. So it’s important for patients to give their time to research. It IS our responsibility!

 

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

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.

HWS Field Trips: Kingston

Research hospitals play a leading role in making Ontario healthier, wealthier, and smarter. To demonstrate the world-class research happening across our province, we took a field trip to historic Kingston, home to a highly innovative, interdisciplinary health research community.

We went behind-the-scenes at Kingston General Hospital, Hotel Dieu Hospital, Providence Care, and Queens University, and were delighted to be joined by patients, research teams, hospital CEOs and local politicians MPP Sophie Kiwala and Mayor Bryan Paterson along the way.

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

Continue reading “HWS Field Trips: Kingston”

Health & Community Leaders Talk: Dr. Roger Deeley

End-of-life issues: How does research enhance these conversations?

By Dr. Roger Deeley, Vice President, Health Sciences Research, KGH, and President, KGH Research Institute (KGHRI)

Dr. Roger Deeley

Palliative care and end-of-life issues have been headline news recently. Our aging population and the resulting strain on our health care system are raising questions about how and where we provide care.  The proposed medically assisted dying bill has provoked a national conversation around what’s important to us and how we want to face the end of our lives.

Many of us are living with these issues, caring for ailing or aging family members or friends, or dealing with our own frailties, be they lingering injuries or life-limiting illnesses. The journey can be long, lonely and painful, both for patients and their caregivers.

At the Kingston General Hospital Research Institute, our clinician-scientists have been studying aspects of end-of-life care for over 20 years. Their findings are being translated into vital policies, tools and best practices for guiding how, when, and where we die.

Dr. Daren Heyland, Director of the Clinical Evaluation Research Unit at KGH, has dedicated much of the past two decades to understanding and documenting the quality of care given to the critically ill, and the need for families and medical practitioners to talk about end-of-life care. As Director of the Canadian Researchers at the End of Life Network (CARENET), he has, with others, conducted several studies that have revealed important information about end-of-life-care and our health care system: For example:

  • The CANHELP study surveyed patients and families about aspects of care that were important to them at the end of life, and how satisfied they were with how this care was delivered. Researchers found that the location of care was very important, as was communication, and avoidance of unnecessary treatments such as life support;
  • The ACCEPT study, which looked at how wishes for care were communicated, found that patient preferences for care were reflected in their care charts only 30% of the time; and
  • The DECIDE study, which examined end-of-life discussions from the health professionals’ perspective, found that health professionals felt that patients and families had difficulty understanding and accepting their love one’s prognosis.

Dr. Heyland was also involved in developing a national framework for advance care planning, a process for reflecting on and communicating one’s wishes for care, and he was part of the creation of the national Speak Up campaign for advance care planning (www.advancecareplanning.ca).

Research and Palliative Care

A related and often overlooked topic is palliative care. Inside our hospital, a project to improve palliative care for patients with life-limiting illnesses has led to a unique research study on palliative care that engaged former hospital patients or their family members in both developing the study and conducting interviews with patients and their caregivers on their needs and wishes for care. While results are pending, an important lesson has already been learned: that patients’ perspectives are important, not just as research subjects, but as active participants throughout the research process, including study development.

In tandem with this study, KGH, Providence Care and the South East Community Care Access Centre have received funding from Canadian Foundation for Healthcare Improvements (CFHI) to develop systems and practices to improve access to palliative care.

Nationally, The Canadian Frailty Network, led by KGH critical care physician John Muscedere and headquartered here in Kingston, supports research and knowledge translation leading to better care practices for the frail elderly. For example, a recent study into lifelong medications for chronic conditions showed that elderly patients and their families support stopping non-comfort medications that have no clear benefit to the patient. This is but one of a broad sweep of studies being carried on across more than 200 institutions and organizations across Canada, offering solutions, policies and best practices leading to better quality of care for the frail elderly.

Aging, ailing, and death are uncomfortable topics to contemplate. But thanks to the efforts of our researchers, caregivers and patients, we’re learning new and better ways to respect and protect the well-being of those who are approaching the inevitable. As we all are.

 

Stay tuned on our blog for more Health and Community Leaders Talk posts and share your insights about the value of health research on Twitter with #onHWS. To learn more about why health research matters for Ontario and how you can support it, download the Healthier, Wealthier, Smarter Policy Platform and check out our other blog posts and videos.

RESEARCH SPOTLIGHT: Kingston General Hospital

Smart City + Trailblazing Research = Patient-Centred, Interdisciplinary Discovery

Large urban centres have a distinct advantage in terms of fostering critical mass of scientists working on a shared problem or within a specific discipline. But are there times when smaller is better?

At the Kingston General Hospital Research Institute, knowledge transfer takes a different route.  Kingston’s small size means proximity to everything, offering investigators unprecedented opportunities for interdisciplinary collaborations that provide a completely new perspective on their work.

An integrated, walkable research campus of universities, college and hospitals facilitates unique collaborative centres, cross-disciplinary training, and seamless integration of patient care with leading-edge research.

This activity will only increase with the opening, later this year, of the W.J. Henderson Centre for Patient Oriented Care, a multi-disciplinary hub within Kingston General Hospital. The 24/7 centre will bring together researchers, patients, trainees and treatment teams across the continuum of care, and make it easier for patients to participate in various stages of research.

“It’s much more collaborative here – Canadians have a good collaborative spirit,” says pathologist and clinician scientist Neil Renwick, who was lured to Kingston General Hospital from New York’s Columbia and Rockefeller universities.

“KGH and Queen’s are going to be very competitive because they have the proximity, the clinical expertise, the patient base, the basic science, and the vision – all of the components for exceptional translational research are here,” he says. “The hospital environment enables you to see how your research impacts real life. And I like the fact that I can walk to work.”

Collaborative research at KGH includes:

Human Mobility Research Centre: Seamlessly integrating research and patient care

Offering labs within two hospitals, meeting spaces and even a computer-assisted surgery suite, HMRC creates unique opportunities for clinicians and scientists to collaborate. “All of our research has patient-focused outcomes,” says Tim Bryant, Professor of Mechanical and Materials Engineering, Queen’s University, and co-director of the Centre. “A surgeon can come here right out of surgery with a question, such as how to improve a procedure, and then do the research or work with a scientist who can help them develop a solution,” he says. “With time, that solution may become a regular procedure for patients.”

Research Spotlight Kingston General Hospital, Human Mobility Research Centre

Collaboration and cross-disciplinary teams are the norm. Orthopedic surgeons are leveraging the biomechanical, imaging and computational modelling expertise of Dr. Michael Rainbow, Mechanical and Materials Engineering, Queen’s, to develop better approaches to treatment of wrist, shoulder, ankle and knee problems.

Dr. Daniel Borschneck, a pediatric orthopedic surgeon, and Dr. Davide Bardana, an orthopedic surgeon, are working with Queen’s chemical engineer and Centre co-director Dr. Brian Amsden on strategies for generating replacement tissue such as ligaments to treat joint injuries.

And orthopedic surgeon and shoulder specialist Dr. Ryan Bicknell is collaborating with Queen’s neuroscientist Stephen Scott to test mobility following shoulder replacement surgery using Dr. Scott’s robotic assessment system, KINARM.

KINARM: One tool, many applications

The KINARM is, in fact, a perfect example of how a research tool is being used clinically to investigate a wide range of disease and injury. This transformational technology is the world’s first robotic system for measuring, with exquisite sensitivity and precision, the effects of brain injury on an individual’s ability to perform ordinary movements and tasks. Used at more than 60 research institutions worldwide, this patented system is also in use at all three of Kingston’s hospitals by researchers exploring neurological impairments in diverse fields, including stroke, Amyotrophic Lateral Sclerosis (ALS) and Parkinson’s Disease, and even cardiac arrest, kidney failure, and major surgery.

Research Spotlight Kingston General Hospital, KINARM

Archer Laboratory: At the heart of collaboration

Dr. Stephen Archer and his team of 20 investigators in the Queen’s CardioPulmonary Unit (Q-CPU) are working to ensure a better quality of life for patients with pulmonary arterial hypertension (PAH), the obstruction of lung arteries, which can lead to fatal right heart failure. PAH patients are typically in their working years, and the disease precludes them from most forms of employment, and full participation in their lives.

This international team, in a network of six clinical trial centres across the Americas, will further define the basic mechanisms that underlie PAH, with an aim of identifying and testing possible treatments, and eventually translating these preclinical discoveries for use in patient trials.

This team approach is crucial to success, says Dr. Archer, a Tier 1 Canada Research Chair in Mitochondrial Dynamics and Translational Medicine, and head of Medicine at Queen’s University and Kingston’s hospitals. “Having preclinical basic scientists, physicians, clinical trial specialists and population health scientists collaborating under one roof ensures that Q-CPU makes significant progress towards effective treatment and cure of PAH,” he says. “It is also training clinicians and scientists to play an important role in this area of health research.”

To learn more about health research at Kingston General Hospital, visit: www.kghri.ca

 

Kingston General Hospital 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. To learn more about what’s needed to support Ontario’s health research enterprise, download our Policy Platform.