RESEARCH SPOTLIGHT: Hamilton Health Sciences

Hamilton researchers discover a simple blood test could save lives after surgery

Researchers at Hamilton Health Sciences’ Population Health Research Institute (PHRI) and McMaster University have determined that a simple blood test can predict and possibly prevent many of the deaths that occur after surgery.

“If death after surgery within the first 30 days was made its own category of death, it would be in the top 5 leading causes of death within North America,” explained Dr. P.J. Devereaux, principal investigator for the “VISION” study.

The VISION study enrolled nearly 22,000 patients aged 45 years or older from 23 hospitals in 13 countries and found that approximately 18 per cent of them sustained heart damage within 30 days of non-cardiac surgery and that, without enhanced monitoring, the vast majority – as many as 93 per cent – of these complications will go undetected, potentially until it’s too late to intervene.

Putting pressure on the heart

“The effects of surgery anywhere in the body create a perfect milieu for damage to heart tissue, including bleeding, blood clot formation, and long periods of inflammation,” says Dr. Devereaux, scientific leader of perioperative medicine at PHRI, director, division of cardiology at McMaster University. “In most cases, this damage occurs within the first 24 to 36 hours after surgery when patients usually receive narcotic painkillers that can mask symptoms of cardiac distress.”

“These discoveries have the potential to save lives.”

After surgery, study patients had a blood test for a protein called high-sensitivity troponin T, which is released into the bloodstream when injury to the heart occurs. Devereaux and his team discovered that patients with troponin T levels beyond a certain threshold had increased risk of death within 30 days of having surgery.

Overall, the study found that 1.4 per cent of patients died within 30 days following non-cardiac surgery.

“One per cent seems like a small number, until you consider that about 200 million surgeries are performed each year around the world,” says Devereaux. “Where we’re letting patients down is in post-operative management. We now know that we need to become more involved in care and monitoring after surgery to ensure that patients at risk have the best chance for a good recovery. These discoveries have the potential to save lives.”

The results of the VISION study were published in The Journal of the American Medical Association.

 

Related Stories:

Hamilton Health Sciences 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: 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.  

 

Related Stories:

 

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.

 

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.”

 

Related Stories:

 

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.

 

 

 

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.

 

Related Stories:

 

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.”

 

Related Stories:

 

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.

RESEARCH SPOTLIGHT: St. Michael’s Hospital

St. Michael’s scientists get down to business

Up on the 5th floor of the Keenan Research Centre for Biomedical Science, Dr. Richard Gilbert, head of the Division of Endocrinology and Metabolism for St. Michael’s Hospital, and Dr. Darren Yuen, a nephrologist with the hospital, work together on cases where diabetes and kidney disease intersect.

On top of stethoscopes and microscopes, the pair has added business scope to their frequent discussions—with the launch of a company called Fibrocor.

Drs. Gilbert and Yuen are two of the three scientific co-founders of Fibrocor, who will work to identify targets and develop therapies to prevent, slow and ultimately reverse organ scarring.

Read more about how research hospitals are driving Ontario’s knowledge and innovation economy.

“Scarring, or fibrosis, can help people in the short-term—such as healing after a cut or sealing off an infection so that it does not spread—but when an injury is chronic, such as with diabetes, the amount of scar tissue formed can cause organ malfunction,” said Dr. Gilbert, who also holds the Canada Research Chair in Diabetes Complications.

The researchers and fellow co-founder Dr. Jeff Wrana, senior investigator at Sinai Health System’s Lunenfeld-Tanenbaum Research Institute, will test biopsy samples of scarred human tissue. They will measure which genes the body activates when scarring begins.

“Once we know what pathways are involved in activating the body’s scarring response, we’re well on our way to understanding how to block it,” said Dr. Yuen. “And because we’ll identify these pathways using human tissue samples, we think they’ll have a much better chance of being effective in future clinical trials.”

Although scarring underlies the development of liver failure, heart failure and certain type of lung disease, the company’s initial focus will be on kidney disease—reflecting Dr. Gilbert’s and Dr. Yuen’s clinical backgrounds and the tremendous unmet need.

By 2018, Fibrocor expects to have developed a new anti-scarring drug that will be ready for testing, not only in kidney disease but also in other diseases that involve fibrosis, the doctors said. The world-class academic team is complemented by management and business development from MaRS Innovation and drug discovery and development services from Evotec AG, which together launched the company with $2M USD financing.

“Because drug development is incredibly expensive and most granting agencies don’t fund this sort of activity, forming the company was a necessity,” said Dr. Yuen. “With Fibrocor, we’ll be part of the developmental strategy, taking our knowledge from the clinic, to the lab, to the boardroom and, hopefully, all the way back to the bedside.”

Written by Geoff Koehler at St. Michael’s Hospital

 

Related Stories:

 

St. Michael’s Hospital is one of Ontario’s 24 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: Thunder Bay Regional Health Sciences Centre

Photo (L-R): Barry Streib, Secretary/Chair, Governance, Board of Directors, Thunder Bay Regional Health Sciences Foundation; Clint Harris, Vice-Chair, Board of Directors, Thunder Bay Regional Health Research Institute; The Honourable Patty Hajdu, Minister of Employment, Workforce Development and Labour and Member of Parliament for Thunder Bay—Superior North; Jean Bartkowiak, President and CEO, Thunder Bay Regional Health Sciences Centre; CEO, Thunder Bay Regional Health Research Institute

 

Investment in Health Research is Making Thunder Bay Healthier, Wealthier and Smarter

Across the province, communities are moving towards knowledge-based economies, and Ontario’s research hospitals are helping them get there. This fact was recently illustrated in Northern Ontario, with an investment of $1.85 million from the Government of Canada to the Thunder Bay Regional Health Research Institute to advance research, innovation and discovery while creating jobs and diversifying the local economy.

“Our Government is committed to positioning Canada as a global centre for innovation,” said the Honourable Patty Hajdu, Minister of Employment, Workforce Development and Labour, and Member of Parliament for Thunder Bay—Superior North, who made the announcement on behalf of the Honourable Navdeep Bains, Minister of Innovation, Science and Economic Development, and Minister responsible for FedNor.  “We are confident this investment will lead to the health care solutions of tomorrow, while growing the local economy and creating meaningful middle-class employment here in Northern Ontario.”

Traditionally known as a resource-based economy, Thunder Bay and its surrounding community is seeing significant growth and diversification as a result of its health research sector.

Read more about how health research is helping to make Ontario communities wealthier

This new funding is expected to result in the creation of 15 jobs at the Thunder Bay Health Research Institute, along with 10 indirect positions through related research projects within the Health Research Institute, the Northern Ontario School of Medicine and/or Lakehead University.

It will also enable the purchase equipment and implement new technologies in the area of probe development and bio-marker exploration. Specifically, the new research equipment will be used in the discovery of new bio-markers and to evaluate the effectiveness of new treatment protocols utilizing isotopes produced at the Health Research Institute’s Cyclotron.

New jobs and new equipment will also open up new avenues of research that will improve care for the local community while driving the economy. The Health Research Institute is poised to:

  • Enhance the conditions for new research while providing better care at a lower cost and improve diagnostic timelines and accuracy
  • Establish formal partnerships with industry, manufacture and sell medical isotopes, and pursue opportunities for contract research and clinical trials
  • Help to attract new medical talent to Ontario, improve training to next generation scientists, and make Thunder Bay an international demonstration site able to host visiting scientists and health care professionals from around the world.

Simply put, as the research arm of the Thunder Bay Regional Health Sciences Centre, the Health Research Institute is poised to continue making its community, the province and Canada healthier, wealthier, and smarter.

Read the full press release.

 

Related Stories:

 

The Thunder Bay Regional Health Sciences Centre 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: Institut de recherche de l’Hôpital Montfort

(Version française originale ci-dessous)

Under the theme “Body and Mind”, the Institut de recherche de l’Hôpital Montfort (IRHM) takes an integrated approach to physical and mental health. The IRHM’s mission is to improve public health, especially among Francophone communities, by conducting collaborative research programs on the health care and service needs of patients and participants (families, natural helpers, health professionals, administrators, policy planners and decision-makers).

Montfort is currently conducting several research projects, with a special emphasis on health challenges created by the language barrier for Francophone minority community members.

Access to psychiatrists in Ontario’s hospitals: A challenge for Francophone patients

French-speaking Ontarians are three times less likely to have daily contact with psychiatrists in the first three days of admission to mental health facilities in Ontario than their English-speaking counterparts.

This finding is based on a study by Dr. Raymond Tempier (IRHM), El Mostafa Bouattane (Hôpital Montfort) and John P. Hirdes (University of Waterloo), published in the Healthcare Management Forum scientific journal.

The study examined close to 270,000 admission assessments concerning mental health care in Ontario between 2005 and 2013, shows that Francophones face a major language barrier when it comes to obtaining specific and highly specialized mental health care services in Ontario – a language barrier that cannot be explained by regional differences.

The article is available online at the Healthcare Management Forum website.  

Objectivation of language barrier impacts on health care quality and safety for Francophones in minority situations

Access to service, and the quality and safety of health care provided to Francophone minority communities entail major issues. While it seems obvious that a language barrier between a patient and a clinician would affect the quality and safety of health care, few scientific studies have endeavoured to prove this assumption among members of Francophone minority communities.

On March 22 and 23, 2016, the IRHM, in cooperation with the Consortium national de formation en santé, organized a meeting in Ottawa for researchers from different disciplines and professions related to the health of Francophones living in minority situations, as well as experts from the methodology field, especially literacy and communications. The purpose of their working sessions was to discuss how to develop a relevant methodology and research program. Partner patients were also invited to the event to share their experiences as health service users.

The main recommendation put forward by the participants was to continue our exploration of the factors that might influence the level of bilingualism among Franco-Ontarians in medical settings, with the objective of developing a language skills assessment tool for patients and health care professionals in clinical settings.

These are just a few examples of researches taking place at the IRHM to improve access and quality of health care for francophone communities in a minority setting. The IRHM relies on its areas of expertise in

  • information and data on the health of Francophones,
  • health innovation and technologies,
  • training and knowledge transfer,
  • collaborative research approach and
  • clinical research.

In addition, the IRHM will soon launch a research program to improve the care of multimorbidity patients, which will be connected to the development of a clinical centre of excellence in multimorbidity at Hôpital Montfort.

Related Stories:

Hôpital Montfort 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.


RESEARCH SPOTLIGHT: Institut de recherche de l’Hôpital Montfort

Sous le thème « Corps et esprit », l’Institut de recherche de l’Hôpital Montfort (IRHM) vise une approche intégrée de la santé physique et mentale. L’IRHM a pour mission d’améliorer la santé de la population, particulièrement des communautés francophones, en menant des programmes de recherche collaboratifs axés sur les besoins des patients et des participants aux soins et aux services de santé (familles, aidants, professionnels de la santé, administrateurs, planificateurs de politiques et décideurs). Plusieurs projets sont en cours à Montfort concernant les défis de la barrière linguistique sur la santé des francophones vivant en situation minoritaire.

L’accès à des psychiatres dans les hôpitaux ontariens : un défi pour les patients francophones

Un patient franco-ontarien a trois fois moins de chance qu’un patient anglophone d’avoir un contact quotidien avec un psychiatre pendant les trois premiers jours de son admission dans un service psychiatrique en Ontario.

C’est la conclusion d’une étude menée par Dr Raymond Tempier (IRHM), El Mostafa Bouattane (Hôpital Montfort) et John P. Hirdes (Université de Waterloo), publiée dans la revue scientifique Healthcare Management Forum.

L’étude, qui s’est penchée sur près de 270 000 évaluations d’admission pour des soins de santé mentale en Ontario entre 2005 et 2013, démontre qu’il existe pour les Francophones une importante barrière linguistique à l’obtention de services spécifiques et hautement spécialisés en santé mentale en Ontario – une barrière qui ne s’explique pas par des différences régionales.

L’article est disponible en ligne, sur le site de Healthcare Management Forum : http://hmf.sagepub.com/content/28/4/167.full

Objectivation des impacts de la barrière linguistique sur la qualité et la sécurité des soins de santé des francophones vivant en situation minoritaire

Il existe des enjeux importants concernant l’accès aux services, la qualité et la sécurité des soins de santé destinés aux communautés francophones vivant en situation minoritaire. Bien qu’il semble évident qu’une barrière linguistique entre le patient et son clinicien puisse affecter la qualité et la sécurité des soins de santé, peu d’études scientifiques se sont attardées à en faire la démonstration au sein des francophones vivant en situation minoritaire. Le but de la session de travail était de discuter comment on peut développer une méthodologie et un programme de recherche sur cette thématique.

Les 22 et 23 mars 2016, l’IRHM en collaboration avec le Consortium national de formation en santé ont tenu une rencontre à Ottawa regroupant des chercheurs de différentes disciplines et professions dans le domaine de la santé des francophones vivant en situation minoritaire, de même que des experts du domaine de la méthodologie, en particulier en littératie et en communication. De plus, des patients partenaires ont été invités à cet événement afin de partager leur expérience en tant qu’utilisateurs des services de santé.

La principale recommandation des participants a été de poursuivre nos travaux pour identifier les facteurs qui peuvent influencer le niveau de bilinguisme chez les Franco-ontariens dans un contexte médical avec l’objectif de développer un outil d’évaluation des compétences linguistiques du patient et des professionnels de la santé dans un contexte clinique.

Voici quelques exemples de recherches menées par l’IRHM afin d’améliorer l’accès et la qualité des soins de santé aux communautés francophones en situation minoritaire. L’IRHM s’appuie sur ses plateformes d’expertises portant sur :

  • l’information et les données sur la santé des francophones,
  • les innovations et technologies de la santé,
  • la formation et le transfert des connaissances,
  • l’approche de recherche collaborative et
  • la recherche clinique.

De plus, l’IRHM va initier sous peu un programme de recherche pour améliorer la prise en charge des patients avec multi-morbidité en lien avec le développement d’un centre d’excellence clinique en multi-morbidité à l’Hôpital Montfort.

Hôpital Montfort est l’un des 24 hôpitaux de recherche qui contribuent à faire de l’Ontario une province plus saine, plus riche et plus informée. Vous pouvez lire d’autres articles (en anglais) sur la recherche dans notre blogue Healthier, Wealthier, Smarter.

Research Spotlight: The Royal

Similar early risk factors found for sexual and violent non-sexual offenders

Feature Photo: Kelly Babchishin, lead author of the ground-breaking new study

Sex offenders and violent non-sexual offenders’ birth and parent risk factors are more alike than they are different, according to a ground-breaking new study from The Royal’s Institute of Mental Health Research (IMHR) and the Karolinska Institutet (Sweden).

The study, “Parental and Perinatal Risk Factors for Sexual Offending in Men: A Nationwide Case-Control Study,” was recently published in Psychological Medicine, a prestigious and frequently cited scientific journal.

“A breadth of evidence suggests the factors around our birth and the characteristics of our parents are important predictors of a wide range of later life outcomes,” says the paper’s main author, Dr. Kelly Babchishin of The Royal’s IMHR, affiliated with the University of Ottawa. “We found that birth factors and parental characteristics similarly predict both sexual and violent non-sexual offenders.

img_9636
Dr. Kelly Babchishin recently received a prestigious Banting Postdoctoral Fellowship from the Canadian Institutes of Health Research as well as the John Charles Polanyi Prize for young researchers.

Gathering the evidence: collaborating with international partners

Through collaboration with the Karolinska Institutet, this research used Sweden’s detailed national registries giving Babchishin and her five fellow researchers, including Dr. Michael Seto, IMHR’s Director of Forensic Mental Health Research, access to a huge volume of accurate data for this study. The researchers looked at birth factors (such as birth weight and size) and parental factors (such as parents’ age, education level, past history of mental illness, and criminal history) for 13,773 male sexual offenders, 135,953 male violent non-sexual offenders, and a control group of more than 740,000 men.

Ground-breaking findings challenge current theories

“There’s considerable overlap in the factors that increase one’s chance of committing sexual offences or violent non-sexual offences. Surprisingly, we did not find risk factors that were unique to sexual offending in this particular study,” says Babchishin, noting that Canadian and Swedish demographics, crime rates and other indicators are similar enough to expect the results to be applicable in Canada.

“The results were very surprising because most theories, public policies and treatments for sexual offending assume this is a unique form of crime and that unique factors must be involved,” says Seto.

The main predictors of future violent criminality, sexual or otherwise, are having young parents with criminal records, psychiatric issues, or lower education; and indicators of poor maternal health, such as low birth weight.

This means interventions tackling maternal health and parent resources could result in fewer offences of both kinds.

Towards a path for prevention

“The purpose of the research is not to stigmatize, but to know what to focus on when it comes to preventing sexual violence from occurring in the first place,” Babchishin says. “These findings suggest prevention efforts aimed at increasing parental education and helping parents cope with mental health problems, as well as maternal health initiatives, could not only reduce sexual offending, but violent offending as well.”

Babchishin is a joint post-doctoral fellow with IMHR and the Karolinska Institutet in Sweden. Last year, she received a prestigious Banting Postdoctoral Fellowship from the Canadian Institutes of Health Research as well as the John Charles Polanyi Prize for young researchers. The study team included researchers from The Royal’s IMHR, the Karolinska Institutet, and the University of Oxford.

Seto says there are more studies in the works to better understand what causes people to commit sexual offences. “This study is the first of a number of planned collaborations that will look at risk factors for sexual offending, across the lifespan, in order to better understand its causes,” he says.
“We hope the results will make important contributions to how we respond to sexual offending.”

 

Related Stories:

 

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: Women’s College Hospital

Bringing virtual mental healthcare to Ontario

Researchers at the Women’s College Hospital (WCH) Institute for Health System Solutions and Virtual Care are testing virtual mental health care that helps patients learn how to monitor and manage their symptoms and support others with similar problems – all while remaining anonymous. This is the largest comprehensive study of an online mental health service taking place now in Canada.

A new collaboration between the Ontario Telemedicine Network and Ontario hospitals is bringing an online service called the Big White Wall to the province and evaluating its potential as a strategy in mental healthcare. The Big White Wall is a website and app developed in the United Kingdom that allows those experiencing mental health concerns to share their feelings with peers in an anonymous community monitored by trained counsellors. The service also provides articles and courses with tips about improving your mental health.

One in five Canadians experience mental illness each year. Dr. Jennifer Hensel, a psychiatrist and lead scientist on the project says that virtual mental healthcare presents us with an exceptional opportunity to help more people access support, gain knowledge and remove barriers from stigma through greater anonymity. “There are so many people with mental health problems that our system’s capacity to provide enough care to everybody just isn’t there,” says Dr. Hensel.

In fact, the researchers are primarily focusing on recruiting patients who are on wait lists to receive mental health services. The pilot will recruit 1,000 patients aged 16 and up from WCH, Ontario Shores Centre for Mental Health Sciences and Lakeridge Health. Participants will be able to use the Big White Wall service to complement existing care.

Dr. Hensel is an Innovation Fellow at the WCH Institute for Health System Solutions and Virtual Care (WIHV), which investigates new ideas to improve health outcomes, both at the individual and population level, while reducing costs across the entire healthcare system. WIHV will evaluate the results of the pilot when it concludes in June of 2017.

The evaluation will assess whether access to the Big White Wall improves mental health recovery, lowers participants’ anxiety and depression levels, reduces calls to mental health crisis lines and decreases the number of emergency department visits for issues related to mental health.

The researchers hypothesize that the service will help participants to manage their own symptoms through these online resources. Dr. Hensel, who is also a research fellow of Women’s College Research Institute, says that self-management is a promising aspect of virtual care, particularly for the majority of people who seek mental health services for mild to moderate symptoms. “Helping people learn how to self-manage their problems, build their own goals and implement strategies is really important,” she said. She added that self-management is beneficial for maintaining mental health over the long-term, for example, preventing future episodes of depression.

Dr. Hensel says that Big White Wall is just one example of the virtual services that WIHV is testing to see whether it is worthy of being scaled up across the entire healthcare system. The aim of the pilot evaluation is to understand more about the people for whom apps like Big White Wall work and why. This can inform future approaches to online mental health treatment in Ontario.

 

Related Stories:

 

Women’s College 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 or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.