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LONDON, ON – In a newly published study, scientists at Lawson Health Research Institute have adapted PET/MRI technology to accurately image salt within the kidneys of patients with kidney disease.  

“Salt is very difficult to image in an MRI because the signal is much weaker than water,” explains Dr. Christopher McIntyre, Lawson Scientist and Nephrologist at London Health Sciences Centre (LHSC). “We wanted to find a way to look at the fundamental role of the kidney in getting rid of salt and water by using a functional MRI.”

Imaging salt within the kidneys has never been accurately accomplished in patients with kidney disease, but Dr. McIntyre and his team developed new technology and software that was adaptable to a PET/MRI machine at St. Joseph’s Health Care London. The new technology allowed the machine to image salt and water levels within the kidney.

“Salt within the kidneys have only been imaged in pre-clinical models, and low weight, healthy volunteers,” says Dr. McIntyre. “Since the kidney is further away from the MRI coils, and the organ moves when a person breathes, it is definitely very hard to image.”

This was the first study to use MRI to look at salt within the kidneys with a wide range of participant with different body types (10 healthy volunteers), as well as patients with kidney disease (five patients). The research team also imaged patients who had a combination of kidney disease and heart failure, because it is especially important for those patients specifically to be able to release salt and water as part of their treatments.

Currently, clinicians rely on kidney biopsies to measure salt levels, but Dr. McIntyre says that method isn’t as accurate or effective as it could be.

 “The problem is that the biopsies are painful, they have risks, and because it is a small sample of the kidney, we don’t get an accurate perspective of the kidney as a whole,” Dr. McIntyre explains. 

The study, which is published in Radiology has now opened the door to new possibilities when it comes to clinical care for patients with kidney disease.

“Salt is very toxic in patients with kidney failure,” adds Dr. McIntyre. “This will now allow us to diagnose and manage both chronic and acute kidney disease. It is a significant step forward.”

The next steps for the research team will be to compare salt MRI’s to biopsies, while also examining potential new therapy developments. 

“We are hoping we will have a higher degree of certainty moving forward to predict what will happen within the kidneys of these patients, with the possibility of using new targeted and effective treatments in the future,” notes Dr. McIntyre.
 

Neurofeedback, also called ‘brain training,’ consists of exercises where individuals regulate their own brain activity. In a new study from Lawson Health Research Institute and Western University, researchers have found that neurofeedback may be an effective treatment for individuals with post-traumatic stress disorder (PTSD). Published in NeuroImage: Clinical, the clinical trial found that neurofeedback was effective in reducing symptoms of PTSD.   

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“Brain connectivity involves different parts of the brain communicating with each other and helps to regulate states of consciousness, thought, mood and emotion,” explains Dr. Ruth Lanius, scientist at Lawson, professor at Western’s Schulich School of Medicine & Dentistry and psychiatrist at London Health Sciences Centre. “Individuals with PTSD tend to have disrupted patterns of brain connectivity, but our research suggests they can exercise their brains to restore patterns to a healthy balance.” 

Neurofeedback uses a system called a neurofeedback loop in which a person’s brain activity is measured through sensors placed on the scalp and displayed back to them using a computer interface. This allows the individual to complete exercises and visually see the results. 

The trial tested neurofeedback with a total of 72 participants, including 36 participants with PTSD and 36 healthy control participants. Of those with PTSD, 18 were randomized to participate in neurofeedback treatment while the other 18 acted as a comparison group.  

The study found that the severity of PTSD symptoms decreased in participants randomized to receive neurofeedback treatment. After treatment, 61.1 per cent of participants no longer met the definition for PTSD. This remission rate is comparable to gold standard therapies like trauma-focused psychotherapy. 

The research team also used functional magnetic resonance imaging (fMRI) at St. Joseph’s Health Care London to capture brain scans of participants both before and after participation in the trial. They found that individuals with PTSD experienced positive changes in brain connectivity in the salience network and the default mode network following neurofeedback treatment.  

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“The salience network is involved in detecting threat as part of the ‘fight or flight’ response. It is normally hyperactive in individuals with PTSD. Meanwhile, the default mode network is activated during rest and is involved in autobiographical memory. We often see that this network is less active during rest and functionally disrupted among individuals with PTSD,” says Dr. Andrew Nicholson, affiliated scientist at Lawson. “Neurofeedback helped restore the functional connectivity of both networks to healthier levels.” Dr. Nicholson is an assistant professor at McMaster University and was formerly a post-doctoral fellow at Schulich Medicine & Dentistry.  

The study involved weekly sessions of neurofeedback over 20 weeks. Participants were asked to reduce the intensity of the brain’s dominant brain wave – the alpha rhythm. Brain activity was visualized as either a still cartoon or a distorted picture. If the alpha rhythm was successfully reduced, the cartoon started moving or the picture started becoming clearer.  

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“Participants were not instructed on how to reduce the alpha rhythm. Rather, each individual figured out their own way to do so,” notes Dr. Lanius. “For example, individuals reported letting their mind wander, thinking about positive things or concentrating their attention.” 

The team notes the treatment could have a number of clinical implications following further validation. 

“Neurofeedback could offer an accessible and effective treatment option for individuals with PTSD,” says Dr. Lanius. “The treatment is easily scalable for implementation in rural areas and even at home.” 

Read more about neurofeedback and the team's research:

• Leveraging technology to diagnose psychiatric disorders
• Solving the mysteries of PTSD

It was a diagnosis that came as a shock for 28-year-old Mitch Kuska who found out he had Multiple Sclerosis (MS) at the age of 26.  “I went from being a young 26-year-old doing regular things, to having to learn about this disease and everything that goes along with it and how it will affect my life." Kuska, an avid cyclist, says knowing that one day he may not be able to physically do the things he loves has been the hardest part of his MS journey so far.  “The scariest part for sure is the uncertainty, because I don’t know what the future holds for me. Before I could look into the future and feel for the most part that I would be healthy.”

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From his doctors, Kuska learned about a study being conducted with London Health Sciences Centre (LHSC) patients by a group of hospital researchers from Lawson Health Research Institute, the research arm of London’s hospitals. They were examining the use of mindfulness as a possible tool for newly diagnosed relapsing MS (RMS) patients. Mindfulness is a type of meditation that focuses on being intensely aware of senses and feelings in the moment.

“It can be a stressful time for people as they have just been diagnosed with a chronic neurological disease that will last the rest of their life,” says Dr. Sarah Morrow, Neurologist and Associate Scientist at Lawson.

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“We do find that there is an increase in anxiety and depression for people with MS, especially depression. In fact, the rates are three times higher for people with MS compared to other neurological disease.” Dr. Morrow is also the Director of the London MS Clinic at LHSC.

As part of the study, 24 newly diagnosed RMS patients were recruited including Kuska. Participants were split up into two groups, either the treatment group or the control group. The treatment group took part in ten sessions of the Mindfulness Without Borders program.

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“Mindfulness is bringing people into the moment rather than worrying about what could happen in the future or thinking about what happened in the past,” says Dr. Arlene MacDougall, Psychiatrist and Lawson Scientist. “It’s about centering yourself and gaining a sense of control of how you will respond rather than react to what is happening inside or outside of you.” 

The participants were evaluated before the sessions and then six months later to see if there was a difference between the two groups. “Immediately after the sessions when we compared the two groups, those in the mindfulness were reporting better coping skills and less perceived stress, and their symptoms of depression had been reduced,” adds Dr. Morrow.

“During the study treatment, I definitely noticed myself being more mindful of my symptoms. Sensing little changes in my body and little feelings here and there,” explains Kuska. “I was more in tune with myself and I felt this mindfulness tool helped me get into the right mindset to start dealing with MS.”

Following these initial findings published in Multiple Sclerosis and Related Disorders, the London research team plans to examine them in a larger study. They are also working to examine if the use of mindfulness would be helpful for people who are in the more progressive stages of MS.  

 

In June 2016, a public health emergency was declared in London, Ontario when HIV rates amongst injection drug users more than doubled.

What was abnormal about the emergency in London? The outbreak occurred despite London having Canada’s largest per capita sterile needle and syringe distribution program, a strong opiate substitution therapy program and a multidisciplinary HIV clinic. Many locations with outbreaks in HIV among persons who inject drugs implement these interventions to lower rates of transmission, but they already existed in London.

Researchers at Lawson Health Research Institute and Western University recognized there must have been a novel method of HIV transmission and looked to find a solution.

In two new studies published in the Journal of Acquired Immune Deficiency Syndrome (JAIDS), the research team found for the first time that HIV can be transmitted through sharing of equipment used to prepare drugs before injection and that a simple intervention - heating the equipment with a cigarette lighter for 10 seconds – can destroy the HIV virus, preventing the transmission.

From August 2016 to June 2017, the research team interviewed 119 injection drug users to understand their injection behaviours and risk for HIV. They discovered that those who shared equipment used to prepare drugs for injection were 22 times more likely to contract HIV than those who did not, despite not sharing needles or syringes.

The equipment includes a metal ‘cooker’ used to dissolve drugs in water and a filter used to draw the mixture, known as ‘the wash,’ into the syringe. Injection drug users reported reusing the equipment when consuming controlled-release hydromorphone, one of the most commonly injected opioids.

“Controlled-release hydromorphone is expensive and difficult to dissolve. After the first wash, large amounts of the drug remain in the equipment which is then saved, shared or sold for future use,” explains Dr. Sharon Koivu, Associate Scientist at Lawson and Associate Professor at Schulich Medicine & Dentistry. “While people know not to share needles, some use their own needle multiple times allowing for contamination of the equipment.”

The team took their findings back to the research laboratory. They confirmed that, on average, 45 per cent of the drug remains in the equipment after the first wash. They not only confirmed the HIV virus can be transmitted between needles, cookers and filters, but also discovered that controlled-release hydromorphone has properties that promote survival of the virus.

“The slow release properties in the drug can unfortunately stabilize the HIV virus,” says Eric Arts, PhD, Chair of the Department of Microbiology and Immunology at Schulich Medicine & Dentistry. “For the first time, we were able to demonstrate that sharing equipment could lead to the type of HIV outbreak we observed in the community.”

The team discovered that when the cooker is heated with a cigarette lighter for approximately 10 seconds, or until the wash bubbles, the virus is destroyed. They termed the technique ‘cook your wash.’

The team also confirmed that heating the cooker did not impact drug concentration.

“We had to make sure that cooking your wash would not change the amount of drug being drawn into the syringe,” notes Dr. Michael Silverman, Lawson Associate Scientist and Chair/Chief of Infectious Diseases at the Schulich School of Medicine & Dentistry, Western University, London Health Sciences Centre and St. Joseph’s Health Care London. “If too much drug was released, it could lead to overdoses. If any drug was burnt off or lost, the intervention would not be accepted by persons who inject drugs.”

Partnering with local community organizations like the Middlesex-London Health Unit and Regional HIV/AIDS Connection, ‘Cook Your Wash’ was launched as a public health campaign. 

“The ‘Cook Your Wash’ campaign is one of the most exciting things to happen in our community,” says Dr. Koivu. “We learned from persons who inject drugs, took that information to the lab to develop a solution and then brought that solution back to the community in record time.”

Dr. Silverman adds that local rates of new HIV cases fell dramatically after the introduction of the campaign. “It wasn’t the sole reason for the reduction in HIV rates as other interventions were also introduced, but the timing suggests it was part of the solution.”

The team hopes this research can be used to inform understanding and interventions in other centres facing HIV epidemics amongst persons who inject drugs.

“We hope our findings can be used to reduce the incidence of HIV transmissions even further and that, one day, society will be HIV free,” says Dr. Silverman.

The two studies, “Heating Injection Drug Preparation Equipment Used for Opioid Injection May Reduce HIV Transmission Associated with Sharing Equipment” and “Sharing of Injection Drug Preparation Equipment is Associated with HIV Infection: A Cross Sectional Study,” are published in the Journal of Acquired Immune Deficiency Syndrome (JAIDS). 

Dr. Gregor Reid, a world-renowned probiotics researcher at Lawson Health Research Institute, can now add the title of movie consultant to his resume. As part of his Fermented Food for Life (FFFL) project, Dr. Reid created a storyline which was made into a feature film titled The Promised Land by producer Charles Liburd. The film is set in Kenya and features the story of two young soccer players who are bullied by older kids. When their mother begins to produce probiotic yogurt their lives begin to improve.

The movie represents an innovative way to showcase the importance of the FFFL project. As a project of the International Development Research Centre, FFFL aims to empower the local production of probiotic yogurt to reach one million people in Eastern Africa. The project is working to create demand for the production of probiotic yogurt which is proven to help boost energy, increase immunity and prevent diarrhea.

“Through our partnership with Western Heads East and Yoba-For-Life, we are working to set up community kitchens where local women and youth produce probiotic yogurt called Fiti and Yoba,” says Dr. Reid, who is also Director for the Canadian Centre for Human Microbiome and Probiotic Research at Lawson, and Professor at Western’s Schulich School of Medicine & Dentistry. “The Fermented Food for Life project helps to enable this by promoting the importance and demand for the yogurt.”

The film, which cost a total of $45,000 to produce, is set in Kenya and features a realistic portrayal of African life and the challenges people face. The film was directed by Owino Sangiewa and produced by Charles Liburd of No Money No Cry Films. Dr. Reid, an avid soccer fan, drafted the film’s storyboard.

“As you walk the streets of Africa, you see many people wearing different versions of football [soccer] shirts. There is a very good player from Kenya named Wanyama who plays for the Spurs which shows that scouts find players in these countries,” says Dr. Reid. “I got the idea of two kids with a talent for the sport. The story shows the challenges of life in this region. The manner in which the mother starts to make a good living is a true reflection of what is happening in hundreds of communities now making probiotic yogurt.”

“I have been working with African filmmakers for some time and it was a joy to be able to work on The Promised Land to promote Yoba-Fiti in such an innovative way. Combining a health message with training and job creation was an ideal way for a small film company to contribute to the community,” says Charles Liburd, producer with No Money No Cry Films. “Film soaks up human capital, and Africa has an enormous youth unemployment problem. By making this film and inspiring young talent we were able to give employment and create opportunities for a number of people. Another offshoot of the Yoba-Fiti project was that we were able to help the young girl, Sheila, who acted in one of the main roles, get into school by obtaining sponsorship. For me, combining all of these things is filmmaking at its best and truest as an art form.”

The film is available in its entirety on YouTube. Dr. Reid also hosted a London, Ontario premiere at St. Joseph’s Hospital in July 2017. The Africa Institute and Western Heads East will be actively promoting the film as a part of their regular activities. 

 

 

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Dr. Reid (above) hosted a premiere for The Promised Land at St. Joseph's Hospital in July 2017.

A first-of-its-kind study led by Lawson Health Research Institute is receiving $1.2 million in funding from the federal government, delivered through the Veteran Homelessness Program, to better understand homelessness amongst women in Canada who are military Veterans.

“This is an important and yet often invisible problem,” says Dr. Cheryl Forchuk, Lawson Assistant Scientific Director based at St. Joseph’s Health Care London’s Parkwood Institute and the study lead. “This is the first Canadian study to focus exclusively on women Veterans’ experience of homelessness. Gender matters, especially when we’re talking about female Veterans who are homeless. If they’ve experienced sexual trauma or abuse or have children, and the only Veteran housing available is a group setting for men, that will be an issue.”

Dr. Forchuk and her team have begun travelling to cities and towns across Canada to conduct interviews with female Veterans experiencing homelessness or who have previously experienced homelessness. They will gather data such as demographics, history of housing and homelessness, and services accessed. The team will also host focus groups with homeless- and Veteran-serving agency staff. The locations have been selected in partnership with The Royal Canadian Legion and other Veteran-serving groups, focusing on areas with pockets of female Veterans experiencing homelessness. 

“We will also explore the pathways and experiences of homelessness, what barriers are faced, what has been helpful and what future services should focus on,” adds Dr. Forchuk.

“This study is a vital step towards addressing the unique challenges faced by female Veterans experiencing homelessness,” says Peter Fragiskatos, Parliamentary Secretary to the Minister of Housing, Infrastructure and Communities and Member of Parliament for London North Centre on behalf of the Honourable Sean Fraser, Minister of Housing, Infrastructure and Communities. “By investing in research like this, we are making significant progress in understanding and improving the support systems for this population, contributing to the federal government's efforts to end homelessness among Veterans.”

“This significant investment reflects our dedication to addressing the issue of homelessness among female Veterans,” says Arielle Kayabaga, Member of Parliament for London West. “By supporting this pioneering study, we aim to uncover the specific barriers they face and develop targeted solutions that honour their service and ensure they receive the support they deserve.”

The goal of the four-year study is to ensure there is accurate data to inform gender-specific interventions and guidelines for policy, practice and care of female Veterans. Canadian Armed Forces Veterans make up a disproportionate percentage of those experiencing homelessness according to a 2018 report.

“It is clear that the circumstances surrounding this particular subset of our Veteran population are not well enough understood,” says Carolyn Hughes, Director of Veterans Services with The Royal Canadian Legion. “It is our hope that this project will help fill in some of those blanks and at the same time, further enlighten all of us who serve Veterans, so that we may provide even more timely and focused assistance when and where it’s needed most.”

St. Joseph’s Parkwood Institute has an embedded legacy of Veterans’ care, having originally been a Veterans’ hospital and now hosting a Veterans’ inpatient centre, the Operational Stress Injury (OSI) Clinic, as well as the MacDonald Franklin OSI Research and Innovation Centre. The research centre is recognized as Canada’s leader in mental health research dedicated to enhancing the lives and wellbeing of military personnel, Veterans and their families. The directors of the centre are co-investigators on the study.

For more information, please contact:    
Debora (Flaherty) Van Brenk 
Communication Consultant
St. Joseph’s Health Care London
C: 226-577-1429 or 519-318-0657
T: 519-646-6100 ext. 42534
@email

Announced at the 2017 Lawson Impact Awards, Drs. Muriel Brackstone and Gregor Reid were recipients of Lawson’s annual Strategic Research Fund (SRF) competition. Their project, “Re-setting the breast microbiome to lower inflammation and risk of cancer,” will examine whether taking an oral probiotic can reduce inflammation and lower the risk of breast cancer.

One in nine Canadian women will develop breast cancer during her lifetime (Canadian Breast Cancer Foundation). Many cancers are considered to be the result of inflammatory processes. While inflammation has been a focus of research in breast cancer, the role of bacteria has not.

Recently, Drs. Reid and Brackstone were collaborators on a study that was the first to describe the breast microbiome, proving the existence of bacteria in human breast tissue. Led by Dr. Reid and his former PhD student, Dr. Camilla Urbaniak, further research demonstrated that the types of bacteria found in women with breast cancer differ significantly from those found in healthy tissue.

One bacterial species from the cancerous tissue, Escherichia coli (E. coli), is capable of producing low amounts of substances known to cause cancer and induce inflammation, while the bacteria found in healthy tissue, like Lactobacillus, are known to interfere with cancer processes.

“The question is whether we can manipulate this to essentially get rid of more harmful bacteria and replace them with beneficial ones like Lactobacillus,” says Dr. Reid, a Lawson scientist and Director of the Canadian Centre for Human Microbiome and Probiotic Research.

In this new study, Dr. Brackstone and Dr. Reid will join forces to test their theory that taking an oral probiotic lactobacilli will lead to these organisms reaching the breast tissue, displacing harmful bacteria and reducing inflammation.

Drs. Brackstone and Reid will compare bacteria from the breast tissues of women at risk for breast cancer who are taking the probiotic against those at risk who are taking a placebo. They will also compare to the breast tissue of healthy women who are not at risk. The research participants will provide nipple and needle aspirates for their bacteria to be analyzed both at the beginning of the study and after three months of either taking the probiotic or a placebo. The samples will also be tested for inflammatory compounds, levels of heavy metals and pesticides that may influence cancer risk.

“I think this study will shed light into what actually occurs in the milk ducts where most breast cancers originate,” says Dr. Brackstone, a Lawson scientist, surgical oncologist and medical director for the London Breast Care Clinic. “If successful, this project could lead to larger studies and contribute to a new way of approaching breast cancer management.”

Now in its third year, Lawson’s Strategic Research Fund (SRF) supports research projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in Lawson’s 2014-2018 Strategic Plan. This year’s competition once again focused on “inflammation”. Chosen projects received $50,000 over a two-year period.

Learn more about this research project:

 

 

Announced at the 2017 Lawson Impact Awards, Drs. Stewart Gaede and Gerald Wisenberg were recipients of Lawson’s annual Strategic Research Fund (SRF) competition. With their project, “Assessing acute cardiac inflammation after left-sided breast cancer radiotherapy with hybrid PET/MRI,” the Lawson researchers will explore the cardiovascular effects of radiation therapy for left-sided breast cancer.

Radiation therapy is critical to modern breast cancer treatment. It has led to improved survival rates with many patients living long lives following their treatment.

Unfortunately, when delivering radiation therapy, we cannot avoid irradiation around surrounding tissues, including the heart. This is a concern since such irradiation may lead to cardiovascular disease later in life.

Currently, the effects of radiation to the heart can only be detected one or two years afterwards. With the help of their Lawson SRF award, Drs. Gaede and Dr. Wisenberg will use PET/MR imaging to detect earlier effects of radiation and construct new guidelines and treatment strategies for left-sided breast cancer patients.

“We’re seeing more and more breast cancer survivors, but many women with left-sided breast cancer are now developing heart disease later in life,” says Dr. Gerald Wisenberg, Director of Cardiac Imaging Research at Lawson and cardiologist at London Health Sciences Centre (LHSC). “We hope to improve their outcomes through this research.”

Recently, Drs. Gaede and Wisenberg discovered that an increase in cardiac inflammation can be detected as early as one week after radiation using PET/MR imaging. This inflammation may be the cause of cardiovascular disease seen in women 10 to 15 years after treatment.

In the new pilot study, the researchers will follow 15 left-sided breast cancer patients undergoing radiation therapy. They will be imaged one week before as well as one week and one year after radiation therapy with Lawson’s hybrid PET/MRI scanner at St. Joseph’s Hospital in London, Ontario.

Areas of inflammation, changes in blood flow, scar formation and fibrosis will be measured by looking at the differences between images. The data will help in the design of new treatment strategies that can hopefully decrease or eliminate inadvertent heart damage. By doing so, it could help to improve patients’ quality of life.

“The earlier we can detect the effects of radiation for left-sided breast cancer, the earlier we can intervene,” says Dr. Gaede, a Lawson imaging scientist and medical physicist at LHSC’s London Regional Cancer Program. “We hope to learn more about the ways in which radiation is affecting the heart so that we can construct new radiation techniques to better spare the heart.”

Learn more about this research:

Now in its third year, Lawson’s Strategic Research Fund (SRF) supports research projects that will advance science in alignment with Lawson’s strategic research goals, as outlined in Lawson’s 2014-2018 Strategic Plan. This year’s competition once again focused on “inflammation”. Chosen projects received $50,000 over a two-year period.

Amanda McIntyre was presented with the 2018 Leadership Award for Fellows & Students at this year’s Lawson Impact Awards, recognizing her skills as a leader, researcher, clinician and community advocate. McIntyre is a PhD candidate in nursing at Western University and a part of Lawson researcher Dr. Robert Teasell’s team at St. Joseph’s Health Care London’s Parkwood Institute.

McIntyre began her career at Lawson as a research assistant in 2011 and since then has built an impressive academic and research record, while at the same time obtaining a nursing degree from Western University. In addition to her many research obligations, she continues to take regular nursing shifts in the emergency department to build her clinical experience.

“We nominated Amanda because she’s kind of like a renaissance person. She does a lot of things and whatever she does, she does really well,” says Dr. Robert Teasell, medical director of the Stroke Rehabilitation Unit at Parkwood Institute.

McIntyre is involved in a variety of research projects in the field of neurorehabilitation and has been an author on 50 peer-reviewed publications.

She is the project coordinator and an editor of the Spinal Cord Injury Evidence-Based Review (SCIRE), an extensive and comprehensive review of the Spinal Cord Injury (SCI) Rehabilitation literature considered to be the leading research synthesis of SCI rehabilitation anywhere in the world. She also had an active role in the development of the Canadian Best Practice Recommendations for Stroke Care.

McIntyre is a two-time recipient of the Mary Elizabeth Horney Fellowship in Rehabilitation Research, which is funded through St. Joseph’s Health Care Foundation. As part of her fellowship, she is conducting research on the transition of stroke patients from inpatient to outpatient rehabilitation, and back to the community. Her doctoral research will focus on the delivery and access of care in emergency departments and the influence this has on patient outcomes.

 

 

McIntyre has assumed a supervisory and mentorship role in Dr. Teasell’s lab. She has been instrumental to the development of many research assistants, students and volunteers.

She is also currently the graduate students’ representative on the Nursing Research Advisory Committee, and a research practicum mentor for Nurse Practitioner students at Western University, allowing her to act as an advocate for current and future nursing students.

She says, “Winning this award is a huge privilege. It represents not just my successes but our entire team’s success, so I think it’s a win for all of us.”

Lawson scientist Dr. Robert Teasell is considered a global leader in neurorehabilitation research and has been instrumental in transforming clinical care in this area across Canada by ensuring that clinical practices are informed by the best available and up-to-date research evidence. In recognition of his accomplishments, he received the Scientist of the Year Award at the 2018 Lawson Impact Awards event this past spring.

Dr. Teasell leads the Collaboration of Rehabilitation Research Evidence (CORRE) research team at St. Joseph’s Health Care London’s Parkwood Institute. He is also the Medical Director of the Stroke Rehabilitation Unit at Parkwood Institute and has an active outpatient chronic pain practice.

He has led the development of three internationally renowned evidence-based reviews for stroke rehabilitation, brain injury and spinal cord injury, which are regarded as the three most comprehensive research syntheses in neurorehabilitation in the world. Dr. Teasell has advised and helped plan stroke care for all of Ontario’s 14 Local Health Integration Networks (LHINs) and six provincial healthcare systems. This is in addition to the many clinical guidelines and models of care he has helped develop and update.

Dr. Teasell also bridges the gap between research and clinical practice through collaborations between his research and clinical teams. His multidisciplinary Rehabilitation Knowledge to Action Project (REKAP) team received the 2014 Sandra Letton Quality Award for their quality improvement project designed to make Parkwood Institute a leader in stroke rehabilitation by improving care through implementation of best practices.

In addition to his neurorehabilitation research, Dr. Teasell has published extensively on chronic pain with a recent focus on the role of obsessive personality traits in determining chronic pain disability and coping abilities. 

 

Drawing on his clinical and research expertise, Dr. Teasell has supervised many students and has been committed to developing the next generation of medical researchers.

“Dr. Teasell has been successful in a number of areas. Certainly in terms of publications and mentorship of students who have gone on and had very successful careers of their own. Despite a busy clinical schedule, he always makes a point of engaging with his research team every day. His staff and students really appreciate the opportunity to work with him,” says Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Director, Lawson Health Research Institute.

Dr. Teasell has authored 335 peer-reviewed articles, as well as many other collaborative group peer-reviewed articles, book chapters, published abstracts, posters, presentations and monographs. He has also been the editor for 14 special journal editions and is on the editorial boards for Topics in Stroke Rehabilitation, Journal of Rehabilitation, and Pain Research and Management. 

In 2016, he was invited to present the Ramon J. Hnatyshyn Lecture, the leading annual national stroke lecture at the Canadian Stroke Congress in Quebec City. In 2010, he received the Canadian Association of Physical Medicine and Rehabilitation Merit award for his many contributions to the field of physiatry. He was also awarded the Royal College of Physicians and Surgeons of Canada McLaughlin-Gallie Visiting Professor in 2012.  This year he will be awarded the Post-Acute Stroke Award of Excellence from the American Congress of Rehabilitation Medicine and the National Stroke Association in the United States.

“I’ve received a lot of national and international awards but there’s nothing better than being recognized by your peers and particularly your peers in the city where you work. It’s been a nice acknowledgement of not just my work, but also the work by the whole research team and all the people who have supported me over the years,” says Dr. Teasell.

Sarah Best, research manager at Lawson Health Research Institute, was a recipient of this year’s Staff Award of Excellence, presented at the 2018 Lawson Impact Awards. The award was created to honour the contributions of dynamic, hardworking staff members who help advance science at Lawson.

Best is a part of the Cognitive Clinical Research Group at St. Joseph’s Heath Care London’s Parkwood Institute. In addition to managing the research group’s staff and trainees, she has a wide range of responsibilities, including developing strategies for recruitment and retention of clinical trial participants, budgeting, assisting with grant applications, and ensuring the team has the appropriate space, hardware and training to complete their research. 

“Sarah has grown a team of skilled, well-trained staff and her leadership has ultimately resulted in an increase in the volume and complexity of trials we can offer for patients with mild cognitive impairment and Alzheimer’s disease,” says Dr. Michael Borrie, Lawson researcher and medical director of the Cognitive Clinical Research Group. 

 

Best is also the budget officer for the Consortium of Canadian Centres for Clinical Cognitive Research and a member of the platform implementation team for the Canadian Consortium on Neurodegeneration and Aging (CCNA). The CCNA was formed by more than 350 clinicians and researchers throughout Canada to accelerate progress in age-related neurodegenerative disease research. 

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) Study is a CCNA study collecting clinical, neuropsychological, and MRI imaging data as well as blood, saliva, and urine samples from participants to learn about who is at risk of developing dementia, to determine how early dementia can be detected and to find out what tests are most effective at detecting dementia. Best has helped facilitate the study start-up and patient recruitment for the more than 30 sites involved in COMPASS-ND, including Parkwood Institute.

“Working in the field of neurodegeneration is really important right now as we see the numbers of individuals that have cognitive impairment growing exponentially. Currently, we only have symptomatic treatments so we’re really looking to find that breakthrough that will lead to a disease-modifying treatment to better serve patients and actually change the course of their disease,” says Best.

She adds, “I’m really honoured to receive this award, especially knowing the previous recipients and the impact that they've had on the London research community.”

Sheila Fleming, executive assistant to Dr. David Hill, scientific director of Lawson Health Research Institute, was the recipient of a Staff Award of Excellence at the 2018 Lawson Impact Awards event this past spring.

In addition to carrying out her administrative support functions for Dr. Hill – in itself a significant responsibility – Fleming goes above and beyond to provide support in a variety of ways to the entire Lawson administration team and research community.

Just one of the many examples of this is the key role she plays in the planning of Lawson’s annual signature events: London Health Research Day (LHRD), Lawson Impact Awards and Café Scientifiques. 

Fleming has built strong relationships across Lawson and its hospital and academic partners. She often acts as a liaison connecting administrative team members to key senior leaders and researchers, and vice versa, so they are able to do their jobs more effectively.

 

 

“Sheila is the ‘hub’ of Lawson. Almost all of us on the administration team, and I’m sure many members of our research community, view Sheila as their go-to person. She has a wealth of knowledge that has guided many of us,” says Stacey Larizza, Chief Operating Officer, Lawson. “She always considers the needs of scientists, staff and trainees, and she is a passionate advocate for them. She does whatever she can to help ensure they succeed.”

Her relationship-building skills have also strengthened Dr. Hill’s advocacy efforts as Lawson continues to join research institutes across the country campaigning for increased funding, diversity in science and support for young researchers from the Canadian government.

“As a scientist it’s not just doing the research, it’s leading people; it’s really knowing how to run a business. So anyway I can help them jump those hurdles, I’m happy to do that,” says Fleming. “In my view, relationships drive everything and that’s how we get work done. If you’re fair and helpful and collaborative, people will respond in kind and then it’s easy to move things forward.”

Fleming also participates in a number of volunteer initiatives. For example, she is President of the Ingersoll District Nature Club, a group that stewards the 36 acre Lawson Nature Reserve south of Ingersoll; helps lead local advocacy efforts in opposing a proposed mega landfill adjacent to Ingersoll aquifers; and provides administrative support to the Diabetic Pregnancy Study Group, a European not-for-profit organization that fosters research and education in diabetic pregnancy.

Dr. Don Richardson was recognized at the 2019 Lawson Impact Awards for his research and innovation in working with veterans with military-related post-traumatic stress disorder (PTSD).  His study titled, “Predicators of Long-Term Treatment Outcome in Combat and Peacekeeping Veterans with Military-Related PTSD,” was recently published in the Journal of Clinical Psychiatry.

 

 

Throughout Dr. Richardson’s career, he has worked diligently to develop and implement best practice assessment and treatment guidelines for Canadian Armed Forces (CAF) members and veterans. He has developed and maintained two clinical research databases  ̶  a database of self-reported health status, by working with patients at the Operational Stress Injuries (OSI) clinic, and a treatment outcomes database. Through this data, he has demonstrated that military trauma populations are complex and are at greater risk of becoming resistant to treatment than most civilian trauma populations.

“Don is extremely deserving of this award,” says Dr. Cheryl Forchuk, Dr. Richardson’s nominator. “When I think of someone who does a great job of linking together research and clinical practice, Don is always someone who comes to mind.”

The treatment outcomes database gives researchers unparalleled insight into the pharmacologic interventions best suited for CAF members and veterans. With the ability to identify when individual patients are experiencing less-than-optimal outcomes, the research team can adjust their treatment plan accordingly.

Over the past 20 years, Dr. Richardson has published over 40 peer-reviewed manuscripts and book chapters on the assessment and treatment of operational stress injuries, PTSD, major depressive disorder, substance use disorders, and suicidal behaviour. He has elevated awareness for the unique mental health challenges faced by CAF members and veterans who present with operational stress injuries.

In light of Dr. Richardson’s findings, he works to assess the current treatment modalities for PTSD, their utility for treating military populations, as well as complementary therapies that may prove beneficial.

Dr. Richardson’s dedication to military mental health research is evident through his unwavering effort and has attracted the attention of many prominent figures in the field of military and veteran health. In 2017, he was granted the opportunity to build a research and innovation center for advancing military and veteran health research and clinical practice. Through a generous donation from two community peers, Dr. Richardson established and leads the Macdonald/Franklin OSI Research Centre, located at Parkwood Institute.

“It is certainly an honour to receive this award,” says Dr. Richardson. “I wish to thank all of my clients for taking the time to fill out the repeated questionnaires, as well as the research staff who support this program, and who work tirelessly to help our CAF members and veterans.”

A study at Lawson is looking to determine if digital breast tomosynthesis, a type of 3D imaging, is better at detecting breast tissue abnormalities than the 2D mammography regularly used today.

During a conventional digital 2D mammogram, two x-ray images are taken of the breast, one from top-to-bottom and another from side-to-side at an angle. This technology is limited by the overlapping breast tissue that occurs from the required compression of the breast, and breast abnormalities may be hidden.

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(Left) 2D mammogram image of left breast, where no lesion was visible. (Right) 3D tomographic image of the same breast showing a lesion, indicated by arrows.

A tomosynthesis exam is relatively new technology in which the x-ray tube moves in an arc over the compressed breast and captures multiple images from different angles. The images are then reconstructed into a set of 3D images by a computer. By being able to examine the breast at multiple layers of depth, the radiologist is better able to distinguish normal breast tissue from potential abnormalities. It is therefore assumed that tomosynthesis may solve some challenges associated with standard mammography, and could be especially useful for women with dense breast tissue.

In the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), women are randomized to receive screening with standard digital 2D mammography, or digital 2D mammography plus tomosynthesis. Participants will undergo either an annual or biennial screening frequency, depending on their risk factors for breast cancer, for approximately four years. Then participants will undergo long-term follow-up for at least three more years. Researchers hope this study will help radiologists evaluate whether the newer technology of tomosynthesis is indeed a more effective tool for detecting aggressive tumours.

Through the Ontario Breast Screening Program (OBSP), women between the ages of 50 and 75 receive regular notices through the mail, encouraging them to schedule a mammogram for breast cancer screening. Women scheduled for a regular OBSP breast exam at St. Joseph’s Hospital London (St. Joseph’s) receive a letter with the study’s contact information. Eligible participants are enrolled at the time of their scheduled appointment. Participating in the study does not significantly change the overall experience of the breast exam. 

“Our goal is to contribute to the body of evidence around tomosynthesis technology, and ultimately, we hope to improve the outcomes for women diagnosed with breast cancer, meaning, earlier detection,” says Dr. Anat Kornecki, Lawson Scientist and Radiologist at St. Joseph’s.

The TMIST study is being conducted in over 100 centres across Canada, the United States, and Argentina. Approximately 165,000 participants will be recruited.

A beneficial and cost-effective approach to mental health care that supports people as they go from hospital and back into the community is outlined in a new resource and has been recognized internationally by the World Health Organization (WHO). 

 

"The immediate period after discharge from hospital, usually the first month, can be one of the most vulnerable times in the life of someone experiencing a mental illness. It can be when they are most at risk of committing suicide,” explains Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson Health Research Institute. “However, what we’ve seen is that there’s often a gap between when someone says ‘goodbye’ to the hospital inpatient unit and ‘hello’ to the community care provider.” 

During a virtual book launch, a research team from Lawson and several community organizations discussed details of a new publication from Routledge, From Therapeutic Relationships to Transitional Care: A Theoretical and Practical Roadmap, edited by Dr. Forchuk. The book combines theory, research and best practices into a “roadmap” for organizations and others worldwide coordinating services or studying mental health care systems. It includes a practical toolkit for implementing the Transitional Discharge Model (TDM), developed and tested in communities across Ontario.  

 

Purchase your copy of the book HERE and enter promo code SMAO3 at checkout for a 20% discount. 

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How Transitional Discharge  works 

TDM was born from a participatory action project with consumers of mental health services. They identified two factors that were most important to them when they were going from hospital to the community: consistency in therapeutic relationships and a supportive peer friendship.  

It became known as a “safety net of relationships” that would bridge the gap between hospital and community services.  

As a person-centred, evidence-based model, transitional discharge supports a smooth adjustment from hospital to community in two main ways:  

• The inpatient staff continue to care for discharged clients until therapeutic relationships are established with community care providers.  
• A friendship model of support with trained peer support workers who have lived experience of mental illness as they have made the same journey.  

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The Bridge represents the way forward for a person being discharged from the psychiatric unit to the hopes of a better life in the community. There is a personal support (peer support and/or overlapping staff members) on the bridge reaching out a helping hand, but there are also pillars supporting the bridge that represent family members, friends, health care workers and other staff. - Norma Jean Kelly 

Perspective of a TDM client and peer support coach  

Lance Dingman was a TDM client during the early phases of the project. “It makes a big difference when you’re able to get back to living in the community and in your own dwelling. You get to make more of your own decisions and learn about what you want to do. You grow with your experience and the guidance of others who are there to support you.”  

Later becoming a peer support coach, Dingman feels implementing TDM for mental health care is important because people can learn from each other and get healthier in the process. “As a peer support worker, I sit with people and they tell me their story. It takes me back and I know what they are going through – I was where they are. I can share my own story and tell them what I did to get better.”  

Cost-analysis and savings for the system  

Dr. Forchuk’s team analyzed the cost of TDM after being tested in nine hospitals across Ontario, including London Health Sciences Centre and St. Joseph’s Health Care London.  

• On average, the length of stay in hospital was reduced by almost 10 (9.8) days per admission.  
• Each site saved approximately $3.3 million per year.  

“People can return home sooner because a higher level of care and support is in place when they leave hospital. If all hospitals in Ontario with mental health services were able to implement our transitional discharge model, we would save $60 million per year in hospital stay costs alone while providing enhanced mental health care.”  

International implementation  

In Scotland, the parliament has already declared TDM as a best practice after demonstrating a significant reduction in readmission rates. 

The TDM approach is now considered a “good practice” by WHO and was recently the only Canadian example included in its Guidance on community mental health services: Promoting person-centered and rights-based approaches. This set of publications provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities. 

According to Dr. Jeremy Burton, we’re in a golden age of microbiome and probiotics research.

“Thanks to advancements in next-generation sequencing, we’re learning more and more every day about the impacts of the microbiome on the human body,” states Dr. Burton. 

 

Effective September 1, 2020, Dr. Burton has been appointed as Research Chair in Human Microbiome and Probiotics at Lawson Health Research Institute for a five-year term. As part of the Chair’s responsibilities, Dr. Burton will also assume the title of Director for the Canadian Centre for Human Microbiome and Probiotics Research, which is located at Lawson. 

Funded by an endowment through St. Joseph’s Health Care Foundation, the position is responsible for leading Lawson’s Human Microbiome and Probiotics research program. The specialized research chair was established at St. Joseph’s in 2007 as a result of a significant investment by Danone International, in recognition of groundbreaking microbiome research by Dr. Gregor Reid, the inaugural holder of the Chair. 

With extensive experience in both academia and industry, Dr. Burton is a world-renowned scientist specializing in urinary microbiome research. He points to the diversity of microbiome research at Lawson as a strength to be leveraged.

“Our program is conducting a diverse array of microbiota-related research from probiotic studies to fecal transplants to the investigation of drug-microbiome interactions,” explains Dr. Burton. “There’s a lot of interest in conducting microbiome research as it’s become clear how it affects so many human systems. We are also working with a number of other groups across the city – both clinical and basic sciences – to meet their microbiota-related research needs.”

There are two pillars to Dr. Burton’s vision for microbiome and probiotics research at Lawson. The first is advancing translational research that leads to improved patient outcomes, such as new microbial therapies. The second is improving our understanding of the microbiome by studying its function in real-time.

“In most studies, we collect patient samples, put them in the freezer and then analyze them later. We now want to follow people in real-time to get a better understanding of how the microbiome functions inside the human body,” notes Dr. Burton. “We hope to accomplish this by harnessing technologies already available at Lawson. For example, we’ve been collaborating with the Lawson Imaging program to look at bacteria in real-time using the Institute’s imaging technology.”

Dr. Burton is known for forging strong interdisciplinary relationships to enhance knowledge translation, especially within the Division of Urology.

“Dr. Burton has established a robust academic laboratory and strategic partnerships that are advancing the Institute’s scientific mandate. He is a natural leader,” says Dr. David Hill, Lawson Scientific Director. “As Research Chair in Human Microbiome and Probiotics, Dr. Burton will further Lawson’s reputation in the field.”

Dr. Burton will build on a 30-year legacy of microbiome research.

“There’s a long history of microbiome research at Lawson and St. Joseph’s,” he says. “We were lucky to have visionaries like Dr. Gregor Reid – my predecessor in this position – who have helped revolutionize the field.”

For Dr. Burton, this is the next step in an illustrious career with Lawson. He first joined the Institute and Western University’s Schulich School of Medicine & Dentistry as a Postdoctoral Fellow in 2001 after completing his BSc, MSc and PhD at the University of Otago in New Zealand.

“I had a very productive time as a Fellow, publishing something like 15 manuscripts in two years. It was an amazing experience and a time that I really relished.” 

He was then recruited to industry in 2003 where he developed a strong background in clinical trials and global business development.  

“Working in industry helped shape me into the principal investigator that I am today. But there were so many questions about the microbiome that I wanted to answer and I ultimately found myself back in academia.”

Dr. Burton rejoined Lawson as a Scientist in 2011. Prior to his appointment as Lawson Research Chair in Human Microbiome and Probiotics, he held the title of Deputy Director of the Canadian Centre for Human Microbiome and Probiotics Research since 2011 and Miriam Burnett Chair in Urological Sciences since 2013. He is also an Associate Professor in the Departments of Surgery and Microbiology and Immunology at Schulich Medicine & Dentistry. 

“What brought me back to London is the people and the collaborative environment. Researchers cross departmental and divisional borders with ease. As a scientist, I can walk from my lab to a clinic, and clinician-researchers can do the same in reverse. Everyone has a ‘can do’ attitude and they are willing to test big ideas with one another.”

Learn about recent microbiome and probiotics research at Lawson:

• Gut microbiome may influence how cancer patients respond to oral therapies, study suggests
• New urinary microbiome study could be first step in providing personalized care to patients with ureteral stents
• Fecal transplants show promise as treatment for non-alcoholic fatty liver disease
• Café Scientifique: The invisible world inside us
• Using probiotics to protect honey bees against fatal disease
• Could microorganisms in poop help treat the deadliest form of skin cancer?
• Researchers find gut microbiome plays an important role in atherosclerosis
• Probiotics for respiratory tract infections could save Canada nearly $100 million a year

New clinical protocol after general surgery cuts opioid prescribing in half

Recognizing the role that opioid prescribing plays in the national opioid crisis, a team of researchers at Lawson and Western University have developed a new clinical protocol called STOP Narcotics. The protocol includes a combination of patient and health care provider education and an emphasis on non-opioid pain control. The study found that they were able to reduce the overall amount of opioids being prescribed after general surgery by 50 per cent while still adequately treating a patient’s post-operative pain. Read more. 

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Probiotics for respiratory tract infections could save Canada nearly $100 million a year

A recent study suggests the use of probiotics to prevent respiratory tract infections in Canada could result in nearly $100 million per year in savings. There is growing evidence that probiotics can reduce the risk of respiratory tract infections and lower their frequency, as well as reduce the duration of an infection, antibiotic use and absences from work. Replicating a research model used in France, researchers examined the potential clinical and economic impacts in Canada. Read more. 

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Blood test can predict optimal treatment for advanced prostate cancer, study finds

An international collaborative study between Lawson, Memorial Sloan Kettering Cancer Center, the Royal Marsden and Epic Sciences is one of the first to demonstrate that a blood test can predict how patients with advanced prostate cancer will respond to specific treatments, leading to improved survival. The study used a liquid biopsy test that examines circulating tumour cells (CTCs) in blood samples from patients with advanced prostate cancer who are deciding whether to switch from hormone-targeting therapy to chemotherapy. Read more. 

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Machine learning could predict medication response in patients with complex mood disorders

Mood disorders like major depressive disorder (MDD) and bipolar disorder are often complex and hard to diagnose, especially among youth when the illness is just evolving. This can make decisions about medication difficult. In a collaborative study by Lawson, The Mind Research Network and Brainnetome Center, researchers have developed an artificial intelligence (AI) algorithm that analyzes brain scans to better classify illness in patients with a complex mood disorder and help predict their response to medication. Read more. 

 

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Lawson researchers receive $4.4 million to study personalized medicine at LHSC

Personalized medicine is the analysis of a patient’s DNA to predict how they will respond to medications. Led by Dr. Richard Kim, scientist at Lawson and clinical pharmacologist at London Health Sciences Centre (LHSC), researchers at Lawson have received $4.4 million to study an expanded personalized medicine program at LHSC that involves full integration of research into patient care. Read more. 

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Drinking more water does not slow decline of kidney function for patients with kidney disease clinical trial shows

A study published in JAMA (Journal of the American Medical Association) by researchers at Lawson and Western University found that coaching patients with Chronic Kidney Disease to drink more water does not slow down the decline of their kidney function. Read more. 

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Funding for unique strategy to prevent homelessness after hospital discharge

On September 10, the Ministry of Families, Children and Social Development, announced that Lawson will receive $223,572 from the Homelessness Partnering Strategy’s Innovative Solutions to Homelessness funding stream to support the project “No Fixed Address Version 2 Expansion” research project. This research will further refine the No Fixed Address strategy for reaching and supporting patients during the crucial transitional period when they are being discharged from the hospital and re-integrated into the community. Read more. 

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Synthetic surfactant could ease breathing for patients with lung disease and injury

Human lungs are coated with a substance called surfactant which allows us to breathe easily. When lung surfactant is missing or depleted, which can happen with premature birth or lung injury, breathing becomes difficult. In a collaborative study between Lawson and Stanford University, scientists have developed and tested a new synthetic surfactant that could lead to improved treatments for lung disease and injury. Read more. 

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Research team develops clinically-validated 3D printed stethoscope

A team of researchers have developed an open-source, clinically validated template for a 3D printed stethoscope for use in areas of the world with limited access to medical supplies – places where a stethoscope could mean the difference between life and death. Read more. 

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Family environment influences emotional well-being of children with epilepsy

Children with epilepsy have a higher risk of developing emotional and behavioural disorders, including depression, anxiety and poor self-esteem, yet it has been difficult for researchers to pinpoint why this occurs. Researchers at Children’s Health Research Institute, a Lawson program, have found that family environment influences the relationship between clinical characteristics of epilepsy at diagnosis and children’s emotional well-being two years later. Read more. 

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How the brain is folded provides researchers with an accurate marker to predict psychosis in high-risk patients

By using images of the brain to look at how its outer surface is folded on itself, researchers can predict which high-risk patients will develop psychosis with more than 80 per cent accuracy.  Before now, there has been no way to examine young people before they become ill to reliably identify who will develop acute psychosis and who will not. Read more. 

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High-dose radiation can improve survival in cancer patients once thought incurable

Cancer that spreads from an original tumour to other parts of the body is generally considered incurable. In an international study led by Lawson, researchers challenged this idea by showing that high-dose radiation can improve survival in patients with cancer that has spread to five or less sites. The study called SABR-COMET was the first randomized phase II clinical trial of its kind. Read more. 

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As the COVID-19 pandemic has continued for a year and a half, many people from all walks of life are feeling the impacts especially when it comes to their mental health and wellbeing.  

Hospital researchers through Lawson Health Research Institute, along with its hospital partners, have been studying the impacts for some key groups.

 

Health care workers have been at the forefront of the pandemic. These heroes have worked tirelessly through every wave and continue to provide excellent care to their patients and community. Dr. Kamia Honarmand, Critical Care Physician at London Health Sciences Centre (LHSC), remembers the stress that she and her colleagues were feeling, and know that something needed to be done.

“Our team wanted to better understand the impact of the pandemic on the lives of health care workers, both personally and professionally, and understand how they were coping when it came to their mental health,” says Dr. Honarmand who is also an Associate Scientist at Lawson. “There was a lot of reasons to be stressed even before the height of the first wave in our region. There was a lot of anxiety. The hospital wanted to find ways to support health care workers and identify resources that would assist them.”

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Dr. Kamia Honarmand, Critical Care Physcian at LHSC and Lawson Associate Scientist 

Frontline health care workers across the region were invited to take part in an online survey about their experiences during the pandemic. “We looked at both the impacts and the preferred coping strategies, and what supportive strategies they would like to have in the hospital in the future.”

• Read more about the study examining how the pandemic affects Southwestern Ontario's frontline hospital workers
   

The Veterans Care Program located at Parkwood Institute, a part of St. Joseph’s Health Care London, provides complex continuing and long-term care for Canadian war Veterans. Dr. Don Richardson, Director of the MacDonald Franklin OSI Research Centre at Parkwood Institute, has been treating and studying mental health among Veterans for many years. He believed this was a group was likely to be affected by the pandemic in unique ways.

“We know that Veterans in general are at a higher risk for depression, anxiety and PTSD,” explains Dr. Richardson, who is also a Scientist at Lawson. “We also knew the pandemic and forced restrictions would have significant impact on Veterans and their families who would be more isolated than they already are.”

More than 1,100 Veterans and around 250 spouses were recruited for the study, completing an online survey every three months for 18 months.

The study is still ongoing, but Dr. Richardson says the initial data has been telling. “We have been able to analyze some of the preliminary data and what we have found is that almost 50 per cent did not indicate their mental health had worsened during the pandemic but 40 to 50 per cent have had difficulty accessing care.”

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Dr. Don Richardson, Director, Macdonald Franklin OSI Research Centre

The hope is that this study will lead to better preparedness in the future to safeguard the mental health of Veterans and ensure their access to care during a pandemic.

• Read more about the Veterans’ study
   

Many people have felt isolation during the pandemic, but that feeling may have even more of an impact for youth suffering from mood and anxiety disorders.

Dr. Elizabeth Osuch, Director of the First Episode Mood and Anxiety Program (FEMAP) at LHSC says the pandemic-led lockdown forced more than a hundred mental health clients out of in-person services.

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Dr. Elizabeth Osuch, Director of FEMAP and Lawson Scientist

“They lost their resources for mental health services and support as soon as the quarantine was announced,” shares Dr. Osuch, who is also a Scientist at Lawson. “We were concerned that it would be devastating to people – and to some people it was. We wanted to make sure they had an avenue to connect with the program.”

Dr. Osuch and the FEMAP team created an online research platform to find out how patients were doing by having them fill out a symptoms and function questionnaire.

“We have analyzed the first wave so far and it shows that male patients were doing better and female patients were doing worse, which was a surprise. One of the risk factors for not doing well was the loss of their job.”

• Read more about the FEMAP study here
   

The pandemic added an extra layer of stress and worry for women who were having a baby.

“This has been an enormous and pivotal time for everyone in the world,” says Dr. Genevieve Eastabrook, Obstetrician-Gynecologist at LHSC. “The experiences during pregnancy and post-partum for both the birthing person and their baby can have effects later in life for children. For example, their overall cardiovascular and metabolic health, bonding experiences and the risk of mood disorders.”

Dr. Eastabrook, who is also an Associate Scientist at Lawson and Assistant Professor at Western University’s Schulich School of Medicine & Dentistry, is working with a team to examine the effects the pandemic may be having for mothers and their babies. As part of the study, the London research team is using an approach called ‘One Health’ which offers a holistic perspective to explore how various risk factors and social determinants of health interact.

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Dr. Genevieve Eastabrook, OBGYN at LHSC and Lawson Associate Scientist

“The unique aspect is that we have a comparative group to see if there are differences in markers such as risk of depression, perceived stress and social supports,” adds Dr. Eastabrook.

Study participants are asked to complete a 30-minute questionnaire at around 6-12 weeks after their delivery. The research team is still recruiting patients for this study.

• Read more about the mother and baby study

 

From the moment the COVID-19 pandemic was declared in March 2020, our teams at Lawson Health Research Institute have been at the forefront. Researchers at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London immediately began to work towards understanding the new virus in an effort to discover lifesaving health-care solutions.

To date, dozens of research projects have been advanced through Lawson with some receiving international attention as ‘world firsts’.  As we mark the three-year anniversary of COVID-19 being declared a global pandemic by the World Health Organization (WHO), we share with you  COVID-19 research highlighted over the past year.

Study finds acute kidney injury associated with severe COVID-19 leads to high mortality rates

Severe cases of a COVID-19 infection can cause a host of serious complications, including acute kidney injury. In a published study, scientists at Lawson found that acute kidney injury in patients with a severe COVID-19 infection leads to a high mortality rate. 

By accessing data collected through the Ontario Renal Network (ORN), Dr. Peter Blake, Lawson Researcher and Provincial Medical Director at the Ontario Renal Network, and his colleagues examined 271 people at 27 renal programs across the province, including patients at LHSC, who received dialysis for acute kidney injury due to a COVID-19 infection. Read more.

Study shows a decline in Veterans’ mental health throughout the pandemic

In published findings from Lawson, more than half of Canadian Veterans reported a decline in their mental health over the course of the COVID-19 pandemic.
When it comes to mental health conditions, Veterans are an at-risk population, often having higher rates of depression and post-traumatic stress disorder (PTSD). When the COVID-19 pandemic hit, scientists at Lawson wanted to understand its effects on this already at-risk population. 

To examine the potential impacts the research team launched a longitudinal study recruiting Canadian Veterans and spouses of Canadian Veterans. Participants complete online questionnaires every three months, with questions focused on mental health and virtual health care services. Read more.

Virtual care associated with significant environmental and patient cost savings

A study published in JAMA Network Open by researchers at ICES, Lawson and Western University found that virtual care during the COVID-19 pandemic led to a significant reduction in carbon dioxide emissions and patient travel-related expenses, such as gasoline, parking or public transit costs.
Findings show that for more than 10 million patients with at least one appointment during the study period (63 million visits in total), virtual care was associated with estimated savings of:
•    3.2 billion kilometers of patient travel;
•    545 to 658 million kilograms of carbon dioxide (CO2) emissions; and
•    $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit. Read more. 

London researchers discover novel method to diagnose long COVID

Published in Molecular Medicine, researchers at Lawson found that patients with post-COVID-19 condition (long COVID) have unique biomarkers in their blood. The team is now working on developing a first of its kind blood test that could be used to diagnose long COVID. The discovery could also lead to new therapeutics for this condition.

The researchers studied 140 blood samples from participants at LHSC and St. Joseph’s Health Care London, including St. Joseph’s Post-Acute COVID-19 Program. Participants were those with presumed long COVID, hospital inpatients with acute COVID-19 infection and healthy control subjects. Read more.

Researchers are combining new technologies to examine blood proteins in COVID-19 patients

Published in the Journal of Cellular and Molecular Medicine, a team at Lawson discovered unique patterns of blood plasma proteins in critically ill patients that may help develop a more personalized approach to treating severe COVID-19.

Called the plasma proteome, the proteins studied are released by cells that often play an important role in the body’s immune response to viruses. The research team studied how they adapt and change to a COVID-19 infection. Read more.