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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

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

Massive investment by the Workplace Safety and Insurance Board (WSIB) to St. Joseph’s Health Care London is largest-ever grant to transform occupational illness and injury

A “game-changer” investment of $65.75 million to Lawson Research Institute of St. Joseph’s Health Care London will transform the prevention, diagnosis and treatment of workplace injuries and illness for Ontarians.

The Workplace Safety and Insurance Board’s visionary 10-year commitment is the WSIB's largest-ever research injection; the largest non-government health research funding in London history; and the biggest single grant received and stewarded by St. Joseph’s Health Care Foundation.

The investment will launch the Occupational Injury Prevention and Treatment Research Network – a first-in-Canada hub where people, technology and science-backed innovation will help solve the human and health costs of occupational injury and illness across Ontario and around the world.

Landmark work, global leadership

“This is a game-changer, something that will transform how we work together to get ahead of work-related injury, pain and mental illness,” says Lisa Porter, PhD, Vice-President Research at St. Joseph’s and Scientific director of Lawson, the research arm of St. Joseph's.

“This investment will propel us to global leadership in finding solutions to some of the most pervasive issues affecting people in workplaces today,” Porter says.

Occupational injuries and illnesses – including chronic pain, physical disability and mental health conditions – accounted for more than 93,000 claims registered through the WSIB last year, with an average lost work time of 63.2 days.

Occupational injuries and illnesses – including chronic pain, physical disability and mental health conditions – have a significant impact on many people, families and businesses in Ontario. Every year they account for almost 250,000 claims registered through the WSIB, with benefit payments of approx. $2.5 billion.  

“Too many Ontario families experience the human cost of workplace injury,” says Jeffery Lang, President and CEO of the WSIB. “We want fewer injuries to happen, and if they do, to be able to help people with a safe and faster recovery. This research is going to help get us there and with their established expertise, the St. Joseph’s Health Care and Lawson Research Institute team are a natural partner for this important work.”  

 Investment and innovation

The network will innovate long-term solutions to prevent mental and physical injuries, accelerate recovery and ensure sustainable health for Ontario workers.

It will feature state-of-the-art infrastructure and expertise including:  

• A first-in-Canada positron emission tomography/magnetic resonance imagery (PET/MRI) scanner dedicated to research into rapid and accurate diagnosis of mental health conditions including post-traumatic stress and depression
• A cutting-edge Computer-Assisted Rehabilitation Environment (CAREN), a unique, virtual-reality environment that will test and solve workplace injury, rehabilitation and chronic pain in new ways
• Three new endowed research Chairs and teams of scientists solving the most critical research questions plaguing people injured at work, an investment that will ensure long-term consistency and sustainability of the work
• Deploying technology in data science, artificial intelligence (AI) and virtual reality, making the network accessible by centres and workplaces across Canada

Rapid-access research area to design and test assistive devices such as splints and mobility technology  

St. Joseph’s President and CEO Roy Butler says, “We know that discovery-driven, patient-focused research improves lives – that is the focus of our hospital-based research at Lawson, and we’re humbled that the WSIB has entrusted us to expand this vital work to minimize the effects of workplace injury, disease and disability. This significant investment will drive innovation opportunities that will translate into novel new treatments and tools that can be used to battle workplace injury and illness”

“This investment will enable us to leverage the deep expertise St. Joseph’s already has in mental health, chronic pain and rehabilitation, and creates the opportunity to expand our knowledge to support workplace wellness, including for frontline health-care workers,” Butler says.

Butler adds that the network will strengthen existing partnerships and create new collaborations – within St. Joseph’s as well as among a wide range of health professionals, researchers, post-secondary institutions and industry locally, across the province and nationally.  

Butler notes St. Joseph’s already excels in research and treatment for related injuries and illnesses.

That includes: preventing and treating chronic pain through the hospital’s Pain Management Program and the Gray Centre for Mobility and Activity hand and upper limb care and injury prevention through the Roth | McFarlane Hand and Upper Limb Centre; advanced imaging expertise; and mental health solutions for veterans and first responders at the MacDonald-Franklin OSI Research Centre. All are specialty research areas of St. Joseph’s with deep roots in addressing occupational injury and illness.

A partnership of promise

Many groundbreaking research initiatives at St. Joseph’s have been made possible by generous supporters of St. Joseph’s, says Michelle Campbell, President and CEO of St. Joseph’s Health Care Foundation.

Medical research in Canada, including the research done in our hospitals, relies heavily on private funding.  Donors to our foundation, invest in research because they know that innovation leads to better frontline care, and healthier communities,” Campbell says.  

“It’s a partnership of promise, a confident stride toward better outcomes for patients. The WSIB’s gift through St. Joseph’s Health Care Foundation is a whole new level of leadership, and we’re proud to be integral to this transformation in workplace health,” says Campbell.

Earlier this year, the WSIB announced a $20-million gift to Fanshawe College to create a Centre of Excellence in Immersive Technology for Workplace Safety, primarily to help first responders and responders-in-training learn to prevent and treat occupation-related mental health issues such as PTSD, anxiety and depression.

The Network at St. Joseph’s broadens that work to bring research-specific innovation aimed at benefiting the physical and mental wellbeing and safety of workers in all occupations.

The new hub at St. Joseph's will make use of the institution’s vast community and research partnerships throughout London and across Canada, in multiple collaborations across a wide range of health disciplines. 

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.”

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

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. 

Thanks to decades of work by dedicated researchers like London, Ont.-based Dr. Paul Adams, haemochromatosis has become much easier to diagnose, though many people are still unaware of the genetic condition. And while treatment options are effective, they are limited, according to a new review published in The Lancet.

In Canada and the United States, one in 227 people have haemochromatosis, making it more common than cystic fibrosis. However, the U.K. Biobank Project, a large-scale biomedical database and research resource, found that only 12 per cent of people who have the condition actually know they have it.

Dr. Adams, a Scientist at Lawson Health Research Institute and Professor at Western University’s Schulich School of Medicine & Dentistry, explains, “The most common genetic test done in Canada and the U.S. is the best way to make the diagnosis, but you have to think of the condition and the doctor has to know that there is a genetic test available. So those two steps are some of our stumbling blocks.”

In Ontario, testing and diagnosis often comes only after some other issue arises, “One day someone stumbles on the fact that there's a liver abnormality, or the patient is complaining of fatigue and the doctor orders blood tests, thinking blood iron is going to be low,” Dr. Adams explains. “And then it turns out to be very high.” 

Most common in people of Northern European ancestry, haemochromatosis results in excess iron in the body and includes symptoms such as fatigue and arthritis pain, and can lead to serious complications like cirrhosis of the liver, liver cancer and death.

Starting in January 2000, Dr. Adams conducted a multi-year study involving 20,000 London, Ont. residents that helped change how haemochromatosis is diagnosed – moving from testing iron levels to genetic testing. With iron levels affected by alcohol consumption, obesity, inflammation and some types of cancer, the previous measure led to many false positive tests. 

But knowing when genetic testing should be done remains a challenge. The underdiagnosis and lack of awareness also remain an issue when it comes to more serious complications.

“If this is diagnosed early, like as a young adult, then this can be treated and those complications won’t develop,” Dr. Adams says. “If you donate blood, treatment is very similar to that procedure and it's tolerated extremely well in most. People who have a lot of excess iron will have this blood taken once a week until their iron levels come down.” 

He hopes this new publication will lead to better diagnosis and treatment, and sees a future in emerging biological therapies.

Dr. Adams continues to be involved in global research, including work with the U.K. Biobank Project on genomic testing, and is investigating partnerships to develop future gene editing treatment.

People looking for more information about haemochromatosis can reach learn more on the Canadian Haemochromatosis Society’s website.

HealthCareCAN held its third annual Lobby Day “H on the Hill” event on Parliament Hill in Ottawa, on Tuesday, October 30, 2018.

Canada’s hospital CEOs and vice presidents of health research joined HealthCareCAN - the national voice of Canada’s healthcare organizations, community and research hospitals - to meet with MPs, Senators and senior government staff.

Collectively, they issued a call for federal action to unlock the tremendous economic potential of the health and life sciences sector to support better health for Canadians.

Dr. David Hill, Scientific Director for Lawson and Integrated Vice President of Research for London Health Sciences Centre and St. Joseph’s Health Care London, participated in the lobby day. Dr. Hill currently sits on the Board of Directors for HealthCareCAN.

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 “Minister of Crown Indigenous Relations @Carolyn_Bennett, Parliamentary Secretary for Science, Sport, and Accessibility @KateYoungMP, and Dr. David Hill, catching up over lunch at #HontheHill #CDNpoli #CDNhealth”

 

Meeting participants stressed the need for action on HealthCareCAN’s recommendations for the 2019 federal budget, specifically:

• Setting a minimum 25% funding floor for the indirect costs of research under the Research Support Fund;
• Granting eligibility to federal infrastructure funding competitions to healthcare organizations, and;
• Investing in digital health platforms to support care, training, and research in healthcare organizations.

Diverse areas of the health and life sciences sector and key health issues were discussed, including:

• Health and science research, granting councils;
• Hospital infrastructure;
• Health innovation;
• Electronic health technology;
• Opioid crisis response;
• Mental health;
• Aboriginal health; and,
• Home care.

Read Dr. Hill’s recent column in Hospital News on bridging the gap from discovery to patient care.

 

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HealthCareCAN provides high-quality policy research advocacy and leadership development services to our members while championing healthcare system transformation in Canada. Visit www.healthcarecan.ca to learn about our solutions to health and healthcare challenges. Follow us on Twitter: @HealthCareCAN

It’s been another year of transformational research at Lawson Health Research Institute. Our teams have published groundbreaking findings and launched new studies that will have a profound impact on patient care.

The following are 12 highlights of research and innovation from across London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London (St. Joseph’s). From trialing new cancer treatments to advancing understanding of mental health, our research teams have achieved a number of important milestones. 

1. New study suggests blood plasma proteins hold answers to better understanding long COVID

Lawson researchers continued to advance understanding of COVID-19 this past year. In one study, researchers found that unique patterns in blood plasma proteins of patients with suspected long COVID could act as a drug target to improve patient outcomes. Read more.

2. New study finds exercise, cognitive training combo boosts mental sharpness in seniors

A study from Lawson and Western University found that a combination of computerized cognitive training and aerobic-resistance exercises can improve functions like memory, attention, recognition and orientation in older adults with mild cognitive impairment. The results suggest a new way to address declining mental sharpness in older adults. Read more.

3. $7.55 million in funding to take LHSC-developed technology global

Technology to diagnose rare genetic disorders developed by researchers at Lawson and LHSC will be going global thanks to $7.55 million in funding from Genome Canada grant and Illumina Inc. The new artificial intelligence-led technology could allow rare diseases to be diagnosed with a simple blood test. Read more.

4. Fecal transplants show promise in improving melanoma treatment

Fecal microbiota transplants (FMT) from healthy donors are safe and could improve response to immunotherapy in patients with advanced melanoma, according to results from a world-first multi-centre clinical trial led by Lawson researchers. Read more.

5. New study shows technology could play an important role in mental health support

A team of Lawson researchers found that the use of ‘smart home’ technology like touch screen devices, activity trackers, weigh scales and medication dispensers may lead to better outcomes for those living with both mental health and physical disorders. The study found that participants using the technology started logging more exercise, making healthier food choices and not missing medication doses. Read more.

6. Canadian children’s hospital visits for suicidal thoughts, self-poisoning and self-harm up during pandemic, study finds

A national study with Lawson researchers found that during the first two years of the COVID-19 pandemic, adolescent emergency department (ED) visits and hospitalizations for suicidal thoughts, self-harm and self-poisoning increased across Canada, with the greatest increase occurring among adolescent girls. Read more.

7. St. Joseph’s to become Canada’s first centre of excellence in molecular imaging and theranostics

A partnership between Lawson, St. Joseph’s Health Care London and GE HealthCare will create Canada’s first centre of excellence in molecular imaging and theranostics at St. Joseph’s. The centre will focus on using precision diagnostic imaging and targeted therapy to advance personalized treatment of cancer and other diseases. Read more.

8. Researchers investigate a new method of sedation for paediatric patients

Intravenous sedatives are normally used to sedate critically ill children. However, they can contribute to a complication called delirium, which includes symptoms of confusion, disorientation, agitation, excessive drowsiness and poor attention. To improve outcomes, scientists at Children’s Health Research Institute (a program of Lawson), Sunnybrook Research Institute and The Hospital for Sick Children (SickKids) are collaborating on a pilot study to understand whether inhaled sedation could be a better alternative to keep critically ill children sedated and comfortable. Read more.

9. New robotic 3D ultrasound may improve accuracy of liver cancer ablation therapy

A technique that turns a normal ultrasound into a 3D image is showing promise in making thermal ablation for liver cancer treatment more accurate in a study from Lawson and Western University. Thermal ablation – using heat to destroy a cancerous tumour – can have fewer complications and a shorter recovery time than surgery. Read more.

10. Assessing neurofeedback in stroke survivors

Functional near-infrared spectroscopy (fNIRS) is used to detect changes in brain oxygen levels using light, but more recently it has also been used to develop brain-computer interfaces – allowing patients with brain injuries to control a device with their thoughts. Researchers at Lawson launched a new study to assess whether fNIRS can be used to improve patient outcomes during stroke rehabilitation. Read more.

11. Specific type of inflammation may be linked to risk of colorectal cancer

A preclinical study found that a specific type of inflammation may be linked to an increased risk of colorectal cancer. Previously, the degree of inflammation caused by illnesses like colitis, Crohn’s disease and other forms of inflammatory bowel disease were shown to be an important indicator of the development of colorectal cancer. However, this new study found the type of inflammation, rather than the severity and duration, may be more important in determining cancer risk. Read more.

12. New study examining if probiotics can improve outcomes in knee replacement surgeries

Lawson researchers launched a study to assess whether daily probiotics can improve outcomes in patients undergoing a total knee replacement surgery. Of the more than 70,000 knee replacement surgeries in Canada each year, nearly 10 per cent of patients experience complications. With patients who are considered healthy likely to have better outcomes, the research team is interested in improving the gut microbiome as a way to support patients’ overall health. Read more.

 

Multiple studies are reporting the pandemic’s impact on the mental health of Canadians, but what effect is it having on our nation’s Veterans and their spouses? 

“With concerns about COVID-19 infection and drastic changes to everyday life, the pandemic is taking a toll on the health of Canadians,” explains Dr. Don Richardson, Associate Scientist at Lawson Health Research Institute and Director of the MacDonald Franklin Operational Stress Injury (OSI) Research Centre, located at St. Joseph's Health Care London's Parkwood Institute. “And it may be particularly distressing for those vulnerable to mental illness.”

Population studies show that Veterans are at double the risk of mental illness when compared to the rest of the population. They experience higher rates of depression, anxiety and loneliness. Spouses of Canadian Veterans are also at higher risk of distress, as they may sometimes undertake significant caregiving responsibilities that that require significant emotional and time investments.  

“It’s currently unknown how the pandemic will impact Veterans and their spouses, but it could result in particularly serious outcomes,” says Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre. 

In a new project from Lawson and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), researchers will seek answers to these questions by partnering with up to 1,000 Canadian Veterans and 250 spouses of Canadian Veterans. Through online surveys, the project will hear directly from Veterans and their spouses to assess the pandemic’s effects on their well-being over time. The team hopes results can be used by health care workers and policy-makers to support Veterans and their families during both the current pandemic and future public health emergencies. 

“We want to hear from all Canadian Veterans and their spouses, whether they’re doing well or not and whether they’re seeking care or not,” explains Dr. Nazarov. 

Participants will complete online surveys, available in both English and French, once every three months for a total of 18 months. They will be asked questions about their psychological, social, family-related and physical well-being, and any relevant changes to their lifestyle and health care treatment. 

“Veterans who regularly access health care services could encounter significant changes, including a move to virtual care appointments. This could lead to increased caregiving responsibilities for spouses,” says Dr. Nazarov. “Given the uncertainty surrounding the pandemic, these changes may persist well into the future, mandating a thorough assessment of patient satisfaction and treatment outcomes.”

The team hopes results can be used to support the wellness of Veterans and their families during public health emergencies. This includes providing health care professionals and policy-makers with information to guide emergency preparedness policies and health care delivery models. They hope results can also be used to recognize early signs of distress in order to target with early interventions.

“We are seeking to understand the impact of COVID-19 on Veterans and their families to identify if this global pandemic is leading to psychological distress or triggering historical traumas,” says Dr. Patrick Smith, CEO of the Centre of Excellence on PTSD. “The Centre’s primary goal is to increase Canadian expertise related to military and Veteran mental health, suicide prevention and substance use disorders. This study can help us understand if the pandemic is having debilitating and life-altering effects, and help us address a potential mental health crisis.”  

Dr. Gregor Reid, a scientist at Lawson Health Research Institute, and his Western University PhD student, Camilla Urbaniak, have previously shown that live bacteria are present in the breast tissues of healthy women. This proves the existence of a breast tissue microbiome. In past studies, Reid and Urbaniak have also proven that human milk contains beneficial bacteria. “Since breastfeeding decreases a woman’s risk for breast cancer, we wondered if beneficial bacteria, like those found in human milk, may be playing a role in lowering the risk of cancer and whether other types of bacteria could be influencing cancer formation,” said Dr. Reid.

To explore these questions, Urbaniak obtained breast tissue samples from 58 women who had either benign or cancerous tumours. In addition, she obtained 23 samples from healthy women undergoing breast reductions or enhancements. Through an analysis of these tissues, Urbaniak found that the bacteria present in the breasts of healthy women differ from those found in the breasts of women with breast cancer. 

Women with breast cancer had elevated levels of both Escherichia coli (E. coli) and Staphylococcus epidermidis. A NASA study has confirmed the London research findings and further identified bacteria associated with breast cancer. Urbaniak and Reid went even further by showing that these bacteria can cause significant damage, known as double-stranded breaks, to DNA. When this occurs, the body tries to repair the damage. However, these repairs often result in errors which can lead to the development of cancer.

Tissues taken from the breasts of healthy women showed high levels of Lactobacillus and Streptococcus, known to promote health and display characteristics that can prevent cancer. For example, Streptococcus produces antioxidants that can help prevent DNA damage.

“This study provides clear evidence that the breast tissue microbiome differs between healthy women and those with breast cancer,” said Dr. Reid. “Our colleagues in Spain have recently shown that probiotics with lactobacilli can be ingested by women and reach the mammary gland. This raises the questions of whether women, especially those at risk for breast cancer, should take probiotics to increase the proportion of beneficial bacteria in the breast.”

In addition to prevention, this finding could have potential for helping with the management of patient disease. “It may be possible to increase the abundance of beneficial bacteria at the expense of harmful ones through the use of probiotics,” said Dr. Reid. “Antibiotics targeting harmful bacteria may also be another option for improving breast cancer management. Additional research is warranted to further explore the role of the breast tissue microbiome in the development and prevention of breast cancer.” 

“In the near future, I hope we can discover which bacteria or combination of bacteria promote cancer development and which ones could help protect against it, and the mechanisms by which they do so,” said Urbaniak. “The next logical step would then be to unravel how we can use this knowledge to protect women from getting breast cancer or how we can manipulate the microbiome to help treat cancer once a woman gets it.”

The study, “The microbiota of breast tissue and its association with breast cancer”, was featured in Applied and Environmental Microbiology, a journal of the American Society for Microbiology. Dr. Gregor Reid is the Director, Canadian Centre for Human Microbiome and Probiotic Research at Lawson Health Research Institute and a Professor of Surgery, and Microbiology and Immunology at Western University. Urbaniak, who recently completed her PhD at Western University, will soon be a postdoctoral fellow at the NASA Jet Propulsion Laboratory (JPL) in Pasadena, California where she will perform microbiome analyses on samples collected from astronauts as well as those collected from the surfaces of the International Space Station.

Exposure to professional experiences can help students envision themselves in specific professions and Dr. Donna Goldhawk aims to do just this by introducing medical research to high school science students. As coordinator of Youth Outreach for the Ontario Research Fund (ORF) grant entitled “Heart Failure: Prevention through Early Detection Using New Imaging Methods,” she is pleased to announce the call for applications to the 2019 Summer Studentship program.

This year, a total of three ORF summer scholarships are available at Lawson Health Research Institute (London), University of Ottawa Heart Institute (Ottawa), and Sunnybrook Research Institute (Toronto). Interested applicants can forward their cover letter and resume to @email by May 15, 2019. 

Dr. Goldhawk is a Scientist at Lawson Health Research Institute and an Assistant Professor in Medical Biophysics at Western University. Since 2009, she has helped inspire students to pursue research by training them in her lab. In conjunction with secondary schools in the Thames Valley region and the Partners in Experiential Learning (PEL) program, she teaches youth that choosing a scientific career allows for multiple opportunities to fuse interests with a specific area of focus. 

The PEL program was introduced in 2004 by Dr. Jim Koropatnick, Lawson Scientist, and Mr. Rodger Dusky, a retired secondary school teacher. PEL has been a long-standing partnership between the Thames Valley District School Board, London District Catholic School Board, Ministry of Education, Western University, London Health Sciences Centre and St. Joseph’s Health Care London.

This unique academic co-op education program identifies high school students interested in research and prepares them for placement in a health research environment. The students earn high school credits and receive training in basic laboratory research. In Dr. Goldhawk’s experience, PEL attracts an excellent caliber of student who is eager to learn, aspiring to pursue further education and capable of contributing to the science of molecular imaging.

Through the ORF, the Ministry of Research and Innovation emphasizes the value of attracting youth to the scientific enterprise. Students can expect experiential learning tailored to their current understanding of science and aimed at expanding this knowledge for a greater appreciation of biomedical research. For example, in Dr. Goldhawk’s laboratory cardiac research is focused on the measurement of iron contrast using MRI.  

“Many cells have naturally distinct iron metabolism; however, we are also using genes from magnetic bacteria to improve the magnetic sensitivity of mammalian cells. MRI can then be used to detect disease processes,” states Dr. Goldhawk. “We are particularly interested in reporter gene expression for MRI, a term coined to describe how changes in the pattern of gene activity and its related protein activity may be visualized.”

Her current team not only includes graduate and undergraduate students at various stages in their programs but also an international collaboration with Dr. Weiwei Zhang, a Western Visiting Scholar from China. In this setting, high school students step into a work atmosphere where they can interact with individuals at different levels. As well, molecular imaging research works closely with multiple areas so students acquire training in both biology and physics. 

“To retain the interest of talented young scientists, it is essential to provide them with interesting challenges that reward their curiosity and ambition to learn,” explains Dr. Goldhawk. “In hospital-based research institutes, youth are also exposed to the clinical side for which our research is targeted. This is a quality scientific experience for youth interested in expanding their outlook, performance, technical, problem-solving and record-keeping skills. I think it is essential to build these opportunities into our scientific programs.”