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Easing the pressure for patients with chronic wounds
Chronic wounds represent a significant burden in Canada. Between four and 30 per cent of patients develop a chronic wound, depending on the health care setting. Over 85 per cent of all Spinal Cord Injury (SCI) survivors will experience health complications related to pressure ulcers, injuries to the skin and underlying tissue resulting from prolonged pressure. These types of wounds can significantly reduce participation in meaningful activities and overall quality of life.
Research from around the world shows that electrical stimulation can help speed the healing of pressure ulcers. This therapy is currently done by a trained health care provider and is not readily available for people across Canada.Electrical stimulation therapy (E-Stim) is a wound treatment that involves applying low levels of electrical current to the wound bed and surrounding tissues. It stimulates several healing processes, promotes local circulation and prevents infections.
The E-Stim Collaboration: A Best Practice Implementation Project for Better Pressure Ulcer Care aims to improve the coordination of pressure ulcer care and promote the use of evidence-informed wound treatments for people living with SCI. In particular, the research project is studying how to best provide E-Stim to people with pressure ulcers, in their own communities.
“Over the years I’ve seen the serious impact pressure ulcers have on the lives of people with spinal cord injury and other health challenges. This is what drives my commitment to not only develop best practice guidelines, but also to ensure they are put into action,” says Dr. Pamela Houghton, Associate Scientist, Lawson and Professor, School of Physical Therapy at Western University. “Advances in technology make it possible for more people with care needs to live at home.”
The pilot project in the South West LHIN has a unique model that builds capacity in the community and taps into the lived experience of people with pressure ulcers and SCI. It brings together the expertise of researchers, clinicians and managers from academia, hospital centres and community care.
Partners include the Parkwood Institute Research program at Lawson Health Research Institute, Western University, Saint Elizabeth’s Health Care Research Centre, Sunnybrook Health Sciences Centre and the South West Community Care Access Centre. An interdisciplinary specialized team, called SCIPUT, has been established within the Spinal Cord Injury Rehabilitation program provided at Parkwood Institute, St. Joseph’s Health Care London.
“Our collaborative team is using the PLAN-DO-STUDY-ACT quality improvement model. This allows us to learn from each cycle and make adjustments as we go,” says Dr. Houghton. “We have just completed the first cycle and are reporting on lessons learned.” Funded by the Rick Hansen Foundation, the team hopes this will set the stage for a larger cross-country initiative.
Those interested in participating can contact phoughto@uwo.ca. The study is open to:
- Individuals with an open pressure ulcer and with a condition that causes limited mobility and/or requires a wheelchair;
- Those who are able and willing to participate in treatment plan, and communicate feedback; and,
- People who are eligible to receive services from South West CCAC.
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Electrical stimulation (E-Stim) directly stimulates several wound healing processes, promotes local circulation and prevents wound infections. It produces faster healing and wound closure. A trained health care provider applies low levels of electrical current to the pressure ulcer using specialized equipment. |
Investing in life-changing research
Through donor support, endowed research chairs are exploring and answering some of the most profound and complex research questions of our time.
Among cherished family photos and special mementos in the office of Jeremy Burton, PhD, is a slightly faded photo of a young woman. Burton points out the framed photo as he enthusiastically talks about his work. It’s a young Miriam Burnett, after whom the Miriam Burnett Chair in Urological Sciences is named. It’s also the first endowed research chair position Burton held at St. Joseph’s Health Care London (St. Joseph’s).
As the research chair for seven years, Burton speaks fondly about the relationship he has with the Burnett family and the crucial role their support has played in advancing his research.
“Thanks to their funding, we became one of the world leaders in urological microbiome research,” he says.
Endowed research chairs at St. Joseph’s receive consistent and sustainable funding so that research leaders and their teams can answer the most profound and complex health questions of our time.
For decades, donors have been inspired by the clinical research taking place at St. Joseph’s and have heavily invested in endowed research chairs. Today, St. Joseph’s Health Care Foundation manages seven endowed chairs focused on several areas, including molecular imaging, fetal and newborn growth and diabetes. Working in partnership with Western University, and with donor support, the foundation recently established four new endowed chairs in mobility, medical biophysics, medical imaging and ophthalmology.
“Medical research in Canada is chronically underfunded, and there is almost no sustainable funding for hospital-based research positions,” says Michelle Campbell, President & CEO, St. Joseph’s Health Care Foundation. “Private philanthropy has filled that gap for years. When a donor gives to an endowed research chair, they are building capacity in the present day and creating future value and opportunity. An endowed gift has a multiplier effect.”
Burton, now the endowed Research Chair in Human Microbiome and Probiotics, has many reasons to be grateful for this support. Not only does the endowed fund pay for Burton’s research salary, it also partially supports the salaries of a lab manager and technical team – all vital for a sophisticated lab to be successful.
The funding also provides the gift of time – a diminishing commodity for any busy research team.
“Scientists need more time to think,” says Burton, a Lawson Research Institute (Lawson) scientist. “We are incrementally being stretched in multiple directions, and the funding gives us the time to do what we are meant to do – find answers to important clinical questions and find solutions to medical problems.”
Distinguished Lawson scientist and university professor Cheryl Forchuk, PhD, wholeheartedly agrees. She recently completed her final term as The Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation & Recovery, another endowed position. As Chair, Forchuk provided scientific and administrative leadership to a large group of researchers based at St. Joseph’s Parkwood Institute focused on mental health, activity and mobility, and cognitive vitality and brain health.
Many research leaders, she explains, can afford to spend only two days a week on their own research projects. Endowed chair positions change that.
“Imagine travelling across the country to create a national study focused on homelessness, two days a week at a time,” she suggests candidly. “You couldn’t.”
Forchuk is referring to her landmark project to better understand how many people in Canada are homeless and who they are. The goal was to develop more accurate sources of data and recommend appropriate support and services. Her work is already resulting in important changes.
Today, Forchuk is embarking on another cross-country research project to find solutions related to homelessness for Canadian veterans who are women.
Like Forchuk, Burton’s Chair position requires him to provide operational and research leadership, including developing research networks and partnerships nationally and internationally to advance studies that will revolutionize care.
“As the Chair, I think it is important that I have wide-ranging projects that benefit people in our own community and beyond,” says Burton, who is optimistic about the outcomes of several of his team’s studies.
He recently partnered with London’s First Episode Mood and Anxiety Program to study the impact of fermented foods on the microbiome of young people taking medications for mental health conditions.
One of the side effects of these medications is weight gain, which deters some patients from taking it. By providing patients with slow-release apple cider capsules, which have similar properties to fermented foods and positively affect the microbiome, they have seen an overall improvement in participants’ mental health and cholesterol after just a few months.
Reflecting on his team’s research achievements to date and the potential of what’s to come, Burton emphasizes how vital endowed chairs are to the sustainability of research and the hope to translate newly discovered knowledge into medical practice.
“Research funding from other sources comes and goes,” he says, “but endowed chair positions that are focused on improving human health provide continuity, build research and create change benefiting all of us.”