In a new study, researchers at Lawson Health Research Institute and Western University are demonstrating that gait, or motion testing, while simultaneously performing a cognitively demanding task can be an effective predictor of progression to dementia and eventually help with earlier diagnosis. To date, there is no definitive way for health care professionals to forecast the onset of dementia in a patient with memory complaints.

Dr. Manuel Montero-Odasso, a Lawson scientist, geriatrician at St. Joseph’s Health Care London, and associate professor in the Division of Geriatric Medicine at Western University’s Schulich School of Medicine & Dentistry, is leading the “Gait and Brain Study.” His team is assessing up to 150 seniors with mild cognitive impairment (MCI), a slight decline of memory and other mental functions which is considered a pre-dementia syndrome, in order to detect an early predictor of cognitive and mobility decline and progression to dementia.

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Dr. Montero-Odasso with study participant, Roy Bratty

“Finding methods to detect dementia early is vital to our ability to slow or halt the progression of the disease,” says Dr. Montero-Odasso. The study, funded by the Canadian Institutes of Health Research, followed participants for six years and included bi-annual visits. Researchers asked participants to walk while simultaneously performing a cognitively demanding task, such as counting backwards or naming animals. Those individuals with MCI that slow down more than 20 per cent while performing a cognitively demanding task are at a higher risk of progressing to dementia.

“While walking has long been considered an automatic motor task, emerging evidence suggests cognitive function plays a key role in the control of walking, avoidance of obstacles and maintenance of navigation,” says Dr. Montero-Odasso. “We believe that gait, as a complex brain-motor task, provides a golden window of opportunity to see brain function.”

The “gait cost,” or speed at which participants completed a single task (walking) versus a dual-task, was higher in those MCI individuals with worse episodic memory and who struggle with executive functions such as attention keeping and time management.

“Our results reveal a ‘motor signature’ of cognitive impairment that can be used to predict dementia,” adds Dr. Montero-Odasso. “It is conceivable that we will be able to diagnose Alzheimer’s disease and other dementias before people even have significant memory loss. Our hope is to combine these methods with promising new medications to slow or halt the progression of MCI to dementia.”

The study, “Association of Dual-Task Gait with Incident Dementia in Mild Cognitive Impairment”, was published in the journal, JAMA NEUROLOGY.

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Members of the study’s research team, from left to right: Korbin Blue, Research Assistant (Co-op Student); Yanina Sarquis-Adamson, Lab Research Assistant; Frederico Faria, Post-Doctoral Fellow; Dr. Montero Odasso, Director, Gait and Brain Lab; research participant; Alanna Black, Lab Research Coordinator; Stephanie Cullen, Research Assistant (Undergraduate Student); and, Navena Lingum, Research Assistant (Master Student). 

Lawson Health Research Institute – the research institute of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London – is ranked seventh in the country in Re$earch Infosource’s 2023 list of Canada’s Top 40 Research Hospitals. 

This is the 13th year in a row that Lawson has ranked top ten in the country, and the seventh-place ranking is up two spots from 2022 – highlighting continued dedication to hospital-based research at LHSC and St. Joseph’s.

Lawson also ranked second for research intensity among the large tier institutions with more than $776,000 of research spending per researcher.

“These rankings help LHSC and St. Joseph’s assess how we compare to similar hospitals across the country,” says Dr. David Hill, Scientific Director at Lawson and Integrated Vice President, Research at LHSC and St. Joseph’s. “Our continuous placement in the top 10 of all research hospitals shows we are doing important and relevant medical research that is making a difference to patient care.”

Lawson has been at the forefront of research in a wide range of specializations, making advances in areas from cancer care and mental health supports to molecular imaging and theranostics in recent years.

“Conducting research in hospitals means it can go from bench to bedside much more quickly,” says Dr. Hill. “Things move much faster now than they ever did. Our top 10 ranking shows we are leading the way, and that funders are confident in London’s hospital-based researchers.”

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research expenditure from the previous fiscal year. The ranking looks at funds from all sources, including both internal and external, to support research in hospitals.

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3D imaging technology could improve outcomes for patients with breast cancer

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. 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. Read more. 

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Antioxidants in the brain linked to improved treatment results in patients with psychosis

Once patients with psychosis start treatment, some get better in weeks while it can take months for others. A research team from Lawson and Western University studied antioxidant levels in the brain, and found that these chemicals, which rid the body of normal metabolic biproducts called free radicals, may improve outcomes of early intervention in psychosis. Read more. 

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Researchers awarded $4.8 million to validate locally developed test, EpiSign, for first-line diagnostic testing of rare hereditary disorders 

A clinical trial named “EpiSign-CAN,” led by researchers at Lawson was awarded $4.8 million to measure the clinical impact of a new molecular genomics test for diagnosing genetic neurodevelopmental conditions. The diagnostic test, called EpiSign, uses machine learning to analyze the EpiSign Knowledge Database. This database compiles information on rare genetic diseases using laboratory analyses of the entire genome, referred to as the epigenome, from patients with suspected genetic abnormalities. Read more.

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Perceptions of confidentiality for Canadian Veterans discussing moral injuries

Lawson researchers are exploring Canadian Veterans’ beliefs about confidentiality in mental health care and whether those beliefs act as a barrier to seeking treatment for a type of trauma known as moral injury. Moral injury describes psychological distress following events where a person performs, witnesses or fails to prevent acts that conflict with deeply held moral standards. Evidence suggests that moral injuries are on the rise among deployed members of the Canadian Armed Forces, and that those exposed to such events are at a higher risk of developing post-traumatic stress disorder and depression. Read more.

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New device could reduce COVID-19 infection risk and demand for invasive ventilators

Researchers designed a non-invasive ventilation mask that could significantly reduce aerosolization – the production of airborne respiratory droplets that may contain viruses or bacteria – when treating patients with COVID-19. The new device aims to reduce infection risks associated with non-invasive ventilation and lessen the demand for invasive ventilators. It is currently being tested through a clinical trial with patients at London Health Sciences Centre (LHSC). Read more.

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Researchers first in world to profile the body’s immune response to COVID-19

By studying blood samples from critically ill patients at LHSC, researchers identified a unique pattern of six molecules that could be used as therapeutic targets to treat COVID-19. Studies show that part of what makes the virus so deadly is that the body mounts an overreactive immune response as the virus grows and replicates. This response releases inflammatory molecules in order to fight the virus, but also destroys healthy cells and organs in the process. Read more.

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Study suggests that surgery may be superior treatment for chronic sciatica

In a randomized controlled trial, surgery was found to be superior to non-operative therapy in the treatment of chronic sciatica. Chronic sciatica can be caused by a disc herniation which compresses a nerve in the lumbar spine causing pain from the lower back to the leg. The primary treatment options for sciatica are surgery or non-operative care. Researchers conducted this study to test if a surgical treatment called microdiscectomy results in better patient outcomes for those with chronic sciatica compared to non-operative care. Read more.

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Researchers unravel two mysteries of COVID-19

A team from Lawson and Western University made significant steps forward in understanding COVID-19 through two back-to-back studies. In one study, the team identified six molecules that can be used as biomarkers to predict how severely ill a patient will become. In the other study, they were the first to reveal a mechanism causing blood clots in COVID-19 patients and potential ways to treat them. The studies were conducted by analyzing blood samples from critically ill patients at LHSC. Read more.

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Gut microbiome may influence how cancer patients respond to oral therapies, study suggests

A study from Lawson and Western illustrated how the gut microbiome interacts with an oral medication in prostate cancer patients, suggesting bacteria in the gut play a role in treatment outcomes. The findings highlight how the drug abiraterone acetate is metabolized by bacteria in the gut to reduce harmful organisms while promoting those that fight cancer. The research team suspects this is one of many examples of how the microbiome influences our response to medications. Read more.

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First Contrast Enhanced Spectral Mammography guided biopsy in North America

Researchers at Lawson performed the first breast biopsy guided by Contrast Enhanced Spectral Mammography (CESM) in North America on June 12, 2020. CESM is a novel diagnostic imaging tool that is able to detect cancerous lesions at a greater rate than standard mammography, and at close rate to MRI. The procedure is faster and more accurate, comfortable and cost effective than an MRI biopsy. Read more.

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Assessing the pandemic's impact on Canadian Veterans and their spouses

A project from Lawson and the Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) hopes to discover the impact the COVID-19 pandemic is having on the mental health of Canadian Veterans and their spouses. They are 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. Read more.

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Fecal transplants show promise as treatment for non-alcoholic fatty liver disease

A randomized controlled trial found that fecal transplants in patients with non-alcoholic fatty liver disease (NAFLD) results in a reduction in how easily pathogens and other unwanted molecules pass through the human gut and into circulation, known as intestinal permeability. The results could have implications for the treatment of numerous conditions including metabolic syndrome and autoimmune diseases. Read more.

Lawson researchers impact the lives of people not just locally, but around the world with groundbreaking studies and translational research that enhances care, health and wellbeing.
Here are some of the research highlights of 2021.

Differences in walking patterns could predict type of cognative decline in older adults

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Canadian researchers are the first to study how patterns in the way older adults walk could more accurately diagnose different types of dementia and identify Alzheimer’s disease. A new study by a Canadian research team, led by London researchers from Lawson Health Research Institute and Western University, evaluated the walking patterns and brain function of 500 participants currently enrolled in clinical trials. Read more.

COVID-19 shown to leave a unique lung fingerprint

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Kidney transplant patient experiences positive recovery with the help of a simple device

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Air pollution exposures contributes to childhood asthma, population-based study shows

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Getting the data on homelessness

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Examining the health impact the COVID-19 pandemic is having on mothers and their new babies

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New therapeutic tool proven effective for MS patients with mental health challenges

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Researchers using MRI scans to pinpoint moral injury effects in health care workers

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Moral injury refers to an injury to an individual’s moral conscious, which can produce profound emotional guilt and shame. Recognizing this is a growing concern, a London research team from Lawson Health Research Institute and Western University’s Schulich School of Medicine & Dentistry is examining moral injury amongst health care workers by imaging the effects on the brain. Read More.

Scientists studying carbon monoxide as a possible treatment for sepsis

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Global study on heart valve repair surgery will improve patient outcomes around the world

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Researchers at Lawson Health Research Institute and Western University had a leading role in a new global study that will change the way surgeons repair leaky valves in the heart. It’s one of the most common heart valve conditions, affecting around two per cent of the population, where many patients don’t even realize they have a leaky valve and are asymptomatic, often presenting to doctors once they are late stage into the disease. Read more.

New study will assess fecal transplants in treatment of pancreatic cancer

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The city of London, Ontario is home to a vibrant health research community. On Wednesday, May 9, researchers from across the city gathered to discuss the importance of equity, diversity and inclusivity (EDI) in the careers of health researchers. Through participation at Exchange: A London Health Research Day Forum on Diversity & Inclusivity, guests discussed the challenges associated with EDI and potential solutions for the future.

Exchange was held the evening before London Health Research Day, the region’s premier research showcase event which features nearly 400 trainee presentations. Trainees are the future of Canadian science and EDI is crucial to that future. This is a topic of national importance that has garnered attention and action from the federal government, funding agencies and scientists across the country.

Recognizing the importance of this topic, Canada’s Minister of Science, The Honorable Kirsty Duncan, and local Member of Parliament for London North Centre, MP Peter Fragiskatos, shared video greetings with Exchange guests.

“The Exchange event highlights a vital area of discussion. It is important to not only recognize but embrace the differences between scientists and the diverse perspectives they bring to research,” said Rebecca Sullivan, a third year PhD candidate at Western University’s Schulich School of Medicine & Dentistry, training in Savita Dhanvantari’s lab at Lawson Health Research Institute, and one of the organizers of the event. “Becoming aware of our own unconscious biases and trying to change these culturally ingrained implicit associations is the only way to make active change in science!”

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Above: Rebecca Sullivan, a third year PhD candidate, leading a scenario-based group activity at Exchange

The evening’s first presenter was Dr. Janet Smylie, Director of the Well Living House Applied Research Centre for Indigenous Infant, Child and Family Health at St. Michael’s Hospital and CIHR Applied Public Health Research Chair in Indigenous Health Knowledge and Information. Dr. Smylie, who also delivered the keynote presentation at London Health Research Day, spoke about the role of anti-Indigenous racism and discrimination within health care professions, including its impact on research. This included a discussion of Dr. Smylie’s own research in the field of Indigenous health.

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Above: Dr. Janet Smylie presenting on "Addressing anti-Indigenous racism and discrimination within health care professions"

Greta Bauer, PhD, a professor in the Department of Epidemiology and Biostatistics at Schulich Medicine & Dentistry, spoke about the role of epidemiology as a toolkit for building equity in health research. This included a discussion on incorporating intersectionality and multidimensionality into population health research methodology.

“The purpose of this work is to give researchers the measurement and statistical tools they need to shift the focus from studying broad population average effects to more heterogeneity within populations,” said Greta. “The whole point is to better study not only diversity in health outcomes, but in the processes that generate those outcomes.”

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Above: Greta Bauer, PhD, presenting on "Epidemiology as a toolkit for building equity"

This talk was followed by a presentation on Gender-Based Analysis Plus (GBA+). GBA+ is an analytical tool used to assess how diverse groups of women, men and gender-diverse people may experience policies, programs and initiatives. The “plus” in GBA+ acknowledges that GBA goes beyond biological (sex) and socio-cultural (gender) differences. We all have multiple identity factors that intersect to make us who we are; GBA+ also considers many other identity factors, like race, ethnicity, religion, age, and mental or physical disability. GBA+ is a method for collecting and reviewing data in an unbiased manner, one that leaves aside many of the assumptions that can mask the GBA+ impacts of a given initiative. Alysha Croker, PhD, Manager, Tri-Agency Institutional Program Secretariat, discussed how GBA+ is being used in research and grant funding, including at the federal funding agencies.

“Diverse research teams can lead to more innovation, greater collective intelligence and an increased capacity to tackle complex issues,” said Alysha, when discussing the importance of EDI in the careers of health researchers.

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Above: Alysha Croker, PhD, presenting on "Incorporating Gender-Based Analysis Plus (GBA+) in research and beyond"

The evening also included a presentation from Shantal Feltham, founder and CEO of Stiris Research, a North American clinical trials management company based in London. Shantal discussed the importance of ensuring that clinical trials are designed to recruit diverse research participants that represent real patient populations. She also discussed her own experiences and perspectives as a female entrepreneur.

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Above: Shantal Feltham delivering a presentation titled "That’s a great idea – It’ll never work"

A group of health research trainees concluded the night with a scenario-based presentation and activity. Audience members were divided into small groups and given a diversity scenario to discuss. Topics ranged from the experiences of LGBTQ+ researchers, racial diversity, physical ability barriers in research labs and more. Notes and ideas from these conversations were recorded and displayed the next day at London Health Research Day.

“Exchange highlighted EDI in health research in action. It featured talks by leading female researchers on issues in Indigenous health and LGBTQ health, implementation of equity in the Canada Research Chairs program, and female entrepreneurship in the field of health research,” said Savita Dhavantari, PhD, assistant director and scientist at Lawson and assistant professor at Schulich Medicine & Dentistry. Savita was also one of the Exchange organizers and the facilitator for the event. “Above all, I hope attendees were encouraged to be fearless in advocating for equity, diversity and inclusivity in health research.”

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Above: Guests at Exchange discussing a diversity scenario

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Above: Savita Dhanvantari, PhD, facilitating the Exchange event

Keynote speaker at joint mental health research day says compassion in action has proven benefit

Compassion in mental health care – and in all health care – is “what separates good from really great” patient outcomes, Calgary-based researcher Shane Sinclair, PhD, told mental health researchers during a conference Oct. 30, 2024, in London.

Sinclair, who heads the Compassion Research Lab at the University of Calgary, was the invited keynote speaker at the Joint Mental Health Research and Innovation Day, attended by about 130 people.

The event was hosted by Lawson Research Institute, London Health Sciences Centre Research Institute and Schulich School of Medicine & Dentistry.

The day also featured 17 poster presentations and 17 oral presentations on different aspects of mental health research. It’s one of the premier annual education-and-development events in mental health science regionally.

This year’s event showcased how compassion could transform health policy, partnerships, systems, care, research and service delivery.

Compassion, respect and excellence are core values of St. Joseph’s Health Care London.

Sinclair noted that the key role of compassion – responding to someone’s suffering with understanding and action – is evidence-based.  

“We do patient-informed and patient-targeted research. And we’ve found compassion makes a difference in how people heal.”
-Shane Sinclair, PhD, compassion researcher

His lab examined the outcomes and satisfaction among patients at 14 emergency rooms across Alberta and found compassion to be the greatest predictor of quality care ratings.  

“What separates good from really great comes down to compassion. These things matter,” Sinclair said.

“It improves their health and their quality of life. It reduces health-care costs, reduces adverse medical outcomes and helps build patients’ trust in the medical information and direction they receive,” he said. 

During a virtual event for Londoners hosted by Lawson Health Research Institute and the City of London, a multi-sectoral research team announced two projects representing a collaborative approach to preventing homelessness from within hospital walls. 

Built on the unique and successful No Fixed Address (NFA) strategy, these projects are being tested as a potential best practice for preventing hospital discharge to homelessness. 

Led by Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Scientific Director at Lawson, NFA seeks to stop the cycle between hospital admissions and homelessness by providing timely and accessible supports to patients who would otherwise be discharged into homelessness. It brings housing and financial supports into the health-care system, starting as soon as upon admission, to assist in finding appropriate housing and supports or avoiding a potential eviction. 

Several departments at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London collaborate with staff from the City of London, Canadian Mental Health Association (CMHA) Elgin-Middlesex, Youth Opportunities Unlimited (YOU), Salvation Army’s Housing Stability Bank and Ontario Works in the City of London to provide direct, on-site (or virtual) support for patients at risk of homelessness.

Patients discharged from hospital to homelessness in Canada face many challenges that make recovery more difficult. They often experience higher readmission rates and emergency department visits. This is particularly concerning for youth, who have been found to be the fastest growing segment of the homeless population.

NFA was initially tested with strong success for mental health patients across the city and the second version of the project was extended to medical units at LHSC’s University and Victoria Hospitals.

PROJECT 1: Collaboration to Address Homelessness - Health, Housing and Income (H2I) 

This research study will evaluate the City of London’s Coordinated Access Outreach program at hospital sites. A Coordinated Access Outreach worker will support individuals at risk of homelessness to maintain or obtain housing. Ontario Works will assist with the provision of income and employment supports and the Salvation Army Housing Stability Bank may be accessed for needed financial resources to secure or maintain housing.  

Over two years, 106 participants will be interviewed in hospital and again six months post-discharge. Focus groups with participants, health care providers and community partners will provide further insight into the effectiveness of NFA. This project is funded by the Canada Mortgage and Housing Corporation (CMHC)’s National Housing Strategy. 

PROJECT 2: Preventing discharge to No Fixed Address – Youth (NFA-Y) 

This research study will customize, implement and evaluate the NFA strategy for vulnerable youth agSwitch to plain text editores 16-24. The unique health and housing needs of youth at-risk will be explored by streamlining housing and financial support into a coordinated system of care, with additional support provided by Youth Opportunities Unlimited and Children’s Aid Society London and Middlesex. 

Over 3-4 years, data to be collected from 93 youth at three time points. Focus groups with youth participants, health care providers, and community agency partners will help enhance the NFA strategy to meet the unique needs of youth. This project is funded by the National Centres of Excellence (NCE) Making the Shift (MtS) Youth Social Innovation Lab. 

Media Coverage 

• Could this project keep discharged hospital patients from homelessness? - London Free Press 
• London, Ont., expands work to prevent homelessness after hospital stays - Global News
• London expands strategy to curb homelessness after hospital stays - Blackburn News 
• What happens to people who are discharged from hospital if they have nowhere to go? - CBC London

Learn more about No Fixed Address 

• Expanded No Fixed Address strategy houses half of those in danger of homelessness   
• Funding for unique strategy to prevent homelessness after hospital discharge

Lawson Health Research Institute is again ranked eighth in the country according to the 2020 edition of “Canada’s Top 40 Research Hospitals List” by Re$earch Infosource. This strong national position has been maintained by Lawson for the past seven consecutive years and keeps the Institute within the top five in Ontario.  

Lawson, the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, has also maintained the top ranking for research intensity among the large tier institutions with $600,000 of research spending per researcher.  

“Now, more than ever, people are understanding the critical importance of hospital-based research and its impact on health care,” says Dr. David Hill, Lawson Scientific Director and VP, Research for London Health Sciences Centre and St. Joseph’s Health Care London.

“We have remarkable people right here in London working on solutions for health challenges that have a worldwide impact. Their knowledge, creativity and dedication never fail to astound.” 

The top 40 list analyzes hospital-based research institutes from across the country on several metrics, including total research income from the previous fiscal year. The ranking looks at funds received from all sources, including both internal and external, to support research at the organization. According to the report, Lawson received $118,796 million in research income in 2019. Despite representing a 4.0 per cent drop from the previous fiscal year, Lawson has maintained its rankings on the national list.  

Hospital-based researchers belong to a health system at the forefront of the COVID-19 pandemic. With close proximity to patients and access to samples, they have mobilized to address COVID-19. Many Lawson research teams are implementing pre-clinical, clinical observational and clinical trial studies to prevent or soften the worst effects for patients with COVID-19. They are also studying the long-term and mental health impacts related to the pandemic.  

“The COVID-19 pandemic is proving to be one of the most pressing health challenges of our time,” notes Dr. Hill. “Lawson excels in rapid response research and is uniquely positioned to tackle health problems from within hospital walls.”  

Quick summary of Lawson's ranking 

• Rank in Top 40 Research Hospitals 2020: 8 (same as 2019) 

• FY2019 research spending: $118,776 million  

• FY2018 research spending: $123,790 million 

• Percentage change 2018-2019: -4.0% 

• Research intensity: $600,000 per researcher  

• Research intensity - percentage of total hospital spending: 7.0% 

The COVID-19 pandemic has had a tangible impact on the mental health and wellbeing of Canadian health care workers, who have faced challenges that include increased workloads, resource constraints and fears of exposure to COVID-19.

Announced today, researchers out of Lawson Health Research Institute's MacDonald Franklin OSI Research Centre, have received $2.8 million in funding from the Public Health Agency of Canada (PHAC) to launch a project that will support the mental health and wellbeing of Canadian health care workers. The project is titled “Promoting Resilience and Mental Health: Adapting Canada’s Department of National Defence Road to Mental Readiness (R2MR) Program to Support Canadian Health Care Workers.”

The project will adapt the current Road to Mental Readiness Program, created for the Canadian Military.  The aim is to identify mental health and wellness barriers in health care institutions, and create a streamlined framework that will build and promote supportive environments within institutions across the nation. 

“This program has been a personalized approach with the military, and we are now adapting it to focus on Canadian health care workers,” explains Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre at St. Joseph’s Health Care London. “We want to educate institutions to create an environment that supports wellness not just at the individual level, but at the institutional level as well.”

The project, which will span 14 months, will assist in the planning, adaptation and testing of the health care focused Road to Mental Readiness Program.

“One of the main reasons we felt this was necessary stems from a recent study our team conducted that focused on moral distress and the mental health of Canadian health care workers,” says Dr. Don Richardson, Lawson Scientist and Director of the MacDonald Franklin OSI Research Centre at St. Joseph’s. “Our preliminary study results found that many Canadian health care workers have been negatively impacted by the pandemic with conditions such as; posttraumatic stress disorder, stress and depression.” 

Once the research team has adapted the current Road to Mental Readiness Program, they will test it with health care workers to confirm its efficacy.

“We hope to have this type of resiliency program adopted by health care organizations across the country,” explains Dr. Richardson. “If proven effective, this would provide additional tools to health care workers to help them cope, improve their resiliency and hopefully mitigate future staff shortages.”

The funding is part of the federal 2021 budget which has committed an investment of $50 million over two years to support projects that address posttraumatic stress disorder and trauma in frontline and essential workers, and others affected by the pandemic. The nine projects announced, totaling an investment of $28.2 million, is the first round of projects being supported through this Budget 2021 commitment.