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Researchers in London are sharing a new resource that can help municipalities and other organizations better understand social isolation and implement solutions proven to be effective. With input from over 35 community partners and people with lived experience, the research team hopes this tool can be used to support community-based initiatives that counteract poverty and homelessness while promoting mental health and social inclusion.  

“The pandemic has highlighted the issues of isolation and homelessness, and we know there is a connection between mental health and poverty. Unfortunately, right now, many people don’t see solutions in sight,” explains Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson Health Research Institute.

“Our new resource offers an expanded understanding of isolation and homelessness based on a very broad view and many different perspectives. We have taken it a step further and given examples of solutions that are working.” She is the lead researcher for CURA (Community-University Research Alliance): Poverty, Mental Health and Social Inclusion.  

Today during a virtual book launch, the team from the CURA discussed details of a new publication from Canadian Scholars: Poverty, Mental Health, and Social Inclusion, edited by Drs. Forchuk and Rick Csiernik. Community partners from Connect for Mental Health (peer support), Impact Junk Solutions from CMHA Elgin-Middlesex, and Goodwill Industries shared more about their successful programs.  

The book brings together research, real stories and information about programs from the London and area community that are working to address these issues. Most of the chapters includes a wide range of co-authors, including psychiatric consumer-survivors, academics, students, front-line service providers and leadership from community partners.  

“In order to find real solutions, the voices of people using the services must be at the centre. Their stories and experiences have been a very important part of producing this book,” says Betty Edwards, Executive Director at Can-Voice, a consumer-survivor group, and Community Director for CURA. "For us to move the needle, we need collaboration across different sectors, for example health, income support, housing and social services. No one sector can solve these issues on their own.” 

The book summarizes the foundational work by the CURA to better understand the inter-relationships between poverty and social inclusion for psychiatric survivors. Social inclusion involves the full participation of marginalized groups in the social and economic benefits of society which can be difficult to achieve for people with the “double jeopardy” of poverty and mental illness. 

“After five years of funding and several published research papers, we wanted to pull the findings together as a whole so that it would be more easily accessed and implemented by a wide range of people and organizations,” adds Dr. Forchuk. “Our hope is that other cities and service providers can pick up this book to see what we’re doing in London, and consider ways that they may reach out to their citizens to address social exclusion. It is also an academic tool to prepare the next generation as they continue to tackle the wicked problem of homelessness.”

“I reflect back on the past 15 months of the pandemic and know how isolated I have felt at times. Imagine the feelings of isolation or being forgotten that would come with experiencing homelessness? And for some, it’s been most of their adult lives,” shares Dr. Csiernik, Professor at King’s University College at Western University. “We know that many people during the pandemic have lost homes, jobs and food security. Some may have new or worsening mental health disorders. The learnings and solutions like the ones presented in the book are needed now more than ever.”  

Social Inclusion Art 

Incorporating an arts-based approach, the book also features photographs taken by photographer Justin Langille who would spend about a month with each of the programs offering solutions and partnered with consumer survivors to capture accurate depictions of what they considered important messages.  

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Impact Junk Solutions employee Allan is reflected in a mirror attached to a dresser being taken away from the home of an individual who recently passed away in the northwest end of London, Ontario in March 2014.  (Photo credit: Justin Langille Photography)

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A supported housing unit rendered uninhabitable by an individual suffering from mental illness, which was a challenge for Impact Junk Solutions to de-clutter.  (Photo credit: Justin Langille Photography)

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Diane assembles parts on the floor of the Goodwill’s RMHC Social Enterprise program in St.Thomas in April 2014.  (Photo credit: Justin Langille Photography)

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A participant pauses for a moment during a Connect group sharing session in October 2014. Connect facilitates peer sessions where individuals experiencing mental illness can learn and share strategies to help their recovery.  (Photo credit: Justin Langille Photography)

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Steve helps a co-worker navigate a couch out from a basement in the Blackfriars neighbourhood in London, Ontario in April 2014. Returning to work has been essential for Steve’s successful recovery from mental illness and substance abuse. (Photo credit: Justin Langille Photography)    

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Connect member Tammy makes breakfast at home in her kitchen. If there is one thing she can do habitually to set herself up for success in her mental health recovery, Tammy says it’s having a good breakfast.  (Photo credit: Justin Langille Photography)

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Goodwill RMHC Social Enterprise program employee Donald applies reflective tape to a stack of pylons in March 2014. (Photo credit: Justin Langille Photography)

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The Goodwill Social Enterprise program includes a successful toy-recycling component that bags and re-sells used toys at a low-cost for low-income families.  (Photo credit: Justin Langille Photography)

Researchers at Lawson Health Research Institute are the first in the world conducting a clinical trial to test a triple intervention aimed at treating Mild Cognitive Impairment (MCI) and delaying the onset of dementia. The Mobility, Exercise and Cognition (MEC) team will be incorporating physical exercises, cognitive training and vitamin D supplementation to determine the best treatment for improving mobility and cognition.

“We have learned the brain processes involved in motor-control - for example how a person walks - and cognition - for example how that person solves a problem - share similar locations and networks in the brain,” explains Dr. Manuel Montero Odasso, Lawson Scientist and Geriatrician at St. Joseph’s Health Care London. “Problems with mobility are connected to lowering function in the mind, and so can be a good indicator of future progression into dementia.”

Dr. Montero Odasso is also an Associate Professor in the departments of Medicine and Epidemiology and Biostatistics at the Schulich School of Medicine & Dentistry, Western University. 

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MCI is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It can involve problems with memory, language, thinking and judgment. While many older individuals experience decline in both mobility and cognition, each are assessed and treated separately with no specific recommendations available for physicians.

The SYNERGIC Trial will combine physical exercises, cognitive training and vitamin D to test how these interventions work together to improve cognition in older adults at risk for dementia. The trial is targeting cognitive decline at the earliest stage, individuals with MCI, where interventions are more likely to have an effect and can be monitored.

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Dr. Montero Odasso explains that both physical and cognitive exercises have shown promising effects for maintaining cognition, while vitamin D deficiency is associated with cognitive decline. A key feature of this trial is that participants will receive individualized and progressive training.

“By delaying declines in cognition, we can improve a person’s quality of life. This research will help to support a more comprehensive preventative treatment with clinical guidelines for physicians whose patients are at risk of developing dementia,” states Dr. Montero Odasso. “Even more, each one year delay of progression to dementia in older individuals at risk has the opportunity to save billions of dollars for the Canadian health care system.”

Individuals over 60 years old with mild cognitive impairment without dementia are eligible for this clinical trial. Those interested in participating are encouraged to contact Research Coordinator Alanna Black at 519.685.4292 ext. 42179.

Participants will be asked to complete a routine of exercises and cognitive training three times a week for six months, with one final assessment at 12 months. The main site for the study is Parkwood Institute with physical exercises taking place at the Labatt Health Sciences Building at Western University, in Dr. Kevin Shoemaker’s Laboratory for Brain and Heart Health.

This study has been funded by the Canadian Consortium on Neurodegenerative in Aging (CCNA) which represents Canada-wide research aimed at enhancing the quality of life and services for individuals diagnosed with a neurodegenerative disease. The MEC team in London, led by Dr. Montero Odasso, includes expert researchers in the field of mobility who aim to develop common assessments for the interaction of cognition and mobility for older people to aid as a diagnostic tool for detecting dementia. 

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Quickly after the COVID-19 pandemic began to grip the world, Lawson Health Research Institute responded with action. Lawson is the research arm of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London. With hospitals focused on providing excellent patient care in the face of an unknown virus, hospital researchers in London, Ontario began critical COVID-19 studies.

“A lot was unknown during the first wave of the pandemic. Any research that wasn’t essential was put on hold. At the same time, we had people with different expertise coming together with different perspectives to see how we could better understand the SARS-CoV-2 virus and the COVID-19 infection,” explains Dr. David Hill, Lawson Scientific Director and VP, Research at LHSC and. St. Joseph's. “Our hospital researchers formulated ideas and very quickly came up with research proposals. These were fast tracked through our processes and within two months we approved over 50 new studies surrounding COVID-19.”

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Dr. David Hill, Lawson Scientific Director and VP, Research at LHSC and. St. Joseph's

Some of these studies were clinical trials, which are research studies performed with people. Many patients from London hospitals get involved as patient participants and when COVID-19 hit, many agreed to be a part of this important research.

“We saw the pandemic happening across the world, and suddenly it was happening here in London. This has probably been the biggest challenge of my career,” says Carol Young-Ritchie, Executive Vice President at LHSC. “We had to look at many of our processes and how we were doing things, and adjust appropriately and nimbly.”

Young-Ritchie adds that as the hospital continued to admit a growing number of COVID-19 patients, a strong focus on research was needed. “It was absolutely critical and important for LHSC as a leader and academic centre to contribute to our collective knowledge. We needed to keep that research going and although it has been challenging, it has also taught us to be innovative.”

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Carol Young-Ritchie, Executive Vice President at LHSC

The same focus was happening at St. Joseph’s Health Care London, with health care providers and researchers finding ways to improve care and outcomes for patients who had contracted the virus. “COVID-19 research through the hospital has been incredibly important,” says Karen Perkin, Vice President of Patient Care at St. Joseph’s. “We had researchers busy looking at the impacts of COVID-19. We had patients on ventilators and we were trying to understand that more. We also had research looking at the impacts for staff members looking after patients. All important, helpful knowledge as we move forward.”

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Karen Perkin, Vice President of Patient Care at St. Joseph’s

Hospital research in London through Lawson is proudly affiliated with Western University. At Western’s Schulich School of Medicine & Dentistry, the new state-of-the-art Imaging Pathogens for Knowledge Translation (ImPaKT) Facility was the perfect environment to conduct COVID-19 research.

“ImPaKT is a special containment facility where research on viruses like SARS-CoV-2 can be done safely,” says Dr. David Litchfield, Vice Dean of Research and Innovation at Schulich Medicine & Dentistry. “It has become a focal point for dozens of studies involving research through Schulich Medicine & Dentistry, as well as partners from the hospitals and other academic institutions and industries.”  

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Dr. Litchfield adds that collaboration between hospital partners and scientists has been the key to successful COVID-19 research. “This collaboration has enabled advances leading to new diagnostic testing for COVID-19, as well as studies using MRI or related imaging tools to investigate long-term impacts of the infection on individuals.”

The rapid research response to COVID-19 couldn’t have happened without community and foundation financial support. “Funding support from our hospital Foundation is something we are so grateful for,” says Perkin, referring to St. Joseph’s Health Care Foundation. “They came right out at the beginning and asked how they could help, as did our donors.”

LHSC’s London Health Sciences Foundation and Children’s Health Foundation were also pivotal in research funding during the pandemic. “Funding is a crucial part to how we do hospital research and the Foundations have been important partners in making sure our research continued,” says Young-Ritchie.

As the pandemic continues, so does the research within our community. Hospital research has already improved diagnostics, treatments and patient outcomes related to COVID-19 and helped people all around the world.

“If you look at some of the achievements that have occurred in just a little more than a year, we have had a number of landmark publications on ways to diagnose COVID-19 compared to other respiratory disorders,” notes Dr. Hill. “We have had many rapid advances and it can take a crisis to bring out the best in people. Then things come together quickly, such as expertise, talent and money – and the job gets done.”

• Lawson COVID-19 Updates

An estimated 55,000 Canadians are living with Parkinson’s disease. While researchers are advancing therapies to treat symptoms, such as tremors, there is currently no method to stop progression.

To begin addressing this problem, a team of scientists at Lawson Health Research Institute is developing an imaging tracer. 

“There’s a protein in the brain called alpha-synuclein (α-syn) that scientists believe is a culprit in causing Parkinson’s disease. The protein forms in ‘clumps’ called Lewy bodies that kill brain cells and potentially lead to disease,” explains Dr. Justin Hicks, Lawson Imaging Scientist. “Unfortunately, we have no way to study it in human brains and this has limited our ability to test therapies against it.”

Efforts have been made to study the elusive protein through modern imaging techniques like positron-emitting tomography (PET). Scientists have attempted to develop a PET probe – a radioactive molecule that targets the specific protein in order to produce highly specific images or scans – but they have been unsuccessful.

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Above: Dr. Justin Hicks working in the Nordal Cyclotron & PET Radiochemistry Facility

“Unfortunately, the Lewy bodies caused by α-syn are hard to distinguish from protein clumps found in Alzheimer’s disease and other dementias. This makes it very difficult to know whether a PET probe has found clumps associated with Parkinson’s disease.”

Through a new study, Dr. Hicks and his team are working to find a solution. To do so, they will examine a different but related protein.

“There’s another protein called fatty acid binding protein 3 (FABP3) and one of its roles is to ‘chaperone’ the α-syn protein in human cells. Past studies have shown that levels FABP3 are higher in patients with Parkinson’s disease when compared to healthy controls,” explains Dr. Hicks. “This suggests that high concentrations of FABP3 can be used as an alternate measure of α-syn.”

They hope to measure levels of the FABP3 protein in place of the α-syn protein, and gain a better understanding of the role that both proteins play in the development and progression of Parkinson’s disease. To image Lewy bodies associated with Parkinson’s disease, the researchers are working to produce a PET probe that targets FABP3.

To accomplish this, they will be working in their lab to find a chemical that targets FABP3. Once found, they will attach a radioactive isotope to the chemical and produce a finished tracer. The tracer will then be tested in preclinical models. 

Once injected, the PET probe will find and stick to FABP3. The PET isotope will emit a small amount of radioactivity and these emissions will show up as PET images.

“The ultimate goal is to develop a PET probe that can be used to distinguish Parkinson’s disease from other neurodegenerative diseases. The probe could also be used to assess new therapies that reduce levels of the α-syn protein,” says Dr. Hicks. “If successful, we hope this research will lead to a better understanding of the progression of Parkinson’s disease and ways to prevent it.”

Dr. Hicks and his team are being funded for this project through Lawson’s Internal Research Fund (IRF) competition. “Lawson’s IRF is extremely important for early career researchers. It allows us to generate data and publications to then apply for larger external funding. It also permits an added level of risk to pursue projects that may not reach their end goal but often spur new lines of research.”

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Above: A graphic depiction of this research project and its goals.