World-renowned brain researcher, Dr. Vladimir Hachinski, is named as this year’s recipient of the Canadian Medical Association’s (CMA) F.N.G. Starr Award for his contributions in stroke research and patient care. This prestigious award is the highest available to CMA members and is intended to recognize outstanding and inspiring lifetime achievement.

Dr. Hachinski, Lawson Scientist and Neurologist at London Health Sciences Centre is the co-founder of the world’s first successful stroke unit. Two earlier centres in the United States were deemed unsuccessful and eventually closed. Dr. Hachinski and his colleague, Dr. John W. Norris, applied their knowledge and fresh perspectives, and opened a stroke centre at Sunnybrook Hospital, Toronto, in 1975.

“We had a tremendous team of volunteer nurses, physiotherapists and other professionals who were very keen to have an impact,” explains Dr. Hachinski. “We implemented the A, B, C, protocol which focused on Accurate diagnosis, Balance and homeostasis in the patient’s physiology, and avoiding Complication. Dr. Josephine Somerville pioneered early rehabilitation in the stroke unit.”

At the time, stroke was still commonly misunderstood in medicine, until Dr. Hachinski coined the term “brain attack” in 1993, describing the similarities in urgency of strokes and heart attacks.

Realizing the success of their protocols on stroke patients, Dr. Hachinski and his colleagues also noticed improved outcomes for dementia rates in the stroke patients they saw. There is still no treatment for dementia, however they were confident they could delay onset through similar stroke prevention and treatment protocols.

After several studies on both animal models and humans, Dr. David Cechetto from Western University and Dr. Hachinski discovered that the region of the brain, known as the insula, is involved in regulating the parasympathetic and sympathetic nervous systems - evidence that there is an important connection in how the brain impacts the heart.

Today there are several stroke centres operating in Ontario. “We were able to prove that our model was successful at improving the lives of stroke patients, so the government facilitated the opening of these centres across the province. We can now say that we have improved outcomes not just for individuals, but at a population level, where public health policy has its true impact,” says Dr. Hachinski.

Currently Dr. Hachinski and his team are seeking funding for a nation-wide study to examine stroke and dementia outcomes across the country, including how several environmental factors play a role in the development of stroke and dementia with the aim of preventing both. “Since this research is multi-disciplinary, it is challenging to find a funding agency as most of them tend to invest in very specific fields of research,” he explains. “We are hopeful that someone will recognize the importance of this research, and we will be able to move forward with our study.”

“I am extremely appreciative and proud to be recognized with the F.N.G. Starr Award, however I am just the face of this honour. Behind me stands an amazing team. I feel that my greatest strength is to recognize and work with talent.”

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.

Image 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.

Community members, patients and families, and those working in the health field attended a special open house on November 28 by research groups at Lawson Health Research Institute. Together, they celebrated the holiday spirit and the gift of hope that is made possible through hospital-based research. 

A part of St. Joseph’s Health Care London, Parkwood Institute represents the next era in care, recovery and rehabilitation. Across the site, clinical and research teams in different disciplines and specialties collaborate not only with each other but also with patients and families. 

“Many people in the community know the high-quality and compassionate care that is supported by the various clinical teams at Parkwood Institute, but aren’t aware of the research happening at this site,” says Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Scientific Director at Lawson.

“Lawson researchers at Parkwood are tackling important challenges with highly innovative and meaningful solutions that help improve care and quality of life.”

For the past three years, the open house gives guests a more in-depth understanding of hospital-based research and its impact. Dr. Forchuk notes that it is a great chance to talk to the researchers and their teams, and to learn about research in a really fun and interactive way. Guests may also learn about opportunities to participate in studies, as the research teams rely on people in the community getting involved.  

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There were 12 interactive program displays from Parkwood Institute Research, a Lawson program, in the areas of cognitive vitality and brain health, mobility and activity and mental health: 

• Cognitive Clinical Trials Group (CCTG)
• Collaboration of Rehabilitation Research Evidence (CORRE)
• Gait and Brain Lab
• Geriatric Mood Disorders Lab
• MacDonald Franklin OSI Research Centre (Occupational Stress Injury)
• Mental Health Nursing Research Alliance (MHNRA) 
• Mental Health INcubator for Disruptive Solutions (MINDS) of London
• Neuropsychiatry and Therapeutic Brain Stimulation Research Group
• Occupational Therapy and Spiritual Care Research Lab
• R2P (Research to Practice) 
• Rehabilitation Mental Health 
• Wound Care

The open house had a festive theme and many of the exhibits involved a problem solving or interactive elements to encourage learning and foster teamwork. 

Karen Vecchio, federal Member of Parliament for Elgin-Middlesex-London, was among the over 200 people in attendance.  

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At the open house, from left: Dr. Cheryl Forchuk, MP Karen Vecchio and Roy Butler, St. Joseph's Vice President. 

“London is a great community to conduct research,” explains Dr. Forchuk. “We are a mid-size city surrounded by rural areas, in many ways reflecting Canada as a whole. A lot of our projects cover the country with multiple sites and results found here by our leading experts are being implemented in health centres and national strategies in this country and around the world.”