Research Ambassadors Knowledge Translation Award
About the award
The "IMHA Research Ambassadors Knowledge Translation Award" was introduced in 2009-2010 in order to encourage CIHR applicants to write excellent lay abstracts. This award is given to Principal Investigators who submit a superior lay abstract for an IMHA-funded grant or award, and was created to assist with an overall goal of CIHR, which is to foster knowledge translation from scientific research into improved health for Canadians, more effective health services and products, and a strengthened health care system. It is important that researchers be able to communicate their work to a general audience and a variety of stakeholders. IMHA hopes that this award will encourage success in this area, and looks forward to continuing to acknowledge excellent lay abstracts in the upcoming years.
- François Desmeules (Centre de recherche - Hôpital Maisonneuve-Rosemont)
- Mary E. McNally (Dalhousie University)
- Alexander Scott (University of British Columbia)
- Irina Voronov (University of Toronto)
- Dana J. Philpott (University of Toronto)
- Girish Dwivedi (University of Ottawa)
- Lindsay McLaren (University of Calgary)
- Hugh Kim (University of British Columbia)
- Aziz Ghahary (University of British Columbia)
- Kei Masani (University Health Network (Toronto))
- Gordon H. Guyatt (McMaster University)
- Fiona Webster (University of Toronto)
- Vinod Chandran (University Health Network)
- Joy C. MacDermid (McMaster University)
- Robin N. Michel (Concordia University)
- Ciarán Duffy (University of Ottawa, CHEO)
- John Esdaile (Arthritis Research Centre of Canada)
- Joy MacDermid (McMaster University)
- Victor Rafuse (Dalhousie University)
- Douglas W. Hamilton (University of Western Ontario)
- Hubert B. Labelle (Saint-Justine Hospital)
- Joanna E. Sale (St. Michael's Hospital)
Criteria for an excellent lay abstract
Judging of lay abstracts is done by the CIHR - IMHA Research Ambassadors (RAs), a panel of non-scientist consumers selected through a call for Expressions of Interest process to represent CIHR – IMHA’s areas of research focus. The RAs select lay abstracts that are well written, easily understood by a lay audience, comprehensive and highly informative. In particular, excellent lay abstracts should:
- include overview of key project elements
- adequately explain technical terms when introduced
- have a logical flow of thought that is easy to follow
- describe anticipated results that are likely to impact future research in the area
- be appropriately presented in general language
- be clear and logical in the explanation of the research project
As examples of excellent lay abstracts, please review the following abstracts that were chosen as past winners of the Research Ambassadors Knowledge Translation Award:
Biomedical - Role of mast cells in tendinopathy
Alexander Scott (University of British Columbia)
Tendons are a kind of connective tissue - tendons connect muscles and bones, allowing joints to move and absorb energy during activities such as sports or manual labour. Tendons often become injured and heal poorly, especially in manual labourers, computer workers, and athletes. Tendon injuries tend to become recurrent and chronic, and for example, can lead to extensive time off work. We have found abnormally high levels of a type of connective tissue cell - the mast cell - in chronically painful human tendons, and also in acutely injured or repetitively strained rodent tendons. This cell type has a well-known role in the allergy response; however, mast cells are also involved in the formation of repair tissue, especially in conditions where there is a chronic or ongoing injury. This project aims to understand the role of mast cells in acute and chronic tendon injuries, including the mechanisms by which mast cells interact with and influence the inflammatory and reparative activity of local tendon cells. This work could lead to new treatments for injured workers and athletes suffering from chronic activity-related tendon pain.
Biomedical - Role of lysosomal pH in osteoclasts
Irina Voronov (University of Toronto)
The human skeleton is continuously rebuilt and renewed throughout life. New bone is made by cells called osteoblasts, while old bone is destroyed (or 'resorbed') by cells called osteoclasts. In a healthy person, bone formation and resorption are balanced. During a disease, for example arthritis, the presence of inflammation around affected joints shifts this balance towards excessive bone resorption. This project is focused on studying the biology of osteoclasts, the bone resorbing cells. Osteoclasts create an acidic environment to resorb bone. A highly specialized acid pump (V-ATPase) is responsible for creating this acidic environment. V-ATPases have other roles that affect not only bone resorption, but also communications inside the cells and formation of mature osteoclasts. We will study osteoclasts from mice with a mutation in the V-ATPase. This will allow us to determine possible new roles for V-ATPases in osteoclasts in a specific and systematic manner.
Clinical - Diagnostic Validity and Reliability of Patients' History and Physical Examination Tests for Common Knee Disorders
François Desmeules (Centre de recherche - Hôpital Maisonneuve-Rosemont)
Many people consult a health professional for knee problems. Knee problems are getting more and more frequent as the population is aging and the increased prevalence of obesity. Knee problems cause pain and limitations in daily activities like walking and stair climbing and reduce participation in physical activities. Many knee problems can be treated if diagnosed rapidly. Currently, health professionals rely heavily on imaging tests for diagnosis, which delays treatment and increases economic health care costs. Scientific evidence shows that the clinical examination done by health professionals, which consist of the patient's history and physical tests suggest that it may be as precise as imaging for the diagnosis of many knee problems. The objective of this project is to determine if a clinical examination is as valid for the diagnosis of knee problems. Moreover with this information, this project will help built a better, more efficient and more precise clinical examination that can be use by different health professionals. This project will also determine if a physical therapist can do a diagnosis as precise as an orthopaedic surgeon. There are many benefits of this project. By developing and showing that a clinical examination is precise, health professionals can do the diagnosis of knee problems faster and more efficiently. Therefore, the patients can be directed to the adequate treatment rapidly without delays. Moreover, if a physical therapist is as precise as an orthopaedic surgeon, patients could have access to a diagnosis without the delays for the consultation with an orthopaedic surgeon. In turn, if patients are treated more rapidly, this could lower the functional incapacities and pain, increase health of the population and lower healthcare cost all at once.
Health Systems/Services, Social/Cultural/Environmental/Population Health - Tui'kn (Passage) to Oral Health: A community-led research partnership to improve oral health in Unama'ki
Mary E. McNally (Dalhousie University)
For the past 10 years, the Tui'kn Partnership, a health-centered partnership comprised of the five Mi'kmaq First Nations communities of Unama'ki (Cape Breton), Nova Scotia, has been working to improve health and quality of life for its people. Very high rates of preventable hospital admissions for dental conditions have been discovered within the communities. This concerning data led the Tui'kn Partnership to engage with researchers to address this problem. Together, we plan to build a strong collaborative team that will use a "two-eyed seeing" approach to create solutions that will reduce oral disease and improve overall health for people living in Unama'ki First Nations.
Biomedical - Nod-like receptors: linking innate immunity and inflammation to chronic disease
Dana J. Philpott (University of Toronto)
The Nod-like receptors (NLRs) are a family of genes that control the body's response to infection and injury. Since these genes control inflammation pathways in the body, if they are activated inappropriately, they can cause the development of a number of chronic diseases, including inflammatory bowel disease, cardiovascular and chronic kidney disease. Inappropriate NLR activation can also predispose people to chronic bacterial infections. Our team believes that the NLRs are important genes in inflammation and chronic disease and that efforts should be made to understand how they work and transfer that knowledge to help patients with common chronic conditions that involve the gut, heart and kidneys. Our goal with this project is to identify key pathways that are triggered by NLRs that control infection, inflammation, healing or chronic tissue damage. Once these pathways are identified, we will develop new tests and drugs that can be used to help diagnose and treat patients with chronic diseases of the gut, heart and kidney.
Clinical - The Effects of Psoriatic Arthritis on Coronary Flow Reserve and Markers of Inflammation and Evaluation of the Response to Biological Therapy
Girish Dwivedi (University of Ottawa)
Patients with severe psoriasis and psoriatic arthritis (PsA) have a particularly high prevalence of heart disease (50% cause of death). There is increasing evidence to suggest that cause of heart disease in these patients may be related to inflammation of the endothelium (cells lining the blood vessels). Newer and stronger medications are now available to treat severe psoriasis that reduces inflammation in the joints but their effects on heart are not known. The objective of this study is to detect early changes (that lead to narrowing of arteries and cause heart attack if untreated) in the endothelial cells lining blood vessels of the heart in patients with psoriasis and PsA. To achieve this purpose we will use sophisticated positron emission tomography (PET) scan to evaluate blood flow to the heart and and also image cells that are particularly active (inflamed) in the body. We will evaluate if any of the above changes improve with the new treatment. We will study three distinct groups of subjects: a) high-risk (PsA patients receiving new treatment otherwise known as biologics (a class of medicinal products that are produced by biological processes such as biotechnology methods); b) low-risk (psoriasis patients not on biologics); and c) control population. By doing this study we may be able to show that the techniques we intend to use have the ability to detect abnormalities at an earlier time point that may allow treatment at an earlier stage. We will also be able to evaluate the benefit (or any harm) of the expensive treatment currently used in severe psoriasis (i.e. biologics). This may lead to a significant change in the current treatment practice and positively impact policy, patient care, outcomes and quality of life in Canada and the world.
Social/Cultural/Environmental/Population Health - Fluoridation cessation: equity, controversy, and decision-making in population and public health
Lindsay McLaren (University of Calgary)
Oral health is an important part of overall health. Oral health problems in childhood can influence well-being throughout the life course. More than half of Canadian children are affected by caries (tooth decay). Surgery for caries is currently the leading reason for day surgery among children under age six in Canada. Caries are generally preventable, and one means of prevention is fluoridation of drinking water. However, an increasing number of Canadian cities are opting to stop fluoridating their drinking water ("fluoridation cessation"). Fluoridation cessation may have important implications for oral health; however, research is extremely limited. In particular, there is only very limited knowledge about the impact of fluoridation cessation on children's oral health, what attitudes members of the public hold about fluoridation and fluoridation cessation, and how decisions are made about fluoridation cessation. This program of research aims to fill these knowledge gaps. Research findings will be important in terms of identifying the best ways to improve oral health in the population, especially because dental health is not included as part of our health care system. This research involves a collaboration between the University of Calgary and the Provincial Oral Health Office at Alberta Health Services.
Biomedical - Regulation of periodontal inflammation by the platelet cytoskeleton
Hugh Kim (University of British Columbia)
Proper function of the immune system is essential for protection against infectious disease and maintaining human health. During the onset of infection, white blood cells and platelets release signaling molecules known as cytokines, which orchestrate a protective inflammatory response. When cytokine release is de-regulated, excessive inflammation results that causes cell and tissue death and loss of function. This is seen in periodontitis (gum disease), which is characterized by gingival (gum) inflammation and destruction of tooth-supporting connective tissues and bone. The purpose of this grant application is to study the mechanisms and identify the proteins responsible for maintaining the health of periodontal tissues. In addition to regulating blood coagulation (clotting), platelets are emerging as pivotal components of the host inflammatory response. We will study in human and mouse platelets, how infection causes cytokine release. The current project will focus on two major questions. First, we will identify the molecular signals that operate during periodontal infection and learn how these signals affect platelet function. We will also test the hypothesis that a group of proteins known as filamins mediate the release of cytokines from platelets. In this context, an improved understanding of platelet function could have important implications for rational treatment of inflammatory diseases, including periodontitis.
Biomedical - Skin cell therapy for the long term treatment of alopecia areata
Aziz Ghahary (University of British Columbia)
Alopecia areata (AA), defined as a non-scarring autoimmune hair loss disease, has a serious impact on the quality of life for AA patients worldwide. It is well established that infiltrated immune cells, known as CD4+ and CD8+ lymphocytes, target the hair follicles of AA patients. Various therapeutic regimens are currently used for the treatment of AA; however, none of them can prevent or cure the disease. Our preliminary results generated from an AA mouse model revealed that none of the mice received skin cells producing an immunosuppressive factor known as IDO developed AA while 80% of control animals developed extensive AA within 8-16 weeks after transplantation of AA affected skin. Here we hypothesize that IDO expressing skin cell therapy can prevent the progression of AA by suppressing the CD4+ and CD8+ cells attacking hair follicles. To address this hypothesis, we will test 4 different objectives through which 1) The potential role of skin cell therapy not only in prevention but also in progression of AA in those patients who already suffer from this disease will be evaluated, 2) The factors that affect the capacity of IDO producing fibroblast therapy in reversing the autoimmune AA disease will be tested and finally 3) The last 2 objectives will reveal the mechanism by which this cell therapy improves or even cures this disease. In conclusion, we strongly believe that, if it is proven to be true, our novel cell therapy approach would overcome the AA autoimmunity and prevent the progression of AA. Potentially this may be a long lasting, possibly permanent treatment for patients who suffer from this devastating skin disorder.
Clinical - Development of novel tool to reduce muscle fatigue during rehabilitation using functional electrical stimulation
Kei Masani (University Health Network (Toronto))
People with spinal cord injury have impaired movements of their arms and/or legs, due to paralyzed muscles. However, when we externally stimulate those muscles using electrical stimulation, muscles can be made to contract to generate different limb movements and physical activities such as walking, standing, and grasping. People with spinal cord injury can also use electrical muscle stimulation to train muscles and maintain muscle strength, which will in turn prevent other complications such as pressure sores, low-impact fractures, and deep vein thrombosis from occurring. Thus, rehabilitation using electrical muscle stimulation is very advantageous for this patient population. However, one aspect that often limits the use of electrical stimulation is the rapid onset of muscle fatigue. One can potentially explain the muscle fatigue following electrical stimulation by the fact that electrical stimulation contracts muscle fibers simultaneously and that electrical stimulation is unable to contract all the fibers within the muscle. We have proposed a new stimulation method that would activate most of the muscle fibers in a regulated cyclic pattern, and showed the effectiveness in our previous CIHR project for leg muscles. In this novel method, special electrodes and a stimulator are used to distribute the stimulation centre over a larger area of skin. In the current project, first, we will design a small electrical circuit with which one can use this method in actual therapy. Secondly, we will test the new method in muscle strength exercise. Thirdly, we will test the new method for arm muscles. We expect that we will translate our new method to a simple form that can be easily used in therapies. The tool may later be commercialized.
Health systems/services - Patient-centred interprofessional shared care model for low back pain management
Gordon H. Guyatt (McMaster University)
It is estimated that 50-80% of the adult population will experience low back pain (LBP) in their lifetime. Although generally acknowledged as having a favourable outcome, growing evidence suggests that LBP is a chronic remitting and relapsing condition for many. It is this group that incurs the largest costs in terms of healthcare utilization and loss of productivity within the LBP population. In Canada, medical expenditures for LBP are estimated between $6 and $12 billion annually. Canadian patients with LBP who seek care are faced with a choice of healthcare and provider options, with little or no collaboration between providers, often leading to fragmented patient care. Treatment results for patients with non-specific LBP in general, when managed as a single group, are suboptimal. Current research suggests that a more specific approach to the management of LBP could lead to tailored treatments and improved outcomes. The Ontario Ministry of Health and Long Term Care has recently approved a pilot study to explore the effect of a shared care model using standardized assessment of LBP patients by allied health professionals (physiotherapists and chiropractors). This model requires a formal evaluation to inform relevant stakeholders whether the model should be abandoned, revised, or implemented across Ontario. We propose to initiate two randomized controlled trials to establish if this patient-centred inter-professional shared care model for LBP is effective. One trial will recruit patients attending to primary care providers and the second trial will recruit patients referred to spine surgeons in Ontario. The primary outcome will be functional recovery; we will also capture quality of life, return to work, and complete cost-effectiveness analyses. If the use of inter-professional shared care is effective in improving LBP-related outcomes, our research proposal will provide essential evidence to support a fundamental change in the management of LBP in Canada.
Social/Cultural/Environmental/Population Health - Finding the complex patient in patient-centred care: an institutional ethnography of chronic pain management in family medicine
Fiona Webster (University of Toronto)
For people who suffer from chronic orthopedic (OA) pain, the family doctor often plays a key role in their education, care and access to other specialists such as orthopaedic surgeons or physiotherapists. Therefore, effective communication and teamwork among these various care providers is very important. The proposed study will study the coordination of these different standpoints using interviews and observations. Interviews will be conducted first with primary care physicians who are involved in the care of patients with chronic OA pain. Interviews will also be done with those who work directly or indirectly with these primary care doctors, including the specialist physicians, nurses, physiotherapists, provincial agency representatives, patients and their family members. The results from this study will be shared with a wide range of people who are involved in delivering care to OA patients in order to improve care delivery across the province. This approach has the potential to help us better understand how to improve clinical practice, with the ultimate goal of improving the health of patients and their families suffering from chronic OA pain.
Network for Canadian Oral Health Research
Debora C. Matthews (Dalhousie University)
The oral health of Canadians has improved dramatically over the past 30 years; children are much less likely to have tooth decay than in the past and older Canadians are keeping more of their natural teeth than their parents and grandparents did. This is good news - good oral health is essential for overall health and wellbeing. While a lot of progress has been made, many challenges remain: we now know that oral disease is linked to other conditions such as diabetes, pneumonia and cardiovascular disease; we know there is a growing issue around oral disease among the frail elderly; and we know that there are groups of Canadians who still have high rates of oral disease and little access to oral care. We can attribute much of the improvement in oral health to research into the causes, treatment and prevention of oral disease. Canada is home to a number of internationally known oral health researchers. Until now, however, most have worked individually or in small groups. This Network for Canadian Oral Health Research will link oral health researchers from ten universities across Canada. The network will: create a registry of researchers, their interests and resources; gather researchers from varied backgrounds but with shared research interests at workshops to plan new research; and work to share the outcomes of research with policy makers, dental professionals and the public. This network will create ways for oral health researchers to share ideas and resources so they can work together to continue to improve the oral health of Canadians.
Cellular basis of endogenous cartilage repair in super-healer mice
Roman J. Krawetz (University of Calgary)
When most body tissues heal after an injury, they recruit specialized cell types known as progenitors to assist in the process; these cells are thought to reside locally in the tissues and are activated when an injury occurs. Once activated, progenitors can turn into different types of cells to regenerate the tissue and heal the injury. In contrast, the cartilage in knee joints has poor healing capacity and patients with cartilage injuries are often left with chronic pain and disability. To create new treatments for cartilage injuries, scientists first need to understand how progenitor cells react when cartilage is damaged and how inflammation in response to the injury affects healing. We have developed methods to study progenitor cells in the knee joints of mice and track them after a cartilage injury to see how they react. A strain of mouse (the super-healer) is available that shows improved wound healing and regeneration of its cartilage after injury. We will look for differences in progenitor cells from regularly healing mice and from the super-healer that might explain its ability to better regenerate cartilage. In a second set of experiments, we will determine if the super-healer progenitors can regenerate cartilage in regular mice by transplanting the cells into injured knees of regular healers. We will also study the capacity of progenitor cells to heal cartilage in a third type of mouse that has no inflammatory response to injury. This work will find out how local progenitor cells contribute to cartilage healing, with the eventual goal of developing new, less expensive treatments for patients with cartilage injuries.
The Firefighter Injury Reduction Enterprise: Wellness Enabled Life & Livelihood (FIRE-WELL) –
Joy MacDermid (McMaster University)
Firefighters are exposed to significant personal risk while providing essential services. Musculoskeletal (MSK) injuries, poor fitness & cardiovascular health are common problems. Firefighters, their union and employer approached researchers to develop, implement and evaluate an evidence-based "wellness" program to prevent injuries, optimize safe return to work and reduce rising health care costs. The research program has 2 phases. The goal is to evaluate the impact of community-based medical, fitness and MSK injury screening. Phase 1 will examine and characterize health problems identified by a doctor specialized in occupational medicine in a series of 300 firefighters and monitor the health services they require. In preparation for Phase 2, we will define job demands using motion analysis of firefighting tasks. Then we will conduct a screen of MSK injury and fitness of 150 firefighters with identified signs of emerging MSK problems. From these, 75 will be assigned to a personal education intervention within their fire station about how to perform their work in a manner that reduces risk of injury. We will evaluate our success by measuring health and work indicators at the start, and 6 & 12 months later. Outcomes include; number/type and cost of injuries, lost work, self-reported overall health status, change in fitness and at-work limitations. They will be measured by trustworthy methods. Mathematical models will help us know if this approach reduces the illness and disability burden experienced by firefighters. Cost savings will be put back into the wellness program to enable program expansion and long-term sustainability. Firefighters intend to lead the project and share it with other groups.
Identifying Biomarkers for Psoriatic Arthritis: From Discovery to Prognostication –
Vinod Chandran (University Health Network)
Psoriasis is a common skin disease affecting 3% of our population. Psoriatic Arthritis (PsA) is a specific arthritis that affects 30% of patients with psoriasis that often leads to progressive joint damage, disability and poor quality of life. Early diagnosis and treatment can prevent joint damage, disability and improve quality of life. However, early diagnosis is often difficult. There is a high prevalence of undiagnosed PsA in patients with psoriasis. Identifying markers in the blood for the presence of PsA will help in early diagnosis and help determine who is going to fare poorly. Since PsA primarily affects the skin and joints, the source of markers for PsA may reside in these tissues. We therefore plan to identify these markers from skin and joint fluid obtained from patients with PsA. The most promising of these markers as well as markers previously identified by us and other researchers will then be investigated in a large number of subjects with psoriasis, PsA and healthy controls to determine if they distinguish patients with PsA from those with psoriasis alone. We also plan to test the usefulness of these markers for predicting future joint damage using methods developed in our long-term follow-up clinics at the University of Toronto. Results of these studies will help us develop blood tests that may serve to screen for PsA in patients with psoriasis. Simple blood tests developed through this program may help in early diagnosis and appropriate management, and thus ultimately prevent disability and improve quality of life in thousands of Canadians suffering from psoriasis and PsA.
Role of calcineurin and its signaling modulators in the dystrophic phenotype –
Robin N. Michel (Concordia University)
The signature feature of muscular dystrophy as a disease is the absence of a key muscle fiber membrane protein called dystrophin. One of the most promising therapeutic strategies for countering muscular dystrophy is to replace in the diseased muscle the missing dytrophin protein with its "twin sister" protein, utrophin, which is found in small amounts in the muscles of people that have muscular dystrophy. We have provided exciting new evidence showing that utrophin is under the control of another muscle protein, calcineurin, an enzyme that we have shown to be an orchestrator of muscle growth. Indeed, we showed that when calcineurin is turned on within a muscle fiber, utrophin is enticed to appear in abundance all over the muscle fiber in areas usually reserved for dystrophin. By virtue of this replacement calcineurin is thus capable of rescuing fibers that are damaged by muscular dystrophy. Within the time frame of this proposal, we plan to further define the role of calcineurin in this rescuing of damaged dystrophic muscles and plan to identify other players in this symphony to help us to better understand and develop strategies and interventions to reverse its damaging effects.
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