Discoveries for life
The faces of health research 2022
HIV and the genital microbiome
Developing new ways to prevent sexual transmission of HIV
Since the first cases of HIV were reported more than 40 years ago, nearly 80 million people have become infected with HIV and 36 million have died from AIDS-related illnesses. Today, nearly 38 million people worldwide live with HIV and more than a million people are newly infected each year. While global efforts have helped reduce infections, increase access to treatment, and save lives, we desperately need new approaches to preventing infections.
Dr. Jessica Prodger, an Assistant Professor at Western University, first witnessed the devastating impact of HIV while doing graduate work in Uganda in the mid-2000s. Medication to treat HIV only became widely available in Uganda in 2006, despite being available over a decade earlier in North America. This experience led Dr. Prodger to focus her research at Western on preventing sexual transmission of HIV and making an impact on the HIV epidemic in sub-Saharan Africa.
Dr. Prodger is researching the role of the genital microbiome in HIV transmission. Unprotected heterosexual sex is one of the common sources of new infections. The foreskin of the penis is the main site of transmission in men and the bacteria that live under the foreskin are known to play a role in the susceptibility to infection. This is why male circumcision can significantly reduce HIV risk. It may also explain why some men who are exposed to HIV through unprotected sex with an HIV positive partner who is not on treatment are less likely to become infected.
As part of her research program, Dr. Prodger is studying penile swabs and tissue samples from adult males in Uganda who have undergone voluntary circumcision to identify the bacteria and immune cells that may be responsible for facilitating and preventing HIV infection. Her work will help us better understand the interplay and communication between the penile microbiome and human tissue and how this relationship can influence the virus. The findings may help develop vaccines and microbicides for HIV prevention.
Improving health for Indigenous women living with HIV
Indigenous researcher works alongside, and learns from, Indigenous women living with HIV
For the past 16 years, Carrie Martin, a Mi’gmaq woman, has worked with Indigenous women living with HIV and other sexually transmitted and blood borne infections. As a community-based researcher, her approach is grounded in Indigenous ways of knowing and doing and decolonizing methodologies.
“It was blatantly apparent that health disparities existed and were perpetuated by a system wrought with discrimination and systemic racism that prevented Indigenous people from enjoying a quality of life similar to their Canadian counterparts,” Martin says of her early realizations when she first started working for the Native Women’s Shelter of Montreal at the age of 21.
It’s been an uphill but rewarding battle for Martin. She launched a medical clinic housed at the Native Women’s Shelter, and in 2008 co-founded the Indigenous Health Centre of Tio’tia:ke. Currently, Martin is the recipient of a $3,469,000 CIHR grant to lead a project entitled Measuring Sexual and Reproductive Health and Rights (SRHR): Responding to the Needs of Indigenous Women and Girls in a Global Context, which will take place in seven countries over five years. This project will improve data collection, use and sharing, and increase partnerships to inform SRHR’s care programming.
Martin’s work strives to be inclusive of all Indigenous cis- and trans-women, genderqueer and femme-identifying folks. Her dedicated work, now largely with Communities, Alliances & Networks (CAAN) and with the financial support of CIHR, seeks to create a more equitable world for women living with sexually transmitted and blood borne infections.
Measuring Indigenous homelessness and addictions in urban settings using Indigenous conceptual frameworks
Stephanie McConkey is a First Nations/mixed European settler doctoral student in the department of Epidemiology at the University of Toronto whose research is currently focused on measuring Indigenous homelessness and addictions in urban contexts. Using the 12 dimensions of homelessness as defined by Jesse Thistle (2017) as a base, McConkey is working to formulate an indicator which can be used to specifically measure Indigenous homelessness and the multitude of factors that contribute to it as well as its impact on substance use among Indigenous peoples living in urban and related homelands.
Given that Thistle’s current indicator of homelessness is applicable to Indigenous and non-Indigenous communities alike, it doesn’t capture the full experience and needs of Indigenous Peoples and the unique factors that contribute to Indigenous homelessness. Stephanie McConkey is dedicated to developing a model which considers the social, colonial, and structural factors which influence Indigenous homelessness. McConkey is taking an Indigenous-partnered approach, where community partners will co-lead the research, including the development of the research question and objectives, design and analysis plan, interpretation of findings, and all knowledge translation activities.
With family members who have experienced homelessness or addictions in their lifetime, McConkey is driven to pursue this area of research and to deepen the understandings of Indigenous homelessness. She is particularly passionate about focusing on using Indigenous theoretical conceptual frameworks to develop statistical models, therefore shifting the common deficit-based data to instead develop statistics which celebrate Indigenous resilience. McConkey aspires this research will help close the gap of social division and inequity endured by Indigenous Peoples experiencing homelessness in urban contexts.
An ally for women with HIV
Achieving better health outcomes and health equity for all women living with HIV
When the first cases of HIV were reported in the early 80s, the disease was initially thought to only affect gay men. More than forty years later, we know that the HIV epidemic has affected all genders, with women representing over half of the nearly 38 million people living with HIV in the world today. In Canada, women represented one in four of the more than 62,000 people estimated to be living with HIV in 2018 and this proportion is believed to be increasing.
While antiretroviral therapy has changed HIV from a fatal disease to a chronic condition, people living with HIV continue to face challenges in accessing treatment and high-quality care. They also continue to face significant HIV-related stigma and discrimination. The effects of stigma are disproportionately felt by women – particularly women from racialized, Indigenous, and gender diverse communities.
For more than 30 years, Dr. Mona Loutfy has been an advocate for women living with or affected by HIV. While pursuing her training as a physician at the Wellesley Hospital in Toronto in the 90s, Dr. Loutfy observed the devastating effects of HIV on her patients and the social factors that influence who becomes infected, the care they receive, and their health outcomes. This experience instilled a commitment to health equity and social justice which has only become stronger throughout her work over the past three decades as a clinician scientist.
In 2006, Dr. Loutfy founded the Women and HIV Research Program, which uses community-based research and works in partnership with women living with HIV to carry out critical research to optimize the lives and care of women with HIV and their families. In partnership with community leaders, Dr. Loutfy and her team have made important contributions in the area of reproductive health and HIV and made a significant difference in the lives of Black, Indigenous, and trans women living with HIV.
Dr. Loutfy led national pregnancy planning guidelines that have enabled people living with HIV to realize their dreams of having children and parenting while preventing transmission of the virus to their babies or sexual partners. She also led the Canadian HIV Women’s Sexual and Reproductive Health Study, a community-based research longitudinal study dedicated to creating knowledge to elevate the health and well-being of women living with HIV in Canada.
In 2022, Dr. Loutfy was recognized with the highest honour in HIV research in Canada, delivering the Canadian Association of HIV Research (CAHR) Mark Wainberg Keynote Lecture. She has also received a CAHR-CANFAR (Canadian Foundation for AIDS Research) Excellence in Research Award and the University of Toronto Department of Medicine’s Michael Gordon Award for Humanism in Medicine.
Understanding the health and social care needs of aging Indigenous adults
Dr. Sharlene Webkamigad is a registered nurse currently working on her Interdisciplinary Ph. D. in the Northern and Rural Health program at Laurentian University. Dr. Webkamigad has dedicated her research to improving the healthcare of aging Indigenous populations, who experience higher rates of chronic conditions than others, and who also have a strong preference to age and die in their own homes. She is focused on determining what the health and social care needs are for Indigenous older adults living outside of long-term care settings and their caregivers to develop a model and policies which address these needs, preferences, and priorities.
Currently, Dr. Webkamigad’s research is focused within First Nations communities in the Anishinabek Nation. Taking an Indigenous community-based participatory approach, Dr. Webkamigad is seeking to identify the perceptions of Anishinabek older adults and their caregivers concerning the impact of community-level supports during the COVID-19 pandemic. Following consultation with the Health and Community Wellness Director and approval from the Chief and Council of Atikameksheng Anishinawbek, a group composed of health care providers, community leaders and Elders have been essential in supporting this research. This collaboration has helped develop local palliative care programs, frameworks for services that demonstrate cultural safety, and the self-determination of tribal councils, among others.
As the granddaughter of a residential school survivor, Dr. Webkamigad has personally witnessed the challenges First Nations older adults and their caregivers face in the management of their health and wellness. Through hearing other residential school survivors’ stories, she is inspired to continue to identify the historical and colonial influences that have impacted the health of aging Indigenous adults, and work towards an improved healthcare system.
Exploring the health benefits of Métis dance
Taking a holistic approach to exploring how culture and social support are connected to heart and stroke health
Dr. Heather Foulds is an assistant professor at the University of Saskatchewan whose current work is dedicated to the health and wellness of the Métis community. Taking a holistic approach, Dr. Heather Foulds is exploring how culture and social support are connected to heart and stroke health, as well as discovering how Métis dance is an important factor in health as both a physical activity and a cultural expression.
As a Métis woman herself, Dr. Foulds possesses a particular interest in this area of research given the sense of identity and the cultural connection that studying this area provides. Having participated in a Métis dance group for five years now, Dr. Foulds has been assisted in this research through the relationships she has formed due to her involvement, and by other Indigenous community members and advisors. As a result, Dr. Foulds has also been able to focus on the cultural and social significance that becoming reconnected to Métis dancing holds for the Indigenous community, such as its history, symbolism, and stories.
Moving forward, Dr. Foulds aspires to share this practice more widely, and she encourages participation in this dance for those outside of the Métis community. Through analyzing a combination of factors, such as the experiences of new dancers and data such as oxygen consumption, Dr. Foulds can assess the physical intensity of the dance and explore the associated physical health benefits that come with it. Not only this but it also provides an opportunity for individuals to be reflective of Canada’s colonial history and enable preservation of knowledge for the Indigenous community. This component of her research complements the more qualitative data from this project that focuses on the physical improvement of cardiovascular health that this practice provides.
Becoming a scientific superhero!
Resources for pediatric research made by kids
The Network of Networks (N2) is an alliance of Canadian research networks and organizations working to enhance national clinical research capability and capacity. Bringing together trialists and clinical research professionals from across the country, N2 provides a common platform for sharing best practices, resources, and research-related content to ensure efficient and high-quality research, integrity of clinical practices and accountability.
As Chair of the N2 Clinical Trials Education and Awareness Committee, Daniela Bianco leads and works with a multidisciplinary team to develop educational and awareness resources/tools that aim to increase public knowledge and understanding of clinical research. The Committee recently produced a fun video as the first part of a toolkit to engage kids and their families and help them learn about research and clinical trials. The video is designed to encourage kids to become “participators” by registering for clinical research studies. It features a real-life participator and three-time cancer survivor who talks about his participation in clinical trials and why research is so important.
The Committee’s video “The Participators” received a special commendation in the 2021 IHDCYH Talks video competition.
Teens Talk Vaping
It’s time to centre teens in research about teen vaping
The Human Environments Analysis Laboratory (HEAL) at Western University specializes in the production, evaluation, synthesis, dissemination, and mobilization of evidence to support effective policies, programs and professional practice aimed at creating healthy and vibrant communities.
Teens Talk Vaping is a “by-youth-for-youth” research project, led by Dr. Jason Gilliland (HEAL Director and Professor at Western) and Dr. Stephanie Coen (Associate Professor at the University of Nottingham, Adjunct Research Professor at Western, and HEAL Faculty Associate), which seeks to understand teen perspectives on vaping. The goal is to better understand teens’ experiences and ideas about vaping, as well as how vaping features into their everyday lives.
As part of the project, teen co-researchers and members of the HEAL Youth Advisory Council, produced a video sharing key themes regarding vaping that came out of focus groups involving project participants aged 13-19. The video takes a first-person point of view and follows the day-in-the-life motions of a fictional high schooler, which includes exposure to vaping in the school’s washrooms, party culture on the weekend where vaping is quite prevalent, and social media visits where vaping is pervasive. It captures some of the tensions that teens face when vaping opportunities and decisions surround them daily.
HEAL’s video “Teens Talk Vaping” received a special commendation in the 2021 IHDCYH Talks video competition.
Promoting resilience in youth who have been victims of interpersonal violence
Putting in place effective measures for prevention and intervention
The work of Dr. Hébert and the members of her research laboratory at Université du Québec à Montréal focuses on childhood sexual assault and violence in youth relationships.
Her research seeks to identify protective factors that can influence individual, family, social and community approaches to reduce the impact of victimization. She also works on projects carried out in close partnership with practice settings to promote the implementation of effective interventions to support optimal youth development and on research to help assess prevention programs intended to curb violence.
Despite the troubling prevalence of sexual assault against youths, it is vital to convey a message of hope for victims, the adults in their lives and workers in the field—a message grounded in research that focuses on the factors that can promote resilience in these vulnerable populations.
Dr. Hebert’s video “Agressions sexuelles envers les enfants” won third prize in the 2021 IHDCYH Talks video competition.
Fears of emergency department visits during the COVID-19 pandemic
Don’t let them prevent you from taking your sick child to the hospital
The COVID-19 outbreak has had a significant impact on how health information is communicated, how individuals seek health information and services, and how these services are delivered. There have been dramatic reductions in the number of children and families who have sought healthcare in emergency departments (ED) at hospitals.
Dr. Shannon Scott and Dr. Lisa Hartling at the University of Alberta are developing and evaluating resources to help families understand essential health information and know when to use healthcare services during the pandemic. They have shown that by engaging parents as partners in health we can help them make decisions, shape treatment expectations for their children, and promote the effective use of health services.
Dr. Scott and Dr. Hartling’s video “What to expect when visiting the ED during the COVID-19 Pandemic” received a special commendation in the 2021 IHDCYH Talks video competition.
Getting young Canadians active again
Throughout the COVID-19 pandemic, Canadian children were less active and more sedentary
Healthy development is fostered through ample physical activity, low sedentary behaviour, and adequate sleep. Doctors suggest that children and youth engage in at least 60 minutes of moderate-to-vigorous physical activity daily, reduce screen time to no more than 2 hours per day, and get at least 8 to 11 hours of restful sleep nightly to optimize physical and mental health.
It was anticipated that the COVID-19 pandemic and the related public health restrictions would change the way children and youth engaged in play and healthy movement behaviours. It was no surprise, then, that Dr. Sarah Moore, an Assistant Professor in the School of Health and Human Performance at Dalhousie University and her colleagues at the Health Populations Institute found that children and youth were less active and more sedentary during the pandemic.
Dr. Moore and her colleagues analysed data from two national surveys, with one focused specifically on Canadian children and youth with disabilities. The surveys collected information on the health behaviours of children and youth, including physical activity, outdoor play, sedentary behaviour, screen time, and sleep over the course of the COVID-19 pandemic. Parents reported that the pandemic not only affected the movement behaviours of their children, it also had a negative effect on their mental and physical health.
Dr. Moore’s video “Canadian children and youth’s movement and play during the pandemic” received a special commendation in the 2021 IHDCYH Talks video competition.
Considering what a person wants rather than expressing an interest for being in their shoes
Ever wonder what makes compassion--compassion? How is it different than empathy, sympathy, kindness, caring? What needs to be present for compassion to occur? What are the key ingredients?
The Compassion Research Lab at the University of Calgary has developed the Pediatric Model of Compassion based on the perspectives of pediatric patients, parents, and their healthcare providers across Canada. This model includes several components including one known as “seeking to understand” which is often the forgotten ingredient in compassionate care.
Whether it be our desire to move from understanding to fixing. Our assumptions that we already understand or better understand what a person actually needs. Or our blind acceptance of the widely held misconception that compassion is understanding what it would be like for us to be in another person's shoes. Without an understanding of both the person and how they optimally experience compassion, we are left tripping over someone else's shoelaces – rolling our ankles and ruining their sneakers in the process – leading to misunderstanding and mistargeted kindness as a result.
The Compassion Research Lab video “What is Compassion? The Defining Features and Power of Compassion” won second place in the 2021 IHDCYH Talks video competition.
How does breastfeeding affect a child’s health and development?
3,500 Canadian kids and their families are helping scientists find answers
Headquartered at McMaster University, and with recruitment sites at The University of British Columbia, University of Alberta, University of Manitoba, and the Hospital for Sick Children, the CHILD Cohort Study involves nearly 3,500 Canadian kids and their families across the country. By following the lives of the babies and their parents over many years, CHILD researchers have made exciting discoveries about how genetic and environmental factors influence childhood asthma, allergies, obesity, and other chronic diseases.
One of these factors is breastfeeding, which benefits babies in many ways. CHILD research has demonstrated that babies who have been breastfed develop a high level of beneficial gut bacteria that promotes healthier growth patterns, lowers wheezing, and helps them avoid getting asthma when they get older. CHILD research has also discovered that how a baby is breastfed matters too – meaning there is a difference between feeding directly from the breast and feeding pumped breastmilk from a bottle, though even a little bit of breastfeeding is beneficial.
The CHILD Cohort Study video “New scientific insights into breastfeeding” won first place in the 2021 IHDCYH Talks video competition.
Researcher aims to improve sleep during the use of mechanical ventilators for ICU patients
When patients are sick enough to be in an intensive care unit at a hospital, they may need a mechanical ventilator to help them breathe. While these machines provide ventilation to improve oxygenation, they may also cause significant discomfort for a patient and potentially serious lung damage.
In an ideal state, a mechanical ventilator works in concert with a patient's respiratory system to produce smooth cycles of inhalation and exhalation. An asynchrony, or a mismatch between a patient's breathing demands and what is being supplied by the ventilator, can result in abnormal breathing patterns and make it difficult for patients to sleep.
With the support of a CIHR Fellowship, Dr. Telias is studying a type of asynchrony called "reverse triggering" in which a mechanical inhalation triggers a second, natural inhalation from the patient, essentially a double breath in, which can increase the volume and pressure of air in the lungs to a harmful level. She has developed an algorithm for a mechanical ventilator that detects normal and abnormal breathing patterns in patients. Dr. Telias is also collecting data from patients on their sleep state (from fully awake to deep asleep) using a new automated sleep depth scoring system called Odds Ratio Product, which allows her to examine the relationship between asynchrony, sleep state, and sedation.
Sleeping on it
Understanding how nightly rest allows us to learn new cognitive skills
All humans require sleep daily to be physically and mentally healthy. Sleep is known to play a role in solidifying new memories and learning. However, researchers do not fully understand the processes in the brain that underlie the consolidation of newly acquired information and skills during sleep.
With the support of a CIHR Fellowship, Dr. Dylan Smith from University of Ottawa Institute for Mental Health Research is combining electroencephalography (EEG) with functional magnetic resonance imaging (fMRI) to peer inside the brains of healthy volunteers and study these processes at work.
Study participants are placed inside an MRI brain scanner wherein they are instructed to solve a visual puzzle before falling asleep. Dr. Smith is analyzing the data from these brain scans with a focus on sleep spindles – fast bursts of brain activity linked to sleep and memory – in parts of the brain associated with learning, such as the prefrontal cortex, hippocampus, and striatum. This research is providing new insight into how our brains integrate new learning while we’re sleeping.
Keep on breathing
How targeting respiratory related neurons could help prevent life-threatening side effects of opioids on respiration
Opioid medication may relieve pain and improve sleep — but it is also addictive and opioid overdose has caused the death of thousands of Canadians in recent years.
Pain relief from opioids occurs when the medication binds to specific receptors in the cells of parts of the brain that regulate breathing. During an overdose, a person's breathing becomes slower and shallower, potentially leading to respiratory failure and death. There is currently no way to prevent this respiratory depression from happening without affecting the pain-relieving properties of opioids.
With the support of a CIHR Fellowship, Dr. Jean-Philippe Rousseau at Unity Health Toronto is studying the neurons located in part of the brain called the preBötzinger Complex. These nerve cells manufacture opioid receptors, as well as a small protein molecule called tachykinin precursor 1 peptide and the neurokinin-1 receptor, which together are believed to mediate respiratory depression caused by opioids. So far, Dr. Rousseau has discovered that stimulating these cells with a blue laser increases the respiratory rate and reverses respiratory depression in mice injected with opioids.
Go to e-sleep
Improving an online program for both infants and parents
About 25% of families have sleep problems with their baby during the first year, which can affect the baby's development and behaviour as well as the health of the parents.
With the support of a CIHR Fellowship, Dr. Elizabeth Keys from the University of British Columbia's Okanagan Campus was able to work with an interdisciplinary team at Dalhousie University to develop and test a mobile app that provides parents with infants aged 6 to 12 months access to evidence-based information, strategies, and resources that encourage sleep. The app was modified from the 'ABCs of Sleeping app for school-aged children', which Dr. Keys helped develop during her postdoctoral fellowship.
As part her work, Dr. Keys reviewed studies of existing online and ehealth programs designed for parents to determine their strengths and weaknesses. Through her involvement in the 'Better Nights, Better Days' research program, she helped collect data from 85 Canadian families on how COVID-19 has affected the sleep patterns of the children in these families. This research has modified the online 'Better Nights, Better Days' pediatric sleep program so that its implementation among 1,000 Canadian families can be evaluated during the COVID-19 pandemic.
Opioid use and osteoporosis
Prolonged use of these medications can impact bone structure
Misuse of opioids has led to a serious public health crisis. In only the first three months of 2020, 1,018 opioid-related deaths were recorded in Canada. Prolonged use of these medications can induce bone loss similar to osteoporosis and increase the risk of bone fractures. It’s critical for researchers to better understand the impacts of opioid use on bone metabolism, quality, and fragility.
To achieve this goal, through use of high-resolution 3-D imaging, Dr. Andronowski and her research team are evaluating how opioids effect the internal structure of bones and their cellular organization. This will lead to potential treatments of opioid-induced bone loss. To carry out this research Dr. Andronowski is performing experiments at the Canadian Light Source, Canada’s national synchrotron facility.
Making employment work for everyone
Evidence to develop public policies that improve the labour market for Canadians with disabilities
According to the most recent Canadian Survey on Disabilities, more than one fifth of Canadians report living with at least one type of disability that affects their daily lives. In addition, nearly 650,000 Canadians who live with a disability are unemployed despite having the potential and desire to work. How do we better align the career goals ofpersons with disabilities with the needs of employers?
Dr. Charles Bellemare is a professor and behavioural economist at Université Laval. As principal investigator of the Disability, Employment, and Public Policies Initiative, jointly funded by CIHR and SSHRC, he is examining how to improve the labour market for persons with disabilities so they can find satisfying jobs, pursue rewarding careers, and achieve financial security. The work of Dr. Bellemare and his team is producing new insights on how labour markets and public policies can help foster better integration of persons with disabilities in the Canadian economy.
To inform their research, Dr. Bellemare and his colleagues are engaging persons with disabilities in ongoing discussion. They are hearing directly from them on the hurdles they face to finding employment and in other areas of their lives. In the end, they are not just helping create better public policy, they are helping make changes that will lead to more fulfilling lives for persons with disabilities in Canada.
At the intersection of research and community safety
Developing safe street crossings and accessible public spaces
Safe, equitable, year-round access to community spaces and infrastructure is a luxury not all Canadians have. The weather in Canada can create barriers and hazards for people who want to access outdoor facilities. The most challenging time is the harsh winter months when snow and icy conditions can make sidewalks and street intersections dangerous for pedestrians. It's even more challenging for persons with disabilities.
Dr. Alison Novak is focused on understanding the role of pedestrian infrastructure, such as sidewalks, street crossings, and street furniture in developing livable and walkable neighbourhoods. Her research is producing evidence to inform recommendations to make homes and public spaces safer and more accessible. This includes offering much needed evidence on safety features for street crossings and how they can be designed to tolerate winter conditions and remain accessible to people with disabilities.
The research done by Dr. Novak is helping create a safer built environment and promoting a higher standard for accessible communities.
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