WHRI partners with Vancouver Island Health Authority and University of Victoria to run womens health symposium

On May 6, 2019, the Women’s Health Research Institute (WHRI), in partnership with Vancouver Island Health Authority and the University of Victoria held a symposium focused on women’s health. The event was funded by a Collaborative Research Mobility Award from UBC awarded to Dr. Brotto.

The symposium brought together faculty members, staff, patient partners, community groups, and trainees from across Vancouver Island to hear about new research in women’s health. The day started with a trainee breakfast led by Dr. Karen Urbanoski, who shared personal experiences and insights about charting an academic career in women’s health.

Following breakfast, we then were treated by a panel presentation, where the theme for the panel was “Supporting vulnerable women: A focus on stigma and safety”. Leading the panel was Lisa Ridgway, a patient partner and lawyer who discussed the role of advocacy among vulnerable women, and how that is important for health research. Dr. Karen Urbanoski, who holds a Canada Research Chair in substance use, addictions, and health services research, focused on the unique social determinants that impact women who are using substances during pregnancy. Dr. Patti Janssen, a Professor in the School of Population and Public Health discussed an innovative project focused on women with a recent history of incarceration, and focused on understanding their health goals. Dr. Elizabeth Borycki, a Professor in the school of Health Information Science at UVic and MSFHR Scholar talked about the opportunities and challenges associated with e-Health apps and patient portals to support vulnerable women. Finally, Dr. Nichole Fairbrother, an Assistant Professor in the UBC Department of Psychiatry and Island Medical Program, enlightened listeners about the common yet rarely recognized condition of post-partum obsessive compulsive disorder.

Following the panel discussion, we had an interactive moderated question & answer period. The audience left inspired at what we had learned and how these scientists and patient partners are changing the landscape of health for vulnerable women.

Networking, conversation, and collaboration were woven throughout the morning focused on women’s health. In alignment with the WHRI’s mission focused on collaboration, new relationships were formed and discussions were rich. The WHRI is excited to expand its network of membership to all researchers, stakeholders, and community persons across Vancouver Island (and across BC) who share an interest in women’s health research.

For more from the event check out @womensresearch, @VIHealthRes, and #5DIM on Twitter, or check out the recording here.

KT Pathways: a free new tool for everyone wanting to close the gap between what we know and what we do

WHRI is excited to announce the launch of KT Pathways, a free digital assessment and learning tool for anyone that creates or uses research evidence.

Why should you care?

A lot of time and money goes into research but much of the knowledge discovered by researchers is never used. That means missed opportunities for that knowledge to contribute to the health and well-being of our communities and society. KT Pathways was developed to help people to use that knowledge.

Who is KT Pathways for?

KT Pathways is for anyone who wants to learn how to close the gap between what we know and what we do. It’s for those who:

  • Want to use evidence to inform the decisions they make in work;
  • Want to produce knowledge that is used by others; or
  • Want to make knowledge more accessible to those who can use it.

 How does KT Pathways work?

Knowledge translation (KT) encompasses all the activities aimed at increasing the impact of research on policy, practice and even further research. KT Pathways is designed to help users assess their current KT skill level. Users rate themselves against the core skills required for successful KT to identify their strengths and areas for development.

If you are a  KT beginner, KT Pathways is a way to learn about all the different skills involved in KT (they may be different than you think). The assessment results will direct you to tools and resources specifically tailored for you.

If you are a KT pro, KT Pathways will help further your growth in the field with up-to-date tools and resources. This tool can help you identify areas for further professional development and increase your KT knowledge and skills.

 KT Pathways development partners

WHRI was one of many academic and health system partners across BC who contributed funding and/or in-kind support to help develop KT Pathways. Other partners in this Michael Smith Foundation for Health Research led initiative include BC-based health authorities, universities, research institutes, the BC SUPPORT Unit and BC Ministry of Health.

Check out KT Pathways and start your KT journey!

Have questions? Contact Nicole Prestley at nicole.prestley@cw.bc.ca.

Q&A with Jessica Liauw

Jessica Liauw is a fellow in the Clinician Investigator Program at UBC, and an Obstetrician and Maternal Medicine specialist. Her clinical practice is focused on high-risk pregnancy, and her research interests are preterm birth, fetal growth, and clinical decision making.

She is currently working the #NavigatingTheGreyZone project, which aims to find ways to help pregnant women decide if they should take steroids to help their babies’ lungs when faced with the possibility of an early delivery.

Keep reading to learn more about Jessica and her work!

  1. Briefly, can you describe your research project?

We are trying to find out what pregnant women and clinicians want to know when deciding whether or not antenatal corticosteroid medication should be used if she is at risk for delivering 4 to 6 weeks preterm. Our overall goal is to create a decision aid to help patients and clinicians make this treatment decision. In Phase 1 of the study, we will interview pregnant women, obstetricians, and pediatricians, to find out what to include in the decision aid. In Phase 2 of the study, we will draft the decision aid, and then ask pregnant women and clinicians to provide feedback on it.

  1. What inspired this research?

Along with some members of the research team, I helped to update a recent clinical practice guideline on the topic of antenatal corticosteroids for preterm birth. From this experience, I became fascinated by the “grey zones” and controversies surrounding this treatment decision, especially for women who are at risk for delivering from 34 to 36 weeks of gestation. I realized that we need to find a way to help pregnant women and clinicians navigate the risks and benefits of this treatment to help patients make the decision that is right for them.

  1. What impact do you hope this research will have on women’s health?

We hope this research will help us understand what pregnant women and their doctors need to help them improve decision making. Research in women’s health is always expanding, which is exciting but can also be overwhelming when trying to make the best decisions at the bedside. From this research, we hope to create an effective decision making tool that patients and clinicians can use together.

  1. Anything else we should know? (recruitment info)

We are looking for pregnant women, obstetricians, and pediatricians to interview for Phase 1 of this study. We need your opinions on what to include in a decision aid about antenatal corticosteroids after 34 weeks’ gestation – we just need 15 minutes of your time. If you are interested in participating please email us at decisionaid@cw.bc.ca. Thank you!

An article co-authored by Dr. WS Chan was recently published in Stroke

The paper, which was also co-authored by WHRI member Dr. K.S. Joseph, is the first Canadian study reporting on the incidence and risk factors of stroke and cerebrovascular disease during pregnancy in Canada.

In her role as an Obstetric Medicine Physician at BC Women’s Hospital + Health Centre, Dr. Chan is often called upon to manage pregnant or postpartum women with symptoms of stroke. Her team noticed that the frequency with which they encountered these women appeared to be increasing, which led Dr. Chan to suggest a study to identify presentation and associated risk factors of stroke in Canadian Women.

In collaboration with investigators from the Canadian Perinatal Surveillance System, Drs. Chan and Joseph evaluated how pre-existing conditions (such as maternal age, obesity, hypertension, diabetes, connective tissue diseases, congenital heart disease, etc.) as well as some of the conditions which develop during pregnancy (like preeclampsia, gestational diabetes, sepsis, or severe postpartum hemorrhage) are associated with the risk of stroke and cerebrovascular events in pregnancy.

The study reported that the overall rate of pregnancy-associated stroke and cerebrovascular events during the period of 2003-2016 in Canada was rising, with the current risk of stroke sitting at approximately 13 cases per 100 000 deliveries. The majority of these occurred postpartum, and were hemorrhagic strokes.

Although the annual rate is lower than those reported in the US (where approximately 22-27 cases are identified per 100 000 births) much can still be done to reduce this risk further in Canada with a better understanding of maternal risk factors for stroke.

Knowing that the presence of preeclampsia confers the greatest risk of stroke during pregnancy and especially postpartum should prompt clinicians to promptly diagnose and manage these patients when symptoms develop, especially after the patient has delivered.

To read the article in Stroke, click here.

To learn more about Dr. Chan, click here.

International Midwives Day: Zoe Hodgson

In honour of International Midwives Day we’re shining the spotlight on Zoe Hodgson, PhD and Registered Midwife.

  1. What are your research interests?

All families face many choices during their pregnancy, birth and postpartum period. Midwives recognise the childbearing client as the primary decision maker and help them make decisions within a context of informed choice. To enable this, a midwife will review the options with a client and discuss the evidence for and against a given procedure, treatment or course of action. However, the current problem faced by midwives is that there is often a dearth of literature on many of the choices available to clients today, meaning such informed choice discussions are based on anecdotal reports alone. This is especially the case when these options are alternatives to the standard practice. The overall aim of my research program is to build research capacity and create a culture of research among midwives in BC particularly in relation to the study of midwifery outcomes.

  1. What inspired you to transition from your career as the Director of Women’s Research to catching babies as a midwife?

I always knew I wanted to be a careprovider. My role at the WHRI enabled me to become familiar with the maternity scene in BC. I was very fortunate to work with midwives, family doctors, nurses and obstetricians. Midwives have only been regulated and legally recognized as autonomous health care practitioners in BC since 1998. As such, midwifery in BC is still relatively new and has so much potential to grow! I saw midwifery as a career where I could both work as a clinician and academic and conduct research that really mattered to families. Not only this, but I was excited by the potential to narrow the gap between the acquisition of evidence and uptake into clinical practice. As a midwife, I can readily share new evidence with the families I care for.

  1. What has been the most interesting part of your journey to midwifery?

What hasn’t?! I am constantly blown away by this profession, the care providers, the families, and how much midwives truly embrace informed choice and support their clients to have their best possible birth experience. When it comes to baby catching, there is never a dull moment! I truly believe I have the best job in the world.

  1. How does your experience as a researcher influence your clinical work (and vice versa)?

Evidence-based practice is a key component of midwifery care. As midwives, we endeavour to provide our clients with the update to date evidence to allow them to make informed decisions. I feel very fortunate to be in the position to be able to use evidence in my daily practice and also be aware of the knowledge gaps and use these to fuel my program of research.

  1. What’s a fun fact about you?

I am one of a team of midwives who is currently training for Tough Mudder in Whistler in June. I am yet to master the monkey bars!

Research Spotlight: National Medical Lab Week

Meet Dr. Vilte Barakauskas, BCCHRI/WHRI joint-researcher and clinical biochemist working at BC Children’s Hospital, who is part of a team working to establish reference intervals for pregnant women to better interpret lab test results.

Dr. Barakauskas works alongside a large team of people who obtain, process, and analyze specimens – like blood or tissue samples – in the department of Pathology and Laboratory Medicine at the BC Children’s  and Women’s Hospitals campus. As a clinical biochemist she works closely with medical lab technologists, medical lab assistants (MLAs), and clinicians in a role focused on interpreting lab test results, to aid in accurate diagnoses and management of disorders and diseases.

In her day-to-day work, she is also involved with quality oversight in the lab to help ensure that they are producing reliable, accurate, and timely results, as well as providing consultation for healthcare providers and physicians. This might include assisting with test result interpretation by reviewing records, producing interpretive reports, evaluating test performance, or helping to find, select, or order and utilize appropriate tests. She is also involved with decisions around implementing new types of tests or developing tests when a need is identified.

In addition to her role in the lab, Dr. Barakauskas is helping to establish reference intervals for pregnant women around the time of labour through the Pregnancy Reference Intervals for Safe Medicine (PRISM) study. For the average person, lab results are interpreted by comparing against a set of reference intervals. These are a range of data compiled from ‘healthy individuals’ (commonly adults), which can help determine whether or not a patient’s test results are within a normal range, or if there might be a need for further investigation and testing.

However, for patients who belong to a population outside of the ‘average, healthy adult’, it becomes difficult to determine when there is a cause for concern. Dr. Barakauskas offers the example of pediatric medicine, where babies and kids are developing so quickly that it becomes harder to pinpoint what ‘normal’ should look like in test results.

Similarly, pregnancy is a time period during which physiology changes and test results might appear abnormal when compared with non-pregnant adults. Currently, there is little available information about reference intervals for this population, and less data directly applicable to our diverse population of women in British Columbia. Access to representative reference intervals is important because they help reduce the risk of under or over diagnoses and support appropriate patient care.

Creating reference intervals is a daunting task, Dr. Barakauskas explains, as it requires a lot of blood sampling and a lot of data. Further, she emphasizes the added difficulty of collecting specimens from ‘healthy’ populations, who are less likely to require bloodwork as part of their routine care, and thus volunteers for research participation and blood collection are required.

As a result, her team is conducting this research both through a recruitment process, where they seek out ‘healthy’ pregnant women to collect blood from, and through retrospective data analysis, where existing data is sorted using mathematical methods. While the study’s primary goal is to produce reference intervals and improve test interpretation, it will also allow the team to compare these two research methods for future development of reference intervals for other populations.

Dr. Barakauskas and her team have finished recruitment for the initial PRISM study of women around the time of labour, throughout which they had great collaboration across lab staff, nurses, and healthcare providers. They are currently starting sample and data analysis. She would like to acknowledge the mothers who participated, along with all the MLAs, lab technologists, nurses, students, BCCH Biobank and others who invested their time and hard work in the PRISM study and is grateful for the mentorship of co-investigators Dr. Wee-Shian Chan, Head of the Department of Medicine at BC Women’s Hospital, and Dr. Benjamin Jung, Clinical Biochemist, currently at SickKids. Together with Dr. Kate Chipperfield, Hematopathologist in the department of Pathology and Laboratory Medicine, Dr. Chan and an expanded team of clinician and patient collaborators, they will work to begin recruitment for the next iteration of PRISM which will look at blood from healthy mothers postpartum, as well as blood from their infants.

Members of the PRISM research team, and BC Children’s laboratory staff.

To learn more about PRISM click here. To read more about Dr. Barakauskas, click here.

World Immunization Week: Working toward an STI vaccine

World Immunization Week is held April 24-30, 2019, to promote the use of vaccines to protect people of all ages against disease. Vaccination has significantly reduced the burden of infectious disease around the world. British Columbia (BC) has always been a global leader in human papillomavirus (HPV) vaccine research and continues to conduct valuable research in this field.

Early in 2019, the WHO reported one of the 10 biggest threats to global health was vaccine hesitancy. Researchers from WHRI, BCCDC, UBC and various BC Health Authorities are currently conducting research exploring methods to address HPV vaccine hesitancy in particular. The findings of this research are expected to inform all programs in BC, and across Canada to improve HPV vaccine uptake rates. In addition, research is being conducted to explore alternate dosing options for the HPV vaccine, which could have significant effects on health system costs and uptake rates while still maintaining high efficacy.

Exciting research is also being done to investigate the effects of HPV vaccination in the province by examining rates of anogenital warts in males and females, and cervical dysplasia for women undergoing cervix screening. In addition, vaccine researchers, clinicians and public health leaders in BC have developed a consortium that will establish BC as a global centre for leadership in the emerging field of sexually transmitted infection (STI) vaccines.

STIs are a significant cause of morbidity, mortality and health system costs globally, and development of vaccines to protect against various STIs has the potential to address this burden. BC is at the forefront of emerging STI vaccine policy and research.

By Laurie Smith

Dr. Jerilynn Prior awarded the 2019 Aubrey J. Tingle Prize

Congratulations to Dr. Prior, who was recently named this year’s recipient of the Michael Smith Foundation for Health Research Aubrey J. Tingle Prize! 

Dr. Prior was also the recipient of the WHRI Knowledge Translation in Women’s Health Research Award in 2017 for her work at the Centre for Menstrual Cycle and Ovulation Research.

Read the full announcement from MSFHR here.

Eating Behaviours and Vulvar Pain

Participants needed for an online questionnaire study examining the association between eating behaviours and sexual function, particularly with respect to chronic genital pain.

Principle Investigator: Dr. Lori Brotto

Co-Investigator: Cara Dunkley

Funded by the Canadian Institute of Health Research

Primary Contact: Yana Svatko at y.svatko@alumni.ubc.ca (Research Assistant)

Requirements: Participants must be female, 18 years of age or older, and have been diagnosed with Provoked Vestibulodynia, a chronic genital

Participation involves completing an anonymous questionnaire online, which can be filled out from home and is expected to take 45 minutes. The survey contains questions about sexual function, genital pain, body image, eating habits, attitudes towards food, personality, and mood. In exchange for your time, participants will receive a $20CAD Starbucks gift card and will be entered in a draw to a $100 VISA gift card. If you would like to participate, the link below to will take you to the online questionnaire.

Website: http://j.mp/2FUyr4B