CTN 236, The “HPV in HIV Study” 2017 Year in Review: Report

Twenty-seventeen was an exciting and productive year for the “HPV in HIV Study”.  The Long Term Follow-Up phase of this study extends the national project to collect longer term data on the immunogenicity, efficacy and safety of the human papillomavirus vaccine in women and girls living with HIV.

Over 150  study visits were completed in 2017, bringing the Follow-Up Study to 457 visits completed to date.  A pediatric immunogenicity and safety analysis was published in the Pediatric Infectious Disease Journal and a parallel adult immunogenicity and safety publication became open access post-publication in the journal Vaccine.   Data was presented at premiere international conferences including EUROGIN in Amsterdam, the Netherlands and at the Infectious Diseases Society of Obstetricians and Gynecologists (IDSOG) Conference in Park City, Utah.  Several awards were gratefully accepted by the team, recognizing study investigators and project outputs.  These accomplishments reflect outstanding work from a national team of investigators, staff and participants, with support from the public, and a multitude of institutions.

We thank the Women’s Health Research Institute for their support and invite you to see our full annual report.  We have adopted a new visual approach to annual reporting and hope you enjoy this new format!







Web-enabled intervention option for BC women with postpartum depression

Madison Lackie, a Masters student working with Dr Lori Brotto and the UBC Sexual Health Laboratory, is part of a team working on creating a treatment program for women with postpartum depression (PPD).  Her work is part of a multiphase research project, involving the creation, feasibility testing, and eventual widespread implementation of a web-enabled intervention option for PPD, using evidence-based cognitive behavioural therapy (a leading treatment option).

“PPD affects a relatively large proportion of new mothers, and the rates of PPD are even greater in women in higher risk populations,” Madison explains.  “For example, Aboriginal women have five times the risk of developing PPD compared to the average Canadian woman.”  With this in mind, the team hopes to create a treatment program based primarily on the population of British Columbia, with a particular focus on the specific needs of Aboriginal and immigrant women.

Our province’s most vulnerable women often face the greatest barriers to access of healthcare, and especially healthcare which specializes in treating more complicated health issues, such as PPD.  These barriers inspired the need for a treatment option that could “be completed from anywhere and by anyone,” and which could “provide a great resource for physicians across the province,” Madison says.

Though the project remains in its early stages, the team has secured a partnership with a local application and web-technology development firm to assist in the creation of the online web-based platform.  It will likely take a few years for the program to be approved as a treatment option to be used in clinical practice, although the team hopes to have the platform ready for efficacy trials by 2019.

“We hope that the outcomes of this project will provide an evidence-based, effective, culturally safe and sensitive, and economical treatment option for women suffering from PPD across the province, and will allow women in even the most rural communities to access quality care in a timely manner,” Madison says.

 

 

The Perinatal Research IMaging Evaluation Centre at BC Women’s

By Carola Muñoz

Sonographer practices an ultrasound on an obstetrics simulator.
BC Women’s Hospital Sonographer, Amanda Easton, demonstrates how to use  the PRIME Centre’s obstetrics simulator “Catherine.”

The Perinatal Research IMaging Evaluation (PRIME) Centre is a new ultrasound research facility located in Vancouver at the BC Women’s Hospital + Health Centre. Funded by a Canada Foundation for Innovation Grant, awarded to WHRI member Dr. Denise Pugash, the PRIME Centre is a hub for researchers to create substantial advances in health care through the use of cutting edge technology. PRIME provides the infrastructure and enables opportunities for researchers, educators, and clinicians to improve the health of mothers and babies in a collaborative environment, progressing from simply describing pregnancy and birth conditions to understanding their conditions.

The PRIME Centre has a suite of both stationary and portable equipment and is equipped with its own Picture Archiving + Communications System (PACS) and offers opportunities for training in basic and advanced obstetrics ultrasound techniques using a state-of-the-art ultrasound simulator machine.

To learn more about PRIME equipment and opportunities for research, click here.

For inquiries, please contact, Carola Muñoz, PRIME Project Coordinator at prime@cw.bc.ca

Congratulations to WHRI recipients of the CIHR Fall 2017 Project Grant Competition!

Grant winners' photos

WHRI is proud to announce that out of the many applicants to the CIHR Fall 2017 Project Grant Competition, six award recipients were WHRI or BCCHRI/WHRI joint investigators, with combined awards totaling over $6.08 million!

The competition intends to “capture ideas with the greatest potential to advance health-related fundamental or applied knowledge, health research, health care, health systems, and/or health outcomes”.  Given the highly competitive nature of the CIHR Project Schemes, this is an outstanding achievement.

This year CIHR committed a $372M investment to the competition, and funded 512 grants.  The overall applicant success rate was 15%, and BC’s success rate ranked highest in the country at 20%.

We look forward to sharing with you more details on the individual projects in the coming months!

WHRI Recipients

Principal Investigator Project Title CIHR Contribution Term
Helene Cote WHRI Investigator Placental mitochondrial dysfunction and pregnancy outcomes in HIV+ and HIV- women $1.6 million*

*Conditional to Stem Cell Oversight Committee approval

5 years
Soren Gantt BCCHRI/WHRI Investigator Viral determinants of natural human cytomegalovirus transmission $1,143,675 5 years
Jennifer Hutcheon BCCHRI/WHRI Investigator Short term benefits but long term harm? Assessing the consequences of antenatal corticosteroid administration for child neurodevelopment $221,850 3 years
Joelle LeMoult WHRI Investigator Characterizing the Peripheral Biology of Depression, Social Anxiety, and theri Comorbidity $573,750 6 years
Saraswathi Vedam WHRI Investigator Giving Voice to Mothers; Measuring access to high quality, respectful maternity care in Canada $883,575 5 years
Paul Yong WHRI/BCCHRI Investigator Sexual pain in endometriosis: role of somatic mutations and local neurogensis $976,904 4 years

The University of Michigan and UBC team up to tackle women’s health issues in Guatemala

Since 2015, a team of researchers based at the University of Michigan (UM), School of Public Health have led research projects on improving cervical cancer screening coverage in both urban and rural/remote regions of Guatemala. Anna Gottschlich, a PhD student, along with her supervisor Dr Rafael Meza at UM led studies to evaluate the acceptability, feasibility and value of using self-collected samples for cervical cancer screening among women of diverse ethnicities in the region. Dr Gina Ogilvie, University of British Columbia Professor and WHRI Associate Director has been an advisor on this important research, and her team was invited to participate in UM’s recent visit to Guatemala in December 2017 to plan next steps to strengthen relationships and collaborations in the region.

The preliminary research conducted in Guatemala has laid the foundation for strong collaborative work, and exciting opportunities to further local cervical cancer prevention projects. Starting in Guatemala City, the team met with Directors of academic, research and policy institution including PATH, the Centers for Disease Control and Prevention, the National cancer hospital (INCAN), the Institute of Nutrition of Central American and Panama (INCAP), and San Carlos University of Guatemala. The group also travelled to Santiago, Atitlan; a remote community primarily consisting of Indigenous peoples, which was the site for much of the pilot work in cervical cancer screening using self-collection. The site is home to an enthusiastic network of local community health workers and clinicians, some of whom are based at Rxiin Tnamet, a non-profit community health organization with decades of experiences offering local clinics and services for preventive medicine and reproductive health, as well as community development programs.

The collaboration between Dr Ogilvie and the team at UM are an example how academic institutions can leverage the skills, resources and expertise of different teams to work together to create meaningful research programs, and academic opportunities for students internationally. Both groups are excited to further the work being done by local policy, research, clinical, and community partners in Guatemala to create sustainable and scalable population health programs.

To learn more about the preliminary research conducted by the team in Guatemala, click here.

 

 

 

IMPACT OF CIHR REFORMS AND FUNDING ON CANADIAN HEALTH RESEARCHERS: IMPLICATIONS FOR SUSTAINABILITY OF HEALTH RESEARCH IN CANADA

By Liisa Galea, Ph.D., Distinguished University Professor, University of British Columbia with help from Stephane Dragon, UBC

In the summer of 2016 we conducted a survey1 with responses from 426 verified professors across Canada representing all provinces and territories except for Nunavut on the impact of the CIHR funding changes over the past 5 years (2009-2016). There are 2395 unique principal investigators (PI)s funded by CIHR’s largest granting programs over the past 5 years, this indicates that 15-20% of the funded PIs from CIHR completed the survey. What we found was alarming and devastating to the scientific community in Canada which will have significant repercussions on our country’s stature on the world stage.

Job losses: Our survey indicated that 350 highly qualified personnel (HQP) jobs had already been terminated as of 2016. Extrapolating this number suggests that approximately 1940 HQP have been let go over the last year. This is likely to be an underestimate as over the past 10 years there have been 3913 unique PIs over the past 10 years, indicating an attrition rate of approximately 40% of professors funded by CIHR within the last 5 years2.  A rough estimate suggests that each biomedical grant is associated with approximately 7.93 trainees, suggesting an overall loss of closer to 5000 HQP jobs.

Trainees: Our survey indicated that our 426 PIs were training 2600 trainees (undergraduate, graduate and postdoctoral fellows).  Our survey data suggests an average rate of average of 6 trainees per PI.  This is very similar to the rate as reported by CIHR with higher number of trainees reported per biomedical grants3.  Furthermore, shockingly 70% of respondents indicating they were avoiding and postponing taking on trainees indicating that these traditional numbers of graduate and post-graduate students will be significantly reduced over the next few years. It is important to understand that many of these trainees, particularly in health research, go onto become MDs, and/or into research roles in private industry. This will mean a significant loss to the talent pool for these areas over the next few years in Canada.

Money for Research: Shockingly, our survey of 426 PIs indicated that total budgets had decreased overall with a net loss of $8M over the time period from 2009-2016. It is important to be aware that since the survey was conducted there have been only two open competitions from CIHR for the year following the survey, indicating more monies lost due to fewer opportunities for funding.

Impactful Research:  By their own account, over 70% of PIs are indicating they are delaying impactful work with the same percentage of PIs scaling down their research programs.  This will already have significant outcomes for Canadian science standing on the world stage.

Leaving Canadian Research: Approximately 40% of researchers across the board were considering leaving their research careers. Over 50% of the senior respondents indicated they were considering retiring earlier and over 40% of mid-career scientists were considering leaving Canada.  Clearly this level of disengagement is a concern for the wellbeing of health research within Canada.

We also asked the respondents to identify their “greatest impediment to performing the best research you can.”  This open ended question was answered by 93% of the respondents.  Collectively this group identified three major themes with Funding Issues (levels, opportunities, amounts) as the number 1 major impediment to doing excellent research and 89% of the population cited Funding Issues as the most salient impediment. Issues with Funding extended to issues for finding, attracting and retaining HQP.

Finally, I would add that many of our respondents identified that a lack of funding for open-ended research (investigator-driven) was a part of funding issues and I note that this survey was conducted almost a year before the Fundamental Science Review was published.  Funding all pillars of CIHR, and diversity matters as a number of studies have indicated that a broad and diverse portfolio is needed in order to maximize taxpayer investment5.

References

A few selected quotes from researchers themselves:

 

“At this time it is the uncertain funding environment that is severely limiting my research program. I am not able to invest in new students given the poor funding climate and despite being recruited to Canada as a CRC (from the US) I am seriously considering returning to the states…” Respondent 5

“…In my field, if I cannot obtain funds to hire students or the reagents for experiments, even a loss of one year’s funding, my research will be at a great disadvantage to my fellow researchers/competitors in other countries…” Respondent 14

 “…An unfunded period brings an absolute end to continuity.  Every lab has unique procedures, research topics and necessary background knowledge that are not immediately acquired by new lab members simply by showing up in the lab on their first day of work.  Losing funding for six months doesn’t mean simply a six-month break in research; it can take many years to restore group expertise and knowledge to a lab.  I am worried that the current funding situation is going to create this situation en masse for researchers all across Canada.  Even a short interruption can set research back by many years.” Respondent 28

“…The frequent rolling out of narrowly focused research programs has made it difficult to keep up with opportunities (as a consequence I am sure the very best people are not carrying out research in the calls for applications).” Respondent 34

“CIHR is operating on 2006 dollars when inflation for science has been increasing at 5%/pa. CFI funding has increased our capacity to do better science but a lack of funds prevents us from using these resources that often sit idle in the labs across the country. The only problem is lack of funding. New procedures for funding is only re-arranging the chairs on the deck of the Titanic” Respondent 147

“Lack of funding and unpredictability of renewal means I cannot make firm offers to prospective trainees, meaning that I am unable to maintain continuity of research programs” Respondent 156

“…, if the CIHR funding climate does not dramatically improve then I am not confident that I will be able to continue conducting research in Canada. For this reason, I am considering leaving Canada within the next 2 years, an am already actively looking at other positions.” Respondent 161

“…Limited future for graduate students in Canada. I can’t in good conscience continue training students ….” Respondent 164

“Lack of funding and unpredictability of renewal means I cannot make firm offers to prospective trainees, meaning that I am unable to maintain continuity of research programs” Respondent 156

 

Inclusive Gender Indicators

The inclusion of transgender individuals in research is increasingly recognized as important for accurate data collection.  However, knowing the best practice for differentiating between biological sex and social gender is not always clear when creating surveys or in other situations where these identifiers are necessary.

A study out of The University of Western Ontario found that “knowledge of the sociodemographic characteristics, health needs, and social experiences of trans populations has been constrained by the lack of measures to identify trans persons in population surveys”.

The study tested several different surveys which asked research participants to identify their sex and gender with multidimensional measures, and provides suggestions for how to incorporate such questions to collect more accurate data.

Their “Multidimensional Sex/Gender Measure (MSGM)” offers the following questions to determine a participant’s biological sex and gender identity :

Fig 4. Multidimensional Sex/Gender Measure (MSGM). https://doi.org/10.1371/journal.pone.0178043.g004

To learn more about the study and MSGM, read the paper online here.

 

International Forum on Women’s Brain and Mental Health

By Liisa Galea

On December 12, 2017, the 1st International Forum on Women’s Brain and Mental Health was held in picturesque Lausanne, Switzerland.  It was organized by the Women’s Brain Project in collaboration with the Global Alliance for Women’s Brain Health and The Lancet Psychiatry.

The forum was held to highlight the susceptibility of women developing a number of brain disorders at higher rates than men. There is a distinct need for researchers and clinicians alike to understand health needs in people with these disorders may be distinctly different in  women versus men.

The forum brought together a number of experts to highlight that proper consideration of sex as a biological variable not being considered in clinical trials or basic research is a barrier to our complete understanding of the disease. The forum discussions and panels also considered the role of caregiver (usually women) and the effects this has on their health and the health of the family, as well as how machine learning and AI (Artificial Intelligence) can aid in understanding women’s brain health.

The four diverse panel discussions considered: Sex effects on the regulation of brain function and disease manifestation towards gender medicine in neuroscience; Psychosocial aspects of female caregivers’ brain and mental health, socio-economic gap and female caregivers’ burden; Sex and Gender in Clinical Trials for Brain and mental diseases: reconsidering the way we test drugs; and finally, Digital biomarkers and new technologies: New tools to support women’s brain health.

The two keynote speakers were by Khaliya and Lynn Posluns of the Women’s Brain Health Initiative (in Canada). Speakers and attendees from around the world gathered to discuss to issues on Women’s health from Malta, the United States, Norway, the UK, India, Switzerland, and Canada. Indeed, Canada was well represented with myself, Gillian Einstein (University of Toronto) and Lynn Posluns (WBHI) present. In addition, representatives from the Pharmaceutical Industry, Federal Drug and Food Administration and Lancet Psychiatry were also participated in the moderation or as speakers. The event was also live streamed.

The goal is to hold forums yearly in Lausanne to further promote the understanding that women’s health is an important area of research. A white paper will be published along with a special issue that is co-edited by myself and the president of the Women’s Brain Project, Maria-Teresa Ferreti, which will be published in Elsevier’s Frontiers in Neuroendocrinology.

For more information please see: http://www.wbp-forum.com/ and be sure to join us next year!

Figure 1. The speakers of Panel 1 at the 1st International Forum on Women’s Brain and Mental Health: Else Charlotte Sandset, Elena Becker-Barroso (our moderator), Liisa Galea, Gillian Einstein (all in the picture, together with Antonella Chadha Santuccione), Not pictured Lawrence Rajendran and Thorsten Buch. Suzana Petanceska who were also part of Panel 1.