BC Women’s Hospital selected as Canadian site of an American research trial

The Women’s Health Research Institute (WHRI) is excited to announce that BC Women’s Hospital + Health Centre (BCWH) has been selected as one of four Canadian sites to participate in a large-scale NIH-funded study entitled “Pharmacokinetics and Safety of Commonly Used Drugs in Lactating Women and Breastfed Infants”. The study is being conducted by the Pediatric Trials Network (PTN), and is being led by Dr. Kevin Watt and the Duke Clinical Research Institute (DCRI).

Many drugs are prescribed to women during lactation based off of a historical absence of observed adverse effects on the newborn. Although most of these medications are likely safe for use during breastfeeding and are often indicated for maternal health reasons, there has been no systemic evaluation of the pharmacokinetics associated with these drugs or its excretion into breastmilk.

To bridge this knowledge gap, researchers will assess the transfer of drugs from mother to child via breastmilk by monitoring drug levels in the mother’s blood, breastmilk, and the child’s blood.  The study will begin with the testing of ten commonly used medications including those used for high blood pressure, infections and depression.  The study will continue to include other medications as long as funding continues.

Dr. Wee-Shian Chan, Site PI, explains that BCWH is in a unique position to contribute and recruit pregnant and breastfeeding patients for this study because of its provincial role in managing high-risk pregnancies and the high rates of breastfeeding at BCWH.

This study will significantly change how we counsel and prescribe medications to breastfeeding patients to ensure best outcomes for both mother and child.

C&W Medical Staff Association Recognition Award recipients announced!

Congratulations to the recipients of the inaugural C&W Medical Staff Association (MSA) Recognition Awards! The awards are intended to give recognition to C&W MSA members who make an outstanding contribution to the delivery of healthcare, training, and research on a local, provincial, and global scale.

WHRI is proud to announce that seven of its members were recognized in the C&W MSA awards, in the following categories:

  • Dr. Nicole Todd: Rookie of the Year
  • Dr. Anton Chau: Mentor/Educator of the Year
  • Dr. Wee-Shian Chan: Leadership Recognition Award
  • Dr. Paul Yong: Research Recognition Award
  • Dr. Ron Abrahams: Indigenous Health and Outreach Advocate
  • Dr. Neora Pick: Indigenous Health and Outreach Advocate
  • Dr. Gina Ogilvie: President’s Award

 

Dr. Joelle LeMoult is a MSFHR 2018 Scholar Award recipient!

Congratulations to Dr. Joelle LeMoult, a recipient of the Michael Smith Foundation for Health Research 2018 Scholar Award for her project Predicting Depressive Symptoms During the Transition to High School.

Dr. LeMoult’s research will focus on the transition period adolescents face in their first year of high school – a period during which 11.5% of adolescents experience a depressive episode. She seeks to find the predictors of depression for this group of adolescents, as well as ways to mitigate the risks.

Read the full announcement here.

Preterm cord blood samples available for research

A partnership between BC Children’s Hospital BioBank (BCCH BioBank), BC Women’s Hospital leadership, and Dr. Pascal Lavoie of the Neonatal Intensive Care Unit has resulted in optimized cord blood collection from premature babies (<33 weeks) for biobanking.

If you are interested in using cord blood for your research contact the BCCH BioBank (biobank@cw.bc.ca) for access.

Dr. Gina Ogilvie wins YWCA’s 2018 Women of Distinction Award!

Picture of Dr Ogilvie with her awardOn June 7th Dr. Gina Ogilvie, Senior Advisor of Research at BC Women’s Hospital + Health Centre and WHRI’s Assistant Director, was given the YWCA 2018 Women of Distinction Award in the category of Research and the Sciences.

A huge congratulations to Dr. Ogilvie for this achievement, and for continuing to inspire us with her hard work toward the eradication of cervical cancer.

An interview with Dr. Melanie Murray, MSFHR 2018 Health Professional-Investigator Award recipient

Dr. Melanie Murray is one of this year’s MSFHR Health Professional-Investigator Award recipients. Her study, Individual disposition and mHealth: Personalized care to improve outcomes, is looking at dispositional traits that might identify which patients are more likely to benefit from antiretroviral adherence support provided by the WelTel program.


How did you become interested in the WelTel intervention?

At Oak Tree Clinic approximately a third of our patients experience barriers to accessing care, to being able to take their antiretrovirals, and to being well. A lot of those barriers focus around the social determinants of health, and so in looking for ways to engage our patients I started talking with Dr. Richard Lester who designed the WelTel intervention. He did a WelTel study in Kenya which was effective there, and he wanted to bring it out of Africa and try it here to see what we could do to improve care for our patients. We started with a pilot study looking at feasibility here at Oak Tree Clinic, and then did a second study with some of our most vulnerable patients to see if WelTel works. The study found that WelTel does work – especially for those who use it – and so that led to the current question which is ‘How do we know ahead of time who might use the program and who might benefit most from it?’

What inspired you to consider personalizing antiretroviral adherence support in persons living with HIV?

It was the results from our second study that show that WelTel works for those who actively engage with the program.  When we talked to health care providers at the clinic and those who are directly interacting with participants of the study there was really nothing obvious about an individual that would give us a hint as to whether the WelTel program was going to work for them. But this finding led us to thinking that although we think this program is great it is not for everyone – and everyone who needs support should have the type of support that is suited to their needs.

Why did you choose to focus on dispositional traits?

When we looked at the results of our effectiveness study (the WelTel Oak Tree study) we found that people who responded to the text messages were more likely to take their antiretroviral and suppress their HIV viral loads.  Then we looked at the demographic information we have about participants to see if there was a clear type of person who responded or didn’t –and there wasn’t. So then we considered that some people just prefer to text, and it could be more about disposition – whether someone is the type of person who likes to communicate that way – and that whether an adherence support works is just about what works for them as an individual. My colleagues Patrick Hill and Grant Edmonds look at big population studies in the US looking at personality and sense of purpose and health outcomes. There are short, easy questionnaires that can be done and tell a lot about a person and what programs might be suited to them, and so we thought perhaps this is a way we could look at the disposition of a person and see if that disposition would give us information about whether they would participate in and use this type of program.

The MSFHR Health Professional-Investigator Research Award is focused on implementation and using research to improve patient outcomes. How do you intend to mobilize the results of your study?

We would like to be able to roll out WelTel clinically to all of our patients who would benefit from the program.  However, resources are limited and it would be nice to have a quick and easy way to determine if the WelTel program would be the right fit for an individual, so as to offer the program to those most likely to benefit from it. In addition, we aim to go back to those individuals for whom text messaging isn’t really a fit and see if we can come up with other programs or strategies for engaging them in their care.

How do you think that these findings will benefit patients?

A lot of the issues that prevent individuals from taking antiretrovirals are the social determinants of health.  Housing, stable food sources, or physical safety, for example, all stand in the way of adherence to medications because these things are of higher priority. If you don’t know where you’re going to get your next meal you’re hardly going to be worrying about taking pills, particularly if those pills require you to eat. What WelTel does is it enables participants to ask for help when a problem arises, rather than at their next clinical appointment which could be months away. It allows us to help deal with smaller problems as they arise, and before they become big crises. If we could potentially roll WelTel out clinically with those individuals most likely to use it, then we could help those persons to engage in care, be well, and address the social determinants of health that stand in the way of their being able to attain adherence to their HIV medications.


Dr. Murray and team have recently conducted Sharing Circles to receive input from Indigenous members of the community on the language and feasibility of their questionnaires, and has been fortunate to receive mentorship from Elders Valerie Nicholson and Sandy Lambert. This process is intended to ensure that survey questions and the WelTel program are culturally safe for the individuals receiving them, and to get feedback on how to make it better. In addition, Dr. Murray and her team are in the process of validating the questionnaires with the Indigenous community so that results of these surveys may be meaningful to the population being studied. .

Looking forward, if her team is awarded CIHR funding for the proposed study they will begin work to enrol approximately 300 participants in the next phase of the study, with a focus on enrolling participants from groups that struggle most often with adherence to antiretrovirals (including Youth, Women, and First Nations individuals). The study will be a partnership between Vancouver Native Health, the Portland Hotel Society, and Oak Tree Clinic.

An interview with Dr. Paul Yong, MSFHR 2018 Health Professional-Investigator Award recipient

Dr. Paul Yong received a MSFHR Health Professional-Investigator Award for his study,  Sexual pain in endometriosis: Role of somatic mutations, which looks at the role of gene mutations in endometriosis sexual pain. This research could help to influence the incorporation of gene mutation testing into clinical care for endometriosis to promote more individualized care.


When did you first become interested in the topic of endometriosis sexual pain?

When I joined Dr. Catherine Allaire and Dr. Christina Williams at the BC Women’s Centre for Pelvic Pain and Endometriosis, I realized that endometriosis-associated sexual pain was common, but we did not fully understand its causes or how best to treat it.  At the same time, I was working at the VGH Multidisciplinary Vulvodynia Program, which focuses on sexual pain associated with vulvodynia.  Both clinical experiences led me to reflect more on the pathophysiology of endometriosis sexual pain, and on how to approach it in a more systematic way.

What led you to study gene mutations as a means for addressing this pain?

This arose through a collaboration with the OVCARE team: I would particularly note the leadership and mentorship of Dr. David Huntsman, the partnership of Dr. Michael Anglesio and Dr. Blake Gilks (who are Co-PIs on our recent CIHR grant), the encouragement of Dr. Diane Miller, and the support of the Gynecologic Cancer Tissue Bank via Dr. Jessica Mcalpine.  We began biobanking specimens from our endometriosis surgeries, and we collectively became interested in deep endometriosis, a subtype that has invasive tumour-like qualities, yet is benign.  We wondered whether somatic driver mutations, which are present in cancers, could also be present in this subtype of endometriosis (and perhaps other subtypes as well).

Could you speak briefly about the novel techniques you are using to analyze samples?

Briefly, this involves isolating endometriosis cells from surgical samples (via micro- or macro-dissection), isolating DNA, and then performing next generation sequencing and bioinformatics analyses to identify somatic (non-inherited) mutations in the endometriosis cells.  This work is done with a local company, Contextual Genomics.   We are correlating these mutations with anatomic and clinical variables, and also with local protein expression through a collaboration with Dr. Mohamed Bedaiwy (Co-PI).

The MSFHR Health Professional-Investigator Research Award is focused on implementation and using research to improve patient outcomes. How do you intend to mobilize the results of your study?

In addition to traditional knowledge translation (publications and conference presentations), we are exploring new approaches to mobilize research results.  First, we have a Patient Research Advisory Board, which partners with the research team in the design, interpretation, and application of the research.  We also disseminate our research through a quarterly online newsletter for patients, as well as the annual Celebration of Hope at BC Women’s.  Furthermore, we have a new collaboration with a KT expert, Dr. Fuchsia Howard (Co-PI), who will lead qualitative studies to inform an online patient education tool for sexual pain in endometriosis.

How do you think that these findings will benefit patients?

If somatic driver mutations are associated with sexual pain in endometriosis, then we may be able to use drugs targeting cellular pathways associated with these mutations, in order to provide a non-hormonal treatment alternative for women with endometriosis.  Moreover, we envision that the study of somatic mutations in endometriosis may lead one day to a novel genomics-based classification for endometriosis, a condition that affects 10% of reproductive-aged women.

I would like to end by thanking and acknowledging our research coordinator, Heather Noga, and all our trainees, without whom this award would not have been possible.

The Third Annual Women’s Health Research Symposium

Drs. Genevieve Creighton, Jessica McAlpine, Aline Talhouk, Kristin Campbell, and Tamil Kendall talking during a facilitated panel discussion
Drs. Genevieve Creighton, Jessica McAlpine, Aline Talhouk, Kristin Campbell, and Tamil Kendall

The Women’s Health Research Institute held the Third Annual Women’s Health Research Symposium on May 9th, 2018 at the University of British Columbia’s Robert H. Lee Alumni Centre.  The event welcomed over 180 attendees, comprised of members of the women’s health research community and its other stakeholders, to discuss current issues and research at the forefront of women’s health and wellbeing in the province. The tone was set with an impactful presentation and acknowledgement of ancestral lands by Elder Roberta Price. Helen Burt, on behalf of UBC, recognized this event and the WHRI as filling an important gap in women’s health research.

The day featured talks from a variety of women’s health professionals, including keynote presentations by Drs. Jennifer Love, Senior Advisor to the Provost on Women Faculty, and Gail Murphy, Vice-President, Research and Innovation, on Women in Science; a series about climate change featuring Drs. Courtney Howard, Glenys Webster, and Shannon Waters; and a talk about the #MeToo movement as it relates to marginalized women by Dr. Kate Shannon.

Dr. Kate Shannon speaking to the room
Dr. Kate Shannon’s presentation on the health impact of violence against women

During a breakout presentation Dr. Lori Brotto and Karen Gelb presented the BC Women’s Health Research Agenda as well as a complimentary document titled Take Action for Change.  The agenda outlines the key challenges in the field of women’s health research as well as strategies to advocate for change individually, locally, provincially, and federally. These themes were present throughout the day, from the morning’s trainee breakfast during which Dr. Lara Boyd shared advice for people new to the field of women’s health research, to the final presentation by Dr. Joy Johnson on the importance of considering sex and gender in health research.

Dr. Joy Johnson presenting
Dr. Joy Johnson presenting after receiving the 2018 Career Contribution to Women’s Health Research Award

In addition to the many insightful presentations, the event also celebrated the important contributions of researchers within the realm of women’s health. During a special awards ceremony, Dr. Denise Pugash was presented with the 2018 Health Professional Investigator in Women’s Health Research Award for her outstanding contributions to research as a full-time clinician. Dr. Joy Johnson, Vice-President of Research at SFU, was awarded the 2018 Career Contribution to Women’s Health Research Award.  The day concluded with Genesa Greening and Jeff Sodowsky of the BC Women’s Hospital + Health Centre Foundation committing to the importance of supporting women’s health research through funding, and presenting the WHRI with a $100k donation for the development of an app for women with postpartum depression.

Thank you to all who attended, and a special thank you to our volunteers, the BC Women’s Hospital + Health Centre Foundation, and our lineup of amazing speakers: Elder Roberta Price, Drs. Lara Boyd, Helen Burt, Jennifer Love, Gail Murphy, Courtney Howard, Glenys Webster, Shannon Waters, Genevieve Creighton, Kristen Campbell, Tamil Kendall, Jesscia McAlpine, Aline Talhouk, Kate Shannon, Nichole Fairbrother, Courtney Howard, Deborah Money, Alison Elliot, and Joy Johnson.

Dr. Courtney Howard’s advice for fighting climate change with health research

Dr. Courtney Howard – an Emergency Room Physician in Yellowknife, NT and primary author on the Lancet Countdown 2017 Report: Briefing for Canadian Policymakers – joined the Women’s Health Institute to present at the Third Annual Women’s Health Research Symposium on May 9th, 2018. Her talk, Climate change and women’s health in the North, and breakout session on climate change were focused on opportunities to improve women’s health outcomes while fighting climate change.

During her talk Dr. Howard outlined a pilot study in Northeastern British Columbia which found that benzene levels in the urine of 29 pregnant women were 3.5 times higher than the general Canadian population. Although it is suspected that the increase in benzene levels is a result of fracking (a process for extracting oil or gas, which can contaminate air and water supply), the study could not conclude that the higher levels of benzene were a direct outcome, nor the health implications of in utero exposure. Dr. Howard suggests that this is just one of many reasons that there is a need for further research into the intersections of environmental science and health.

While the intricacies of environmental science and the oil industry’s jargon might seem like a roadblock for those in health research, Dr. Howard suggests that researchers partner with experts working in those fields. Multidisciplinary collaborations can provide insight into industry procedures, entry points for meaningful change, and opportunities to mitigate environmental impacts.  This approach can make presentations to policymakers and government officials more effective as information about health outcomes can be balanced with industry-related action items.

Another way to influence policy change is to frame the impact of climate change within the context of health outcomes.  Drawing on human connections to demonstrate how issues will personally affect policymakers can be far more effective than framing them on a larger scale.  For example, “smoke from forest fires increases a child’s risk for asthma by x” draws a much clearer personal connection than “the increase in forest fires will significantly impact the climate over the next 100 years”.

In the Lancet Countdown 2017 Report: Briefing for Canadian Policymakers Dr. Howard and co-authors outlined seven recommendations for ways that Canada can respond to climate change:

  • Ensure funding for research and best-practice information sharing between public health communities in different regions to fine-tune adaptation capacity to severe weather events.
  • Phase out coal-powered electricity in Canada by 2030 or sooner, with at minimum two thirds of the power replaced by non-emitting sources.
  • Develop a National Active Transport Strategy for Canada and calculate healthcare cost savings.
  • Enhance support for tele-commuting and telehealth options.
  • Provide health-sector support for Health Canada’s draft health eating guidelines which emphasize plant-based protein sources.
  • Increase funding for research into the local health impacts of resource extraction, with a focus on impacts on Indigenous populations.
  • Integrate Health Impact Assessments as a core component of the federal Environmental Assessment process.

Although these recommendations are aimed at policymakers, the emphasis on research and healthcare demonstrates an opportunity for health researchers to make a difference for climate change.

To read the Lancet report click here. To hear more about Dr. Howard’s work you can view her TEDTalk here.