MESSAGE FROM THE CEO AND VP RESEARCH

Marilyn Emery - Dr. Paula Rochon

At Women’s College Research Institute (WCRI), we are asking the questions that really matter. Our internationally recognized scientists lead innovative and focused research programs that deliver essential health system solutions and are designed to improve the health of women and to target chronic conditions affecting women across their lifespan.

By collaborating with other scientists internationally and engaging with diverse groups, we are reaching out to the world and transforming care through science. Our research enhances prevention strategies, improves treatment models, and transforms how care is delivered.

In WCRI’s 2014 Impact + Innovation Report, we demonstrate how our research is being used to support services for women with mental illness, to empower women in managing their cancer risk, to create standards that are being adapted internationally to increase the value and quality of research, and to shape international guidelines for chronic diseases.

As part of our dedication to disseminate knowledge on women’s health, we created Women’s Xchange. Through this knowledge translation and exchange centre, we are leading a provincial initiative to make sex- and gender-based analysis part of all research studies and to provide the tools to make this happen. Our goal is to ensure that all studies will provide a unique perspective on the distinctive aspects of women’s health. And when we learn about women, we also learn about men. Promoting a gender-sensitive approach to research improves health and quality of life for all.

Much of our impact can be measured in the way we share our knowledge with the world. Our scientists continue to be exceptionally productive, publishing their findings in some of the most influential journals internationally. In the past year, our scientists published more than 250 peer-reviewed publications, a 60 per cent increase from the last five years, and the global media coverage of our science shows just how important and relevant our work is to the world. Our growing leadership and capacity is also reflected in our steadfast fiscal growth – our external research funding has grown more than 25 per cent over the last year and more than 60 per cent over the last five years – and in a challenging funding environment.

Most of our scientists are also clinicians – their research is informed by their clinical practice and can be directly translated into improving clinical care locally and beyond. This will be enhanced when the research institute moves into Women’s College Hospital’s new facility, which will be completed in 2015. This union will bring our scientists even closer to the clinics, programs and patients that they are impacting. The iconic pink cube at the centre of this new state-of-the-art facility will become a space that we will use to exchange ideas and continue to grow our groundbreaking research and reach.

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DEVELOPING INTERVENTIONS TO HELP PREGNANT AND POSTPARTUM WOMEN MANAGE MENTAL ILLNESS

Untreated depression in pregnancy and postpartum can have harmful effects for mothers and their infants and families.

That’s why Cindy-Lee Dennis, PhD, and Dr. Simone Vigod are working together to better understand depression in pregnancy and postpartum and to develop innovative, accessible treatment interventions to help manage it. Their work has attracted remarkable funding and international media attention and is advancing mental health services for women in Ontario and beyond.

Dennis currently holds the Shirley Brown Chair in Women’s Mental Health Research at Women’s College Hospital (WCH). The chair – a partnership between WCH, the Centre for Addiction and Mental Health, and the University of Toronto – was created by a community-based fundraising campaign honouring a young lawyer who succumbed to severe depression.

“If left untreated, depression in pregnancy or the postpartum period can have significant negative effects on child development that can last into adulthood,” says Dennis. “My program of research focuses on developing and evaluating interventions that improve maternal health and enhance infant outcomes.”

Cindy-Lee Dennis, PhD; Dr. Simone Vigod

Cindy-Lee Dennis, PhD; Dr. Simone Vigod

Dennis recently evaluated, for the first time, telephone-based interpersonal psychotherapy by trained nurses for the treatment of postpartum depression. The results showed that therapy can be effectively administered to depressed mothers across Canada.

 

“We know that interpersonal psychotherapy is an effective treatment for postpartum depression and mothers often prefer it over medication,” says Dennis. “However in its usual face-to-face format, women in rural and remote areas often do not have access to it. If the telephone format is implemented, all women could receive this effective treatment at times that are convenient for them.”

Dennis was invited to discuss this trial with health policy-makers in New York City, as they are considering implementing the intervention for depressed mothers across their city.

Dennis is also conducting a study to examine the onset, course and consequences of postpartum depression in mothers and fathers.

“This study will produce urgently needed knowledge that will inform the development of effective postpartum depression interventions for both parents,” she says.

"While antidepressant drugs are the standard of care for moderate to severe depression, many pregnant women are hesitant to take the drugs; however, these women are also aware of the risks of untreated depression. They have a difficult decision to make about their treatment during pregnancy."
– Dr. Simone Vigod

In 2012, Dennis presented the inaugural Clinician-Scientist Award from the Shirley Brown Chair program to Dr. Vigod, a psychiatrist in the reproductive life stages program at WCH and scientist at Women’s College Research Institute. One of Dr. Vigod’s areas of research is answering important questions about how to better manage depression in pregnancy.

“Current treatments for depression in pregnancy are less than ideal,” says Dr. Vigod. “While antidepressant drugs are the standard of care for moderate to severe depression, many pregnant women are hesitant to take the drugs; however, these women are also aware of the risks of untreated depression. They have a difficult decision to make about their treatment during pregnancy.”

To address this issue, Dr. Vigod is exploring the use of non-drug treatments for depression in pregnancy. This year she will launch a pilot study to evaluate an innovative treatment – transcranial direct current stimulation – for moderate to severe depression in pregnant women.

“If effective, this would offer women an alternative to medication,” says Dr. Vigod.

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RESEARCH PARTNERSHIPS THAT STRENGTHEN THE REACH OF HEALTH SERVICES

Gender-based violence is believed to be the most widespread human rights violation of our time, seriously harming women, families and communities across the globe.

"According to the World Health Organization, one in three women will experience physical or sexual violence, and we know that this type of violence has a detrimental effect on the mental, sexual and reproductive health of women and girls that can sometimes be fatal," says Janice Du Mont, EdD, a scientist at Women’s College Research Institute (WCRI).

Du Mont’s research is focused on making the world a better place for women and girls. She leads an interdisciplinary research program that examines the impact of gender-based violence on women’s health. Her work has focused largely on evaluating hospital-based programs and policies in order to improve health service delivery to victims of sexual assault and interpersonal violence in Ontario and abroad.

"Much of my work could not have been possible without my partnership with the Ontario Network of Sexual Assault and Domestic Violence Treatment Centres," says Du Mont.

The Ontario Network of Sexual Assault and Domestic Violence Treatment Centres is made up of 35 hospital-based centres that provide emergency care to victimized individuals. The first centre was established at Women’s College Hospital (WCH) in 1984, and since then, the network has grown to include hospitals across the province. Sheila Macdonald, MN, is the provincial coordinator of the network and clinical manager of the centre based at WCH.

Sarah Daisy Kosa; Shannon Elliot; Janice Du Mont, EdD

Sarah Daisy Kosa; Shannon Elliot; Janice Du Mont, EdD

"My close collaboration with Sheila and the network is allowing us to do research that addresses the complex needs of victims of violence and provides the basis for improving and expanding forensic and healthcare services for these individuals," says Du Mont.

Du Mont and Macdonald have conducted several large-scale multi-centre studies to develop, implement and evaluate programs of sexual assault care. Their findings are effectively shaping health policy and practice; for example, recommendations from a study designed to address the unmet needs of drug-facilitated sexual assault victims led to new provincial standards for sexual assault care. This research received widespread global media attention. Another province-wide multi-centre study resulted in a policy to provide free-of-charge HIV post-exposure prophylaxis to sexual assault victims in Ontario.

"We are able to make these significant strides in advancing care and service delivery because we involve important stakeholders in the work we do," says Du Mont. "This includes policy-makers, healthcare providers, community organizations, and representatives from the legal and law enforcement sectors."

"Much of my work could not have been possible without my partnership with the Ontario Network of Sexual Assault and Domestic Violence Treatment Centres."
– Janice Du Mont, EdD

Currently, Du Mont and Macdonald are collaborating with elder abuse experts to develop an elder abuse intervention that will eventually be implemented and evaluated at Ontario’s Sexual Assault and Domestic Violence Treatment Centres. In a coordinated and integrated manner, this intervention will address the complex functional, social, forensic and medical needs of older adults who have been abused.

"Elder abuse is a growing issue in the world’s aging population, particularly for women," says Du Mont. "We hope that our intervention will prevent or reduce the use of emergency services and other health services by victimized older adults."

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USING VIRTUAL SUPPORT SYSTEMS TO IMPROVE WOMEN’S MENTAL HEALTH AND WELL-BEING

Women who have been treated for gynecological cancer often struggle with concerns about body image, sexuality and self-esteem. And because these concerns are personal and sensitive, many women feel uncomfortable talking about their challenges with their doctor and close ones.

Helping these women has been an area of interest for Catherine Classen, PhD, senior scientist at Women’s College Research Institute, as well as academic lead of the Trauma Therapy Program, director of the Women’s Mental Health Research Program, and clinical psychologist at Women’s College Hospital.

Classen and her team developed a much-needed private, online support group to help reduce psychosexual distress for women who have been treated for gynecological cancer. The intervention, called GyneGals, is currently being trialled across North America with funding from the Canadian Institutes of Health Research (CIHR) and Ovarian Cancer Canada.

"The idea behind GyneGals was to create a comfortable space for women to discuss how gynecological cancer has changed the way they feel about themselves, their relationships and their sexuality, and to learn new ways for coping," says Classen. "And because GyneGals is online, it’s accessible to women, no matter where they live."

Lisa Skelding; Agata Drozd; Jessica Kalbfleisch; Dr. Lisa Barbera; Catherine Classen, PhD; Yvonne O’Meara; Dr. Sarah Ferguson

Lisa Skelding; Agata Drozd; Jessica Kalbfleisch; Dr. Lisa Barbera; Catherine Classen, PhD; Yvonne O’Meara; Dr. Sarah Ferguson

GyneGals is a 12-week intervention provided in a discussion board format, where women can contribute at any time and mental health professionals participate as moderators. There are also two moderated chat sessions. Radiation oncologist Dr. Lisa Barbera of Odette Cancer Centre and surgical oncologist Dr. Sarah Ferguson of Princess Margaret Hospital participate in the second chat session to address concerns or questions.

"In my experience, cancer patients are reticent to talk about sexual issues in face-to-face groups. Offering online support groups for gynecological cancer patients addresses an unmet need."
– Catherine Classen, PhD

"Online groups can be particularly helpful for conditions that are highly sensitive and private, potentially stigmatizing, or so rare it is virtually impossible to get a group together," says Classen. "In my experience, cancer patients are reticent to talk about sexual issues in face-to-face groups. Offering online support groups for gynecological cancer patients addresses an unmet need."

Although the trial is still ongoing, many women have already said that GyneGals provided them with useful information and tips for coping and helped them realize that their challenges are not unusual.

If the intervention proves to be effective, the long-term goal is to make it widely available to women.

"We hope to reach as many women as possible with GyneGals and help support them in their journey towards improved health and well-being," says Classen.

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SUPPORTING COMMUNITY-BASED RESEARCH TO IMPROVE THE HEALTH OF WOMEN AND GIRLS IN ONTARIO

At Women’s College Research Institute (WCRI), we believe that investing in community-based women’s health research has the potential to improve the health and well-being of all women in Ontario.

This vision sparked the creation of Women’s Xchange, a knowledge translation and exchange centre based at Women’s College Hospital (WCH) and funded by the Ministry of Health and Long-Term Care. By promoting the development of women’s health research across the province, the centre aims to create a more equitable and sustainable healthcare system for women and all Ontarians.

"Women’s Xchange is really about reaching out to researchers, trainees and community partners, and connecting and supporting them to make women’s health a priority in research," says Dr. Paula Rochon, vice-president of research at WCH and lead of Women’s Xchange. "It leverages the 100 years of history and expertise housed at WCH to grow momentum in women’s health research throughout Ontario."

Pooja Patel; Dr. Paula Rochon; Stephanie Lagosky; Robin Mason, PhD

Pooja Patel; Dr. Paula Rochon; Stephanie Lagosky; Robin Mason, PhD

Last year, Women’s Xchange launched the $15K Challenge, a competition that provides funding to researchers and community organizations across Ontario to conduct research to advance the health of women and girls. The initiative allows community groups to come forward with research ideas and partner with academics to study important questions. Ultimately, these projects will benefit local communities and some may be further developed provincially and beyond.

"We know that women’s health is influenced by many factors beyond traditional healthcare," says Robin Mason, PhD, a community-based researcher at WCRI and scientific lead of Women’s Xchange. "The $15K Challenge is not only an opportunity for us to mentor and empower community organizations in conducting research, but it also has the potential to improve the health of local communities."

"The $15K Challenge is not only an opportunity for us to mentor and empower community organizations in conducting research, but it also has the potential to improve the health of local communities."
– Robin Mason, PhD

Women’s Xchange developed a community-based research application and review process for the $15K Challenge and invited groups across Ontario to submit projects that would identify unmet needs within a community, explore or test solutions to problems, or better understand factors that influence women’s health.

In its first three rounds of competition, Women’s Xchange received 71 proposals for small-scale projects initiated by community organizations, as well as 17 for large-scale projects that would involve collaborations between community and academic organizations. In total, 24 small projects and two large projects were funded.

"The research funded by the $15K Challenge will address a number of women’s health issues across a broad range of populations and locations," says Mason. "Through these projects, we will learn more about how to improve the health of Ontario’s tremendous diversity of women."

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EMPOWERING WOMEN TO MANAGE THEIR CANCER RISK

The Familial Breast Cancer Research Unit at Women’s College Research Institute (WCRI) is a world leader in the study of inherited cancers. Led by Dr. Steven Narod, a Tier 1 Canada Research Chair at Women’s College Hospital (WCH), the unit has become internationally recognized for identifying effective strategies to prevent and manage breast and ovarian cancer, particularly in women and families with an inherited BRCA1 or BRCA2 mutation.

The BRCA1 and BRCA2 genes produce proteins that help repair DNA; but when the genes are mutated, the proteins don’t function normally and increase a woman’s risk of developing breast and ovarian cancer. Dr. Narod and his team have the world’s largest bio-bank of samples from BRCA mutation carriers (in collaboration with over 70 centres across the globe), and they are using this resource to better understand how BRCA mutations shape cancer risk and prognosis in women.

In the past year, the team has published several high-profile studies that may strengthen the recommendation for a number of cancer management strategies. A study by Amy Finch, PhD, a postdoctoral fellow working with Dr. Narod, demonstrated the clear benefit of preventive removal of the ovaries and fallopian tubes on reducing overall cancer risk and mortality in women with BRCA mutations. Kelly Metcalfe, PhD, an adjunct scientist at WCRI, found that bilateral mastectomy may be an effective first-line treatment for BRCA mutation carriers with early-stage breast cancer. And Joanne Kotsopoulos, PhD, a scientist at WCRI, showed that the use of oral contraceptives at a young age increases the risk of breast cancer in BRCA1 carriers and should be avoided.

Familial Breast Cancer Research Unit

Riona Murphy; Olivia Moran; Aletta Poll; Rachael Pettapiece-Phillips; Jennifer Gallagher; Ping Sun, PhD; Marcia Llacuachaqui; Dr. Javaid Iqbal; Sonia Nanda; Alejandra Ragone; Robert Royer; Dr. Mohammad Akbari; Dr. Steven Narod; Joanne Kotsopoulos, PhD; Kelly Metcalfe, PhD; Dr. John Semple; Lindsay Schnarr; Dr. Shiyu Zhang; Dina Nikitina; Glenda Sun; Jennifer Ng

"Our team’s work is benefiting women of all ages and providing accessible prevention and management strategies that women and clinicians around the world can use," says Dr. Narod. "Many of our findings also inform the genetic testing and counselling services we provide at our own unit to families with BRCA mutations."

The Familial Breast Cancer Research Unit is also working to uncover new genetic markers that have a role in cancer risk and mortality. Using the latest technology, Dr. Mohammad Akbari, scientist at WCRI, is leading the team’s state-of-the-art laboratory at WCH to identify new genetic mutations that may impact cancer risk and survival.

"Our research studies demonstrate, time and time again, the importance of providing genetic testing for women at the time of cancer diagnosis and even earlier in their lives."
– Dr. Steven Narod

In addition to conducting world-class cancer genetics research, Dr. Narod and his team are continuously striving to increase global access to cancer genetic testing. The team’s laboratory was the first to offer rapid comprehensive genetic testing for BRCA mutations at the research level in Canada. Since then, the unit has been actively involved in enabling other countries to initiate their own cancer genetics screening programs. For instance, Dr. Narod and his team have provided genetic testing infrastructure and training for physicians and scientists in the Bahamas, so that all women on the islands can be eligible for BRCA testing. The unit is following this model to do the same in other countries including Brazil, Iran, Mexico and Vietnam.

And here in Ontario, Dr. Narod and Metcalfe have re-launched the world’s only cancer genetic testing program for Jewish women. As part of the study, Jewish women in Ontario are being offered free genetic testing for the common BRCA genetic mutations found in the Ashkenazi Jewish population.

"Our study on Jewish women will help identify those with a genetic predisposition to developing cancer who might otherwise not come to the attention of the medical community and receive the preventive care and screening that might benefit them," says Metcalfe, who is leading the study with Dr. Narod.

"Our research studies demonstrate, time and time again, the importance of providing genetic testing for women at the time of cancer diagnosis and even earlier in their lives," says Dr. Narod. "Knowing whether a woman has a BRCA mutation will help guide prevention and treatment decisions and improve the health and longevity of women around the world."

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IMPROVING QUALITY AND EFFICIENCY IN MEDICAL RESEARCH

Health research has led to significant global health improvements. But experts have made the case that many more important discoveries could be made if the global research community addressed inefficiencies in the way studies are designed, carried out and reported.

This year, Dr. An-Wen Chan, Phelan Scientist at Women’s College Research Institute, co-led a group of experts from Europe, Australia and the United States to publish a series of papers in The Lancet that outlined solutions to reverse these inefficiencies.

"Over one hundred billion dollars of research investment are wasted globally every year," says Dr. Chan. "But much of this waste is avoidable. Our series of papers documents the extent of problems at each stage of health research and proposes far-reaching recommendations to increase value and reduce waste in research."

These recommendations targeted academic institutions, funders, policy-makers, journals, research ethics boards, and regulators – stakeholders who shape how research is conducted.

One of the papers, led by Dr. Chan, put a spotlight on the fact that the research community and healthcare professionals do not have access to complete and unbiased study information.

Kevin Lam; Jessica Kitchen; Dr. An-Wen Chan

Kevin Lam; Jessica Kitchen; Dr. An-Wen Chan

"Half of all health research is never published," says Dr. Chan. "When studies do get published, access to them is often restricted and costly, and key details are often missing about how well the study was conducted. We need to fix this inaccessibility issue because it not only wastes research and healthcare dollars, but more importantly, it jeopardizes patient health as doctors may unknowingly prescribe ineffective or harmful treatments."

In his paper, Dr. Chan called on stakeholders to implement incentives and standards that will encourage scientists to fully share and report their studies.

"Half of all health research is never published. We need to fix this inaccessibility issue because it not only wastes research and healthcare dollars, but more importantly, it jeopardizes patient health."
– Dr. An-Wen Chan

One initiative already fulfilling this goal is a set of guidelines developed by the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) group to help scientists develop high-quality, detailed clinical trial protocols.

Chaired by Dr. Chan, the SPIRIT group is an international group of trial investigators, journal editors, industry sponsors, ethicists and funders. Their guidelines have received global endorsement by over 25 trial groups, industry sponsors and academic institutions. In addition, over 75 medical journals have introduced policies to encourage scientists to adhere to the SPIRIT guidance, and some countries in Europe have implemented the SPIRIT guidelines nationally.

Dr. Chan is now collaborating with MaRS Innovation to develop a web-based tool that will help researchers develop, format and manage their clinical trial study protocols according to SPIRIT guidelines.

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TAPPING INTO SILICON VALLEY TO IMPROVE HEALTHCARE

People with complex chronic diseases frequently transition between hospital care and community care and are not well served by our health system, which is built around institutions and disease conditions.

"As a primary care provider, I see first-hand how my patients with complex needs jump from one specialist to another to manage their health," says Dr. Onil Bhattacharyya, Frigon Blau Chair in Family Medicine Research at Women’s College Hospital (WCH). "Pulling this information together and creating a cohesive plan of care for these patients is challenging. A big question that drives much of my work as a scientist is, how can we organize care so that healthcare providers work together to meet patient needs?"

To address this issue, Dr. Bhattacharyya is co-leading an initiative called BRIDGES (Building Bridges to Integrate Care), a platform funded by the Ontario Ministry of Health and Long-Term Care to select, support and develop new models of innovative, integrative care for people with complex chronic diseases.

Dr. Varuna Prakash; Dr. Samuel Vaillancourt; Dr. Ilan Shahin; Dr. Onil Bhattacharyya; Leigh Hayden, PhD; Dr. Payal Agarwal; Laura Pus; Magdalena Rybak, RN

Dr. Varuna Prakash; Dr. Samuel Vaillancourt; Dr. Ilan Shahin; Dr. Onil Bhattacharyya; Leigh Hayden, PhD; Dr. Payal Agarwal; Laura Pus; Magdalena Rybak, RN

"BRIDGES is an incubator that brings together researchers, healthcare providers, policy-makers and community service workers to think about healthcare solutions," says Dr. Bhattacharyya. "We have funded nine new models of care and helped project teams refine and test their model, creating a collaborative environment to help them redesign or expand their idea into a suite of related programs."

Dr. Bhattacharyya is building from this experience to create an incubator at WCH and lead a provincial network called BEACCON (Better Access and Care for Complex Needs), which is funded as part of the Canadian Institutes of Health Research’s Strategy for Patient-Oriented Research.

"A big question that drives much of my work as a scientist is, how can we organize care so that healthcare providers work together to meet patient needs? "
– Dr. Onil Bhattacharyya

Under Dr. Bhattacharyya’s guidance, the incubator will apply methods from the software and design industries – which involve iteratively testing and refining a product or service to find something that works well for users – to develop new models of care for people with complex needs. These methods are about generating new ideas and managing uncertainty.

"Silicon Valley has been a hotbed of disruptive solutions that have delivered waves of products and services based on users’ needs and increased efficiency – something the health system desperately needs," says Dr. Bhattacharyya. "The approaches used by Silicon Valley startups embrace uncertainty and may offer health system solutions better suited to patients with complex chronic diseases."

Dr. Bhattacharyya’s work, focused on quality and innovation, is transforming the way health system research is done. His work has the potential to enable hospitals, institutions and doctors across the province to deliver cost-effective solutions that improve patient experience and outcomes.

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VIEWING Anita Benoit, PhD

NEXT Dr. Jacob Udell

Anita Benoit, PhD

Some Aboriginal women are overburdened with stressors like violence, discrimination, stigma and poverty, all of which have contributed to this population’s over-representation in the Canadian HIV and AIDS epidemic.

"The goal of my research is to understand how Aboriginal women living with and without HIV experience and manage stress, so that I can then work with them to develop culturally appropriate, stress-reducing therapeutic interventions that will improve their health and well-being," says Anita Benoit, PhD.

Benoit is a postdoctoral fellow working with Dr. Mona Loutfy, a scientist at Women’s College Research Institute whose research focuses on sexual and reproductive health, stigma and access to care for women with HIV.

To conduct her research, Benoit is collaborating with the Ontario Aboriginal HIV/AIDS Strategy, 2-Spirited People of the 1st Nations, and the Native Women’s Resource Centre of Toronto. Her work is supported by the Canadian Institutes of Health Research and the Alternative Funding Plan Innovation Fund.

"Interventions to promote healthy outcomes and well-being in Aboriginal women typically lack a cultural component and an awareness of the lived experiences of Aboriginal women," says Benoit. "In my research, Aboriginal women’s lived experiences are at the forefront."

Benoit will use methods such as in-depth semi-structured one-on-one interviews and sharing circles to collect data. Her research process will include ceremonies by a spiritual leader, and the impact of stress on well-being will be discussed using a medicine wheel (a symbolic representation of the mental, emotional, physical and spiritual aspects of well-being and wholeness). Once Benoit designs an intervention with and for the women, she will pilot it with the group.

Some of her findings have already been used by the Native Women’s Resource Centre of Toronto to create a space for peer outreach workers to talk about healthy sexuality and HIV prevention with interested individuals.

VIEWING Dr. Jacob Udell

NEXT Dr. Javaid Iqbal

Dr. Jacob Udell

Dr. Jacob Udell, a research fellow at Women’s College Research Institute and cardiologist at Women’s College Hospital, is leading innovative research to improve the heart health of Canadians.

This year, he was awarded the Rising Star Award from the CIHR Institute of Health Services and Policy Research for his novel work on understanding the effect of the flu vaccine on cardiovascular health. One of his recent studies found that the flu vaccine may reduce the risk of heart attack or stroke.

"If the flu vaccine can reduce the risk of cardiac events, these shots could have a considerable impact on cardiac health," says Dr. Udell.

To confirm the effectiveness and safety of the flu vaccine as a therapy for people with heart disease, he is now collaborating with researchers across the United States and Canada to conduct a large clinical trial. He hopes that this trial will explain the mechanism behind how the flu vaccine protects cardiovascular health.

"Hundreds of thousands of people die each year from cardiac causes in North America," says Dr. Udell. "While preventive care involves lifestyle changes and medication, soon we may also be able to tell patients that getting your flu shot may save your life."

Dr. Udell’s other projects include a trial to investigate the metabolic benefits of a new non-invasive laser liposuction technique, as well as a study of the long-term cardiovascular outcomes for women who take fertility therapy. His work has generated national and international recognition and media coverage, leading to his role as a spokesperson for the Heart and Stroke Foundation of Canada.

VIEWING Dr. Javaid Iqbal

Dr. Javaid Iqbal

"It is well known that immigrant women often face barriers to timely breast screening, putting themselves at risk of being diagnosed with breast cancer at a more advanced stage," says Dr. Javaid Iqbal, a research fellow working with Drs. Paula Rochon and Steven Narod.

"Given the diverse and large immigrant population in Canada, understanding how immigrant status affects breast cancer presentation has been a major area of interest for me."

For his postdoctoral fellowship, Dr. Iqbal is linking multiple databases in Ontario to compare breast cancer stage at diagnosis between immigrant women and the general population in Ontario.

"Diagnosing breast cancer at an earlier stage significantly increases a woman’s chances of survival," says Dr. Iqbal. "I hope that my research findings will help the scientific community to understand biological differences in breast cancer among multiethnic immigrants, as well as assist policy-makers to create awareness programs and screening policies to increase early detection in the most vulnerable ethnic groups among immigrants."

Once his fellowship is complete, Dr. Iqbal will start a master’s, funded by the Canadian Institutes of Health Research, to evaluate the impact of recent and subsequent pregnancies on breast cancer mortality.

Young women diagnosed with breast cancer often ask about subsequent pregnancy and its possible impact on breast cancer mortality. Unfortunately, there are no guidelines that define a safe time to get pregnant after breast cancer.

"It is important that we obtain accurate data on the impact of pregnancy on breast cancer, so that health professionals can offer evidence-based guidance to women wishing to have a baby after breast cancer," says Dr. Iqbal.

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THIS IS HOW OUR SCIENCE IS TRANSFORMING HOW CARE IS DELIVERED

Dr. Mohammad Akbari
Dr. Sacha Bhatia
Dr. An-Wen Chan
Dr. Onil Bhattacharyya
Catherine Classen
Cindy-Lee Dennis
Dr. Sheila Dunn
Janice Du Mont
Dr. Ophira Ginsburg
Andrea Gruneir
Dr. Gillian Hawker
Dr. Paula Harvey
Joanne Kotsopoulos
Dr. Mona Loutfy
Dr. Lorraine Lipscombe
Robin Mason
Dr. Sutapa Mukherjee
Dr. Steven Narod
Dr. Paula Rochon
Dr. John Semple
Dr. Valerie Taylor
Dr. Simone Vigod

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COLLABORATIONS THAT ARE CHANGING THE WAY WE THINK ABOUT PATIENT HEALTH

Our scientists are partnering with other experts in Canada and around the world to lead scientific research that is having a global impact on improving the health of women, advancing care for people with chronic conditions, and delivering much needed health system solutions. Together we are tackling some of the most pressing issues in healthcare today and are inspiring real innovations in patient care globally.

IMPROVING THE HEALTH OF PATIENTS WITH BOTH OSTEOARTHRITIS AND DIABETES

Osteoarthritis is the most common form of arthritis, affecting one in eight Canadians. With no cure, management of the condition focuses on pain relief and preserving mobility.

"Diabetes is particularly common among people with osteoarthritis, given the shared risk factors – aging and obesity – and the negative effects of diabetes on joint tissues," says Dr. Gillian Hawker, a senior scientist at Women’s College Research Institute (WCRI) who focuses on improving access and outcomes of care for people with osteoarthritis.

Dr. Hawker is now collaborating with Dr. Lorraine Lipscombe, director of the Centre for Integrated Diabetes Care at Women’s College Hospital and scientist at WCRI, to understand the relationship between osteoarthritis and diabetes.

"Despite the fact that many people suffer from both conditions, little research has been done to understand how osteoarthritis impacts diabetes outcomes in people with both conditions," says Dr. Hawker.

"For example, physical inactivity due to osteoarthritis leads to poorer fitness and weight gain – does this contribute to poorer outcomes in people with diabetes? And does reduced hand strength and dexterity from hand osteoarthritis affect the ability of people with diabetes to prepare meals and perform glucose monitoring? Currently, we don’t have sufficient evidence about how these common chronic conditions interact. Understanding these relationships will help us to improve the way these patients are cared for."

Drs. Hawker and Lipscombe are conducting a population-based study that will answer important questions about the impact that osteoarthritis disability has on diabetes self-management and complications.

"If there is an association, our study will make a case for targeted screening and enhanced management of osteoarthritis in people with diabetes," says Dr. Lipscombe.

Dr. Gillian Hawker

" Despite the fact that many people suffer from both conditions, we don’t have sufficient evidence about how these two common chronic conditions interact."
– Dr. Gillian Hawker


Dr. Steven Narod

" While prophylactic oophorectomy is recommended for women with a BRCA mutation, the long-term effects on cardiovascular health and quality of life are not well understood."
– Dr. Steven Narod

RESHAPING THE FUTURE FOR WOMEN AT HIGH RISK FOR BREAST AND OVARIAN CANCER

When a woman has a mutation in her BRCA genes, she is at a higher risk of developing breast and ovarian cancer.

Research has long shown that women with a BRCA mutation can decrease their risk of cancer and mortality by surgically removing their ovaries and fallopian tubes. For this reason, doctors often advise women who carry such a mutation to have this procedure.

"While this prophylactic surgery is safe, its long-term effects on cardiovascular and bone health, as well as quality of life, are not well understood," says Dr. Steven Narod, a Tier 1 Canada Research Chair in Breast Cancer at Women’s College Hospital. "We need to do more research so that we can establish clinical guidelines to help keep the young women who opt for this surgery healthy."

Dr. Narod and his postdoctoral fellow Amy Finch, PhD, are doing just that by teaming up with Dr. Paula Harvey, a scientist at Women’s College Hospital who specializes in cardiovascular disease in women.

"When a woman loses ovarian estrogen, it increases her risk for cardiovascular disease, which is the leading cause of death for women," says Dr. Harvey. "Understanding the effects of ovary removal surgery on young women with a BRCA mutation is a priority for this population."

Dr. Narod and Dr. Harvey’s study, funded by the the Canadian Institutes of Health Research, will follow a cohort – the largest of its kind in Canada – of premenopausal women undergoing this procedure.

"We’re hoping that our study will tell us more about how this surgery affects young women in the short and long term, and what doctors should be doing to improve these women’s health and well-being," says Dr. Narod.

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ABOUT WCRI - WOMEN'S COLLEGE RESEARCH INSTITUTE

WHO WE ARE

Women’s College Research Institute (WCRI) is a multidisciplinary research institute based at Women’s College Hospital (WCH) – Canada’s leading academic, ambulatory hospital and a world leader in women’s health. WCH is fully affiliated with the University of Toronto and is a member of the Toronto Academic Health Science Network.

WCRI is one of only a few hospital-based research institutes worldwide to have a significant focus on women’s health. Our scientists, all of whom have academic appointments at the University of Toronto, conduct research that improves the health of women, helps people prevent and manage complex chronic conditions, and delivers innovative health system solutions.

QUICK FACTS

  • Women’s College Research Institute was established in 2006, building on a 100-year-long legacy of innovation at WCH.
  • WCH is fully affiliated with the University of Toronto and all WCRI scientists hold academic appointments at the university.
  • Our researchers collaborate with more than 70 centres in 30 countries around the world.
  • Nearly 200 individuals contribute to the work of our institute, including 23 core scientists, trainees at all levels and research staff.
  • WCH is a top 40 research hospital in Canada.
  • Almost 70 per cent of our core scientists are also clinicians providing care at WCH.
  • We were recently awarded the largest ever grant in Canada to study breast cancer in young women.
  • Some of our scientists hold the highest academic honours in Canada, including fellowship in the Royal Society of Canada and the Canadian Academy of Health Sciences.
  • For two consecutive years, our young scientists have won a Rising Star Award from the Canadian Institutes of Health Research.

METRICS

TOTAL AWARDED RESEARCH FUNDING

In fiscal year 2013-2014, WCRI continued to see a steady growth in funding. Thisincrease reflects our growing leadership in women’s health research. The research quality of our world-class scientists is building our capacity to attract research funding. WCRI is grateful for the consistent support from its funders, including Women’s College Hospital Foundation.

METRICS

MEDIA

Our researchers and their work are covered by national and international media outlets. A few examples of research studies that received extensive coverage this year include:

  • Dr. Simone Vigod’s study that reported that women in urban areas show high rates of postpartum depression. It received extensive coverage by nearly 500 media outlets in North America, Europe, Australia, Asia and Africa.
  • Dr. Jacob Udell’s paper that reported that the flu shot halves the risk of heart attack or stroke in people with a history of heart attack. It was covered by hundreds of media outlets in nearly 20 countries.
  • Dr. Steven Narod and Amy Finch’s study that found that preventive oophorectomy reduces the risk of death by 77 per cent for women with a BRCA gene mutation. Their paper was the most-accessed Original Report in the Journal of Clinical Oncology in May 2014.

 

RESEARCH ETHICS BOARD QUALIFICATION

The Women’s College Hospital Research Ethics Board (WCH REB) underwent a rigorous qualification assessment to harmonize research ethics board processes, specifically regarding qualifications and approvals across the Toronto Academic Health Science Network (TAHSN). The WCH REB met or exceeded all requirements of the TAHSN REB Qualification Assessment.

 

SELECTED RESEARCH HONOURS

Dr. Mohammad Akbari

  • Capacity Development Award in Prevention from the Canadian Breast Cancer Foundation and the Canadian Cancer Society Research Institute

Anita Benoit, PhD

  • CIHR Fellowship Award

Dr. An-Wen Chan

  • Outstanding Paper Award, Women’s College Research Institute, Women’s College Hospital

Cindy-Lee Dennis, PhD

  • Helping Hands Hope Award from the Mood Disorders Association of Manitoba

Dr. Gillian Hawker

  • Fellow of the Canadian Academy of Health Sciences

Dr. Javaid Iqbal

  • Canada Graduate Scholarship

Dr. Noah Ivers

  • CIHR New Investigator Award

Joanne Kotsopoulos, PhD

  • Canadian Cancer Society Career Development Award in Prevention

Dr. Steven Narod

  • Karen Campbell Research Excellence Award from Ovarian Cancer Canada
  • Mentorship Award, Women’s College Research Institute, Women’s College Hospital

Dr. John Semple

  • Cause Leadership Award from the Canadian Breast Cancer Foundation Ontario Chapter

Dr. Jacob Udell

  • CIHR Institute of Health Services and Policy Research Rising Star Award
  • Outstanding Paper Award, Women’s College Research Institute, Women’s College Hospital

Dr. Simone Vigod

  • John M. Cleghorn Newly Established Researcher Prize (University of Toronto, Department of Psychiatry)

OUR PEOPLE

Women’s College Research Institute would to like to acknowledge the talent and dedication of its scientists, trainees, and research advisory board members over the past year. Their unwavering commitment to research is helping us extend our reach and transform care around the world. Our success would not have been possible without the contributions of our research support staff and operations team, as well as other departments at WCH, including strategic communications, finance, human resources and the Association of Volunteers.

CORE SCIENTISTS

Mohammad Akbari, MD, PhD
Sacha Bhatia, MD, MBA, FRCPC
Onil Bhattacharyya, MD, PhD, CCFP | Frigon-Blau Chair in Family Medicine Research
Heather Carnahan, PhD
An-Wen Chan, MD, DPhil, FRCPC
Phelan Scientist
Catherine Classen, PhD
Cindy-Lee Dennis, PhD | Shirley Brown Chair in Women’s Mental Health Research
Janice Du Mont, EdD
Sheila Dunn, MD, MSc, FCFP
Ophira Ginsburg, MD, MSc, FRCPC
Andrea Gruneir, PhD
Paula Harvey, BMBS, PhD, FRACP
Gillian Hawker, MD, MSc, FRCPC | F.M. Hill Chair in Academic Women’s Medicine (former)
Sophie Jamal, MD, PhD, FRCPC
Joanne Kotsopoulos, PhD | Cancer Care Ontario Chair in Population Studies
Lorraine Lipscombe, MD, MSc, FRCPC
Mona Loutfy, MD, MPH, FRCPC
Robin Mason, PhD
Sutapa Mukherjee, MBBS, PhD, FRACP
Steven Narod, MD, FRCPC, FRSC | Tier 1 Canada Research Chair in Breast Cancer
Paula Rochon, MD, MPH, FRCPC | VP, Research, Women’s College Hospital
John Semple, MD, MSc, FRCSC | Canadian Breast Cancer Foundation Chair in Surgical Breast Cancer Research
Valerie Taylor, MD, PhD, FRCPC
Simone Vigod, MD, MSc, FRCPC | Shirley Brown Clinician-Scientist


ADJUNCT SCIENTISTS

Izzeldin Abuelaish, MD, MPH
Geoffrey Anderson, MD, PhD
Cornelia Borkhoff, PhD
Shannon Dunn, PhD
Gillian Einstein, PhD
Eleanor Fish, PhD
Sophie Grigoriadis, MD, PhD, FRCPC
Eva Grunfeld, MSc, MD, DPhil, FCFP
Susan Jaglal, PhD
Ava John-Baptiste, PhD
Carmen Logie, MSW, PhD
Kelly Metcalfe, RN, PhD
Lori Ross, PhD
Leonardo Salmena, PhD
Lena Serghides, PhD


TRAINEES

POSTDOCTORAL FELLOWS
Anthony Antoniou, PharmD
Ananya Banerjee, MSc, PhD
Taryn Becker, MD, MSc
Anita Benoit, PhD
Amy Finch, MSc, CGC, PhD
Javaid Iqbal, MD
Lisa McCarthy, RPh, PharmD, MSc
Bheeshma Ravi, MD
Jacob Udell, MD, MPH, FRCPC
Sarah West, MSc, PhD

GRADUATE STUDENTS
Vasily Giannakeas (MPH candidate)
Troy Grennan, MD (MSc candidate)
Celeste Hamilton (PhD candidate)
Noah Ivers, MD, CCFP (PhD candidate)
Iliana Lega, MD, FRCPC (MSc candidate)
Geetha Mukerji, MD, FRCPC (MSc candidate)
Nadia Nandlall (MSc candidate)
Rachael Pettapiece-Phillips (MSc candidate)
Dallas Seitz, MD, FRCPC (PhD candidate)
Adriana Valentini (MSc candidate)

* In addition, we host numerous undergraduate and practicum students throughout the year, and many of our scientists serve as committee members for graduate students not based at WCRI.


RESEARCH ADVISORY BOARD

Women’s College Research Institute has established a Research Advisory Board to provide advice on matters related to strategic areas. We thank them for their contributions over the past year.

Linda Rabeneck (Chair), MD, MPH, FRCPC
Vice-President, Prevention and Cancer Control, Cancer Care Ontario
Professor of Medicine
Professor, Institute of Health Policy, Management and Evaluation; Dalla Lana School of Public Health, University of Toronto

Lori Ferris, PhD, CPsych, LLM
Associate Vice-President, Research (Oversight and Compliance)
Professor, Dalla Lana School of Public Health, University of Toronto

Vivek Goel, MD, MSc, SM, FRCPC
Professor, Dalla Lana School of Public Health, University of Toronto

Alejandro Jadad, MD, DPhil, FRCPC, FCAHS
Founder, Centre for Global eHealth Innovation, University Health Network
Canada Research Chair in eHealth Innovation
Professor, Department of Anesthesia; Institute of Health, Policy, Management and Evaluation;
Dalla Lana School of Public Health, University of Toronto

Catharine Whiteside, MD, PhD, FRCPC
Dean, Faculty of Medicine, University of Toronto
Professor, Faculty of Medicine, University of Toronto

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A MESSAGE FROM KATHERINE HAY AND WOMEN’S COLLEGE HOSPITAL FOUNDATION

Katherine Hay

The innovative work of Women’s College Research Institute (WCRI) is diverse, far-reaching and life-changing. While our reach is extraordinary indeed, so too is the exceptional commitment and generosity of our supporters!

By investing in multidisciplinary women’s health research with an international reach, our donors are partnering to enable the translation of groundbreaking discoveries into new models of clinical care, here and across the globe. Together, we are changing the future of healthcare.

Through the generosity of our donors, Women’s College Hospital Foundation was able to provide funding to support the extraordinary work of WCRI – over $1.3 million this year alone! We are also proud to announce the establishment of an endowed research Chair in Ambulatory Anesthesia, the first of its kind in Canada, created through the partnership and generous support of the department of anesthesia, an individual donor, a corporate donor and an estate gift. The creation of the chair provided the vehicle to establish the Toronto Pain Medicine Institute Network at Women’s College Hospital that will offer patients across the city integrated services and improved wait times.

The enormous ripple effect of the $8.4 million invested by donors since 2006 is best reflected in the inspiring work being carried out by WCRI chairs today. For example, the Shirley Brown Chair in Women’s Mental Health Research, Cindy-Lee Dennis, PhD, is exploring clinical problems facing women with postpartum depression and developing innovative, accessible treatment interventions. Last year, over 49,000 Canadian mothers experienced depression within the first 12 months postpartum, putting at least 80,000 children at risk for adverse outcomes. Work such as Dennis’s not only demonstrates the significant impact of donor support, but also serves as an illustration of how donor contributions can be a catalyst for future breakthroughs.

There is a sense of pride when we reflect on the partnership we have with donors and with WCRI. Our collective commitment to excellence and making a difference has put Women’s College Hospital at the forefront as an international leader in women’s health. Our scientists, physicians, staff, volunteers and – you, our donors – are building the hospital of the future, and changing the future of healthcare. Together, we can!

Endowed chairs, established by our generous supporters:

  • The Atkinson Chair in Women’s Health
  • The Canadian Breast Cancer Foundation, Ontario Region, Chair in Surgical Breast Cancer Research
  • The Chair in Ambulatory Anesthesia
  • The F.M. Hill Chair in Academic Women’s Medicine
  • The F.M. Hill Chair in Health System Solutions
  • The Frigon Blau Chair in Family Medicine Research
  • The Phelan Scientist in Dermatology
  • The Shirley Brown Chair in Women’s Mental Health Research

 

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PROFILE


Dr. Mohammad Akbari is uncovering new genetic markers linked to hereditary cancers and exploring how they alter cancer risk, response to cancer treatments, and mortality.

PROFILE


Dr. Sacha Bhatia is a health policy researcher focused on developing and testing new ideas, programs and approaches that will improve healthcare.

PROFILE


Dr. An-Wen Chan is shaping research policy and standards internationally to increase value and reduce waste in research.

PROFILE


Dr. Onil Bhattacharyya applies principles from technology startups to design and test new models of care for patients with complex needs. His work aims to improve patient experience and reduce system costs.

PROFILE


Catherine Classen, PhD, examines effective psychotherapeutic interventions that address the unique challenges faced by women who are dealing with major life stressors such as interpersonal trauma and serious medical illness.

PROFILE


Cindy-Lee Dennis, PhD, conducts research that is focused on providing effective care to women and families impacted by postpartum depression.

PROFILE


Dr. Sheila Dunn conducts research on women’s reproductive health, including contraception and cancer screening, and explores innovations that will improve women’s access to reproductive healthcare.

PROFILE


Janice Du Mont, EdD, examines the impact of gender-based violence on women’s health, focusing on improving health services for those who have been sexually assaulted.

PROFILE


Dr. Ophira Ginsburg aims to improve access to early detection and treatment for breast and cervical cancer, among underserved populations in Canada and in low- and middle-income countries such as Vietnam and Bangladesh.

PROFILE


Andrea Gruneir, PhD, is committed to understanding how older adults use health services, so that opportunities can be identified to improve their care.

PROFILE


Dr. Gillian Hawker is improving access to care and outcomes for people with osteoarthritis, the most common form of arthritis.

PROFILE


Dr. Paula Harvey is focused on understanding cardiovascular disease in women and finding new ways to improve their heart health and prevent cardiac events.

PROFILE


Joanne Kotsopoulos, PhD, is uncovering novel strategies for the prevention, treatment and management of breast and ovarian cancer, especially among women with a genetic predisposition.

PROFILE


Dr. Mona Loutfy is breaking down HIV-related stigma and improving the health of women with HIV.

PROFILE


Dr. Lorraine Lipscombe focuses on improving prevention, care and outcomes of diabetes, particularly in women.

PROFILE


Robin Mason, PhD, is improving healthcare practices and services for women who have experienced gender-based violence or abuse.

PROFILE


Dr. Sutapa Mukherjee aims to better understand sleep across the life span with a major emphasis on sleep health, sleep epidemiology and genetics in men and women.

PROFILE


Dr. Paula Rochon conducts research that aims to make drug therapies safer for older adults, particularly women.

PROFILE


Dr. Steven Narod has profoundly shaped current knowledge on how to assess breast and ovarian cancer risk and reduce its mortality among women with BRCA mutations.

PROFILE


Dr. John Semple is improving outcomes for women who undergo clinical breast reconstruction and developing innovative approaches to monitor the recovery of patients post-surgery.

PROFILE


Dr. Valerie Taylor examines the complex relationships between mental health, obesity and chronic disease, and is finding ways to help people manage their health more effectively.

PROFILE


Dr. Simone Vigod is optimizing outcomes for women with mental illness during pregnancy and the postpartum period.