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Exploring bones and joints in action

Skeletal Observation Lab provides insight into every joint in the human body.

The capabilities of the new equipment is demonstrated during the opening. Photo credit KHSC

Researchers at Queen’s University and Kingston Health Sciences Centre (KHSC) are celebrating the completion of a $2.5 million facility that offers unique, X-ray vision insights into the biomechanics of nearly any joint in the human body.

While advances in orthopedic medicine have improved the mobility of humans worldwide, the precise workings of our skeleton and its joints are still notoriously difficult to understand, particularly when in motion.

The Skeletal Observation Laboratory (SOL), a facility supported by Queen’s and KHSC at the Hotel Dieu (HDH) site, is helping to fill that gap. One of only a few such labs in Canada, it offers leading-edge technologies for capturing, in exquisite detail, how the machinery of our bones and joints work when they’re in dynamic action.

During the opening event, Michael Rainbow, the lab’s lead investigator and assistant professor of Mechanical Engineering at Queen’s, and David Pichora, orthopedic surgeon and president & CEO of Kingston Health Sciences Centre, demonstrated the new, ultra low-dose, load-bearing CAT scanner. Unlike conventional CT machines, which require patients to lie down, with no load on their joints, this scanner can perform 3D scans while the person is standing.

A closer look at the new equipment. Photo credit KHSC

The lab is helping doctors and scientists develop new treatments and preventative strategies tailored to individual bone and joint disorders.

Dr. Rainbow demonstrated how the lab’s powerful imaging equipment – such as high-speed X-ray, and high speed video capable of 1,000 frames per second – helps him explore the complex machinery of foot function during walking and running.

“Better understanding of this complicated network of bones and joints will lead to better designed footwear, prosthetics and orthotics for patients,” he says.

The Skeletal Observation Laboratory is a satellite facility of the Human Mobility Research Centre at KHSC’s Kingston General Hospital site. It is co-located at HDH with the Human Motion Research Lab and the Queen’s Centre for Neurosciences clinical lab, enabling patient-oriented “research from brain to joints.” 

Funders of the Skeletal Observation Lab and its research include the Canada Foundation for Innovation (CFI), Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council (NSERC), Queen’s Faculty of Engineering and Applied Science and Department of Mechanical and Materials Engineering, The Estate of Donald McGeachy, BSc (Mech Eng) 1940 and University Hospitals Kingston Foundation (UHKF).

An Inuit approach to cancer care promotes self-determination and reconciliation

Cancer rates are rising among Inuit and critical oncology specialists and treatments are often located in urban centres, thousands of kilometres away from remote communities in Inuit Nunangat. (Alex Hizaka), Author provided

For thousands of years, Inuit have adapted to the changes in their environment, and continue to find new and innovative ways to survive.

But life expectancy among populations in Inuit Nunangat (the traditional territory of Inuit in Canada) is an average of 10 years less than that of the general Canadian population.

Cancer is a leading cause of this disparity. Inuit experience the highest mortality rates from lung cancer in the world, and mortality rates of some other cancers continue to increase disproportionately.

Inuit communities tend to be self-reliant and are renowned for working together for a common goal, which is evident in their self-governance and decision-making activities. They have also endured a long history of cultural insensitivity and negative health-care experiences that span generations

 

Map of Inuit Nunangat (Inuit Regions of Canada)

The ways the Canadian health-care system interacts with Inuit populations plays an important part in this health disparity. And there is an urgent need for Inuit to be able to access and receive appropriate health care.

In 2015, the Truth and Reconciliation Commission of Canada (TRC) report made 94 recommendations in the form of Calls to Action. Seven of these Calls to Action specifically relate to health. They explain the importance of engaging community members, leaders and others who hold important knowledge in the development of health care.

As members of a team of Inuit and academic health-care researchers, we have been working with health-system partners to support Inuit in cancer care. We focus on enhancing opportunities for Inuit to participate in decisions about their cancer care through the shared decision-making model, in a research project we call “Not Deciding Alone.”

We travel thousands of miles for cancer care

Our collective success in addressing the TRC Calls to Action will require health research to focus on addressing the health-care inequities experienced by Inuit, First Nations and Métis populations in ways that take action to promote self-determination.

This is important as current health-care models do not often support Indigenous values, ways of knowing and care practices.

Poor cultural awareness in our mainstream health-care systems discourages Indigenous people from seeking care and engaging with health services. It increases the risk that Indigenous people will encounter racism when seeking care.

There are many documented instances of our health-care system’s failure to provide appropriate health care to Indigenous people, due to unfair assumptions and demeaning and dehumanizing societal stereotypes.

These health system failures discourage people from seeking care, and have resulted in death, as in the case of Brian Sinclair, who died after a 34-hour wait in a Winnipeg hospital emergency room in September 2008.

There can also be significant physical barriers to care for Inuit. Critical health services such as oncology specialists and treatments are often located in urban centres such as Ottawa, Winnipeg, Edmonton, Montréal and St John’s, thousands of kilometres away from remote communities in Inuit Nunangat. This leaves many Inuit negotiating stressful urban environments, dealing with cultural dislocation and navigating complex health systems without the benefit of community support networks.

 

People must fly out of remote communities for cancer treatment. (Alex Hizaka), Author provided

During our research, an Inuit peer support worker explained what it can be like for those who travel far from their family and community for their care:

“People come with no idea of why, and we are having to bridge two worlds for them. Often patients have no idea why health-care providers tell them to get on a plane, and then they think they are coming for treatment for three days and then it becomes two weeks. It is a tough situation as often people have no money, no support. People need to be able to explain their situation and how it is for them. People need to know that they are not alone.”

Research shows that these geographical challenges significantly impact access to health care and are often exacerbated by language barriers. Together these factors may make people vulnerable to additional harms unrelated to the health conditions for which they seek treatment.

Patients and health-care providers work together

Shared decision-making is an important evidence-informed strategy that holds the potential to promote patient participation in health decisions

In this model, health-care providers and patients work together using evidence-based tools and approaches and arrive at decisions that are based on clinical data and patient preferences — to select diagnostic tests, treatments, management and psycho-social support packages.

Shared decision-making is considered a high standard of care within health systems internationally and it has been found to benefit people who experience disadvantage in health and social systems.

Shared decision-making has also been found to promote culturally safe care, and has the potential to foster greater engagement of Inuit with their health-care providers in decision-making.

The concept of cultural safety was developed to improve the effectiveness and acceptability of health care with Indigenous people. Culturally safe care identifies power imbalances in health-care settings — to uphold self-determination and decolonization in health-care settings for Indigenous people.

The aim of a shared decision-making approach is to engage the patient in decision-making in a respectful and inclusive way, and to build a health-care relationship where patient and provider work together to make the best decision for the patient.

Most importantly, our approach has emphasized ways of partnering that align with the socio-cultural values of research partners and community member participants, both to develop tools and create approaches to foster shared decision-making. The term “shared decision-making” translates in Inuktitut to “Not Deciding Alone” and so that is the name of our project.

The results are outcomes that Inuit are more likely to identify as useful and relevant and that respect and promote Inuit ways, within mainstream health-care systems.

Self-determination through Inuit Qaujimajatuqangit

Our research uses the guiding principles of Inuit Qaujimajatuqangit — a belief system that seeks to serve the common good through collaborative decision-making — as the foundation for a strengths-based approach to promote Inuit self-determination and self-reliance.

Inuit Qaujimajatuqangit principles have been passed down from one generation to the next and are firmly grounded in the act of caring for and respecting others.

There is important learning taking place within academic and health-care systems that involves deepening understandings of what “patient-oriented care” means. We need to learn how to do research in partnership with those who are the ultimate knowledge users in cancer-care systems — patients.

In our work, Inuit partners and community members are leading the development of shared decision-making tools and approaches, building on their strengths and resiliency. Our research and health systems are beneficiaries of these partnerships that hold potential to create health care that is welcoming and inclusive for all.

With guidance and support from Inuit and more broadly, from Indigenous partners, we are learning how to take action on the TRC recommendations, and to make respect and kindness integral to best practice in research and health care.

______________________________________________________________________________

Janet Jull, is an Assistant Professor in the School of Rehabilitation Therapy at Queen's University. Inuit Medical Interpreter Team is part of the Ottawa Health Services Network Inc.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

International faculty and staff supports

The Human Rights & Equity Office is holding discussion sessions about developing and strengthening supports for employees coming to Queen's from abroad.

Staff and faculty participating in the first brainstorm meeting
Queen's faculty and staff participating in a brainstorming session about supports for international employees.

The Human Rights & Equity Office (HREO) recently invited international staff and faculty to engage in an initial conversation about what potential supports or groups could be created or strengthened to assist those moving from abroad for employment at Queen’s University.

A group of international faculty and staff gathered on Sept. 30 for a brainstorming session facilitated by Queen's Human Rights Advisor Nilani Loganathan, who guided the group in an exercise to begin to identify gaps in services and programs, and suggest ways that could better support international employees.

“I’m very pleased with the ideas brought forth by those who attended our first session,” says Loganathan. “We touched on a number of areas, including issues concerning relocating to Kingston, settling in at Queen’s, employment and education supports for families, and much more. We’re looking forward to continuing the conversation and collecting more feedback that will best inform our path forward.”

Employees who identify as international staff and faculty will have additional opportunities to provide their input. The next session is to take place on Friday, Nov. 15 in Mackintosh-Corry Hall, B176 from 12pm – 1pm. Please email hrights@queensu.ca to confirm your attendance.

Championing new thinking

Nobel Prize Laureate Martin Chalfie met with a group of promising Queen's graduate students to talk success, failure, taking risks, and the future of research.

Nobel Laureate Martin Chalfie at a round table meeting with Queen's University graduate students.
Nobel Laureate Martin Chalfie meets with Queen's University graduate students for a round table discussion on the road to research success.

A group of Queen’s University’s most promising graduate students recently sat down with Nobel Prize Laureate Martin Chalfie, who shared his stories of achievement and failure in hopes of illuminating and inspiring their journeys toward research success.

Over 35 graduate students and post-doctoral researchers took part in an exclusive round table discussion with Dr. Chalfie during a visit to campus by the Nobel Prize Inspiration Initiative (NPII) – an international outreach program organized by Nobel Media and biopharmaceutical firm AstraZeneca that strives to connect Nobel Laureates with scientific and student communities at universities and research centres worldwide.

“As researchers, we know that all discovery and progress is built on the push and pull of failure and success,” says Fahim Quadir, Dean of the School of Graduate Studies, who introduced the round table discussion. “Advancement in science and society, and the creation of new knowledge, often begins with a leap in the dark, with the courage to risk failure simply in order to propel ourselves one step closer to the goals our research pursuits seek to advance.”

Students from over a dozen disciplines attended the candid, closed-door discussion, which touched on topics ranging from science communication and public perceptions of science, to mental health and multi-disciplinary approaches to research.

“The round table with Dr. Chalfie was enlightening and inspiring,” says Mandy Turner, a third-year PhD candidate and Vanier Scholar in the Faculty of Health Sciences’ Department of Biomedical and Molecular Sciences. “Being a graduate student can sometimes feel siloed, so it was comforting to have the opportunity to hear from an accomplished researcher like him, as well as my peers across the university who echoed many of my concerns about the future of science and science careers.”

One of the recurring anxieties expressed by those in attendance centred on a perceived shift in society’s attitude toward the merit of scientific knowledge.

“From time to time, I feel nervous about my pursuit of a career in science, since it seems like hard-earned results and evidence are less and less accepted by the public and policymakers,” says Matthias Hermann, who has just begun his third year as a PhD candidate in Chemistry. “When I expressed my worry to Dr. Chalfie during the round table he reminded us that throughout history there have always been people who deny facts and evidence, which has only served to underline the importance of scientists’ work. I really appreciated this response.”

Many of the round table participants also remarked on Dr. Chalfie’s charisma and candor.

“To have this person who achieved one of the highest honours of a research career be so humble and sincere about his life was very inspiring to me,” says Artur Sass Braga, PhD candidate in the Department of Civil Engineering. “He was so open about his initial failures in academia and shared with us that there is no secret formula or method to becoming a successful researcher. This perspective helps tremendously as it lessens the burden of the expectations graduate students can often feel are placed upon them.”

The round table preceded a sold-out NPII public event at the Isabel Bader Centre for the Performing Arts featuring Dr. Chalfie in conversation with award-winning journalist and author André Picard, Canada’s Chief Science Advisor Mona Nemer, and Queen’s own Nobel Laureate, Arthur B. McDonald. Both events also coincided with the launch of a new website highlighting Queen’s University’s vast complement of research pursuits and achievements, much of which involves Queen’s graduate researchers.

“The round table gathering was also about recognizing the enormous contributions our graduate students and postdoctoral fellows make to knowledge production; to championing new thinking and to uncovering groundbreaking discoveries,” says Dr. Quadir. “I am proud of our students and post-docs for their relentless efforts to advance new knowledge that serves the greater public good.”

Learn more about the Nobel Prize Inspiration Initiative event that took place at Queen’s on September 25, 2019, and view a video recording of our online Facebook Live broadcast of the event.

It’s time to change the way we think about depression and menopause

[Dr. Claudio Soares]
Dr. Claudio Soares was presented the 2019 Outstanding Clinical and Basic Research Award from the North American Menopause Society by Dr. Marla Shapiro, NAMS past president. (Supplied photo)

For middle-aged women experiencing menopause, the struggle to have their symptoms and side effects acknowledged is real. These symptoms can include hot flashes, chills, irregular periods and anything from anxiety and fluctuating moods to clinical depression. In 2015, The Guardian argued that the healthcare system is failing women who are peri- or post-menopausal: “menopausal symptoms are primarily a result of oestrogen deficiency; in the peri-menopause, which can commence several years earlier, fluctuating hormone levels are largely to blame. One in four women will experience debilitating symptoms that can last up to 15 years.”

And it turns out that a subset of women may be particularly vulnerable to depression around the time of menopause as a direct result of these hormonal changes.

Dr. Claudio Soares, head of the Department of Psychiatry in the Faculty of Health Sciences started doing research in this area almost 20 years ago. And last week, he earned a major award for what he discovered. Dr. Soares' foundational studies for the treatment of perimenopausal depression research earned him the 2019 Outstanding Clinical and Basic Research Award from the North American Menopause Society.

But Dr. Soares’ findings haven’t always been widely accepted.

According to Dr. Soares, the role that hormones play in perimenopausal women’s health, and in particular their mental health, is not well enough known among doctors who graduated in the past 10 to 15 years. That’s because of the highly-publicized results of the U.S. Women’s Health Initiative (WHI) trial, published in 2002, which suggested that women taking hormone therapy could face more health risks – especially for breast cancer – than health benefits.

The initial interpretation of the WHI results led to a state of panic among patients and some doctors, and to a significant drop in women taking hormone therapy. “A full generation of physicians have been trained to be less aware of effects of hormones on brain, heart, and bone health – and depression – and to be very cautious or even skeptical of the benefits of hormone therapy,” says Dr. Soares, “and instead be only focused on the negative effects.”

Dr. Soares’ research identified a role for individually tailored hormone therapy. In other words, for some women, the benefits do outweigh the risks.  

The group that Dr. Soares focused on was women in their late 40s or 50s who experienced chaotic fluctuations in hormone levels and were prone to depression. The most vulnerable were women with a previous major depressive disorder, and those who suffered from premenstrual mood symptoms or post-partum depression.

When he began his research almost two decades ago, there was little attention paid to the ‘brain aspects’ of menopause. Dr. Soares says he and others were sometimes accused of pathologizing menopause, or perhaps more accurately re-pathologizing it.

Menopause is a normal condition that all women experience as they age. And before the WHI trial results, hormone therapy was quite widely prescribed for menopausal women to address hot flashes and vaginal dryness. But it was also heavily promoted – perhaps overly so – for its purported “anti-aging” capabilities.

Now more than a decade later, more doctors are becoming aware that there is no “one size fits all” hormone therapy for women experiencing menopause, and that there can be a role for different types, dosages, and durations of therapy depending on the issue.

But he says that still today when middle aged women come to their doctors complaining of a significant increase in irritability, mood swings and anxiety, “you’d be surprised how infrequently physicians ask whether there is any association with their hormonal changes or menstrual cycle changes.”

Physicians may ask if depression is getting worse, but they may not connect the dots about how hormonal changes could be making these women more vulnerable. Instead, doctors often focus on the possible role of iron deficiency, thyroid conditions, changes in life circumstances, and stress at work.

Dr. Soares is gratified that the Canadian Network for Mood and Anxiety Treatments has recognized the role of hormone therapy as a treatment for peri-menopausal depression, driven primarily by the results of his research. In the CANMAT’s 2016 guidelines for women with peri-menopausal depression, estrogen delivered through a skin patch has been recognized as a treatment, along with other conventional treatments such as antidepressants and psychotherapies.  With that, it will be more likely for women who do need hormone therapy to be able to access it.

Depression in humans can take more than two dozen forms. Naturally, clinicians and researchers are keen to better identify types of depression in order to better predict and diagnose particular vulnerabilities and thereby improve treatment.

Dr. Soares’ work has brought women who suffer from depression related to menopause one step closer to the treatment they need, and is paving the way for a change in how physicians interact with their female patients.

This past week, Dr. Soares was in Chicago to accept his award. I couldn’t think of a more fitting tribute to a researcher who persevered in the face of criticism to create a better outcome for patients.

This column was first published on the Faculty of Health Dean's Blog.

Funding on the cutting edge

MPP Steve Clark announces $930,000 in funding for five new research projects and two researchers.

  • ORF funding announcement group shot
    A total of $930,000 in new provincial investments in local research projects was announced on Monday. Attending the event were, from left: Farhana Zulkernine (Computing); Michael Rainbow (Mechanical and Materials Engineering); Bhavin Shastri (Physics); Kingston and Thousand Islands MPP Ian Arthur; Principal and Vice-Chancellor Patrick Deane; Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark; Interim Vice-Principal (Research) Kimberly Woodhouse; Laura Wells (Chemical Engineering); and Sheela Abraham (Biomedical and Molecular Sciences). (University Communications)
  • Kimberly Woodhouse, Interim Vice-Principal (Research) applauds the announcement of new funding
    Kimberly Woodhouse, Interim Vice-Principal (Research) applauds the announcement of $930,000 in new funding through the Ontario Research Fund. (University Communications)
  • Principal and Vice-Chancellor Patrick Deane speaks at announcement
    Principal and Vice-Chancellor Patrick Deane speaks about the importance of the new funding received by Queen's University through the Ontario Research Fund. (University Communications)
  • Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark speaks with Kimberly Woodhouse, Interim Vice-Principal (Research).
    Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark speaks with Kimberly Woodhouse, Interim Vice-Principal (Research). (University Communications)
  • Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark announces new support through ORF
    Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark makes the funding announcement at Mitchell Hall on Monday, Sept. 30. (University Communications)

Queen’s University welcomed Leeds-Grenville-Thousand Islands and Rideau Lakes MPP Steve Clark who announced $930,000 in new provincial investments in local research projects.

The university receives $650,000 for five research projects through the Ontario Research Fund – Research Infrastructure program and Michael Rainbow (Mechanical and Materials Engineering) and Laura Wells (Chemical Engineering) were awarded $280,000 in  Early Researcher awards to help them build research teams for their work in the areas of foot function and cataract surgery.

“We want to ensure the brilliant researchers here at Queen’s and across Ontario who are making discoveries that could help cure diseases, inventing new technologies, and creating whole new industries and jobs have the support, tools and facilities they need to do their work,” says Clark, who made the announcement on behalf of Vic Fedeli, Minister of Economic Development, Job Creation and Trade.

In his research Dr. Rainbow is using recent advances in 3D x-ray imaging to measure the foot’s complex function during walking and running. The work will provide fundamental information necessary to design more effective footwear, prosthetics, and orthotics for Ontarians.

Dr. Wells is examining how cells interact with intraocular lens which are used to treat decreased vision due to cataracts. In many cases patients who need a second cataract surgery or pediatric patients are not eligible for intraocular lenses. Her research will help develop new materials to improve outcomes for these patients.

“The research being conducted at Queen’s is cutting-edge and contributes directly to improvements in the lives of Canadians,” says Queen’s University Principal, Patrick Deane. “This funding is critical, helping to support new research facilities and providing spaces for our faculty, students and staff to continue to push the boundaries of science and exploration.”

The five projects receiving Research Infrastructure program funding include:

Ali Etemad (Electrical and Computer Engineering) $125,000 - Developing methods for smart homes and smart vehicles to ambiently monitor users via sensing and wearable technologies.

Farhana Zulkernine (Computing) $80,000 - Building a smart framework to address real-time processing and storage of multi-modal big data.

Sheela Abraham (Biomedical and Molecular Sciences) $162,500 - Investigating normal healthy stem cells as they age, and how malfunctions in cell signaling events eventually contribute to leukaemogenesis.

Madhuri Koti (Biomedical and Molecular Sciences) $150,000 - Improving cancer immunotherapy outcomes by examining genetic features of tumours that dictate anti-tumour immune response, for the optimal design of patient specific treatment combinations.

Bhavin Shastri (Physics) $132,500 - The proposed brain-inspired processors will fundamentally leverage the strengths of nanophotonic devices with neuromorphic architectures, to outperform current microelectronics in energy efficiency and computational speeds, which currently limit hardware scaling in digital electronics.

“Ontario’s investments are helping researchers build strong teams, and ensure that they have the modern facilities, equipment, tools, and resources they need to complete their work.  The funding announced today will lead to discovery and innovation, attract future investment to the province, and have a direct impact on the economy," says Kimberly Woodhouse, Interim Vice-Principal (Research).

University student mental health care is at the tipping point

 

Mental disorders are treatable, but a key stumbling block towards positive campus responses in health care has been a lack of systematically collected data. (Photo by Miguel Henriques / Unsplash)

As a new crop of students enter university, the sense of hope and promise is tangible. While students are at an exciting developmental stage, as a researcher and practising clinical consultant to university student health services, I know that for some students the associated stress and new pressures will become overwhelming.

Several authoritative reports from Canada and the United Kingdom have drawn attention to increased demand for student mental health care that is straining university resources. Reports also point out that campus mental health services and initiatives are fragmented and inadequate to address the growing breadth and depth of student mental health need.

The tension between need for effective, accessible and engaging student mental care and the status quo in terms of resources has reached a tipping point. Such a state of affairs risks student well-being and academic success and has consequences for the university as evidenced by recent tragedies across different campuses in different countries. A key stumbling block toward change has been a relative lack of systematically collected data to help universities with the development of a coordinated and comprehensive system of student mental health care.

In the face of a seemingly changing university landscape and a relative lack of data, we have launched a new research initiative called “U-Flourish.” In collaboration with colleagues at Queen’s University and Oxford University, we are launching a longitudinal study to evaluate the scope of mental health need among undergraduate students and understand what factors determine different student mental health and academic outcomes.

As a multidisciplinary group of clinicians, academics and students, experienced in developing and evaluating mental health services and studying the onset of mental disorders, we know the importance of the university taking a lead role in the development of a system of student mental health care.

Competition has increased in universities, as enrollment and threshold grades for entry to professional and graduate schools have risen. (Photo by Alexis Brown / Unsplash)

Time of transition, critical period

One of the most important contributors to healthy individual growth and societal development is higher education. Success depends upon health, including mental health. The transition to university coincides with a critical period of accelerated biological, psychological and social development with the peak period of risk for onset of serious and persistent mental illness. The brain is undergoing accelerated growth and has heightened sensitivity to risk exposures commonly encountered by university students, such as stress, recreational drugs, alcohol and sleep problems.

University students are also exposed to a number of unique stresses related to financing their studies and making new social connections. Research finds that in Canada, younger students (under the age of 22) are driving undergraduate growth. Not only a rising number of international students, but also domestic students are studying away from home and their support network.

Competition has increased in Canadian universities and across the western world, as enrolment and threshold grades for entry to professional and graduate schools have risen.

Evidence suggests that not fitting into the predominant demographic at university and constant social media presence may be important psychosocial risk factors associated with mental health problems. Many students experience distress and their ability to cope is overwhelmed.

Serious and persistent mental illness typically emerges over childhood and adolescence. Researcher shows that 75 per cent of all mental disorders onset by the mid-twenties, and typically there is is a substantial delay between illness onset and first treatment contact. This delay is associated with progression to more complex disorders, dropping out of school, addiction and self-harm.

Emerging research underscores the substantial unmet need for screening and effective care of students. A large international study using World Health Organization surveys reported that one-fifth of college students met criteria for a 12-month mental disorder. Yet, treatment rates were exceedingly low and mental disorders were associated with higher rates of drop out.

Absence of evidence-based models

There is limited publicly available information about the outcomes of current student mental health services in Canada or the U.K. From what we as a research collective have observed, most campus mental health services do not have validated quality or outcome indicators embedded in routine care. These circumstances make it difficult to assess how effective current services are.

Student mental health services vary significantly across institutions in how they are organized, integrated and resourced. These variances reflect in part the absence of an evidence-based model guiding the development of student mental health care, and a lack of universal benchmarks for informing standards of care.

There is also a lack of consistency around approaches to determine and monitor the mental fitness of students to continue or return to studies after taking medical leave for a mental health reason.

Unique student needs

University mental health services have typically developed from short-term counselling services which are generally not adequately organized or resourced to systematically assess or respond to the full spectrum of university student mental health need. Compared to community-based care, student mental health services need to be more proactive, expeditious and preventive in nature.

 

University students are particularly disadvantaged in accessing timely and appropriate care as they move between university and home. (Photo by Alexis Brown / Unsplash)

University students are particularly disadvantaged in accessing timely and appropriate care as they move between university and home, and are at an age between child and adult services. Students often struggle with impairing and distressing symptoms that fall short of inclusion criteria for specialized community-based services.

It is likely that effective reform will mean not only re-organizing and strengthening existing services, but also developing new campus-based services and partnerships with specialty programs in the community based on clinical need.

Key principles for development

With an intent to help universities move forward, our research collective has set out key principles to guide the development of an integrated system of student mental health care moving forward. We propose that university mental health services should:

  1. Be accessible, evidence-based, culturally competent and developmentally appropriate;

  2. Have an engaging clinical triage at the student’s first point of contact that is linked to a properly resourced service, where intensity of care matches complexity of needs (stepped care);

  3. Have facilitated transitions between campus and community-based services;

  4. Have outcome and quality indicators embedded in routine care;

  5. Develop standards-of-care and fitness-to-study guidelines;

  6. Rely upon integrated research to inform development.

Determining risk factors

The U-Flourish research program aims to evaluate the scope of mental health need and identify what factors contribute to poor mental health and academic outcomes in university students and what might be important targets for early intervention and prevention initiatives on campuses.

Preliminary research found that almost one-third of students starting university at Queen’s screened positive for both clinically significant anxiety and depressive symptoms (45 per cent with functional impairment) and 18 per cent had significant sleep problems. Almost one-third of students had serious thoughts of ending their life and 6 per cent reporting having attempted suicide at least once. Mental illness, including having suicidal thoughts and self-harm, are treatable conditions. People can get help. Yet, in this study only 8.5 per cent of students indicated that they were receiving any form of treatment. Collectively, evidence points to a significant unmet need for mental health assessment and targeted intervention at entry to university.

The transition to university represents a critical opportunity for prevention through effective screening for mental health problems including suicide and self-harm, and to deliver appropriate evidence-based interventions at the right time.

To support positive outcomes for all students, researchers, clinicians and universities must work together and use the available evidence to put in place a co-ordinated system of mental health care that meets the needs of our students.

If you are experiencing suicidal thoughts, you are not alone. If your life or someone else’s is in danger, call 911 for emergency services in Canada or the U.S. (or 999 in the U.K.). Or, in Canada, download The LifeLine App to find one-touch hotline crisis call, text and chat options and prevention and awareness tips; or call Canada Suicide Prevention Service (CSPS) at 1-833-456-4566.

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Anne Duffy is a clinician-researcher in the Department of Psychiatry, Division of Student Wellness at Queen's University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

Working towards a sustainable future

Researchers from across Queen’s are making discoveries that help us protect our planet.

Image of Queen's University Biological Station
Queen's University Biological Station (Photo by Allen Tian)

Queen’s recognizes that climate change is one of the most pressing challenges of the 21st century, and it is helping to create a more sustainable world through the knowledge and innovations that are being produced by researchers in all areas of the university.

Across Queen’s, faculty members have dedicated themselves to researching questions connected to the environment and sustainability. Taking interdisciplinary approaches to topics as wide ranging as water quality, health, economics, and engineering, Queen’s researchers are making discoveries that will help make the future of our planet greener.

Several Queen’s faculty members are actively exploring the effects that human societies are having on the environment. For instance, Dr. Diane Orihel, Assistant Professor in the Biology Department and Queen’s National Scholar in Aquatic Ecotoxicology, is working to understand how chemicals effect the environment.  Currently, she is the principal investigator on a project that studies the impact of diluted bitumen, or “dilbit,” on fresh water.

Similar to Dr. Orihel, Dr. John P. Smol, Canada Research Chair in Environmental Change, uses lake sediment samples to unravel the history of environmental change in order to improve understanding of human impacts on aquatic ecosystems. Dr. Smol leads an international program in the field of paleolimnology that tracks long-term trends in climatic change and develops new approaches to studying water-quality problems, among other goals.  

Water quality is also a primary focus of the Beaty Water Research Centre, which investigates a variety of issues related to the environment. Four faculty members affiliated with the centre were recently awarded with the NSERC Brockhouse Canada Prize for Interdisciplinary Research in Science and Engineering. Drs. Pascale Champagne (Civil Engineering, Chemical Engineering), Michael Cunningham  (Chemical Engineering, Chemistry), Philip Jessop (Chemistry), and Warren Mabee (Geography and Planning, School of Policy Studies) were recognized with this prestigious award for their work in enhancing the value and sustainability of our natural renewable resources through collaboration. With the funding provided by the award, this team of researchers aims to design solutions, such as green industrial processes, to address problems caused by climate change.

Developing innovative solutions that protect the environment also motivates the research of Dr. Kerry Rowe, Canada Research Chair in Geotechnical and Geoenvironmental Engineering. To help guard the environment from contamination by waste, Dr. Rowe is currently developing new guidelines and techniques for building waste-disposal sites.

In order to tackle the problems of climate change, society will need policy solutions as well as scientific innovations. That is where the work of Dr. Kyla S. Tienhaara, Canada Research Chair in Economy and Environment, comes in. Dr. Tienhaara studies government interventions in the economy through public policies that aim to achieve environmental sustainability. Through this research, Dr. Tienhaara aims to increase the environmental outcomes of future government spending initiatives.

Dr. Heather Castleden, Canada Research Chair in Reconciling Relationships for Health, Environments, and Communities, is addressing problems created by climate change by bringing together different systems of knowledge. By applying Indigenous and Western knowledge systems to research involving social and environmental justice and health equity, Dr. Castleden’s work aims to reconcile relationships between Indigenous peoples and Settler Canadians as well as society’s relationship with the land, water, and air that sustain us.

Beyond our individual researchers, Queen’s also has a number of research centres and institutes that investigate an array of different issues that bear on the environment and sustainability, such as the Queen’s Institute for Energy and Environmental Policy, the GeoEngineering Centre at Queen’s-RMC, and the Centre for Energy and Power Electronics Research (ePower).

To learn more about the many Queen’s researchers who are making discoveries that will help lead to a sustainable future, visit the new Queen’s research website.

Nobel Laureates share their thoughts on research success

Nobel Prize Inspiration Initiative excites sold-out audience at Queen’s University.

  • Acclaimed journalist and author André Picard (left) interviews Nobel Laureate Martin Chalfie during the Nobel Prize Inspiration Initiative event at Queen's University. (Photo by: Bernard Clark)
    Acclaimed journalist and author André Picard (left) interviews Nobel Laureate Martin Chalfie during the Nobel Prize Inspiration Initiative event at Queen's University. (Photo by: Bernard Clark)
  • Following the one-on-one chat, Picard and Chalfie were joined on stage by Canada's Chief Science Advisor Mona Nemer, and Queen's University's own Nobel Laureate, Arthur B. McDonald.
    Following the one-on-one chat, Picard and Chalfie were joined on stage by Canada's Chief Science Advisor Mona Nemer, and Queen's University's own Nobel Laureate, Arthur B. McDonald. (Photo by: Bernard Clark)
  • The public discussion took place at the Isabel Bader Centre for the Performing Arts at Queen's in front of a sold out audience, and over 2000 online viewers.
    The public discussion took place at the Isabel Bader Centre for the Performing Arts at Queen's in front of a sold out audience, and over 2000 online viewers. (Photo by: Bernard Clark)
  • Dr. Chalfie met with groups of excited audience members following the public discussion.
    Dr. Chalfie met with groups of excited audience members following the public discussion. (Photo by: Bernard Clark)
  • Earlier in the day, Dr. Chalfie met with students, faculty, and staff at Ingenuity Labs.
    Earlier in the day, Dr. Chalfie met with students, faculty, and staff at Ingenuity Labs. (Photo by: Bernard Clark)
  • Students demonstrated various robotics projects for Dr. Chalfie during his tour of the new Ingenuity Labs space in Mitchell Hall.
    Students demonstrated various robotics projects for Dr. Chalfie during his tour of the new Ingenuity Labs space in Mitchell Hall. (Photo by: Bernard Clark)
  • Students, faculty, and staff also toured Dr. Chalfie through cutting-edge new laboratory spaces at the Beaty Water Research Centre.
    Students, faculty, and staff also toured Dr. Chalfie through cutting-edge new laboratory spaces at the Beaty Water Research Centre. (Photo by: Bernard Clark)
  • Following the tours, Dr. Chalfie met with a group of Queen's graduate students for an exclusive roundtable discussion on "success and failure at the research frontier".
    Following the tours, Dr. Chalfie met with a group of Queen's graduate students for an exclusive roundtable discussion on "success and failure at the research frontier". (Photo by: Bernard Clark)

A sold-out crowd packed Queen’s University’s Isabel Bader Centre for the Performing Arts for the rare opportunity to hear two Nobel Laureates discuss their roads to research success, together with Canada’s Chief Science Officer Mona Nemer, and award-winning journalist and author André Picard.

Nobel Laureate Martin Chalfie, who was awarded the prize for chemistry in 2008, visited Queen’s as part of the first-ever Canadian tour of the Nobel Prize Inspiration Initiative (NPII). Organized by Nobel Media, in partnership with biopharmaceutical firm AstraZeneca, the NPII is an international outreach program striving to connect Nobel Laureates with scientific and student communities at universities and research centres worldwide.

Queen's Principal and Vice-Chancellor Patrick Deane talking with Nobel Laureate Martin Chalfie.
Queen's Principal Patrick Deane in conversation with Nobel Laureate Martin Chalfie.

“We are honoured to host the Nobel Inspiration Initiative and I’m excited to know that among our live audience and viewers online, we have potential future Nobel Prize Laureates who will be responsible for discoveries that make our world a better place,” says Patrick Deane, Queen’s Principal and Vice-Chancellor, during his opening remarks. “At Queen’s, we believe in the fundamental value of research and want to create an environment where researchers can push boundaries, test limits, fail safely and take risks to achieve the kind of success talked about here today.”

Picard moderated the engaging and often humorous 90-minute dialogue, which touched on the guests’ own research journeys, and topics ranging from basic research, gender imbalance in science fields, commercialization, and public trust in scientists. Richard Reznick, Dean of the Queen’s Faculty of Health Sciences, first introduced Picard and Chalfie, who spoke one-on-one before Dr. Nemer and Queen’s own Nobel Laureate, Arthur B. McDonald, joined in for expanded discussion and an audience Q&A session.

“The Nobel Prize doesn’t necessarily go to the smartest scientist or the most productive, or the one with the biggest group or most published papers; it goes, in my opinion, to scientists who do things that change the way we do science or we think about the world,” says Dr. Chalfie. “Furthermore, most people don’t sit up at night thinking, How am I going to win a prize? The reward for many of us is in the discovery.”

Queen's University's Nobel Laureate Arthur B. McDonald meets with audience members following the panel discussion.
Queen's University's Nobel Laureate Arthur B. McDonald meets with audience members following the Nobel Prize Inspiration Initiative public discussion.

Dr. McDonald adds: “The Nobel Prize is the icing on the cake. The real victory is in the breakthrough.”

The panelists spoke at length about the formative years of their careers, discussing early obstacles. Dr. Chalfie brought up an early-career project that did not work out and drove him to abandon the field temporarily, which stood in contrast to part of the NPII public event’s title, Failure, persistence and joy: finding the right balance for research success.

“I was very fortunate to get back into it,” he says. “When I experienced this early disappointment… I didn’t feel I should ask people for help. I didn’t have people telling me that the first time you do things, you’re going to fail. Persistence has to be coupled with mentorship and support.”

As part of the day-long NPII event, Dr. Chalfie sat with some of Queen’s most promising graduate and post-doctoral students, and early-career researchers, prior to the public dialogue for an exclusive roundtable discussion about success and failure at the research frontier. He also toured two cutting-edge, multi-disciplinary research and learning spaces on campus – the Beaty Water Research Centre and Ingenuity Labs at newly-opened Mitchell Hall – meeting with graduate and post-doctoral students, staff, and faculty.

During the public conversation, Picard posed the issue of the gender gap in science, technology, engineering, and mathematics fields to the panelists for their comments.

Mona Nemer meets with audience members following the NPII public discussion.
Canada's Chief Science Advisor Mona Nemer speaks with audience members following the public discussion.

“I’m uplifted when I look at the audience today and see so many young people,” says Dr. Nemer. “I’m looking at the many women in the audience and I want you all to know there is a place for you in these fields. Don’t let anyone stop you.”

Dr. McDonald agreed, stating that his field – physics—“needs a revolution of women in the discipline”. He also urged current students to try a variety of things while in university to discover where their passions may lie.

“Science is fun. It’s an adventure,” he says. “Embrace it!”

The event coincides with the launch of a brand new website highlighting Queen’s University’s vast complement of research pursuits and achievements. The site tells the stories behind research happening right here at Queen’s and highlights how research affects our lives and helps to shape our collective knowledge about the world.

For those who could not be among those present at the event, or among over 2000 viewers who joined our live online broadcast, you can view a video recording of the event now. A captioned version of the video will be available in the coming days.

Disturbing the peace – Meet Luissa Vahedi

[Luissa Vahedi]
Luissa Vahedi has been studying the UN peacekeeping mission in Haiti as part of her master's in epidemiology, offered through the Department of Public Health Sciences at Queen's.

When you think of peacekeeping missions you might imagine blue helmeted troops handing out candy to children, and field hospitals helping the sick while distributing food and water.

But there are unseen challenges in introducing a large group of predominantly male soldiers into this type of environment for months or years at a time.

Luissa Vahedi has been studying the UN peacekeeping mission in Haiti as part of her masters in epidemiology – a field which focuses on the determinants of public health.

“As the mission wound down in 2017, there were anecdotal reports of sexual interactions between peacekeepers and local women,” she says. “My research aims to understand how these relationships occur and what could be done to support the women that have given birth to children or have been exposed to sexual abuse and exploitation. Examining the legacy of this peace operation in Haiti is very timely and will help us understand how to prevent human rights violations within future peacekeeping operations.”

When she was first considering masters studies two years ago, Vahedi's connected with Susan Bartels, an associate professor of Emergency Medicine with a cross-appointment in Public Health Sciences at Queen’s, who had a funding opportunity to study peacekeeping. The research strongly related to Vahedi's interests, as she previously volunteered at a sexual assault centre and wanted to research more about the intersection of health and gender. Dr. Bartels eventually became Vahedi's supervisor, alongside Heather Stuart, a professor in Public Health Sciences, Psychiatry and Rehabilitation Therapy, as well as the Bell Canada Chair Mental Health and Anti-Stigma Research.

The project involved analyzing data gathered from Haitians who voluntarily completed surveys through tablets provided by the research teams. The surveys provided broad prompts, asking the participants to tell the researchers a story about what it was like to live near UN bases. After this, the participants self-interpret their experiences which provided rich qualitative and quantitative data to Vahedi and the team.

“You get to go back to the story and contextualize those numbers with the actual lived experiences of these women and girls,” she says. “Health is comprised of physical, emotional, social, and political factors, and projects like this provide greater understanding as to how those factors affect daily behaviors, population patterns, and who we are as people. Through this degree I have learned practical skills in data analysis that are very transferable to both public health and in policy making.”

Using the data, Vahedi has built a regression model to try and predict where these interactions were geographically more likely to take place during the peacekeeping mission, and to understand how people's perceptions of these sexual interactions affects the legitimacy of the UN within Haiti.

Preparing for this project involved reading broadly about political science, the history of Haiti, and other related works. While this wasn’t something Vahedi expected as she started her research, she feels the opportunity has helped her to better round out her education and keep her open to new learning opportunities – and, besides, reading is one of her passions.

As she nears the end of her program, Vahedi is preparing for a year off from school to give her time and space to prepare a PhD application. She hopes to continue her studies in epidemiology or public health, while advocating for the use of epidemiological methods to help improve health outcomes for people in fragile states such as Haiti.

“Graduate studies can be stressful, so it has made all the difference for me that I have found a department that is supportive and had the opportunity to work with supervisors who want to see me grow and develop,” she says. “I knew it was a place for me because the campus is beautiful, it is housed in a really great city, and the public health sciences department at Queen’s has been so amazing. Working on a project that I feel very passionate about has been especially gratifying, and I am very privileged and grateful to have this opportunity.”

Hear more from Luissa Vahedi on a recent edition of the Grad Chat podcast on 101.9 CFRC.

Learn more about the Epidemiology program. 

This article was originally published by the School of Graduate Studies.

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