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Understanding bleeding disorders

Women with bleeding disorders can wait up to 15 years to get appropriate testing and treatment. (Shutterstock)

About 30 per cent of all women report heavy menstrual periods at some point during their reproductive years. Up to 15 per cent of these have an underlying bleeding disorder and yet most have never been diagnosed, leaving thousands of women to suffer from a treatable problem.

As a hematologist and clinician scientist at Queen’s University who cares for patients with inherited bleeding disorders, it is a major source of frustration for me that women with bleeding disorders can wait up to 15 years to get appropriate testing and treatment.

I worry even more about what happens to those who never get diagnosed. These women are at risk of acute hemorrhages leading to blood transfusions and the need for hysterectomy.

Because April 17 is the 29th annual World Hemophilia Day — a day focused on outreach and education about hemophilia — I would like to share some evidence-based information about heavy periods, what it means to be a female “carrier” of hemophilia and how you can easily test yourself for a bleeding disorder.

Iron deficiency and abnormal periods

Bleeding disorders that affect women include von Willebrand disease and hemophilia — both are inherited and are caused by low levels of “clotting factors” (proteins needed for normal blood clotting).

In families with a bleeding disorder, it is common for women to not realize their periods are heavy because other affected women in the family have similar problems. To them, heavy periods seem normal.

There are also social stigmas against an open discussion about periods that can be difficult to overcome. And there is a lack of accurate information about normal versus abnormal periods.

Key features of heavy and abnormal periods include having to change pads or tampons more than every hour, having iron deficiency anemia, frequently soaking through your sheets at night and bleeding that lasts longer than seven days.

Iron deficiency anemia is of particular concern because it leads to fatigue and shortness of breath as well as poor school and job performance.

Iron deficiency and heavy periods are too often ignored but can be signs of an underlying bleeding disorder. Both are easily treated once the diagnosis is made.

Women can also have hemophilia

Women who are carriers of hemophilia are very often considered to be “only carriers” — capable of passing on a mutant gene to their children. They may be told this by their doctor. Their bleeding then often goes untreated because of this misconception.

My own research has shown, however, that around 30 to 40 per cent of hemophilia carriers experience abnormal bleeding including heavy periods, post-partum hemorrhage and joint bleeds. Some, but not all, have low clotting factor levels.

Effective treatments for heavy periods in women with bleeding disorders are widely available. These include the oral contraceptive pill and medications like tranexamic acid (that prevent clot breakdown) and desmopressin (that increases clotting factor levels).

Gynecologic options such as the levonorgestrel intrauterine device (IUD) and endometrial ablation also exist.

In rare cases, women with bleeding disorders require clotting factor infusions to control heavy periods. If iron deficient, iron supplementation is a key component of treatment as it improves quality of life. Dietary iron intake alone is not enough to correct iron deficiency, particularly once it has caused anemia.

Historically, much of the focus of research and education for hemophilia was on improving treatment for boys and men with the disease. The mainstay is frequent intravenous infusions of the missing clotting factor. Significant advances have been made including the development of better treatments and the possibility of cure.

Are your bleeding symptoms normal?

Many organizations are now focused on increasing public knowledge about bleeding disorders. The recognition that women can also have hemophilia is increasing through the efforts of organizations like the World Federation of Hemophilia.

Related articles
Unraveling mysteries in the blood
International research leader earns top honour
New website developed at Queen’s University helps women detect the signs and symptoms of a bleeding disorder

The role of novel therapies for women with hemophilia isn’t clear, and additional research is required to understand exactly why these women bleed. One recent study from my lab showed that the blood clotting system of hemophilia carriers doesn’t react to hemostatic stress (such as trauma) as well as it does in healthy controls. A rapid and sustained increase of blood clotting factors is required to halt bleeding following injury and this was significantly impaired in hemophilia carriers.

If you are wondering if you have a bleeding disorder, the Self-BAT (self administered bleeding assessment tool) is freely available and can tell you if your bleeding symptoms are normal or abnormal.

This tool analyzes information about your bleeding symptoms to generate a bleeding score. A high bleeding score is associated with an increased chance of having an underlying bleeding disorder and should be discussed with your doctor.

Significant advances have been made in understanding the problems faced by women with bleeding disorders. More research and education is needed so that all women are diagnosed and treated properly.The Conversation

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Paula James is a professor in the Department of Medicine at Queen's University with cross-appointments to the Department of Pathology and Molecular Medicine and the Department of Pediatrics.

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.  

Queen’s University moves to right historic wrong

Principal Daniel Woolf and Dean Richard Reznick formally apologize for school’s 1918 ban of Black medical students.

  • A century after banning admission of Black students to its medical school, Queen’s University has extended a formal letter of apology.
    Principal and Vice Chancellor Daniel Woolf and Dean of Health Sciences Richard Reznick sign the formal letter of apology during the meeting of Queen's University Senate on Tuesday, April 16. (University Communications)
  • Dean of Health Sciences Richard Reznick
    Dean of the Faculty of Health Sciences Richard Reznick makes a presentation after signing a formal letter of apology for the 1918 ban on admission of Black students to Queen's University's medical school. (University Communications)
  • Edward Thomas, Daniel Bartholomew
    Present at the signing ceremony was Daniel Bartholomew, centre, son of Ethelbert Bartholomew – an upper-year student whose medical career was abruptly ended by the policy in 1918. (University Communications)

A century after banning admission of Black students to its medical school, Queen’s University has extended a formal letter of apology acknowledging the institution’s past racist actions and repeated failures to hold itself accountable. In an official ceremony, Principal and Vice-Chancellor Daniel Woolf and Dean of Health Sciences Richard Reznick signed the letter and expressed profound regret on behalf of the institution for injustices enacted upon its Black medical students, alumni, and prospective applicants.

“We are resolved to confront our past actions, and to more fully understand the meaning of the university’s historical racism, including a commitment to identify its causes and consequences to the best of our ability,” reads the formal apology issued by Principal Woolf and Dean Reznick. “In reckoning with our institutional history, we are committed to acknowledging our failures and to learning from our mistakes. It is our sincere desire to confront this past, learn from it, and never again repeat it.”

In 1918, the Senate of Queen’s University voted to support a motion prohibiting students of African descent from attending its medical school, at the request of the Faculty of Medicine – a ban that went enforced until 1965. According to recent research by Queen’s PhD candidate, Edward Thomas, the ban was put in place to demonstrate alignment with discriminatory policies favoured at the time by the American Medical Association, the organization that ranked medical schools in North America.

Even after 1965, archival evidence suggests the historical facts of the ban were misrepresented by the university when confronted with the issue in 1978, 1986, and 1988. In 2018, once Mr. Thomas presented his research findings to the current Queen’s Senate and brought to light the motion’s continued existence, the university formally rescinded the resolution that enabled the ban.

“As an institution, we can never undo the harm that we caused to generations of Black students, and we have to accept that our actions contributed to the inequities in the medical profession that still exist today,” wrote Dr. Reznick in a blog post published in advance of the ceremony. “I hope, though, that our actions will continue to move the School of Medicine in the direction of greater inclusivity, diversity, and equity.”

The public apology marked the first in a series of necessary steps identified by a commission of Queen’s faculty, students, and staff formed by Dean Reznick to address this historic injustice. Family members of individuals affected by the ban will receive personal letters of apology, and the School of Medicine will soon house an exhibit addressing the ban and its impacts. Course curricula will place greater focus on diversity, equity, and inclusivity, and a symposium examining the past, present, and future of the Black medical student experience is being organized for Winter 2020.

The School of Medicine established a mentorship program in March 2019, through which Black faculty members have volunteered to serve as mentors to Black medical students enrolled at Queen’s as they progress through clerkship, residency, and into the medical profession. The school has also created an admissions award for Black Canadian students entering into the first year of undergraduate medical education. Recipients will be awarded up to $10,000, based on academic achievement and demonstrated financial need.

“The Faculty of Health Sciences has shown great leadership in righting this historical wrong, and I look forward to seeing the implementation of its new programs to support Black student success and diversity in the medical profession,” says Stephanie Simpson, Queen’s Associate Vice-Principal (Human Rights, Equity, and Inclusion). “We owe much to the staff, faculty, students, and alumni who work tirelessly to ensure that this campus is a place where everyone feels welcomed, valued and respected, and able to participate without discrimination.”

For more detail on this matter and on the university’s future steps, read Dean Reznick’s blog post in full.

An ‘innovative and collaborative’ educator

Throughout her career at Queen’s University Heather Murray, an associate professor in the Department of Emergency Medicine, has won a number of teaching awards.

[Heather Murray]
Heather Murray (Emergency Medicine) is the winner of the 2019 Chancellor A. Charles Baillie Teaching Award.

Described by her colleagues as a “passionate, dedicated, innovative and collaborative,” educator it is perhaps no surprise that Dr. Murray is this year’s recipient of the Chancellor A. Charles Baillie Teaching Award, which recognizes undergraduate, graduate or professional teaching that has had an outstanding influence on the quality of student learning at Queen’s.

While Dr. Murray is honoured to receive the award, she is quick to highlight that many fellow faculty and staff members have contributed to her teaching achievements.

“I'm thrilled to be included in the list of stellar educators at Queen’s who have been recognized with this award – it's a huge honour,” Dr. Murray says. “At the same time, I recognize that it takes the collective work of a team to deliver excellent teaching. I'm able to create high quality learning events because of a large amount of background effort from both the Department of Emergency Medicine and the Undergraduate School of Medicine. The environment in my department and at the medical school encourages innovation and excellence. I'm fortunate to work here. It is clear that the learning experience of students is paramount.”

As a faculty member, Dr. Murray has been heavily engaged in teaching, curriculum development and leadership within the Undergraduate Medical Education program at the School of Medicine and has played a significant role in almost every aspect of the curriculum.

This hasn’t gone unnoticed.

“The adjudication committee was particularly impressed with the energy and imagination Dr. Murray brings to educational innovations and her fearless and relentless approach to improving student learning through educational change,” says Jill Scott, Vice-Provost (Teaching and Learning). “Dr. Murray is an exemplar for scholarly approaches to educational leadership with her tireless efforts to include clinical reasoning into the medical school curriculum.”

In winning the award several achievements were highlighted.

The first was the development, implementation and evaluation of a new curriculum enhancing the medical student learning of evidence-based medicine (EBM) and critical appraisal of scientific literature. The curriculum has had a lasting impact on student confidence and ability to interpret and apply emerging medical science long after they have graduated from Queen’s.

Chancellor A. Charles Baillie Teaching Award recipients:
2018 Erik Knutsen, Faculty of Law
2017 Catherine Donnelly, School of Rehabilitation Therapy
2016 Jill Atkinson, Department of Psychology
2015 James Fraser, Physics, Physics Engineering and Astronomy
2014 Stephen Lougheed, Biology
2013 Anne Godlewska, Geography
2012 Lindsay Davidson, Surgery
2011 Brian Frank, Electrical and Computer Engineering
2010 Mark Weisberg, Law
2009 Richard Ascough, Theology/Religious Studies
2008 Bill Newstead, Chemistry
2007 Ron Easteal, Anatomy and Cell Biology
2006 John Smol, Biology

For this work, Dr. Murray was recognized with the inaugural Principal’s Education Award for Curriculum Development.

With the support of a number of Emergency Medicine colleagues Dr. Murray also created a series of Diagnostic Reasoning teaching sessions embedded in the second-year Clinical Skills course. Beyond the lessons, this intervention displayed a vision to realign the clinical skills teaching activities of physicians with educational encounters that are authentic to their clinical practice experience, enhancing the impact of the experience for both student and faculty.

She also designed a new course in the second year of Medical School (Case of the Month) which uses patient illness stories to not only teach fundamental clinical knowledge, but also incorporate complex elements such as legal issues, professionalism, and complex communication.

Dr. Murray says that she works hard to ensure her students understand what she is teaching and, when complete, they will have an appreciation of how these challenging concepts apply to the practice of medicine on a practical level.

“The volume of information medical students receive and are expected to understand is daunting; creating relevance by drawing a line between content and the real world applications is really important,” she says. “I strive to make my learning events engaging. Although I love adding humour whenever possible, more often engagement means adding patient perspectives to the content. At the end of the day, I want my students to become excellent physicians incorporating the best possible evidence while sharing care decisions with their patients. Everything I do works towards that goal.”

Dr. Murray will be recognized during Spring Convocation and will be the featured speaker at the annual teaching awards ceremony in January 2020.

More information about the Chancellor A. Charles Baillie Teaching Award, including eligibility requirements, is available on the Centre for Teaching and Learning website.

Making Health Sciences more inclusive for Indigenous students

Indigenous Access and Recruitment Coordinator Cortney Clark is helping Indigenous students find their way into health sciences programs, navigate the university, and thrive in their time at Queen’s.
Cortney Clark is the Indigenous Access and Recruitment Coordinator for the Faculty of Health Sciences at Queen's University.

This article was first published on the Faculty of Health Sciences Dean’s Blog.

Last year, the Faculty of Health Sciences welcomed Cortney Clark as the new Indigenous Access and Recruitment Coordinator. In this role, Cortney is doing the very important work of helping Indigenous students find their way into health sciences programs, navigate the university once they’ve arrived and ultimately thrive in their time here at Queen’s. 

A Mohawk woman and member of the Bear Clan of the Wahta Mohawk Territory in northern Ontario, Cortney knows very well that Indigenous people in Canada face obstacles to resources, like higher education, that many settler Canadians never experience.

“This work feels personal for me,” Cortney says. “I understand the need for this work and I want to use my lived experiences and abilities to help propel reconciliation through accessible and culturally safe higher education.”

She first started working to build connections with Indigenous communities as a recruitment coordinator for the Aboriginal Post-Secondary Information Program (APSIP).

Through APSIP, Cortney travelled widely to more than 55 different Indigenous communities, many of them in remote and rural locations in northern Ontario. In these different communities, she advised learners on Indigenous access policies to higher education, and specifically advised on the application and admissions processes for Canadian universities and colleges.

While she found it rewarding to help so many people in so many different areas, Cortney has been particularly excited to be able to provide “wraparound service” to the community of health sciences students at Queen’s in her new role. Wraparound service means that she works with Indigenous students from the beginning of their application process through to their graduation.

Cortney advises prospective students on their applications to the Faculty of Health Sciences; she works to create a culturally safe community for students when they arrive; and she helps connect them with career development resources tailored to their needs. She is also available to help students with anything else that arises during their time at Queen’s. All the students that she works with have her cell phone number, and they know that she will answer if they call.

On top of her recruitment, advising, and student support programming portfolio, Cortney is also an active member in a number of different committees in the Faculty of Health Sciences that are advancing our TRC initiatives. For instance, Cortney is a part of the faculty’s Indigenous Health Education Working Group (IHEWG), which is comprised of faculty members and students from each of our three schools.

IHEWG works to build connections with Indigenous communities to find out how Queen’s can help them achieve better health outcomes. The working group is also developing a range of initiatives to ensure that Queen’s trains health practitioners to deliver culturally safe care for Indigenous patients, who frequently encounter racism and insensitivity in the Canadian health care system.

To work towards this goal, the IHEWG, along with the Office of Professional Development and Educational Scholarship, has organized an important series of events with Barry Lavallee, a professor at the University of Manitoba, a practicing family physician, and an expert on Indigenous health. Dr. Lavallee will be visiting May 15-17. He will provide training on working with Indigenous communities and also give a public lecture on how racism affects Indigenous health.

The IHEWG also recently led the hiring of Tim Yearington, the new Indigenous Curricular Innovation Coordinator in FHS. Tim will take a key role in decolonizing our health sciences curriculum and ensuring that Indigenous knowledge as well as the perspectives of our Indigenous students, health professionals and patients are reflected in our programs.

Cortney is also working to help integrate services for Indigenous students across Queen’s by serving as an active member of the Community of Practice Working Group. This group is chaired by Kandice Baptiste, Director of the Four Directions Indigenous Student Centre, and it aims to connect all the Indigenous staff and leadership who work closely with Indigenous policy and Indigenous students at Queen’s.

As you can see, Cortney has already been very busy since starting her new role at the faculty in August. And she is planning a lot of projects for the coming months. Just over March break, she did recruitment work at the Little Native Hockey League in Mississauga, where she spoke to over 227 hockey teams of Indigenous students and their parents about post-secondary programs at Queen’s.

She is also hosting, in partnership with Four Directions, an academic recruitment fair for prospective Indigenous graduate students on May 4, at Queen’s. Universities from across Canada, including Trent, McGill, Concordia, Toronto and Lakehead, just to mention a few, will be participating in what promises to be an important event for helping Indigenous students realize the different research opportunities and programs in graduate-level education.

I am very grateful for all the work that Cortney has been doing to help the faculty work towards its goals for responding to the TRC report, and I know that the rest of my colleagues on the decanal team are as well.

Dean Reznick thanks Andrew Willson for his assistance in preparing this blog.

Seminar fosters discussions and lasting connections

 

[RSC Semninar Speakers]
Three Queen's faculty members – Heather Stuart, John McGarry, and Joan Schwartz – will be presenting aspects of their research at the Eastern Ontario Regional Seminar of the Royal Society of Canada on Saturday, April 13. (University Communications) 

Members of the Queen’s and Kingston communities will have the opportunity to hear four of Canada’s leading researchers speak about their experiences and discoveries as the university hosts the Eastern Ontario Regional Seminar of the Royal Society of Canada on Saturday, April 13.

For academics in the arts, humanities, social sciences, natural sciences, and engineering, being elected to the Royal Society of Canada (RSC) – either as a Fellow or a Member of the College of New Scholars, Artists and Scientists – is one of the highest honours they can achieve.

At the seminar, four RSC members – three from Queen’s and one from University of Ottawa – will provide insights into their work and experiences.

The schedule of presentation includes:
- 10 am: Heather Stuart, Bell Canada Mental Health and Anti-stigma Research Chair, Queen’s — The Nature and Nurture of Mental Illness Related Stigma
- 11 am: John McGarry, Sir Edward Peacock Professor and Canada Research Chair in the Department of Political Studies, Queen’s — ‘The Diplomat’s graveyard’:  Why Resolving the Cyprus Problem is not Easy
- 2 pm: Jamie Benidickson, Faculty of Law, University of Ottawa — Sewage Then and Now: Public Health Challenges and Climate Change Opportunities
- 3 pm: Joan Schwartz, Department of Art History and Art Conservation, Queen’s — Rethinking Discursive Origins: Alexander von Humboldt, Photography, and the Pursuit of Geographical Knowledge

The annual event is organized under the guidance of co-chairs John Burge (Dan School of Drama and Music), a Fellow of the RSC, and Amir Fam (Civil Engineering), a Member of the College of New Scholars, Artists and Scientists.

“Each year this seminar brings together researchers who are leaders in their fields and this year’s group is no exception,” says Dr. Burge. “The sharing of intellectual ideas can be a great stimulus for one’s own creativity and this seminar is a great opportunity to broaden one’s horizons and knowledge base.”

Another goal of the Eastern Ontario Regional Seminar is to bring together leading researchers and community members to foster fascinating discussions and lasting connections.

“At the heart of the seminar is the common quest for knowledge and the sharing of perspectives,” says Dr. Fam. “By bringing together speakers from across disciplines the seminar helps foster new contacts and new paths of thought for not only the audience but the presenters as well.”

All events take place at the Queen’s University Club (168 Stuart St.) and talks are open and free to the public. Following the first two presentations a luncheon is being hosted by Principal Daniel Woolf. Registration is required for the luncheon, which costs $30. Registration for the luncheon by Friday, April 5 would be appreciated. RSVP by phone, 613-533-6000 x78797 or email: FEAS.ResearchAdmin@queensu.ca.

For more information about the presentations, visit the Royal Society of Canada website.

Awards Gala to honour trailblazers and community builders

[QUAA Awards Gala recipients]

A former governor of the Bank of Canada, a legal advocate for same-sex couples, and the country’s first Inuk heart surgeon are among the honorees at the upcoming Queen’s University Alumni Association (QUAA) Awards Gala.

“These recipients are trailblazers and community builders,” says Jeremy Mosher (Artsci’08), volunteer president of the QUAA. “Through volunteerism or their jobs, they have made a significant impact on Queen’s, their cities, and the country.”

Chancellor Emeritus David Dodge (Arts’65, LLD’02) is receiving the Alumni Achievement Award, the highest honour bestowed by the QUAA. Dr. Dodge had a high-profile career in federal public service, serving as both the deputy minister of health and deputy minister of finance, before being named the governor of the Bank of Canada in 2001. He served as Queen’s chancellor from 2008 to 2014.

Past recipients of the Alumni Achievement Award include NASA astronaut Drew Feustel (PhD’95); former Royal Bank of Canada chief executive officer Gord Nixon (Com’79, LLD’03); and former Princeton University president Shirley Tilghman (Arts'68, DSc'02).

Donna May Kimmaliardjuk (Artsci’11) will receive the One to Watch Award. The former president of the Queen’s Native Students Association is Canada’s first Inuk heart surgeon. She received an Indspire Award and serves as a role model to her community and Indigenous youth.

Kirsti Mathers McHenry (Law’03) is receiving the Alumni Humanitarian Award. She and her wife, Jennifer, are the driving force behind Ontario’s All Families Are Equal Act, which passed in the provincial legislature in 2016. It improved the rights of same-sex parents in a number of ways, including no longer forcing couples who use assisted reproduction to have to adopt their own children.

A total of 11 awards will be handed out. Other recipients include: 

The Queen’s University Alumni Association Awards Gala will take place on April 6 at Ban Righ Hall. For more information or to purchase tickets to the event, visit the Queen’s Alumni website.

Pursuing a Paralympic dream

Queen's nursing student Sarah Anne Cormier hopes to compete in snowboarding at the 2022 Paralympics in Beijing.

[Sarah Anne Cormier]
Sarah Anne Cormier is kept busy with her studies at the School of Nursing as well as long training sessions in the gym and on the slopes. (Supplied Photo) 

This article was first published on the Faculty of Health Sciences Dean’s Blog.

In 2017, Sarah Anne Cormier, a fourth-year undergraduate student in the School of Nursing, attended the Paralympian Search in Toronto in order to try out for running teams and development programs in Canada. While she was undergoing numerous tests of her running ability, she was also asked to fill out a form that asked her what other sports she participated in. Sarah had been snowboarding for years, but she didn’t think she should put it down. She had never really snowboarded competitively, and she didn’t want to be misleading.

When she asked a staff member working the Paralympic Search about the form, the staff member told her that she should definitely write down snowboarding. The Paralympic Committee was looking for snowboarders.

Sarah took the advice, and filling out that form ended up changing her life, because now she’s training intensely to make it onto Team Canada, with the goal of competing in the 2022 Paralympics in Beijing.

After the Paralympian Search in Toronto, Sarah was invited to a snowboarding development camp at Blue Mountain, where she made an impression on the Canadian coach for Paralympic snowboarding. The coach told Sarah that he thought she had real potential, and that he wanted to train her. Sarah agreed, and shortly thereafter started an intense training regimen for the sport.

In the summer, when there is no snow for Sarah to train on, she works on strength and conditioning in the gym five days a week. In the winter, when she can snowboard, she still trains four days in the gym on top of getting on the snow every chance she gets. Sarah estimates that this winter she has spent 50 days training on the slopes.

One of Sarah’s strongest motivations to undertake all this training – on top of her rigorous academic schedule in the School of Nursing – is to help inspire other disabled people to know that they can achieve more than they probably realize.

Sarah was born with complications from amniotic band syndrome, a condition that occurs when a fetus becomes entangled in the amniotic bands of the womb. As a result of this condition, Sarah was born missing her left leg below the knee as well as having various finger amputations on both of her hands. She has had to undergo seven surgeries throughout her life to address the complications caused by the syndrome.

When she was five, her parents signed her up for Track 3, a non-profit organization that teaches children with disabilities how to ski. Sarah loved skiing, but when she became an adolescent the sport made her feel self-conscious. When Sarah skied, she did not wear her prosthetic leg, but instead used outriggers as support for balance.

This system worked great, but when Sarah was 12 she started to get uncomfortable with the feeling that people were giving her unwanted looks when she skied on one leg. She didn’t want the attention that came with skiing, but she also didn’t want to give up winter sports.

Sarah found an answer to her dilemma: snowboarding.

If she took up snowboarding, she realized, she’d be able to wear her prosthetic leg. She asked her parents if she could take up the sport, and they agreed.

Even though she has been snowboarding now for 16 years, Sarah feels like she still has a lot to learn.

“Right now I’m trying to break 16 years’ worth of bad habits,” she says. But with the help of her coach and teammates, she also feels like she’s making significant progress.

And it’s clear that her hard work is paying off. In January, Sarah competed at her first provincial race in Bromont, Que. Even though she felt nervous to be competing, she didn’t let her nerves get the best of her: she won silver the first day of the event and gold the second day.

Sarah still has a lot of steps to take before she can reach her dream of making it onto Team Canada and competing in the 2022 Paralympics. Before she can make it onto Team Canada, she’ll need to make it onto the Next Gen team. And before she can do that, she needs to compete in two different World Para Snowboard Cups and finish with competitive times.

But Sarah is well on her way to making her dream come true, and all of us in the Faculty of Health Sciences are proud of her and are rooting for her.

At the same time, Sarah says she could never have achieved what she has so far without the support of the School of Nursing.

Sarah is currently halfway through her placement in the ICU at Kingston General Hospital, and she loves how much she learns there every day. Even though her schedule can be hectic as she tries to balance late nights in the hospital with long training sessions in the gym and on the slopes, Sarah says the nursing faculty and her fellow students always do what they can to help her. When she has to be away from home for long stretches, her friends from the school will even come walk her two dogs, Odin and Atticus.

Sarah will graduate this May, and I’m very happy to share her story with you. Mostly because it is so inspiring, but also because it shows how well rounded our students at Queen’s can be. Even though we have the most dedicated students in Canada, they’re also often people who are pursuing additional passions outside their studies. And this is something that we embrace and encourage in the Queen’s Faculty of Health Sciences.

Before I go, I also want to share the video below with you. Sarah was gracious enough to be interviewed last year for a video series about being an Indigenous nursing student at Queen's, and it's well worth watching. 

If you want to keep up with Sarah’s progress toward her snowboarding goals, you can follow her on Instagram @sacorms12.  

Dean Reznick thanks Andrew Willson for his assistance in preparing this blog.

 

Building research infrastructure

Queen’s University researchers have secured more than $1 million in research infrastructure funding from the Canada Foundation for Innovation (CFI) John R. Evans Leaders Fund.

“Through this support, researchers will be able to build the foundational research infrastructure required to conduct cutting-edge research, and contribute to important new developments in their fields,” says Kimberly Woodhouse, Vice-Principal (Research).

 A total of nine Queen’s researchers will receive the federal funding in a variety of fields, from the ongoing search for dark matter to investigating stem cells, to probing the transition from suicide ideation to attempts to establishing a mobile-inclusive music theatre makerspace.

The following Queen’s researchers have received funding:

Sheela Abraham (Biomedical and Molecular Sciences) has received $162,500 to further the study of cancer stem cells in relation to chronic myeloid leukaemia using systems biology. With the funding, she plans to investigate cell signaling events outside cells controlled by extracellular vesicles and look into if these extracellular vesicles may be key controllers in the aging of stem cells and how this could lead to cancer. Dr. Abraham will also investigate the possibility of using extracellular vesicles as biomarkers for chronic myeloid leukaemia, which would help doctors detect the disease more efficiently, and improve patient treatment and survival.

Joseph Bramante (Physics, Engineering Physics, and Astronomy) has received $49,970 to better determine dark matter’s origin, character, and connection to known physics. Novel new physics search techniques are being developed alongside identified techniques, including using thermal emission of neutron stars as a signature of dark matter, searches for multiply interacting massive particles at underground laboratories, the abundance of elements like gold in dwarf galaxy as a tracer of so-called “asymmetric” dark matter, and charting dark matter’s interaction with neutrinos.

Julia Brook and Colleen Renihan (Dan School of Drama and Music) has received $40,800 to create a music theatre makerspace in order to examine the development and implementation of music theatre activities with underserved populations, such as students in rural and on-reserve communities as well as seniors and adults with cognitive exceptionalities. Participants will work with facilitators to develop music theatre activities using acoustic and digital music tools as well as custom made sets and costumes from the makerspace.

Kenneth Clark (Physics, Engineering Physics, and Astronomy) has received $189,951 to develop a scintillating bubble chamber to support the ongoing search for dark matter. Direct detection involves the interaction of dark matter in a purpose-built detector such as that used by the PICO collaboration. This group has produced world-leading results for a spin-dependent interaction of dark matter with the backgrounds being the largest issue. The scintillating bubble chamber would identify these backgrounds, leveraging the current efforts for a significant improvement in the dark-matter hunt.

Vahid Fallah (Mechanical and Materials Engineering) has received $125,000 to support research into improving the process of selective laser melting, also called metal 3D printing. In this research program, the selective laser melting processing of reactive/sensitive metals will be optimized for more stability and a less reactive build environment. The former will be achieved by optimizing the laser optics assembly, and the latter will be realized by strictly controlling the build atmosphere through an innovative build enclosure design.

Madhuri Koti (Biomedical and Molecular Sciences) has received $150,000 to support her research program’s goals of identify tumour-specific genetic features that specifically associate with the anti-tumour immune responses and whether these could aid in decision making for combination immunodulatory treatment; design optimal combination of chemotherapy and immunotherapy approaches for use with immune stimulating drugs; and  develop markers of chemotherapy-specific host immune alterations for future design of biomarker guided clinical trials to improve patient outcomes.
 
Bhavin Shastri (Physics, Engineering Physics, and Astronomy) has received $132,500 to establish a facility with an experimental test and measurement platform and an optical probe station to demonstrate photonic integrated circuits for neuromorphic computing. Photonic neuromorphic processors have the potential to outperform microelectronics in energy efficiency and computational speeds by seven- and four-orders of magnitude, respectively.

Jeremy Stewart (Psychology) has received $100,000 to support research into identifying factors that predict the transition from suicide ideation to attempts. This transition is a pivotal target for suicide prevention, but little is known about which youth will make this shift and what processes are involved.  The research will employ electrophysiology, laboratory-based behavioural observation, and real-time, daily Smartphone-based assessments to gain novel insights into the processes involved.

Aaron Vincent (Physics, Engineering Physics, and Astronomy) has received $50,000 for his research into developing novel ways to search for and detect dark matter, using its effect on stars such as the sun, and how to use neutrinos as probes of new physics beyond the Standard Model. This research relies on computer simulations of particle physics and astronomical systems such as stars, clusters, and the cosmos, as well as statistical methods aimed at exploring the many possible models of new physics to compare them with data from dozens of different experiments conducted in underground laboratories, ground-based observatories, and in space.

For more information on the supported projects, or to learn more about the John R. Evans Leaders fund, visit innovation.ca.

Find out more about research at Queen’s.

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Unraveling mysteries in the blood

Queen’s University researcher Paula James explores why genetic carriers of hemophilia A often experience abnormal bleeding.

Queen’s University researcher Paula James has revealed women who are carriers of hemophilia A, an inherited bleeding disorder, experience abnormal bleeding in about 30 per cent of cases. Dr. James is working to unravel the mystery as to why this abnormal bleeding, including nosebleeds, heavy periods, and bleeding following childbirth, occurs.

To define abnormal bleeding, Dr. James used a bleeding score where higher numbers represent more intense bleeding.

“It’s long been assumed that women who carry this gene don’t have bleeding symptoms but we now know that isn’t true,” says Dr James, who also works as a clinician-scientist at Kingston Health Sciences Research Institute. “Some patients have low levels of clotting Factor FVIII in their blood, and for those that don’t, there must be other contributing factors. It’s a challenging problem because it has led to their bleeding symptoms being dismissed and not treated properly.”

Her team has discovered that women who are carriers of hemophilia A respond differently to the stresses that cause bleeding – even those who have normal levels of Factor VIII in their blood.

“Normally when we’re injured or cut or stressed in other ways, a number of the elements that help our blood clot go up. However, we thought that it might not work that way in these women,” says Dr. James. “So what other things could be happening within someone’s body that would make them at risk for bleeding?”

To find out, Dr. James and her group compared levels of Factor VIII circulating in the blood levels of 17 women who are carriers of hemophilia A with those of seven normal control patients. The volunteers’ blood was tested before and after being treated with Desmopressin, a drug that causes an immediate increase in clotting factor levels that mimics the way the body responds to being cut or injured.

The researchers were looking to see whether the women’s response to the drug was related to how much Factor VIII was already in their blood. “We wondered whether a person’s response was only dependent on where they were starting from using a baseline,” James says. “That turned out not to be the case.”

Dr. James’ study showed that, compared to the control group, the Factor VIII response in Hemophilia A patients, including those with normal clotting factor levels, was both significantly reduced and shorter-lived. These results were correlated with those that had higher levels of abnormal bleeding.

The research results suggest that the women may not be able to generate and sustain a high enough increase in Factor VIII in response to bleeding, likely because of the FVIII mutation that causes hemophilia A. Abnormal bleeding can lead to iron deficiency, which causes fatigue, sleep disturbance, and impaired learning and work performance.

“It’s a huge quality of life issue for these women,” says Dr. James. “We need to understand this disease better in order to treat it properly. While we still don’t have all the answers, this discovery adds significantly to our understanding of why, even when they have normal clotting factor levels, women who are carriers of hemophilia A have abnormal bleeding.”

The study was published in Blood Advances

In tune with the community

Queen's University nursing students gain valuable experience while working with different organizations and groups.

[NURS 405 programs]
Students from the School of Nursing's NURS 405 course worked with university and community groups on a wide range of topics including food security, physical activity, healthy eating, and mental health. 

Becoming a well-rounded student to prepare for life after graduation often involves working in the community. The NURS 405 course in the Queen’s University School of Nursing provides a unique town-gown opportunity for fourth-year nursing students.

As part of their clinical placement, the students work with community organizations on projects that focus on a wide range of topics including food security, physical activity, healthy eating, and mental health. This year, two of the projects featured students working with Kingston Housing and the Office of the Provost.

“There is a lot of critical thinking included with these projects,” says School of Nursing Professor Deborah Tregunno. “The students often go into these assignments thinking they know what’s best for their community clients. But this is very much a learning experience on both sides, which is critical to their development in nursing.”

Meagan Franchetto and Jillian Koskins worked with the Frontenac Housing Corporation’s tenants on developing resources focusing on food insecurity and nutrition, including shopping for food, food labels, food storage and preparation. On a weekly basis, both students interacted with the tenants and Franchetto says it was moving to positively influence the daily lives of her clients.

“It was easy to assume we would go in and know exactly what to do because of our training,” she says. “That wasn’t the case at all. We really took the opportunity to get to know our clients and built the programming around their exact needs. It was eye opening.”

Sarah Gelmych and Courtney Gallant took on the challenge of enhancing the university’s Swipe It Forward program. The pilot program was designed to combat food insecurity on campus through the donation of meals from students with meal plans.

“Many people on the Queen's campus are unaware that students are facing food insecurity issues,” says Gallant. “The Swipe it Forward program is a way to help and our job was to raise the profile of the program within the student population but also with the faculty and staff.”

Gelmych says 39 per cent of post-secondary students in Canada face some type of food insecurity which essentially means there are barriers to the student eating properly on a daily basis. With the program, students can donate up to five meals per semester and a new poster campaign, designed by Gelmych and Gallant, should help raise the profile of the program on campus.

They also created a new website Food For You which provides links to programs on campus.

“We are teaching the students to communicate with all populations – the NURS 405 course lets them step outside the ‘Queen’s bubble’ and work in the community,” says School of Nursing instructor Denise Neumann-Fuhr. “The community organizations reap the benefits but so do our students.”

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