Discoveries for life

The faces of health research 2024


Are health systems ready to meet the challenge of climate change?

Adapting international innovations for climate change mitigation, policy, and measurements in the Canadian and OECD health system context

“My work stresses the importance of considering the environmental impact of our actions, whether in healthcare or in our personal lives. By making climate conscious decisions in our everyday lives, such as choosing active forms of transportation like cycling, reducing energy consumption at home, and reducing red meat consumption, not only we can reduce our carbon footprint, but also improve our health, and benefit the health care system.”

Dr. Sophie Wang
Health Policy Researcher and Postdoctoral Fellow, Organization for Economic Cooperation and Development (OECD)

Mrs. Francesca Colombo
Head, OECD Health Division

Climate change is one of the most pressing issues of our time, and it poses significant threats to global population health. From extreme weather events to altered disease distribution, the impact of climate change is felt in numerous ways. Surprisingly, the healthcare sector is contributing to the problem by emitting greenhouse gases at a level comparable to the aviation industry. In Canada, healthcare is estimated to contribute 4.6% of greenhouse gases.

Dr. Sophie Wang is a health policy researcher at the Organization for Economic Cooperation and Development (OECD) where she aims to better understand the range of policies, strategies, and actions that countries can implement to reduce carbon emissions along healthcare delivery pathways. Her current focus is primary care, which is the first place people go when they need medical assistance. She is assessing the potential carbon emission savings achieved when conditions such as asthma, diabetes, and hypertension are treated in primary care settings rather than in the hospital, where carbon emission is much higher.

Dr. Wang is also reviewing various carbon emission reduction policies beyond the healthcare sector including household energy, transportation, and food. For example, her work suggests the benefits of adopting policies that invest in urban bike share initiatives and planning for mixed use neighbourhoods where amenities are within walking distance. These policies not only reduce carbon emissions but can also decrease the risk of becoming overweight and obese, thus improving health outcomes. By better understanding the interconnected natures of these benefits, Dr. Wang’s work seeks to promote healthier lifestyles, prevent health issues and diseases, and ultimately create a more sustainable healthcare system. Working at the OECD, she is well-situated to turn evidence into policies for real change.

Further reading

COVID-19-Self-Testing: Analyzing its Effectiveness Across the Globe

Examining diagnostic accuracy and future implications

“The COVID-19 pandemic shifted the general population's understanding of self-tests and raised the profile of diagnostics globally. This analysis has added to the evidence base needed for COVID self-test policies. While we may wish to hastily move on from the pandemic, learning lessons from a global self-test rollout is vital, for as they say- history often repeats itself.”

Dr. Nitika Pant Pai
Associate Professor. Division of Clinical Epidemiology, Experimental Medicine, Infectious Disease, McGill University
Senior Research Scientist, Research Institute of the McGill University Health Centre (RI-MUHC) - Infectious Diseases and Immunity in Global Health (IDIGH).
Associate Member, School of Population and Global Health (SPGH)

Apoorva Anand
Public health researcher, Program manager COVID trial. Research Institute of the McGill
University Health Centre (RI-MUHC)
Research Coordinator, The Hospital for Sick Children

COVID-19 self-testing using rapid antigen tests has been a game-changer in fighting the pandemic by making it easier to detect the infection quickly, leading to lower transmission in crowded healthcare settings, workplaces, schools, and other public places. By the end of 2021, these tests were available in pharmacies and grocery stores across Canada, making it possible to curb transmission and, in the case of a negative result, facilitate the continuation of social activities.

Dr. Pant Pai, an associate professor of the Department of Medicine at McGill University, and her team conducted an analysis of 70 studies across 25 countries and 780,000 individuals to determine the accuracy of COVID-19 self-testing.

Their findings show that COVID-19 self-testing has high specificity, meaning the ability to correctly detect when a person doesn't have the virus (true negative) with an accuracy of above 98%. False negatives were primarily observed when the individual was outside the contagion window. Sensitivity, the ability to correctly detect when the person has the virus (true positive), was also high, especially in symptomatic populations, supervised settings, and when digital support systems are available. Dr. Pant Pai's study revealed widespread acceptance, availability, and convenience of self-testing globally.

Dr. Pant Pai is also developing digital innovations to support remote testing technologies for viruses, building on her early work with tests for HIV and other sexually transmitted and blood borne infections (STBBI). She will soon publish the results from a clinical trial that took place in South Africa, involving COVID-19 self-testing coupled with a smartphone/tablet app. This app offers guidance on self-test interpretation and assesses a participant's risk of severe COVID-19. Dr. Pant Pai hopes her findings will help those with COVID-19 exposure get test results faster and start necessary action. COVID-19 self-testing and associated strategies like this will likely continue to be critical tools in pandemic management, offering a convenient and effective method to identify cases and reduce the spread of viruses in public and healthcare settings, with implications extending beyond COVID-19.

Apoorva Anand is first author and trainee of Dr. Pant Pai for the study reviewing the COVID-19 self-testing. She was also the project manager for Dr. Pant Pai's COVID-19 Smart Care Clinical Trial.

Further reading


Implementing E-Mental Health Equity and Care in Canada

Are we ready to embrace digital approaches for mental health?

“I believe in the vast potential of digital health for mental well-being, advocating for inclusive care from prevention to intensive support. I think it's essential to involve Canadians in research and to work towards reducing barriers to accessing virtual mental health services.”

Dr. Gillian Strudwick
Senior Scientist, CAMH;
Associate Professor, University of Toronto

Dr. Gillian Strudwick, a nursing leader and senior scientist, advocates for digital interventions in mental health care across Canada. During Dr. Strudwick's early days in clinical practice, almost all essential medical information was recorded on paper. Nowadays, clinicians have shifted to digital trackers, with the potential of using data mining and technology to improve research and patient care. But while digital technologies are widely used in non-mental health contexts, there hasn't been the same level of uptake for mental health.

During the COVID-19 pandemic, Dr. Strudwick witnessed an increase in mental health challenges due to isolation. While digital health interventions were available, there was no reliable guidance from experts or organizations as to which services might be helpful, suitable, or safe for Canadians. Therefore, Dr. Strudwick and her team decided to create a digital library of mental health interventions, which resulted in a helpful catalogue of resources for people to access.

In addition, her team developed the SaskWell text messaging platform to help people in Saskatchewan with their mental health during the pandemic. To enroll in the program, participants would fill out a brief survey about their age, location, and other preferences (e.g., Indigenous-focused resources). Based on their replies, participants were paired with a digital mental health tool. Every week, they received tips to boost their wellness and a chance to provide feedback.

Dr. Strudwick points out that the demand for e-mental health tools is growing rapidly, but this shift could inadvertently create a larger gap between those who have access to these technologies and those who do not. The lack of infrastructure in some parts of Canada reduces accessibility for communities with limited internet. The long-term objective is to bridge the gap and ensure that everyone can get access to mental health services.

Further reading

The Terminal Diner: A place everyone visits once

Leveraging participatory design and the arts to disseminate health services research to the general public, collect insights, and inform future research

"Our collective ability to engage in conversations about end of life helps to inform not only our own personal care experiences, but it also informs the future of research and care by giving us a glimpse into what people hope for and prefer in the Canadian health care system. There is a great opportunity to connect Canadians to current research through art, design, and other initiatives that make it engaging and personal for them."

Dr. Sarina Isenberg
Bruyère Chair in Mixed Methods Palliative Care Research, Bruyère Research Institute
Assistant Professor, Department of Medicine, University of Ottawa
Assistant Professor, School of Epidemiology and Public Health, University of Ottawa

Because death and end of life are often difficult and negative topics of conversation for many Canadians, many people opt to avoid the topic altogether, often until they are immediately faced with it. Research has shown that while people may have many contacts with the health care system as they become sicker, they may not receive palliative care or other adequate supports. Among the care they do receive, they often see an inconsistent mix of providers, which can negatively impact their quality of life.

Dr. Sarina Isenberg, a researcher at the Bruyère Research Institute and University of Ottawa, recognizes that research findings and questions do not always feel accessible to the public, and some people may not think the research is "relevant" to them, but the reality is everybody will die. That's why Dr. Isenberg and her team created The Terminal Diner, an interactive installation that combines research and design to explore the topic of end-of-life experiences. The goal of this unique exhibit is to invite people to explore this topic in an approachable way and to build public awareness around a universal experience. Having been previously exhibited at Evergreen Brick Works in Toronto, the exhibit is currently being displayed at the David Braley Health Sciences Centre in Hamilton until April 1, 2024. Future venues include the Ottawa School of Art, Bruyère's Saint Vincent Hospital in Ottawa, and the McGill International Congress on Palliative Care in Montreal. This CIHR-funded work is done in collaboration with Dr. Michelle Howard of McMaster's Department of Family Medicine, designers Karen Oikonen and Kate Wilkes, research staff Aria Wills and Shuaib Hafid, and caregiver partner Nyanna Flynn.

Further reading

Cancer, Firefighting and Science: Unique Partnerships

How cross-discipline expertise can help advance our understanding and treatment of cancer

"I am extremely motivated to improve our ability to treat people with advanced stage cancers. The unfortunate reality is that for many cancers, people aren't diagnosed until late stage when the disease is very aggressive and current therapies have limited efficacy. My lab has identified several features of the tumour microenvironment that contribute to the aggressive disease and have developed a novel approach to eliminate the barriers to therapeutic efficacy. As a Fire Chief, I am so thankful to bring my expertise as a cancer researcher to the fight against the alarmingly high incidence of cancers among firefighters."

Dr. Jim Petrik
Professor and Canada Research Chair, University of Guelph
Fire Chief, Guelph Eramosa Fire Department

As a translational cancer researcher, Dr. Jim Petrik at the University of Guelph is investigating how manipulating the tumour microenvironment can enhance the uptake and efficacy of treatments such as chemotherapy, virotherapy, and immunotherapy. Tumours often have an abnormal structure of blood vessels that disrupts blood flow and leads to a low oxygen state known as hypoxia. This state can reduce the effectiveness of cancer treatments and lead to poorer outcomes for patients. Dr. Petrik's lab has developed an approach that normalizes the tumour vasculature to enhance vascular perfusion and reduce tumour hypoxia. They have shown that this remodeling of the microenvironment increases the uptake of cancer therapies by approximately 500% and induces regression of advanced stage ovarian and pancreatic cancers in preclinical models. Dr. Petrik and his team are very excited to be working towards clinical trials with this novel therapeutic approach.

Dr. Petrik combines his career in cancer research with a leadership position in the firefighting services as the Fire Chief for the Guelph Eramosa Fire Department. This role gives Dr. Petrik the opportunity to bring his cancer research expertise to addressing the alarming increase in the incidence of many different cancers among firefighters. As Fire Chief, he is collaborating on a CIHR-funded study on barriers to the use of personal protective gear by firefighters. As a member of the Canadian Association of Fire Chiefs Cancer Committee, Dr. Petrik and his fire service colleagues are taking a science-based approach to keeping firefighters safe. Together they are working to understand the exposure vulnerabilities that firefighters face and responding to the need for a robust medical monitoring program for firefighters.

In June 2023, Canada's Parliament passed Bill C-224, which calls on the Minister of Health to develop a national framework to raise awareness of cancers linked to firefighting with the goal of improving access for firefighters to cancer prevention and treatment. It also designated January as Firefighter Cancer Awareness Month in Canada.

Further reading

Flames and risks: firefighters at risk of cancer and other diseases

Researchers seek to enhance protection for firefighters by assessing the risk of disease and exposure to hazards

Dr. Paul Demers and Dr. Jeavana Sritharan

"All three of us started research on firefighters when we were getting our PhDs. With the classification of firefighting as carcinogenic by the International Agency for Research on Cancer in 2022 and the passing of Bill C-224 in Ottawa, firefighting has moved to everyone's hot list. Our work continues to provide unique contributions to firefighter research to shape policies and prevention measures through epidemiology, exposure, and surveillance research."

Dr. Paul Demers
Director and Senior Scientist, Professor
Dr. Tracy Kirkham
Associate Director and Senior Scientist, Assistant Professor
Dr. Jeavana Sritharan
Scientist, Assistant Professor
Occupational Cancer Research Centre, Ontario Health
Dalla Lana School of Public Health, University of Toronto

Firefighters are at increased risk of cancer and are exposed to a mix of carcinogenic (cancer causing) hazards, including fire smoke, flame retardants, diesel engine exhaust, asbestos, and shift work. The International Agency for Research on Cancer (IARC) recently re-classified firefighting as carcinogenic to humans on the basis of sufficient evidence for cancer in humans, with the strongest evidence for bladder cancer and mesothelioma, and probable associations with prostate, colon, and testicular cancers, as well as skin melanomas and non-Hodgkin's lymphomas.

Drs. Paul Demers, Tracy Kirkham, and Jeavana Sritharan at Ontario Health's Occupational Cancer Research Centre and the University of Toronto's Dalla Lana School of Public Health are seeking to enhance protection for firefighters by assessing the risk of disease and exposure to hazards. They developed a surveillance system that has been used for large epidemiologic studies that have identified higher risks of certain cancers among firefighters consistent with the IARC evaluation. By gaining a better understanding of the risk of cancer and related exposures, they are helping determine appropriate preventative measures for firefighters and ultimately reduce disease risk.

These researchers have an ongoing project to examine respiratory fit testing for firefighters during simulated life support tasks, which may contribute to enhancing respiratory protection requirements, respiratory fit testing protocols, and other health and safety measures. They are also developing methods to measure exposure to polyfluorinated substances (PFAS) and other flame retardants in firefighters and completed a study examining the effectiveness of measures to control diesel engine exhaust in firehalls.

In June 2023, Canada's Parliament passed Bill C-224, which calls on the Minister of Health to develop a national framework to raise awareness of cancers linked to firefighting with the goal of improving access for firefighters to cancer prevention and treatment. It also designated January as Firefighter Cancer Awareness Month in Canada.

Further reading

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