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Patient literacy - Dr. Régis vaillancourt, Director of Pharmacy
Mexico pictogram team: Dennise Albrecht, Régis Vaillancourt, Elena Pascuet and Fanny Zegarra
Low literacy, education, language and culture impact all levels of the healthcare process, from communicating with medical professionals to reading a prescription bottle. According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), about 26% of the world’s adult population are illiterate. Understanding health information, such as instructions for medications, can be difficult and can negatively impact patient health outcomes.
To help address this problem, Régis Vaillancourt, CHEO’s Director of Pharmacy, developed a series of pictograms – simple and descriptive images that graphically convey instructions to patients on how medicine should be safely taken.
These were originally developed through funding from the International Pharmaceutical Federation (FIP) and then validated in Oaxaca, Mexico by joint funding with Pan-American Health Organization ( PAHO) to modify images to better meet cultural needs. Using this preliminary data this team has now been awarded a World Health Organization's (WHO) World Alliance for Patient Safety Small Research Grant in the amount of $20,000 USD. The Small Research Grants project is a new initiative of the WHO, World Alliance for Patient Safety. Its aim is to stimulate research studies on patient safety priority areas by providing seed funding for small research projects.
This project aims to effectively integrate these validated culture-specific pictograms for the labelling of medications into use at four Mexican hospitals that are teaming with CHEO as part of an international collaborative partnership serving varied indigenous and linguistic populations.
Pictogram interventions will be evaluated for the effectiveness in improving patient comprehension, medication adherence, and retention of medication instructions. Their use in clinical practice may help reduce the risk for medication dosing errors, thereby improving patient safety and contributing equity for health. The collaborative effort by CHEO will enhance the capacity of the Mexican partner hospitals (Civil, HNO, Guerrero) to respond effectively to the healthcare needs of their diverse linguistic population groups and to strengthen the system capacity required for sustainability and replication at each site. Pictograms will be integrated as a new standard of care.
The transfer of knowledge between all collaborative institutions is essential in our collective goal of optimizing patient care, improving patient health, and promoting patient safety throughout the community.
http://www.who.int/patientsafety/research/grants/first_round_awards/en/index.html
Dr. Jane Rutherford
 Childhood Obesity Taking on Pandemic Proportions – Leaving Entire Generation in Danger
Recent studies have shown that children growing up in North America today are at risk of being the first generation in modern times that will have a shorter life expectancy than their parents. This is an alarming realization! Researchers at CHEO are heeding the call and working hard at finding solutions.
Jane Rutherford is associated with the Healthy Active Living and Obesity (HALO) research group at the CHEO Research Institute. HALO is committed to developing innovative strategies to treat and prevent childhood obesity.
Rutherford has been busy working on a variety of clinical studies to further understand how to best address the physiological and psychosocial factors associated with childhood obesity as there are clear limitations and deficiencies in the current available services. Additionally, the work of HALO will help better define the important risk factors for the development of childhood obesity.
“While we know a lot about pediatrics and the health of kids and adults, we don’t really know that much about the health of obese children and what trajectory they will follow,” explains Rutherford. “When devising a treatment plan, it’s unrealistic to compare obese children to healthy kids.”
The Gamebike study is an example of a successful HALO research project. In this study, a recumbent exercise bicycle was connected to a PlayStation console. The main purpose of this study was to evaluate the feasibility and the health benefits of using the PlayStation as an incentive to exercise, instead of a standard stationary cycling program, where youth only had access to the music of their choice. The 10-week study demonstrated that stationary cycling while playing video games is just as effective as stationary cycling to music at improving fitness, body composition and cholesterol profiles in obese teens. These results indicate that capitalizing on youth’s attraction to video games could eventually help increase physical activity and fitness levels in youth however, further investigation and research is needed.
While medical professionals have grasped the severity and effects of childhood obesity, health care funding and societal perceptions are lagging behind. “Societal perception is that overweight people are just lazy and that they have failed at self control. Studies have shown that negative reinforcement does not work. It’s important that we really understand why children become obese,” explains Rutherford.
Childhood obesity did not happen overnight. “The environment that we live in now is not always suited to good health,” says Rutherford. “Because we are so busy, we try to do things as quickly as possible and in the end we are expending less energy to do things. We choose to spend less time on healthy habits, which creates an imbalance in our body’s energy in, energy out demands.”
HALO believes we all have a role to play in derailing childhood obesity. “We need to get everyone on board,” says Rutherford. It is becoming clear that investing in childhood obesity is a necessity if we are to save future generations of children. While it’s important that we focus on preventative measures, we are in a situation where many children are simply past that. “All of our patients are at the treatment stage,” explains Rutherford. “We are past saying here’s a booklet – you need to exercise and eat better. The many reasons why they aren’t doing that need to be addressed.” With consistent funding, HALO will continue to provide essential research in, and long term management solutions for, childhood obesity.
Photo: Dr. Stasia Hadjiyannakis & Dr. Jane Rutherford with the Gamebike
Dr. Martin H. Osmond
CHEO-Led Team Creates New Tool to Determine
When CT Scan is Needed in Children with Minor head Injury
The Children’s Hospital of Eastern Ontario (CHEO) Research Institute led a team of researchers from ten paediatric teaching hospitals across Canada who created a new tool for emergency room doctors to better assess the need for computed tomography scans (CT Scans) in young patients with minor head injury – reducing possible exposure to cancer-causing radiation.
Each year more than 650,000 children across North America are rushed to the emergency room with minor head injuries (those head injuries resulting in loss of consciousness, amnesia, disorientation and/or vomiting). CT scans are important for the diagnosis of serious brain injury in these children but have the drawback of exposing children to significant amounts of ionizing radiation.
“There are currently no widely accepted, evidence-based guidelines and North American physicians are more likely to follow a conservative approach of ordering CT scans for most children with minor head injuries,” said Dr. Martin Osmond, chief executive officer of the CHEO Research Institute and lead researcher on this study. “The CATCH Rule is a ‘master checklist’ that will help physicians decide which child should receive a CT Scan to look for intracranial lesions and which can be safely sent home without imaging.”
The CATCH rule should prove to be an extremely useful tool across North American hospitals, especially since CT scanning rates in children with minor head injury have risen rapidly over the last 10 years and there are growing concerns that exposure to ionizing radiation at an early age may result in a significant rise in lifetime fatal cancer risk.
The study, titled “CATCH: A Clinical Decision Rule for the Use of Computed Tomography in Children with Minor Head Injury”, was published in the Canadian Medical Association Journal (CMAJ) on February 8, 2010.
The CATCH rule was derived in 3866 Canadian children. Before widespread use it will be prospectively validated in multiple sites by the end of this year.
To read the full study, please visit the CMAJ website at: http://tinyurl.com/27o4mp6 Meet Dr. Osmond:
The CHEO Research Institute (CHEO RI) coordinates the research activities of over 300 CHEO scientists and clinicians who seek to better understand and solve pediatric health problems. Since its inception in 1984, its impact has been influential and has resulted in collaborative research with local and international scientific partners.
On November 16, 2009, Dr. Martin H. Osmond, MD, CM, FRCPC, Director of Clinical Research at the CHEO RI, Associate Professor in the Department of Pediatrics at the University of Ottawa, and a practicing physician at CHEO was appointed CEO and Scientific Director of the CHEO RI and Vice-president of research at CHEO.
Dr. Osmond now oversees research activity that spans diverse fields, such as cancer, obesity, emergency and critical care medicine, as well as molecular biomedicine, mental health and eHealth.
It is a known fact that hospitals with a strong research program deliver the best care. “The stronger the research, the stronger the care,” adds Dr. Osmond. “It helps us attract the brightest physicians and scientists who enjoy being up-to-date in their practice, which in turn translates into better health outcomes for the children and youth of our community. And with our strong links to the University of Ottawa, we are doing our part to train young researchers who will be responsible for tomorrow’s discoveries. That is an important component of the CHEO RI and it is a role we take very seriously.”
Dr. Osmond obtained his medical degree at McGill University’s Faculty of Medicine, did his family medicine residency at the Ottawa Civic Hospital and his pediatric residency at CHEO, where he has been practicing emergency medicine since 1992. He continues to work in the Emergency Department and to work on research projects to this day.
“Throughout my career at CHEO, I’ve seen first-hand how clinical research has improved clinical care. It has literally changed the way certain conditions are treated, such as croup cough, asthma and bronchiolitis, to name a few. And that’s not just at CHEO, but across Canada and across the world.”
“The problems one sees at the bedside in clinical practice drive most of the questions that we are trying to answer,” adds Dr. Osmond. And only when we can fully understand the basic mechanisms of the way the human body and cells work can we understand how cancer or debilitating conditions work, can we then seek the answers that will lead to better treatments,” concludes Dr. Osmond.
Through the CHEO Foundation's $25 million BIG STEPS Campaign, CHEO hopes to expand the current capacity of its Research Institute to directly improve the health care of pediatric patients in our community. “We are a direct reflection of the generous support of the public and the professional community. Without it, the RI would not be able to attract the best investigators or invest in essential equipment needed in our labs, and for that, we owe them a great deal of thanks for their unwavering support,” says Dr. Osmond.
Dr. Robert Screaton
Piecing Together a Puzzle
An investigator looks at beta cell regeneration
Dr. Screaton is an Assistant Professor in the Department of Pediatrics, Department of Cellular and Molecular Medicine at the University of Ottawa and a member of the CHEO Research Institute’s Apoptosis Research Centre. A Canada Research Chair In Apoptotic Signaling, Tier II, he is also a recipient of an Ontario Early Researcher Award. By studying apoptosis (or programmed cell death), he hopes to gain some insight into beta cell survival mechanisms in order to improve treatment options available to Type I and Type II diabetes patients.
In 2008, Dr. Screaton and his team received an award to further investigate the role of TORC2 and CREB signaling in beta cell regeneration. In doing so, they are trying to identify what contribution TORC2 makes to CREB activity. The ultimate goal is to apply their findings to improve islet cell function and preserve islet cells during islet transplantation, a promising treatment for children with Type 1 diabetes.
“By understanding the intricacies of how beta cells respond to extracellular cues, medical researchers can learn how beta cells normally function and, in turn, to treat problems that arise in disease. Right now, we have powerful new screening tools to identify as yet unknown molecular mediators that respond to signals and stir the cell into action. We've found some missing pieces of the puzzle, and we're set to find more.”
To learn more about Dr. Screaton's work, please visit: http://www.cheori.org/screaton_index.html |