PSI Grants Approved in September 2019

Results from September 2019 Grants Committee Meeting

PSI Foundation is pleased to announce that 10 grants were approved totalling $1,142,500. For more information regarding these funded studies, please visit the Funded Research page.

PSI Foundation would like to thank all of our applicants for submitting their applications and the external peer reviewers for strengthening the scientific rigour of our granting program.

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Resident’s Research Identifies Barriers to Colorectal Cancer Screening in Immigrants

As the child of immigrants, Dr. Shixin (Cindy) Shen has had a long-standing interest in immigrant health issues, including cancer screening. While pursuing the Public Health and Preventive Medicine Residency at the University of Toronto, she found that there was little information about the barriers to colorectal cancer screening that immigrants in Ontario may face. “Colorectal cancer is the second most common cause of cancer, and 40% of all immigrants in Canada live in Ontario,” she says. “Yet, there wasn’t much information about colorectal cancer screening in immigrants in Ontario, despite the fact that they tend to have lower screening rates.”

To address this knowledge gap, Dr. Shen and her supervisors, Dr. Aisha Lofters and Dr. Richard Glazier, looked at the immigration and non-immigration factors that influence screening rates in immigrants, in order to get a better understanding of which are the most important.

They looked at data from a number of health care administrative databases, as well as the Immigration, Refugee and Citizenship Canada’s Permanent Resident Database, which contains records of individuals who obtained immigrant status since 1985.

Dr. Shen found that within the immigrant population there were significant differences in rates of screening non-adherence, related to different factors. Among the factors related to immigration, an individual’s region of birth and the income level of that region, as well as their immigration class (economic, family or refugee) were the most important factors that predicted screening non-adherence. Among the factors not related to immigration, individuals with no or moderate use of the health care system and those not rostered to a care team were less likely to be screened.

The results emphasize the health inequalities that immigrants may face in Ontario. “Some of these factors, especially when combined, contributed to significant disparities in screening uptake,” says Dr. Shen. “For example, among refugees from low-income countries who were not rostered and who lived in low-income areas, the rate of non-adherence to screening was 71%, compared to 25% for economic immigrants from high-income countries who were rostered and lived in high-income areas.”

The study was supported by a Resident Research Grant from PSI Foundation, which was critical for allowing the team to access the multiple databases and to support Dr. Shen’s work on the study. “The funding from PSI Foundation allowed me to lead the study from beginning to end, which was a very helpful learning experience,” she says. “I was able to further develop my skills in critical thinking, problem solving, and evidence generation, which will be helpful in my career as a public health physician.”

Dr. Shen notes that the study is just the starting point in understanding the screening barriers in this population, and that further research is needed to explore these factors in more depth. Ultimately, she hopes that the research can be used to help policymakers find ways to increase screening rates in this priority population.

“We know that screening is important for reducing cancer incidence and death rates, and we know that there are social factors that lead to poorer access to services and poorer health status,” she says. “With this research, we hope to have a better understanding of the potential causes of differential access to preventive care, so that we can address them properly and bridge the gap in health outcomes. The goal is to level the playing field so that everyone can lead healthy lives.”

Unique Early Childhood Research Group Suggests Breastfeeding Duration May Not Reduce Household Food Insecurity

Health professionals agree that breastfeeding is important for long-term child health, and it has also been suggested by policymakers as a way to reduce the risk of poverty and household food insecurity (HFI). But a recent PSI Foundation–funded study has challenged the conventional wisdom regarding breastfeeding duration and HFI, suggesting that it may be more important to focus on other strategies to reduce poverty.

“The benefits of breastfeeding are well recognized, but will it protect families from household food insecurity? Maybe not,” says Dr. Peter Wong, a pediatrician in Toronto.

Because breastmilk substitutes are expensive and could take money away from a household’s food budget, policymakers have suggested that encouraging longer duration of breastfeeding can be one way to decrease the risk of HFI. No research demonstrating the effectiveness of this strategy had previously been done, although studies have shown that the presence of HFI may adversely affect the duration of breastfeeding.

With a PSI Foundation Healthcare Research by Community Physicians grant, Dr. Wong and a team of researchers led by Drs. Patricia Parkin, Jonathon Maguire, Cory Borkhoff and Catherine Birken at TARGetKids!, a research group that focuses on early childhood health, explored this question. A unique research group in Canada, TARGetKids! includes a study population of 10,000 healthy children recruited at community-based practices to provide information about their growth, development and lifestyle to help researchers answer questions about this understudied group.

Dr. Wong and his colleagues surveyed 3,000 families from TARGetKids!, asking questions about breastfeeding duration, household food insecurity and family income. Surprisingly, they did not find an association between breastfeeding duration and HFI, suggesting that shorter duration does not increase the risk of HFI in their study population.

While Dr. Wong notes that the TARGetKids! study group provided access to a large study sample, he also says that the participants were not necessarily reflective of the population where HFI is a pressing concern, which may have influenced the results. Still, the study suggests that breastfeeding on its own may not be enough to help families struggling with poverty and HFI.

“To address household food insecurity, we need a higher level, upstream strategy that addresses more societal problems,” says Dr. Wong. “We need policies that will reduce insufficient income and poor employment. That’s where we’ll make a greater difference.”

Dr. Wong and the team are now planning to examine how breastfeeding and other health-related factors might influence measures of early childhood health, such as nutrition, development and cardiometabolic health. His primary role as a practising pediatrician, as well as his interest in community engagement, public health and epidemiology, gives him unique insight into these types of research questions. “As community physicians, we interact with families and kids on a daily basis, and we have a good appreciation for their health and social challenges,” he says. “We are able to formulate research questions that really have an impact on the health of families and communities.”

And he appreciates that PSI Foundation is supportive of physicians like him who do not have access to the same resources as academic researchers. “Full-time community clinicians have a challenging time competing in the same funding pool as academic researchers,” he says. “PSI Foundation demonstrates that physicians really do care about medical research and about asking questions that address the health of Ontarians.”

New Tool Uses Vital Sign Variability to Predict Potential of Organ Donation

Headshot of Dr. Sonny Dhanani

“PSI Foundation really looks into the needs of our patients’ and their families and the gaps in our medical practice. At PSI Foundation, where it’s physician-driven, they seem to understand what we want to do, and they understand that these ideas may not be funded elsewhere.” – Dr. Sonny Dhanani

When a new policy came into effect in Canada in 2006 that allowed organ donation after circulatory determination of death, not just neurologic determination, it unlocked the potential for many more organs to be donated. But at the same time, it created confusion in the medical community.

“The community wanted more clarity around the declaration of death related to circulatory death,” says Dr. Sonny Dhanani, an intensive care physician and researcher at the Children’s Hospital of Eastern Ontario. “When circulatory death became a way to donate organs, we needed more evidence about when and how death should be determined.”

He and his team began a small observational study, funded by PSI Foundation, that helped to provide a greater understanding of the process of circulatory death.

But just as importantly, they needed a way to predict how long a patient would live after being withdrawn from life-sustaining therapy. In the case of circulatory death, time is of the essence – organs are only viable to be transplanted for about two hours after withdrawal of life sustaining therapy, as blood flow and oxygen are depleted.

With PSI Foundation funding, Dr. Dhanani and his team looked for ways to predict how long a patient would live after removing life-sustaining therapy, with the goal that patients predicted to die within the two-hour time frame would be the best candidates for organ donation.

In their observational study of 650 patients, the team observed vital signs waveforms starting up to an hour before the patient was removed from life support and continuing up to 24 hours later. By comparing the waveform patterns and the variability of the patterns, they were able to develop a model that predicted how long an individual would live after withdrawal of life support.

They found that their model was as accurate as current clinical assessments, but has the potential to be done more efficiently, automatically and in real time. Ultimately, they hope to put all of the data together – the waveform decision tool, clinical decision tools and physicians’ assessments – to create a comprehensive prediction of whether a patient would be a good donor candidate.

“The situation right now is hard on families and the health care team. A lot of resources are mobilized for people who won’t become donors,” says Dr. Dhanani. “Our predictive tool would be personalized and done in real time, which helps to inform families about the dying process and allows the health care team to have more confidence when approaching potential families about organ donation.”

While it may seem difficult to engage families in this type of research, Dr. Dhanani and his team have always prioritized family engagement in their research, and in fact, they found high rates of participation in their studies. In their pilot study, more than 90% of the families approached consented to participate, much higher than other for other studies involving the ICU.

“If it’s felt that someone won’t die in the appropriate time frame, families aren’t even being approached to discuss donation,” says Dr. Dhanani. “That’s a missed opportunity. Our tool would help to ensure that this doesn’t occur. Everyone should have the opportunity to be a donor.”

2019 Second Quarter Update

In an effort to keep Ontario’s physicians and the general public more informed about PSI Foundation, we will be providing quarterly updates about our activities and news. This is the first such update, and we hope it is useful in keeping up to date with our activities. We welcome any feedback you may have about these updates.

The second quarter has been a busy one at PSI Foundation, starting with the annual general meeting (AGM) in April to announcing new grants and funding opportunities in June. Read on to find out more about our activities.

Annual General Meeting focused on knowledge translation

This year’s AGM was held on April 26 in Toronto, and it included continuing education and the business meeting. The continuing education portion of the meeting focused on knowledge translation (KT) and included presentations from leaders in the field and former recipients of the PSI Foundation Graham Farquharson Knowledge Translation Fellowship. Attendees also participated in round table discussions related to overcoming barriers to implementing KT in their institutions.

During the business meeting, representatives from PSI’s Board provided updates from the various committees, presented a history of the Foundation and its successes, and updated attendees on plans related to PSI’s 50th anniversary.

Read more about the event.

Seven new grants approved in June 2019

PSI Foundation is investing a total of $683,000 in seven new grants, which were approved at the June 2019 grants committee meeting.

The new grants, awarded to researchers at institutions in Ottawa and Toronto, represent a range of research types and fields, for example the physical and mental health of children with medical conditions and disabilities, pregnancy and parental leave of women physicians, and immune system response to oncolytic virus infection of colorectal tumours. Congratulations to all of the successful researchers! Read more about the new grants.

The Grants Committee thanks all of the applicants and external reviewers for their time and expertise during this process.

PSI Health Research Grants enhanced

Starting with submissions received as of January 2020, PSI Foundation is raising the amount of funding available for Health Research Grants, from $200,000 over two years to $250,000 over three years. We are very happy to increase the support for our researchers with this enhancement. More information is available here.

Fellowship funding opportunities for 2020 announced

Two of PSI’s annual fellowship programs will soon be accepting applications for 2020.

The Research Trainee Fellowship provides $50,000 over two years to medical doctors enrolled in a PhD or MSc program, or to students enrolled in a combined MD/PhD or MD/MSc program. This fellowship is meant to support MDs who are pursuing research in clinically relevant fields. Applicants must have the support of a mentor and of their institution.

The Graham Farquharson Knowledge Translation Fellowship provides a maximum of $300,000 over two or three years to support a new investigator who is working in KT research, and it is meant to protect at least half of the fellow’s time for such research. Applicants must be within the first five years of their academic appointment, or may be practising physicians either with an academic appointment or working with a supervisor who has an academic appointment.

Researchers or physicians who are interested in applying must work with the research office at their institution, as the institution, not the individual, must submit the application. If you have questions or would like more information about either program, please contact the PSI Foundation office.

PSI Foundation’s 50th anniversary preparations underway

PSI Foundation will be marking our 50th anniversary on June 4, 2020, and we have a variety of activities planned to celebrate this milestone. We will share details over the coming months, but for now, we are pleased to announce two one-time funding opportunities.

The Mental Health Knowledge Translation Fellowship will provide up to $300,000 in funding over two or three years to support a new investigator working in KT specifically related to mental health. For a number of years, mental health research was outside the scope of PSI Foundation’s mandate, but recently it has been included in the primary Health Research Funding program. This new fellowship is specifically earmarked for mental health research. The funding is meant for physicians within the first 10 years of an academic appointment, or for practising physicians with an academic appointment or with a supervisor who has an academic appointment, and it will protect at least 50% of their time to do KT research related to mental health. Please contact the PSI Foundation office with questions or for more information.

In addition, a Mid-Career Clinical Research Award will provide up to $300,000 in funding over three or four years for a clinician-researcher between five and 15 years of their first academic appointment. This award recognizes that this phase of a researcher’s career is particularly challenging, with additional academic roles and responsibilities as well as the ongoing clinical work, and it will protect at least 50% of a recipient’s time for research that aligns with PSI Foundation priorities. Those who are interested in applying for this one-time opportunity should contact the research office at their institution, as applications must be sent by the institution, not the applicant.


Please contact the PSI Foundation office for information about any of these topics, and follow us on Twitter (@PSIFoundation) for updates.

Grants Approved in June 2019

Results from June 2019 Grants Committee Meeting

PSI Foundation is pleased to announce that 7 grants were approved totalling $683,000. For more information regarding these funded studies, please visit the Funded Research page. PSI Foundation would like to thank all of our applicants for submitting their applications and the external peer reviewers for strengthening the scientific rigour of our granting program.

Stay Connected

We invite you to follow us on Twitter to stay on top of PSI news, including new funding opportunities and updates to our funding guidelines.

Enhancement to PSI Health Research Grants: Maximum Amount and Duration

Changes to the Current Funding Guidelines: Health Research Grant

PSI Foundation is pleased to announce that the maximum amount and duration of funding for Health Research grant will be increased to $250,000 for 3 years for submissions received as of January 1, 2020.

Stay Connected

Follow us on Twitter @PSIFoundation for the latest news and updates, such as updated application forms, funding guidelines, and policy revisions.

PSI Foundation 2019 Annual Meeting Focuses on Knowledge Translation

Physicians and researchers representing different disciplines, organizations and career stages attended PSI Foundation’s annual meeting on April 24, 2019 in Toronto. The meeting, with its focus on knowledge translation (KT), featured presentations and roundtable discussions, as well as networking opportunities for those who attended.

Knowledge translation is meant to improve outcomes for patients

Using different examples of research, the morning’s speakers demonstrated the challenges and barriers associated with KT, but also its importance in improving patient outcomes.

Dr. John Sievenpiper, a physician-scientist at St. Michael’s Hospital and the 2015 Graham Farquharson Knowledge Translation Fellow, spoke about how research and KT have helped to inform clinical practice guidelines around dietary recommendations related to sugars and cardiometabolic health. With current popular diets favouring extremely low sugar consumption, Dr. Sievenpiper’s team performed meta-analyses of trials and observational studies examining the role of sugar-sweetened beverages and other sweet foods (including fruit juice, fruit and yogurt) in metabolic and cardiovascular diseases.

The evidence suggests that while sugar-sweetened beverages have adverse associations with health, the association for other foods is not as simple. These studies have informed clinical practice guidelines to move away from dietary recommendations focused on one nutrient or a one-size-fits all approach to something more tailored: the best diet is the one that patients will adhere to.

Questions and Answers after Dr. John Sievenpiper's presentation

Dr. Andrea Gershon, a scientist and respirologist at Sunnybrook Health Sciences Centre and the 2013 Graham Farquharson Knowledge Translation Fellow, spoke about her research to improve care for people with chronic obstructive pulmonary disease (COPD) as an example of the KT cycle. She and her team identified knowledge gaps, for example the lack of quality measures for COPD, then researched existing knowledge through literature reviews and expert panels.

Diagnosis of COPD provided an example of another part of the KT cycle – assessing barriers and developing ways to overcome them. While pulmonary function tests (PFT) are the gold standard for diagnosis of COPD, only 35% of diagnosed patients actually received one. Her team identified the barrier – a belief that PFT does not improve outcomes – and found evidence from population and health databases that showed that patients who received PFT did have better outcomes. They are now using this knowledge to develop strategies targeting both clinicians and patients to increase rates of PFT.

With these two specific research examples in mind, Dr. Sharon Straus, Director of the KT Program at St. Michael’s Hospital and a professor at the University of Toronto, discussed different KT strategies and potential barriers that can hinder the process. Key barriers include:

  • The sheer volume of knowledge. With thousands of papers published every day, it’s impossible for a practising physician to keep up.
  • Strategies that only target individual physicians. Instead, strategies need to include the provincial health care system and workflows at individual hospitals.
  • Lack of evaluation and sustainability. These ideas should be incorporated into KT strategies right from the beginning.

In the roundtable discussion that followed, participants emphasized the importance of understanding and engaging the end user when developing KT strategies, the need for institutional cultures that support changes to workflows and processes, and the importance of learning about KT and opportunities for mentorship earlier in medical education, while recognizing that KT is its own specialized field. Finally, patient engagement in the research process was discussed, including considering them as stakeholders in grant review panels and as end users of the research.

Roundtable discussions

Business meeting features highlights of PSI’s history and plans for the future

The afternoon began with the Foundation’s business meeting, with reports from the committee chairs included in the Annual Report. Board member Dr. Deborah Cook provided a history of PSI Foundation and statistics about the number and types of grants funded, and Dr. Bill Hemens, President of PSI’s board, provided an update on PSI’s 50th anniversary plans for next year, which include the establishment of a mid-career award and a Knowledge Translation Fellow in Mental Health and Addiction, and hosting the Health Research Alliance’s meeting in Toronto in September 2020.

With this context, most of the afternoon consisted of roundtable discussion about ideas to help improve PSI Foundation. Many participants emphasized the importance of PSI’s community grants and suggested ways to improve support for community-based physician-researchers, as well as provided ideas to help connect and engage researchers, physicians and medical students.

PSI thanks all of the participants of the annual meeting for attending and contributing to the productive discussions.

Grants Approved in March 2019

Results from March 2019 Grants Committee Meeting

PSI Foundation is pleased to announce that 12 grants were approved totalling $614,000. For more information regarding these funded studies, please visit the Funded Research page. PSI Foundation would like to thank all of our applicants for submitting their applications.

Stay Connected

We invite you to follow us on Twitter to stay on top of PSI news, including new funding opportunities and updates to our funding guidelines.

2019 PSI Graham Farquharson Knowledge Translation Fellowship – Dr. Andrew Pinto

Picture of Dr. Andrew Pinto, 2019 PSI KT Fellow

“Knowledge translation is a key part of all research, but is absolutely vital to achieving the ambitious mission of the Upstream Lab: to reorient healthcare to consider and intervene on social determinants. We have long known that factors such as income, housing and employment make a big difference in individual and collective health. But we lack evidence-based interventions and service models that consider all facets of health, and that fully integrate health and social care. The PSI Graham Farquharson KT Fellowship will support me in studying how robust data on social determinants can improve patient care, how novel interventions can address social needs, and how organizations can change their culture through quality improvement. This work will also get patients and communities involved in setting the agenda to ensure that their views and priorities are at the heart of our efforts to tackle social determinants.”

The PSI Foundation is delighted to announce Dr. Andrew Pinto of the University of Toronto as the 2019 PSI Graham Farquharson KT Fellow. The Fellowship provides $100,000 per year for three years and helps protect a new, promising clinician’s research time, allowing the Fellow to undertake high-impact translational research.

Dr. Andrew Pinto is the founder and director of The Upstream Lab, where he leads a team to design and rigorously evaluate interventions that address the social determinants of health. These are the daily living conditions that strongly predict who is healthy and who becomes sick. Dr. Pinto works with patients, health providers, community services and policymakers to develop interventions at the individual, organization, neighbourhood and population level. Dr. Pinto is a Public Health and Preventive Medicine specialist and family physician at St. Michael’s Hospital. He completed his residency at the University of Toronto and his Master’s in Health Policy, Planning and Financing at the London School of Economics and the London School of Hygiene and Tropical Medicine as a Commonwealth Scholar. Currently, he is a Scientist in the Centre for Urban Health Solutions at the Li Ka Shing Knowledge Institute at St. Michael’s Hospital and an Assistant Professor at the University of Toronto, appointed to the Department of Family and Community Medicine, Faculty of Medicine and the Dalla Lana School of Public Health.

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