Grant Recipients » 2016
The Manitoba Medical Service Foundation has been awarding Research Grants to researchers since 1971, and over $14.5 million has been donated to furthering this cause, with over $20.1 million provided in support of all awards.
Go to Previous Awards Annual Brochures to view previous year's awards. Contact the Administrative Assistant for information on awards prior to 2009.
Please Note: Institutional Costs are not eligible expenses for MMSF Grants and Awards funding.
Characterization of Escherichia coli Antimicrobial Resistance Efflux Pumps Inherited by Horizontal Gene Transfer
- Dr. D. Bay
Bacterial infections are difficult to treat due to the activity of membrane proteins known as multidrug transporters. They recognize and transport a wide variety of antiseptics and antibiotics out of the cell before they are effective. Even worse, transporters known as qac confer resistance to many commonly used antiseptics and antibiotics in hospitals, and are spread between unrelated bacteria on mobile genetic elements known as integrons. Escherichia coli (E.coli) strains are frequent targets, and represent one of the most isolated species from multidrug resistant hospital infections and food contaminants. Qac are predicted to enhance multidrug resistance of E.coli especially when they grow as sessile surface attached biofilms that form on contaminated medical tubing and implants.
Our aim is to characterize the multidrug resistance of commonly identified qac genes that are spread by integrons in E.coli when they are grown as surface attached biofilms and as free living planktonic cells. Non-pathogenic E.coli will be used to measure the extent of multidrug resistance conferred specifically by qac genes to determine their inherent resistance properties. Many multidrug transporters related to qac genes are naturally encoded in the E.coli genome. These transporters will be deleted to specifically identify drugs transported only by qac. Each qac gene will be expressed in these E.coli transporter deletion strains and will be used to identify qac-specific resistance differences between biofilms and planktonic cultures.
These findings will identify specific qac genes that enhance E.coli multidrug resistance and uncover growth conditions that alter qac function. This knowledge is essential to improve and design novel antiseptics, antibiotics and inhibitors to combat the spread of integrons. It will also help clinicians create improved strategies to eradicate integron-transferred multidrug resistance.
Dr. Denice Bay — PhD (Microbiology) University of Manitoba 2007; B.Sc. (Microbiology) University of Manitoba 2000
Assistant Professor, Medical Microbiology and Infectious Diseases, University of Manitoba
Early Loosening and Failure of Femoral Stems Coated With Hydroxyapatite in the Presence of Metal Corrosion and Wear Particles
- Dr. B. Flynn
Total hip replacement is a long-standing surgical intervention with typically excellent outcomes for patients. Innovation has driven the development of new hip replacement implants to improve function and durability. Hydroxy-apatite (HA), a substance that promotes bone growth, has been applied as a coating on the femoral stem component of some hip replacement designs. This coating helps to stabilize the stem within the femur thus providing longevity to the hip replacement.
A recent phenomenon has been noted in some patients with these femoral stems; well- grown-in stems become progressively looser until a revision surgery is required. Some hip replacement implants produce metallic particles either through wear of the ball and socket or through corrosion between tapered junctions between components. It is hypothesized that these metallic particles are reacting with bodily fluids creating an acidic environment immediately surrounding the hip replacement. This is causing the HA coating to dissolve, thus loosening the stem from the bone over time.
The purpose of this study is to determine if a relationship exists between HA coating dissolution and metallic wear and corrosion measured on retrieved components, and to determine the overall mechanism of femoral stem loosening. Further, this research will assess if patient, implant, or surgical factors are associated with increased risk for wear, corrosion, HA dissolution, and subsequent femoral stem loosening.
Finally, the end goal is to establish procedures for highlighting patients at risk for such femoral stem loosening, guidelines for monitoring the progression of loosening, and intervals in which surgical intervention is required. The hope is these cases can be caught early, the femoral stem retained, and the offending components replaced via a less invasive surgery compared to replacement of the femoral stem.
Dr. Bryan Flynn — Adult Reconstruction Fellowship (Orthopedic Surgery) Dalhousie University 2015; FRSCS(c) (Orthopedic Surgery) Dalhousie University 2014; MD (Medicine) University of Manitoba 2009; B.Sc. (Science) University of Manitoba 2004
Arthroplasty Fellow, Department of Surgery, University of Manitoba & Winnipeg Regional Health Authority
Mood and Anxiety Disorders and Psychotropic Use in Spousal Caregivers of Dementia: A Population-Based Study
- Dr. I. Kuo
The number of Canadians inflicted with dementia is increasing with an aging population. Spouses of those with dementia inevitably become informal caregivers, bearing the around-the-clock responsibility of looking after their partners’ daily needs, while coping with cognitive and behavioural changes. Small, community-based studies have suggested that spousal caregivers of dementia patients are at risk of developing depression and anxiety. However, the true impact of dementia on the spousal caregivers’ mental health is poorly understood.
The primary objective of this study is to determine the risks of developing mood and anxiety disorders, and also to measure psychotropic medication use (i.e. mood-regulating drugs), in spousal caregivers of dementia patients. Using the provincial population in Manitoba and health care administrative databases, findings of this study will provide robust information on the mental health risks attributable to their partners’ dementia and inform future policy-making to improve the quality of life of dementia spousal caregivers.
Dr. I fan Kuo — M.Sc. (Population and Health Outcomes Research) University of British Columbia 2014; PharmD, University of British Columbia 2009; ACPR (Accredited Hospital Pharmacy Residency) St. Paul's Hospital - University of British Columbia 2005; B.Sc. (Pharmacy) University of British Columbia 2004
Assistant Professor, College of Pharmacy, University of Manitoba
Incidence of Cardiac Arrhythmias in Patients with Peripheral Artery Disease and Coronary Heart Disease
- Dr. D. Leyva
In patients with heart artery blockage (CAD), irregular heartbeats may lead to sudden death. Because of the overlap between CAD and a disease that produces blockages in the leg arteries (PAD), it is reasonable to propose that irregular heartbeats may also be found in patients with PAD. PAD affects about 800,000 Canadians and is an important contributor to Canadian national rates of heart attacks and strokes. It is largely unrecognized and under-treated compared to other heart diseases.
A susceptibility to irregular heartbeats may explain the increased risk for cardiac complications in patients with PAD. The purpose of the study is to identify the presence and type of heartbeat disturbances in patients with PAD and their relationship to artery abnormalities and other chronic diseases. We are also trying to identify potential variables that lead to an increase in heartbeat disturbances in patients with PAD, and to compare the incidence and type of heartbeat irregularities found in these patients with those of patients with known heart artery blockages.
First, we will examine the electrical activity of the heart from 110 patients with a positive diagnosis of PAD. The incidence and type of irregular heartbeats will be recorded. Then, we will analyze electrical activity of the heart as well as heart function in 110 CAD patients. Statistical analysis will be used to identify potential relations between different variables and irregular heartbeats.
We anticipate a higher number of irregular heartbeats in patients with PAD compared to those with CAD. Our results should improve the physician awareness of the potential high presence of dangerous irregular heartbeats in PAD patients and the ability to use simple screening tools to determine higher risk patients.
Dr. Delfin Rodriguez Leyva — Specialist in Critical Care Medicine (Medicine) University of Medical Sciences of Holguin 2004; Specialist in Cardiology (Medicine) university of Medical Sciences of Holguin 2000; MD (Medicine) Higher Institute of Medical Sciences, Santiago de Cuba 1996
Associate Professor, Internal Medicine, University of Manitoba
Associate Professor, Physiology and Pathophysiology, University of Manitoba
Professor, Internal Medicine, University of Medical Sciences of Holguin
Professor, Critical Care Medicine, University of Medical Sciences of Holguin
The Development of an Interactive Online Vaccination Information Resource for Parents to Reduce Vaccine Hesitancy
- Dr. J. Potter
One of the first decisions parents make on behalf of their children is whether or not to have them vaccinated. For many, the internet is a preferred source of information, but much of the information found is misleading or inaccurate. This frequently leads to uncertainty if vaccination is the right course of action for their child, and has resulted in decreasing vaccination coverage combined with an increase in vaccine-preventable illness.
The intent of this study is to develop an online tool to reduce parental vaccine hesitancy and provide accurate, credible, accessible and timely information to parents in an interactive manner. Components of this tool will include an information section, an “ask a question” section and a blog, allowing interaction between users and site moderators to address concerns and discuss current events as they develop.
Focus groups will be assembled to seek feedback from the intended audience (parents using the site) regarding site design, with the goal of making the online tool visually appealing, easy to navigate and understand, and useful. The feedback will be used to modify and refine the site as applicable. It will be piloted for a three month period. A subsequent study will then assess the effect of the site on users’ vaccine hesitancy.
By directly addressing parents’ specific concerns regarding vaccination, we hope to increase confidence in this effective intervention and ultimately reduce morbidity and mortality related to vaccine-preventable illness on both an individual and population level.
This study is also significant as it’s one of only a limited number of web-based interventions ever to be evaluated for its effect on health promotion, and if successful, may provide a model for intervention in other areas.
Dr. Jen Potter — CCFP (Family Medicine) McMaster University 2005; MD (Medicine) University of Manitoba 2003; B.Sc. (General) University of Manitoba 1999
Lecturer (Academic/Salaried) Family Medicine, University of Manitoba
Early Life Origins of the Food Allergy Epidemic: Predictors of Persistent Peanut Allergy at Age 5 Years
- Dr. E. Simons
Food allergies are becoming more common among Canadian children. A peanut allergy is the most common and persistent food allergy in young children, and most do not outgrow it. Peanut allergies affect children and their families, schools and communities.
Children who begin eating peanuts earlier may have a lower chance of being allergic to them. They may tolerate eating peanuts even if they have had a positive allergy test. Some children have allergy testing for peanuts before ever trying them. Many children avoid peanuts when they have a positive allergy test, even if they have never had a reaction. Some of these children may actually be able to eat peanuts, but if they don’t try early enough, they may be more likely to develop a peanut allergy.
We will determine if children who eat peanuts earlier are less likely to develop a positive allergy test to peanuts or a lasting peanut allergy. Some children who are avoiding peanuts will have a peanut challenge in the hospital if an allergy doctor thinks it is safe. They will then know for sure if they have a peanut allergy. We will also look at cells and antibodies in the children’s blood to see if we can tell which children will develop a peanut allergy.
This study will guide pregnant women and parents of infants and young children about whether they should let their children eat peanuts. We will include our findings in guidelines for doctors who counsel families about children’s diets or order allergy tests. We will also tell parents about our results. This study will contribute to reducing the number of children who develop and live with a peanut allergy.
Dr. Elinor Simons — PhD (Clinical Epidemiology) University of Toronto 2015; M.Sc. (Epidemiology) State University of New York at Albany 2008; ABAI Certification (Allergy & Immunology) John Hopkins University 2005; ABP Certification (Pediatrics) University of Wisconsin-Madison 2002; MD (Medicine) University of Manitoba 1999; B.Sc. (Medicine) University of Manitoba 1999; B.Sc. (Biochemistry) Queen's University 1995
Assistant Professor, Pediatrics & Child Health, University of Manitoba
Clinician Scientist, Children's Hospital Research Institute of Manitoba
The Use of Electronic Medical Records to Change Clinician Behaviour and Increase Adherence to Choosing Wisely Recommendations
- Dr. A. Singer
Choosing Wisely is an initiative that aims to reduce unnecessary testing and use of treatments. We plan to assess primary care clinician adherence to the Choosing Wisely recommendations with intent of improving uptake. We will use personalized, quarterly reports informing clinicians in Manitoba primary care clinics of their practice patterns. We will also evaluate the cost reduction of changing these behaviours.
We will examine the prescription of antibiotics for common viral illnesses, the measurement of Vitamin D tests, annual screening blood work, and the prescription of medications to treat symptoms of dementia that may cause serious harm. We will recruit clinicians from the 37 clinics participating in the Manitoba Primary Care Research Network who are contributing electronic medical record (EMR) data and already receive quarterly reports containing information about the details of their practice. There will be three groups of clinicians: one group will receive quarterly feedback reports on their use of the four interventions, one group will receive information about the Choosing Wisely campaign without the personalized feedback, and the third group will receive the standard reports they have been receiving prior to the study with no added information.
Our study proposes to change clinician behaviour in a way that reduces usage of inappropriate and inefficient patient care. By reducing unnecessary care, we can improve population health and reduce health care costs by minimizing the risk related to unnecessary medical care. Our study will provide insight as to whether audit-feedback reports using primary care EMR data are capable of modifying clinician behaviour. If successful, similar quality improvement practices could be used to promote other desirable practice patterns.
Dr. Alexander Singer — CFPC (Family Medicine) University of Manitoba 2009; MB BAO BCh (Medicine) University College Dublin 2007; B.Sc. (Microbiology and Immunology) McGill University 2002
Assistant Professor, Family Medicine, University of Manitoba
Network Director, Manitoba Primary Care Research Network, Canadian Primary Care Sentinel Surveillance Network
eHealth Family Physician Champion, eHealth Manitoba
Biomechanical Mechanisms Underlying Age-Related Challenges in Mediolateral Gait Stability
- Dr. J. Singer
Sideways falls during walking are a common and significant health concern for many older adults. These falls often lead to hip fracture, which reduces independent mobility and can increase the risk of mortality. Such reduction of individual independence can place a large burden on family members, caregivers and the Canadian health care system. The direct and indirect cost of falls has been estimated at one billion and six billion Canadian dollars, respectively.
We still lack specific understanding of why older adults fall during walking. From a biomechanical perspective, the control of muscle force output from the lower limbs not only generates forward movement during walking, but controls the side-to-side movement of the whole-body centre of mass. This side-to-side control is challenging because the combined force output from the lower limbs must first stop and then reverse the direction of centre of mass during each step. Age-related changes in lower limb force output may change centre of mass movement, leading to instability.
The proposed work uses newly-developed measures to better understand the biomechanical mechanisms underlying age-related challenges in sideways balance control during walking. Among groups of younger and older adults, we will quantify both the centre of mass movement and the mechanical forces that control this movement. We also seek to link age-related challenges in sideways balance control specific joints of the lower limb.
Various exercise and balance training programs have shown success in improving balance control and functional outcomes for older adults. Better understanding of the specific mechanisms that contribute to sideways instability among older adults is important to improve the specificity of interventions, target specific balance control challenges and reduce the risk of falls, injury and subsequent mortality.
Dr. Jonathan Singer — Post-Doctoral (Neuromotor Control) Sunnybrook Research Institute 2015; PhD (Biomechanics) University of Waterloo 2012; MA (Biomechanics) University of Ottawa 2005; B.SC. (Hon) (Human Kinetics) University of Ottawa 2003
Assistant Professor, Kinesiology and Recreation Management, University of Manitoba
Research Affiliate, Health Leisure and Human Performance Research Institute, University of Manitoba
Research Affiliate, Centre on Aging, University of Manitoba
Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) Study: A Pragmatic, Randomized Clinical Trial
- Dr. V. Wourms
Post-operative delirium, or confusion after surgery, is a common and distressing problem for both patients and families. Afflicted patients may not be fully able to participate in their care, may suffer prolonged hospital stays and readmission, and may be temporarily prevented from a return to normal activities. Families are faced with loved ones who are not themselves and require an increased degree of care and attention after surgery.
Despite its impact, delirium is often underdiagnosed or unrecognized after surgery. This limits our ability to identify it and study the impact of treatments which might lessen the risk. One of the potential contributors to delirium after surgery based on recent evidence may be the dose of anesthesia.
Patients at risk of post-operative delirium will have an EEG (brain-wave) monitor applied, and brain-wave patterns will be recorded. In one group of patients, the anesthesiologist will guide anesthesia dose to avoid brain-wave patterns associated with deep anesthesia, as well as traditional methods of monitoring heart rate and blood pressure. In the control group, only traditional methods of monitoring anesthetic depth will be used. Brainwave patterns will be recorded in both cases.
After surgery, patients will be followed for the development of delirium, and receive appropriate medical care. We will then look back to see which of the patients who had brain-wave activity consistent with deeper anesthesia developed delirium. We believe that we can prove that by assisting anesthesiologists to find an ideal dose for a patient with EEG assistance, we can reduce one of the risks of delirium after surgery.
This study will also help us set the framework for future studies to determine other methods of reducing delirium risk.
Dr. Vincent Wourms — Neuroanaesthesia Fellowship (Neuroanaesthesia) University of Toronto 2013; FRCPSC (Anaesthesiology) University of Manitoba 2011; MD (Medicine) University of Saskatchewan 2006; B.Sc. (Hon) (Microbiology and Biochemistry) University of Saskatchewan 2002
Assistant Professor, Anaesthesia and Perioperative Medicine, University of Manitoba
Staff Anaesthesiologist, Anaesthesia and Perioperative Medicine, Health Sciences Centre
Neuroanaesthesia Fellowship Director, Anaesthesia and Perioperative Medicine, University of Manitoba & Health Sciences Centre
First-Time vs Repeat Travel to India, Bangladesh or Pakistan and Risk of Acquiring Antibiotic Resistant Organisms
- Dr. T. Wuerz
Antibiotic resistant organisms, such as Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae, are becoming increasingly common throughout the world. Infections due to these bacteria have a higher mortality rate and are more costly to treat than similar infections due to non-antibiotic resistant bacteria. While antibiotic usage is driving this epidemic, one reason for the dramatic increase in the number of these infections in recent years is travel.
In this proposed study, we will investigate the relationship between previous exposure of gut microbes to travel, and the risk of carrying highly drug resistant bacteria, having diarrhea during travel, or both.
We plan to recruit two groups of volunteers travelling to India, Bangladesh or Pakistan to participate in a pre- and post-travel study. One group will be those who have never before travelled to these areas, while the other will contain those who have lived in one of these areas for five or more years. We will administer a questionnaire to obtain information about antibiotics taken before or after travel, whether they experienced diarrhea during travel, and other factors that could affect the analysis. They will be asked to keep a diary of their stools during travel, and we will collect pre- and post-travel rectal swabs to determine which groups of travelers acquire resistant gut bacteria.
This study will contribute to our understanding of the health consequences during travel of previous gut microbe exposure. It will also explore which groups of travellers are at highest risk of picking up the highly drug resistant bacteria and carrying them back to their home countries. This will allow us to plan targeted actions to prevent the spread of these bacteria within the vulnerable populations.
Dr. Terence Wuerz — DTMH (Tropical Medicine) (University of Alabama) 2012; FRCPC (Infectious Disease) (University of Manitoba) 2012; FRCPC (Internal Medicine) (Dalhousie University) 2011; MD (Medicine) (University of Manitoba) 2007; B.Sc. (General Science) (University of Manitoba) 2003
Assistant Professor, Internal Medicine, University of Manitoba
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