POST-DOCTORAL FELLOWSHIP RECIPIENTS
LABARGE POST-DOCTORAL FELLOWSHIP IN MOBILITY
This year marked the first competition for the Labarge Mobility PDF. Funded by the LCMA, the award provides $70,000 per year for two years for salary support, plus $15,000 for research expenses and professional development during the two-year term. The applicant’s supervisor is required to provide at least $10,000 in matching funds for salary, benefits and research expenses. MIRA’s internal review committee vetted the proposals, and the top three were ranked by the Chair of MIRA’s International Scientific Advisory Committee to select a recipient:
PATRICIA HEWSTON: CAN DANCE REDUCE FALLS RISK IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT?
Supervisor: Alexandra Papaioannou, Health Sciences; Mentors: Amanda Grenier, Social Sciences; Steven Bray, Science
In 2018, MIRA and the LCMA held a competition to identify the inaugural Labarge Post-Doctoral Fellow in Mobility; Dr. Patricia Hewston was the successful candidate. The vision for Patricia’s project is to build infrastructure and capacity to initiate a program in aging and mobility with a technology that measures gait called GAITRite to inform best practices for falls prevention to optimize mobility and well-being of older adults with mild cognitive impairment (MCI). MCI can be a transitional state between cognitively intact and dementia, and is associated with double the risk of falls compared to those without MCI. Falls can result in declines in mobility, activity avoidance, institutionalization, and mortality. Given the importance of preventing falls in older adults with MCI, simple yet highly predictive technologies are advantageous to provide precise and standardized feedback to assess and track change in fall risk before and after intervention and inform best practices for falls prevention.
GRADUATE SCHOLARSHIP RECIPIENTS
Funded by the LCMA, four graduate students have now been supported to develop skills and experience in aging research at the graduate level. The recipients were selected for their demonstrated high academic achievement, proven interest in aging and mobility research, ambition to collaborate with other disciplines, and participation in research activities that show potential to benefit older adults.
2018 LABARGE MOBILITY SCHOLARS
STEPHANIE CHAUVIN: TECHNOLOGY FOR PROMOTING EXERCISE ADHERENCE AND MOBILITY IN OLDER ADULTS
Supervisor: Marla Beauchamp, Health Sciences; Mentor: Meridith Griffin, Social Sciences
Mobility limitations are a substantial challenge that many older adults with chronic health conditions face, which may lead to adverse outcomes such as disability, hospitalization, and death. The overarching goal of this project is to examine how technology can promote exercise adherence and mobility in older adults. The first study will explore the participant experiences of a home-based fall-prevention exercise program using DVD technology for older adults with chronic obstructive pulmonary disease. The second study aims to determine the effect of computer and mobile technology interventions versus face-to-face and/or hard copy/digital documentary-delivered interventions on exercise adherence and physical function in older adults. A systematic review and meta-analysis will be conducted to compare interventions. The results of these studies will allow for a better understanding of the role technology plays and how to best utilize technology to increase exercise adherence and mobility in older adults.
TANNER STOKES: WHOLE MILK TO AUGMENT MUSCLE PROTEIN SYNTHESIS IN OLDER WOMEN - A RANDOMIZED, CONTROLLED TRIAL
Supervisor: Stuart Phillips, Science; Mentor: Gregory Steinberg, Health Sciences
Older adults experience progressive loss of muscle mass and strength accompanying the aging process, termed sarcopenia, which predisposes those affected to an increased risk of falls, fractures, diabetes, and an impaired ability to perform activities of daily living. Sarcopenia is inevitable; but research suggests that we can attenuate these losses by increasing dietary protein intake above current recommendations and encouraging physical activity. The primary aim of this study is to assess the efficacy of proteins contained in whole and skimmed milk compared to a common dairy alternative (i.e., almond beverage) on indices of mobility in older women. The team chose to look specifically at women because they live, on average, longer than men and a majority are not currently meeting basic protein requirements. Results from this study will help equip health care practitioners with a practical, easily-implementable strategy with the potential to reduce the impact of sarcopenia in the aging population.
2017 LABARGE MOBILITY SCHOLARS
SYDNEY VALENTINO: STAIR CLIMBING OUTCOMES IN CARDIAC REHABILITATION EXERCISE (SCORE) TRIAL
Supervisor: Maureen MacDonald, Science; Mentor: Eva Lonn, Health Sciences
One in twelve Canadians are living with heart disease; and, by the age of 65, it is the leading cause of death. After a cardiac event, exercise improves recovery, reduces the chance of reoccurrence, and the benefits are maintained as exercise is adhered to. The purpose of this study is to assess the changes in cardiac structure and function in individuals with coronary artery disease undergoing traditional endurance-based exercise (TRAD) in comparison to stair-climbing-based high intensity interval training (HIIT). Eligible participants are recruited from the Cardiac Health and Rehabilitation Centre at the Hamilton General Hospital to complete three cardiac testing sessions at the beginning, middle and end of the cardiac rehabilitation exercise program. As of September 2018, seven participants have successfully completed three months of cardiac rehabilitation as part of either the HIIT or TRAD groups, and an additional three participants are enrolled in the exercise program. The team believes that stair-climbing based HIIT has the potential to elicit similar physiological benefits as traditional cardiac rehabilitation, albeit with increased time efficiency and minimal equipment requirements. Recruitment, testing, and analysis is currently ongoing to understand the full benefits of this exercise modality on the cardiovascular system. Thus far, the SCORE trial has demonstrated stair climbing-based HIIT exercise is feasible within standard cardiac rehabilitation programming.
MICHAEL KALU: MOBILITY ENHANCEMENT COMPREHENSIVE CARE MODEL
Supervisor: Vanina Dal Bello-Haas, Health Sciences; Mentor: Amanda Grenier, Social Sciences
During the first year of study, two scoping reviews have been completed. These have been presented at two conferences and submitted for publication in peer-reviewed journals. The first scoping review was focused on understanding the role of physiotherapists (PTs) and occupational therapists (OTs) in care transitions. Of the 21 included studies, only three mentioned the role of OTs or PTs in care transitions; however, the roles were not explicitly described and there was no evidence of overt involvement of rehabilitation professionals in the care transition processes. The second scoping review was aimed at examining the association between socioeconomic status (SES) and mobility in older adults. In this review, 53 analyses (77%) reported a statistically significant association of SES (income, education, and occupation) and the mobility of older adults. This implies that older adults with higher education, higher income and who have held or hold skilled jobs have improved physical mobility.
MIRA Post-Doctoral Fellowships
Through a competitive process vetted by MIRA’s internal reviewers, the Institute has now funded and awarded six post-doctoral fellowships to incoming trainees. Each one-year award includes $50,000 for salary and $15,000 for research expenses and professional development, and is matched by $10,000 from the supervisor. Candidates have one primary supervisor and two mentors from other Faculties.
2018 MIRA Post-Doctoral Fellows
Cheng Zhu: Improving mobility of Alternate Level of Care (ALC) seniors in the Canadian health care system: Data driven solutions
Supervisor: Manaf Zargoush, Business; Mentors: Alexandra Papaioannou, Health Sciences; Reza Samavi, Engineering
This research intends to address the ALC-related problems with interdisciplinary approaches, including machine learning and operations research. The aim is to provide valuable managerial insights and design a systematic framework of operating ALC facilities and services by answering the following research questions: (Q1) What is the proper structure of ALC facilities? and What types of post-acute older adult patients should each facility accommodate? (Q2) For planning purposes, what is the capacity of each centralized facility? and How should the centralized staff be scheduled for decentralized care needs in a specific region over the time? (Q3) What are the proper transition policies (in terms of admission and discharge) to move patients efficiently and optimally in an ALC-related system, including the transition among different ALC facilities, as well as between ALC and acute care providers or homes?
Nour El Shamy: Designing decision support systems for older adults in e-commerce
Supervisor: Khaled Hassanein, Business; Mentors: Rebecca Ganann, Health Sciences; Scott Waters, Science
Electronic commerce (e-commerce) has become an integral part of what constitutes the human condition, impacting the way we make day-to-day purchasing decisions, conduct transactions, and consume products and services. There are significant societal and economic benefits of having more older adults adopt e-commerce: e-commerce affords older adults a convenient channel to access virtually unlimited products and services that transcend spatial and temporal boundaries. By effectively utilizing e-commerce, older adults may enjoy higher autonomy and independence in their daily decision-making activities. The overarching primary objective of this research program is the improvement of the online shopping experience of older adults. This can be achieved by developing and testing Decision Support Systems (DSS) that are specifically tailored to the needs and challenges of older adults in the complex environments of e-commerce.
Irene Mussio: Vaccinating to protect my peers - analyzing flu vaccinations and beliefs in small network settings
Supervisor: Jeremiah Hurley, Social Sciences; Andrew Costa, Health Sciences; Jean-Eric Tarride, Health Sciences
This project involves a two-part study to test the relationship between beliefs about the flu vaccine and its health consequences and the decision to receive the vaccine, with the goal of informing targeted policy interventions to increase flu vaccinations. The team will do this by combining state-of-the-art techniques in experimental economics and social network analysis. This study is important for our understanding of how networks evolve over the lifecycle and the impact of networks and beliefs on healthy decision-making, particularly among older adults whose networks become more disrupted as they age.
Wael Brahim: Remote monitoring of breathing patterns and mobility patterns
Supervisor: Lotfi Belkhir, Engineering; Mentors: Qiyin Fang, Engineering; Joshua Wald, Health Sciences
The health condition of older people can be evaluated using several indicators. Some vital signs can provide immediate or early warnings of abnormal activities inside the patient room. However, the current methods of monitoring suffer from a low level of acceptability among older adults, especially those suffering from dementia. These methods require full contact with the patient’s skin and can be very disruptive. The team’s project aims to enable a new level of contactless and inconspicuous health and monitoring capabilities of older people that will eliminate these inconveniences by using remote monitoring of indicators based on thermal camera capture. The team’s objective is to develop a fully commercial system, totally safe and contactless, capable of monitoring older people’s health conditions and providing timely alerts for any disorder or condition that requires immediate medical attention.
2017 MIRA Post-Doctoral Fellows
Tara Kajaks: Addressing the challenges of caregiving using a ‘co-occupation’ perspective: An integrated research program examining aging and mobility in the community
Supervisor: Brenda Vrkljan, Health Sciences; Mentors: Jennifer Heisz, Science; Cheryl Quenneville, Engineering
This project aims to investigate the challenges experienced by older adult caregivers and their spouses as care recipients using a unique ‘co-occupation’ perspective. This research is particularly important given the propensity for older adults to choose to age in place, and Canada’s shift to a health care system that encourages homecare but is not yet capable of addressing all the needs of Canadians being cared for in their homes. In particular, there is often a dependency on the spouse to provide much of the care, even in older adulthood where the caregivers themselves may have compromised health. Researchers have sought to understand homecare challenges by looking at individual components of the care system, such as the care recipient, the caregiver, the environment, and the availability of equipment and assistive devices; However, the team is unaware of research that considers the caregiver and recipient dyad combined with the physical and cognitive workload of care provision using a ‘co-occupation perspective’, where both individuals work in synergy to accomplish the mutual goal of completing the given activity of daily living.
In addition to receiving MIRA post-doctoral funding, Tara was the successful candidate for the 2018 AGE-WELL-MIRA post-doctoral fellowship, which allowed her to secure a second year of funding through AGE-WELL ($50,000) by leveraging MIRA support.
Caitlin McArthur: Portable technology to support exercise in the homes of frail older adults: A development and pilot study
Supervisor: Alexandra Papaioannou, Health Sciences; Mentors: Paula Gardner, Humanities; Amanda Grenier, Social Sciences
This research project focused on the development and testing of a portable technology platform to promote sustainable exercise participation within the homes of frail, older adults who have been discharged from hospital. The project engaged cross-disciplinary perspectives by incorporating the expertise of faculty members from the Faculties of Health Sciences (Dr. Papaioannou), Humanities (Dr. Gardner), and Social Sciences (Dr. Grenier) into the design and evaluation of the platform. The technology that has been developed will increase the enjoyment, affordability, and sustainability of rehabilitation in the home. Older adults who receive limited home care services and cannot access community exercise classes will be able to participate in enjoyable exercise within their home. In the future, the platform will be able to be used across several sectors where older adults access services, for example in communities, complex continuing care or long-term care. Further, limited physical therapy home care resources will not be additionally burdened. The team has used design thinking and participatory methods to incorporate older adults into the design and implementation of the platform. As noted above, Caitlin was successful in competing for CIHR funds to continue her work at McMaster.