Current Gateway Research

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Growing Healthy Huron Families

Claudio Munoz MD, PhD, Gateway Rural Health Research Institute

In this new Health Promotion project, families create a healthier life through participation in a new approach to developing a healthy lifestyle.  Most programs focus on individuals making changes to their lives but most of us value the people we spend the most time with, our families. The Growing Healthy Huron Families project offers participating families the chance to learn together and use this experience to determine how, as a family, they can make changes that will improve their lives. And you will not be alone. Many families will be sharing this experience with you and you will have a health coach to offer support as you take the steps to improving your life.  This 9 month project will include 3 months of workshops and 6 months of evalution.  The workshops are a chance to participate with your family and learn how to exercise, cook and parent in a healthy, productive way and ALL of this on a low budget.  We will help educate families that no matter what your income is, it is possible to be healthy!

This project was funded by The Ministry of Health Promotion and Sport  (now amalgamated with The Ministry of Health)

Frequency of Mild Cognitive Impairment in a Rural Population

Research Team

Claudio Munoz MD, PhD - Gateway Rural Health Research Institute
Craig Hudson MD, FRCP - Alexandra Marine & General Hospital, Goderich, Ontario  

Study Overview

Risk of Alzheimer’s Disease is particularly high in rural Southwestern Ontario due to high prevalence of risk factors including:

  • Third-largest aging population in Canada
  • Second-highest rate of cardiovascular disease (CVD) in Canada
  • Higher rates of:
    • Stroke
    • Obesity
    • High blood pressure
    • Diabetes

Mild cognitive impairment (MCI) is a transition stage between the cognitive decline of normal aging and the more serious problems caused by Alzheimer's disease (AD).  Individuals with MCI progress to AD at a 10-15% rate annually, whereas individuals with no cognitive impairment do so at a rate of 1-2%.  Thus, identifying patients with MCI is important in order to implement strategies designed to prevent or delay the onset of the disease minimizing the burden it represents for the individual, the family and society.

Objectives

  • To explore the prevalence of MCI in an aging rural population
  • To identify barriers to MCI screening in a rural primary care setting

Study Methods

  • Sample size: 150 patients
  • Age: 65 years old or older
  • Setting: Communities across Huron County
  • Mini-Mental Scoring Test (MMST), a standardized instrument for early dementia screening, will be applied to Huron Community Health Centre patients  

Study Status

  • Study Partners:
    • Schulich School of Medicine - The University of Western Ontario
    • Southwestern Ontario Medical Education Network (SWOMEN Program)
  • Study already approved by the Ethics Review Board at The University of Western Ontario
  • Data collection has begun       

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Prevalence of Peripheral Arterial Disease in a Rural Population

Research Team

Claudio Munoz MD, PhD - Gateway Rural Health Research Institute
Akshay Shetty, Student - Schulich School of Medicine, The University of Western Ontario

Study Overview

Clinical guidelines recommend intense cardiovascular risk factor modification in patients with peripheral arterial disease (PAD) because their risk of death from myocardial infarction is about 5-fold higher than in non-PAD patients. However, the diagnosis of PAD often occurs only when the disease becomes symptomatic at advanced stages.  Early detection of asymptomatic patients is possible by performing the Ankle-Brachial Index (ABI), however this simple, non-invasive, effective screening procedure is not routinely performed in most primary care offices.  Since rural communities in Southwestern Ontario have the second-highest rate of heart disease in Canada, it is important to ascertain the prevalence of PAD and implement effective strategies for routine ABI determination in the rural setting.  

Objectives

  • To explore the prevalence of PAD in an aging rural population
  • To identify barriers to routine ABI determination in a rural community health centre

Study Methods

  • Sample size: 200 patients
  • Age: 55 years old or older
  • Setting: Communities across Huron County
  • ABI determination using a hand-held ultrasound system
  • ABI > 0.9 is diagnostic of PAD  

Study Status

  • Study Partners:
    • Schulich School of Medicine - The University of Western Ontario
    • Southwestern Ontario Medical Education Network (SWOMEN Program)
  • Study approved by the Ethics Review Board at The University of Western Ontario
  • Data collection has begun

Weath to Health

Feng Chang, RPh, BScPhm, PharmD - Gateway and School of Pharmacy, University of Waterloo
Claudio Munoz MD, PhD - Gateway Rural Health Research Institute
Dan Stringer, RPh, BSc, BScPhm - Gateway
Jenny Seguin, BScPhm candidate, School of Pharmacy, University of Waterloo
Maral Mirhosseini, BScPhm candidate, School of Pharmacy, University of Waterloo

Study Overview

An evident connection between health and wealth has been determined in several population studies, linking wealth to outcomes such as mortality, chronic disease, self-reported health status and functional status.  As people age, they experience many changes in financial status and health-related needs, many of which are unexpected and may be difficult to manage if not adequately prepared and educated. An educational program designed to teach community members who are in pre-retirement about health and finance as it relates to retirement will enable them to better self-manage their health as they age. Given that residents of rural Ontario suffer the added burden of lower income and more prevalent chronic disease, involving them in the development process of an educational tool will help to address their specific learning needs pertaining to retirement planning.

Study Objectives

  • To determine the present health and financial status and knowledge level in the pre-retirement population of Seaforth, Ontario.
  • To determine the best way to address the identified educational needs of the study population

Study Methods

  • Sample size: 30 participants
  • Age: 40-75 years old
  • Setting: Seaforth, ON
  • Completion of a questionnaire to gauge health and financial knowledge and status, participation in a structured interview to gather perspectives on the topic
  • Additional viewpoints will be gathered from an advisory panel focus group consisting of 7 retired members of the community

Study Status

  • Study under went ethics review by the Office of Research Ethics at the University of Waterloo - APPROVED

 

Craig J. Hudson, MD, FRCP(C)


Dr. Craig Hudson was born and raised in Toronto, Canada. He attended the University of Waterloo where he first developed an interest in research science. He earned his medical degree at the University of Toronto in 1988 and became a Fellow of the Royal College of Physicians of Canada in 1993 with specialty certification in Psychiatry. He is a past recipient of the Medical Research Council Clinician Scientist Award which allowed for extensive post-doctoral research focusing on the role of phospholipids in the treatment of major mental illnesses.


Throughout his career, Dr. Hudson has maintained a balance between research and clinical work. His current research focuses on natural health solutions to common psychiatric disorders, particularly natural source tryptophan and essential fatty acids. Dr Hudson is not anti-medication but likes to include natural health solutions in the treatment of his patients when clinically indicated. He has published extensively in a variety of medical journals including Archives of General Psychiatry, British Journal of Psychiatry, Canadian Journal of Physiology and Pharmacology and Nutritional Neuroscience.
He is married with four sons and maintains a clinical practice as he pursues his research interests.

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The Artemis Study

Research Team

Robert Petrella MD, PhD, FCFP, FACSM (Lawson Research Institute)
Claudio Munoz MD, PhD (Gateway Rural Health Research Institute)

Study Overview

Patients with Type-2 diabetes mellitus currently use devices such as blood glucose monitors, blood pressure devices, heart rate monitors and pedometers to assist with self-management of the disease. Lifestyle monitoring solutions such as these may prevent cardiovascular and other health-related complications associated with diabetes. New technologies, such as portable imaging devices, are also being developed in order to assist patients with measuring early changes in their cardiovascular health. The overall objective of this project is to develop an improved knowledge base for evaluating the effectiveness of lifestyle modification strategies and multiple types of self-monitoring devices in urban and rural populations.

Objectives

  • To determine the effectiveness of lifestyle modification strategies for the prevention of diabetes in a high-risk rural and urban patient populations
  • To determine the effectiveness and feasibility of new monitoring technologies to prevent diabetes and improving cardiovascular risk factors

Study Methods

  • 300 high-risk patients (150 rural, 150 urban)
  • Study duration: 1 year
  • Outcomes: Changes in blood glucose, weight, blood pressure, intima-media thickening (IMT) of carotid arteries, and Quality of Life   

Study Status: Ongoing

  • 150 rural subjects recruited on schedule in Seaforth, only 64 subjects recruited in London

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Prevalence of Peripheral Arterial Disease in a Rural Population

Research Team

Claudio Munoz MD, PhD - Gateway Rural Health Research Institute
Akshay Shetty, Student - Schulich School of Medicine, The University of Western Ontario

Study Overview

Clinical guidelines recommend intense cardiovascular risk factor modification in patients with peripheral arterial disease (PAD) because their risk of death from myocardial infarction is about 5-fold higher than in non-PAD patients. However, the diagnosis of PAD often occurs only when the disease becomes symptomatic at advanced stages.  Early detection of asymptomatic patients is possible by performing the Ankle-Brachial Index (ABI), however this simple, non-invasive, effective screening procedure is not routinely performed in most primary care offices.  Since rural communities in Southwestern Ontario have the second-highest rate of heart disease in Canada, it is important to ascertain the prevalence of PAD and implement effective strategies for routine ABI determination in the rural setting. 

Objectives

  • To explore the prevalence of PAD in an aging rural population
  • To identify barriers to routine ABI determination in a rural community health centre

Study Methods

  • Sample size: 200 patients
  • Age: 55 years old or older
  • Setting: Communities across Huron County
  • ABI determination using a hand-held ultrasound system
  • ABI > 0.9 is diagnostic of PAD 

Study Status

  • Study Partners:
  • Schulich School of Medicine -UWO
  • Southwestern Ontario Medical Education Network (SWOMEN Program)
    • Study approved by the Ethics Review Board at UWO
  • Data collection started in the summer of 2010 by a medical student at Gateway

® Gateway Rural Health Research Institute