News & Events

Three Department of Anesthesia, Pain and Perioperative Medicine researchers are working on projects that have received more than $1-million from the Fall 2016 Canadian Institutes of Health Research (CIHR) grant awards.  

Principal Investigator Jason McDougall received $761,175 for his research in arthritis pain. The funding is over a five-year term.

Co-investigators Jill Chorney and Ron George received $256,274 for their research on postpartum genito-pelvic pain. The project is a three-year term. Natalie Rosen, PhD, with Department of Psychology and Neuroscience is the Principal Investigator.

CIHR awarded 475 research grants, with only nine being awarded in Nova Scotia, all at Dalhousie. There were 2,884 applications submitted across Canada.

The Department continues to demonstrate a strong and productive research portfolio.  Last year, Department researchers – principal and co-investigators - had 60 projects funded totaling over $10.5 million, with 50 new research projects initiated.

Research Projects:

Project Title: Contribution of Proteases and Protease Activated Receptors to Join Neuropathy and Arthritis Pain

Principle Investigator: Jason McDougall

CIHR Contribution: $761,175

Term: 5 years

Abstract: At present, there are 4.6 million Canadians living with the pain of arthritis for which there are inadequate drug treatments. Current medications provide only limited pain relief and most drugs have significant negative side-effects. Thus, there is an urgent need to discover novel, more effective analgesics with low toxicity. During arthritis, enzymes are released into the joint which cause damage to the cartilage, bone and ligaments. In addition to the digesting effects of these enzymes, they can also signal pain and inflammation by acting on specific targets called PARs. We have shown that these PARs are present on nerves in the joint and we believe that one mechanism by which enzymes signal pain is by stimulating these PARs. We hypothesise that PAR activation can lead to nerve damage and consequently arthritis pain. In this project, we plan to identify the enzymes responsible for joint nerve injury and pain. We will also test drugs that block PARs to see if we can protect joint nerves from further damage and uncover a new way of alleviating arthritis pain.  

Project Title: Biopsychosocial predictors of postpartum genito-pelvic pain: A two-year follow-up

Principal Investigator(s): Natalie Rosen

Co-Investigators: Chorney, Jill E; George, Ronald B; Lee-Baggley, Dayna L; Pukall, Caroline F; Snelgrove-Clarke, Erna E

CIHR Contribution: $256,274

Term: 3 years

Abstract: During pregnancy and after childbirth, many women experience pains that can significantly interfere with their lives. Pain in the genital or pelvic region ("genito-pelvic") is particularly poorly understood, often misdiagnosed or ignored, and viewed as shameful by the women who experience it. Yet this pain may be very common, with average estimates of 27% at 3 months, 24% at 6 months, and 16% at 1 year postpartum. It can negatively affect women's sexuality, psychological wellbeing, and relationships. There is a critical lack of research describing the symptoms and persistence of genito-pelvic pain after childbirth, as well as the potential predictors that may help identify women who are at risk. The goal of this study is to examine the prevalence and biopsychosocial predictors of women's genito-pelvic pain and couples' psychological and sexual wellbeing from mid-pregnancy to 24 months postpartum. We will follow our established cohort of women (assessed at 20 and 32 weeks gestation, 2 weeks, 3- and 6-months postpartum) to 12 and 24 months postpartum and involve partners. We expect that breastfeeding and labour characteristics (e.g., tearing) will be associated with greater pain and sexual and psychological problems in the first year after birth, but their impact will decrease by the second year. We also expect that certain psychological and social variables in pregnancy, such as a greater fear of pain, will be associated with more pain and problems after childbirth. Finally, we expect that greater empathy in the postpartum period will be associated with women's lower pain and both partners' greater sexual and psychological wellbeing. Findings will improve our understanding of how postpartum genito-pelvic pain develops and why it persists for some women. Results will also aid in identifying novel intervention targets, as well as the most critical time points for best preventing and treating genito-pelvic pain and its consequences.

Dalhousie is home to four new Canada Research Chairs, including Javeria Hashmi – Assistant Professor, Department of Anesthesia, Pain Management and Perioperative Medicine for her work in improving and understanding chronic pain.

The Canada Research Chairs Program supports and attracts the world’s best researchers in the fields of engineering and the natural sciences, health sciences, humanities, and social sciences. Over 142 new and renewed Canada Research Chairs were announced in May by the Honourable Kirsty Duncan, Minister of Science.

https://www.dal.ca/news/2017/05/12/attracting-the-best-and-brightest--government-of-canada-announce.html

Department Member, Dr. André Bernard’s co-authored paper: Medical professionalism and physician leadership: the time for action is now was published in the Canadian Journal of Physician Leadership in March 2017.

The paper explores the changing expectations of physicians and the medical profession. It suggests this may provide a unique opportunity for physician leaders to play a role in addressing issues at the system level: by unifying the profession, improving relations between physicians, and ensuring greater focus on patient-centred care. It calls for action to ensure physicians reclaim their role as health system leaders and contribute to a system that provides high-quality care for patients and a rewarding career for physicians.

The journal is published by the Canadian Society of Physician Leaders.

Paper authors: Jenny Buckley, MA, MSc; André Bernard, MD; Emily Gruenwoldt, MHA; Cécile M. Bensimon, PhD; Jeff Blackmer, MD, MHSc

Dr. Bernard is the Department Cabinet Chair, Medical Director of the Preop Clinics, Dalhousie University Assistant Professor and Chair of Doctors Nova Scotia’s Board of Directors.

On March 1, the Department of Anesthesia, Pain Management and Perioperative Medicine welcomed Rwandan residents Drs. Alcade Rudakemwa (right) and Eugene Tuyishime (left).  They are participating in a four-month anesthesia elective as part of Department’s Global Health Program.

Despite the distance travelled, sight-seeing and vacationing is far from these young men’s minds when they shared what they hoped to gain from their visit in Canada.

This elective is much bigger than training.  They describe it as an opportunity to learn new clinical skills, while also understanding how to organize an anesthesia program, develop clinical standards, introduce new patient-safety measures and gain knowledge and connections to become effective leaders and advocates for health-care advancement back home in Rwanda.

When the two spoke of their health-care system it brings new perspective to physician shortages.

“We have about 20 anesthesiologists for a population of 12 million people,” said Dr. Rudakemwa. “We have a vision to have 60 by 2025 and reach 80 by 2030,” added Dr. Tuyishime.

Dalhousie’s Global Health Program is part of the equation to achieve this vision.

“I plan to learn as much as I can so I can take new skills back to Rwanda to practice and teach to my colleagues.,” said Tuyishime.  “We will be the new teachers of our country.”

The pair is optimistic that their country is on the cusp of great advancement, citing improvements being made in just the last three years.

From a clinical perspective, they are both keen to learn and gain confidence in administering regional anesthesia. Recognizing the benefits to patients, health-care costs and overall system efficiency, they are eager to grow their country’s capacity in providing this service.

More broadly they want to make life-long connections that will support them on their journey to be advocates for a better health-care system in Rwanda.

“Health care is a human right,” said Dr. Tuyishime. Dr. Rudakemwa added, “And we are here and willing to bring great things to our country.”

Dr. Tuyishime extended an invitation to his new Department colleagues to join him in Rwanda and become part of this important journey.

Learn more about the Department’s Global Health initiative.