Capstone research projects database
The Capstone research project is where students work on real-world issues.
See the Capstone projects TRP students have worked on over the years.
A Pilot Study of Cystic Volume Reduction by Foam Sclerotherapy in Autosomal Dominant Polycystic Kidney Disease
Tolvaptan is not able to address existing cyst burden in patients with autosomal dominant polycystic kidney disease (ADPKD).
Background
ADPKD is the most common inherited kidney disorder worldwide with a prevalence between 1:400 and 1:1000. Patients eventually develop kidney failure and require dialysis.
Tolvaptan is the only treatment approved in Canada. Tolvaptan reduces further growth of cysts but does not reduce the cyst burden. Foam sclerotherapy is a novel treatment able to permanently shrink the size of cysts with minimal reported side effects.
From 2014 to 2016, more than 60 patients underwent an experimental foam sclerotherapy procedure at Toronto General Hospital (TGH) with promising results!
Project team
- Dr. Ioan-Andrei Iliuta
TRP supervisors
Project advisory committee
- Dr. Anna Gagliardi, Senior Scientist, Toronto General Hospital Research Institute (TGHRI)
- Dr. Eran Shlomovitz, Assistant Professor, University of Toronto Department of Surgery
- Dr. York P-C Pei, Senior Scientist, Toronto General Hospital Research Institute (TGHRI)
See our community directory for more on committee members.
Acute myeloid leukemia research in the era of advanced genetic sequencing: an exercise in knowledge translation
The identified need is the reduction of occurrence of relapse of acute myeloid leukemia (AML) following allogeneic hematopoietic cell transplantation (HCT), as the prognosis of this patient group is very poor.
Background
Allogeneic hematopoietic cell transplantation (HCT) may offer survival benefit to patients with acute myeloid leukemia (AML) (Koreth et al, 2009, Cornelissen et al, 2007). A major challenge when treating AML patients with allogeneic HCT is disease relapse, with a one-year post-relapse survival less than 20% (Devillier et al, 2013).
An even bigger challenge is predicting relapse, as AML is a genetically complex disease and there are currently no widely established sensitive tools.
The gold standard for determining treatment response in AML is by microscopic examination of bone marrow and assessment of irregular, immature “blast” cells, with less than 5% blasts considered to demonstrate remission.
Leukemia-associated immunophenotypes (LAIPs), which are defined at diagnosis by multi-parameter flow cytometry (MFC), can be used for monitoring in patients with AML (Kern et al, 2010).
Studies using MFC on marrow samples pre-allogeneic HCT show that any level of detectable minimal residual disease (MRD) is associated with an increased risk of relapse (Walter et al, 2013). However the routine use of MFC may be complicated by issues such as the possible shift in antigen expression post-allogeneic HCT as well as the issue of standardization of the method in that particular setting.
Project team
- Frank Michelis
TRP supervisors
AID Parkinson’s Disease Patients: Decreasing psychological stress associated with the recent diagnosis of PD
Parkinson’s Disease (PD) is a movement disorder that affects the nervous system. Its symptoms occur due to low dopamine levels in the brain. Symptoms tend to worsen over time, but the disease progression can vary among patients. Thus, the unexpected nature of PD is associated with a decline in mental health. Such disease uncertainties raise questions of what the future may hold for these patients in terms of disease diagnosis, prognosis, treatment outcome, functional decline, and how it may adversely affect their career. Thus, patients become apprehensive and anxious about the future.
We found three gaps and problems in our in-depth search for the root cause of heightened psychological stress of recently diagnosed PD patients. The problems are:
- diagnostic uncertainties of the disease
- prognostic uncertainties
- uncertainty of treatment outcomes.
The next problem is prognostic uncertainties related to the uncertainty these patients may have regarding the accumulative damage their unique disease progression may yield - whether that damage be personal, professional, or social difficulties. Among these problems, we chose to focus on prognostic uncertainties as our main problem to the possibility of further exploration of this problem, possible interventions, and resulting tangible outcomes.
Background
Our project aims to broaden our understanding of the experience of recently diagnosed PD patients. We aim to delve deeper into the etiology of the main stressors affecting recently diagnosed PD patients. One of these main stressors that we have identified through conducting several discussions with key stakeholders is the prognostic uncertainties associated with the recent diagnosis of the disease.
Project team
- Azadeh Bojmehrani
- Yasmin Aboelzahab
- Yomna Elsheikh Ahmed
TRP supervisors
Project advisory committee
- Ms. Heather Beim, Employer Liaison to provide service to new Canadians
- Dr. Connie Marras, Faculty Member, Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto
- Dr. Heather Boon, Vice-Provost, Faculty & Academic Life, University of Toronto
See our community directory for more on committee members.
Anestheffi Optima: Prototyping the use of a Digital Assistant to Improve Pre-Anesthesia Clinic Efficiency and Experience for the Obstetrical Population
At the heart of academic hospitals, we’re on a mission to transform the Pre-Anesthesia Clinic setting. Our focus is to enhance workflow efficiency to lift the burden from Anesthesiologists and amplify patient satisfaction. We’re not just reimagining; we’re revolutionizing.
We propose integrating “Patient Empowerment Resources” through a Large Language Model tailored and designed for this specific purpose. By uniquely delivering easily accessible resources through a Digital Assistant in the PAC, we aim to enhance the patient experience and reduce the workload of healthcare professionals.
Project team
- Dr. Elio Belfiore
- Shalini Jaisankar
TRP supervisors
Project advisory committee
- Dr. Daniel McIsaac, Professor, University of Ottawa
- Dr. Angela Jerath, Associate Professor, Department of Anesthesiology and Pain Medicine, University of Toronto
- Dr. Fabricio Zasso, Staff Anesthesiologist at Mount Sinai Hospital, Assistant Professor in the Department of Anesthesiology and Pain Medicine, University of Toronto
See our community directory for more on committee members
Assessing the implementation of TickiT® during group clinic sessions with patients who have neonatal brachial plexus injury (NBPI): a quality improvement study
Lack of consistency in how the tool was introduced into the clinic and evaluated over time in terms of its feasibility - It was often unclear how the clinicians would use TickiT® to improve or inform clinical practices in terms of translating the survey results into actions or innovations in their clinic area.
Background
This quality improvement (QI) study assessed the implementation of TickiT® (the pre-clinic survey) using an observational approach to learn of facilitators and barriers associated with e-health adoption and to identify areas of improvement. Observations were performed during three NBPI clinics.
Results showed that TickiT® was adopted gradually overtime and that someone acting as an early facilitator was instrumental in encouraging clinician engagement with the tool. Barriers and facilitators to e-health implementation should be considered before initiating the adoption of a novel tool.
Project team
- Beth Cruchley
TRP supervisors
Assessing the Usability of DataDay - A Self-Management App for Individuals with Mild-to-Moderate Dementia and Mild Cognitive Impairment (MCI)
Many people living with dementia and MCI manage their condition at home without ongoing access to health services, resulting in poorer health outcomes, loss of empowerment, and caregiver burden. Notably, people living with mild-to-moderate dementia & MCI lack effective tools to self-manage their condition.
Therefore, there is a need for an evidence-based tool that enables patients to self-manage their condition and improve their quality of life.
Our study aims to assess the usability of DataDay, a self-management application, and its ability to improve the quality of life of people living with mild-to-moderate dementia or MCI and their caregivers.
Background
Over 55 million people are living with dementia globally, with this number expected to reach 139 million by 2050 - 1.7 million of which will be in Canada. Therefore, accessible tools for daily support are more crucial than ever.
Dementia and MCI impacts memory and daily functioning, making consistent self-management difficult. Many individuals manage their condition at home, often seeking healthcare only in times of crisis, increasing their risk of hospitalization and emergency room visits. These acute care visits are often associated with a greater risk of poor health outcomes related to delirium, behavioural problems, reduced physical function, and increased mortality.
DataDay is a digital self-management app developed by Dr. Arlene Astell at the Dementia Ageing Technology Engagement (DATE) Lab. It aims to provide daily support to people living with mild-to-moderate dementia or MCI in order to slow decline and dependency, subsequently improving the quality of life and autonomy of patients and their caregivers.
The app combines the Novel Assessment of Nutrition and Ageing, or NANA, toolkit with ReMind, a reminding and scheduling app co-created with people with dementia. DataDay consists of four modules, each featuring games and data entry logs to track cognition, physical activity, mood, and nutrition.
To test the current iteration of DataDay, we conducted a 6-week longitudinal intervention study in which patient-caregiver dyads used the app and provided feedback. We subsequently conducted focus groups with caregivers to enrich our findings of the barriers and facilitators to the DataDay's use. Lastly, we created a comprehensive guide on inclusive research in individuals living with dementia and MCI, using DataDay and the Toronto Translational Thinking Framework.
Project team
TRP supervisors
Project advisory committee
See our community directory for more on committee members.
Assisting IBD Mothers on Breastfeeding
To develop a patient-centric educational tool that provides information and resources that can aid mothers with Inflammatory bowel disease (IBD) in breastfeeding.
Project team
- Stella Rho
TRP supervisors
Project advisory committee
- Dr. Peter Habashi, Director, IBD Clinic at Mount Sinai Hospital
- Laura Bradbury, Nurse Practitioner and Psychotherapist
- Keri-Ann Berga
See our community directory for more on committee members.
Autism Spectrum Disorder in Children with Down Syndrome: Perspectives and Experiences of Healthcare Practitioners and Caregivers in Canada
Early intervention is essential for children diagnosed with both Down Syndrome (DS) and Autism Spectrum Disorder (ASD); a condition known as DS-ASD. However, the complex challenges involved in distinguishing ASD in the presence of DS often lead to significant diagnosis delays.
This study aims to identify the factors contributing to diagnosis delays within the Canadian healthcare system and seeks to explore physicians’ current practices regarding DS-ASD and understand the challenges faced by caregivers. As a mother of a child with DS, my advocacy for equitable healthcare is driven by personal experience and commitment to research in the field.
Background
Autism Spectrum Disorder (ASD) and Down Syndrome (DS) are independently well-documented, each with distinct developmental trajectories. However, the cooccurrence of ASD in individuals with DS, known as DS-ASD, remains under-researched and poorly understood. Recent findings indicating a higher prevalence of ASD among children with DS challenge prior views that these two conditions are mutually exclusive and emphasize the need for more focused research in this area.
A significant concern is the delay in diagnosing ASD in children with DS compared to their neurotypical peers. Neurotypical children are diagnosed with ASD around the age of three. However, children with DS tend to be suspected of having ASD between the ages of 4-5 and are often not diagnosed until around the age of 10. This delay can result in critical missed opportunities for early interventions, which are most effective at an early age. The delay in diagnosing ASD is multifaceted, involving factors such as overlapping symptoms leading to diagnostic overshadowing, where behaviors typical of ASD are mistakenly attributed to DS; a lack of specialized training among healthcare professionals about DS-ASD cooccurrence; and a lack of ASD screening tools that accommodate the unique presentation of children with DS, often leading to underdiagnosis or misdiagnosis.
Without a timely diagnosis of ASD, children with DS are at risk of exacerbated behavioral problems and increased difficulties in communication and social interactions, impeding their educational and personal development. Addressing these challenges requires increased awareness, early and accurate screening, and tailored interventions to ensure that children receive the support they need on time.
This study adopts a comprehensive approach by integrating insights from both caregivers and healthcare professionals, offering a more complete understanding of the challenges and dynamics within the Canadian healthcare context. The objectives are threefold: 1) Identify the obstacles healthcare practitioners encounter in diagnosing ASD in children with DS; 2) Assess their awareness of DS-ASD cooccurrence; and 3) Examine the experiences of caregivers navigating the diagnostic and care pathways for children with cooccurring DS-ASD.
Project team
- Dr. Julija Atanasova
TRP supervisors
Project advisory committee
- Dr. Jennifer Crowson, President, Canadian Down Syndrome Society
- Dr. Kerry Boyd, Associate Clinical Professor, Department of Psychiatry & Behavioural Neurosciences, McMaster University
- Dr. Rudaina Banihani, Developmental Pediatrician Sunnybrook Hospital; Assistant Professor University of Toronto
See our community directory for more on committee members.
Watch Dr. Atanasova's Capstone Defense presentation
Black Women Health Equity – Perinatal Health
The term health equity follows as the pursuit for the removal of avoidable health disparities from affected populations, particularly Black communities within this context. Canada does not track race-based health data (Canadian Institute for Health Information, 2020). Other countries like the United Kingdom and the United States that have a large percentage of the African diaspora and other communities of people of colour (POC) that may be impacted by social and systemic structures use race data to analyze health disparities disproportionately affecting these populations.
Without access to data that underscores the severity of the disparities, it is impossible to gain an understanding of predispositions to certain diseases, lower screening rates, and increased morbidity and mortality within these populations. Therefore, there is a need for more studies examining the intersection of race in health outcomes to understand Canadian health disparities for the Black population.
In a study comparing preterm birth rates between women of different races in the US and Canada, researchers found that Canadian women were less at risk of preterm birth than women in the US. However, even though there was a decreased risk overall in Canada for both Black and Caucasian women compared to the US, the disproportionate risk of delivering a preterm infant for Black women in the US was mirrored in Canada.
The purpose of this project:
- To bring awareness to Black health issues in a Canadian context
- To highlight health disparities experienced by the Black Canadian community
- To push for more studies that include racial data in health contexts
- To educate non-Black Canadians about the health disparities experienced by Black communities
Find out more
TRP Alumni Create Self-Advocacy Handbook for Black Patients Navigating Perinatal Care
Project team
- Gabrielle Retta
- Gemma Kabeya
TRP supervisors
Project advisory committee
- Ms. Althea Jones, Founder, CEO, Registered midwife, Ancestral Hands Midwives and Womb & Wellness
- Dr. Notisha Massaquoi, Assistant Professor, Department of Health and Society, University of Toronto, Scarborough
- Dr. Sume Ndumbe-Eyoh, Assistant Professor, Dalla Lana School of Public Health at the University of Toronto
See our community directory for more on committee members.
Cancer Outpatient Nutritional Status
Despite the existence of nutrition education programs, many cancer patients are not implementing recommendations into their daily lives.
Background
Nutrition plays a key role in the recovery and treatment experience for cancer patients. Multiple programs exist in Toronto to educate patients as to what they should eat to improve their recovery. These programs also provide meal preparation tips that consider treatment side effects, ingredient seasonality, convenience, and more.
Project team
- Julia Antolovich
- Razan (Rosie) Bouzeineddine
- Craig Madho
- Kathleen Mounce
TRP supervisors
See our community directory for more on committee members.