Publications
BMD Medical Ethics
| 10.1186/s12910-021-00706-3
2021
The Impact Of Reporting Magnetic Resonance Imaging Incidental Findings In The Canadian Alliance For Healthy Hearts And Minds Cohort
In the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.
Neurology
| 10.1212/WNL.0000000000012765
2021
Effect of Cognitive Reserve on the Association of Vascular Brain Injury With Cognition: Analysis of the PURE and CAHHM Studies
To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.
IJIH
| 10.32799/ijih.v16i2.33098
2021
Entsisewata’karí:teke (You Will Be Healthy Again): Clinical Outcomes of Returning to a Traditional Haudenosaunee Diet
Haudenosaunee Peoples of eastern North America have a strong agricultural tradition and culture associated with maize horticulture. Traditional foodways and diet were disrupted after the people were dispossessed from traditional lands maintained prior to colonization. As a result, Haudenosaunee have been disconnected from their traditional diet and lifestyle, and chronic diseases such as diabetes and obesity are increasing. Healthy Roots was developed in Six Nations of the Grand River territory by Haudenosaunee community members. It started as a 90-day challenge, in which participants adhere to a diet of traditional foods found in Haudenosaunee territories pre-European contact.
THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
| 10.1210/CLINEM/DGAA815
2021
Diabetes, Brain Infarcts, Cognition, And Small Vessels In The Canadian Alliance For Healthy Hearts And Minds Study
Diabetes is a risk factor for cerebrovascular disease and cognitive impairment. The anatomical basis for this is uncertain.
CJC Open
| https://doi.org/10.1016/j.cjco.2020.07.013
2020
The Canadian Alliance for Healthy Hearts and Minds: How Well Does It Reflect the Canadian Population?
The intent of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to understand the early determinants of subclinical cardiac and vascular disease and progression in adults selected from existing cohorts—the Canadian Partnership for Tomorrow’s Health, the Prospective Urban and Rural Evaluation (PURE) cohort, and the Montreal Heart Institute Biobank. We evaluated how well the CAHHM-Health Services Research (CAHHM-HSR) subcohort reflects the Canadian population.
EUROPEAN HEART JOURNAL. CARDIOVASCULAR IMAGING
| 10.1093/EHJCI/JEZ226
2020
Cardiovascular risk scoring and magnetic resonance imaging detected subclinical cerebrovascular disease
Cardiovascular risk factors are used for risk stratification in primary prevention. We sought to determine if simple cardiac risk scores are associated with magnetic resonance imaging (MRI)-detected subclinical cerebrovascular disease including carotid wall volume (CWV), carotid intraplaque haemorrhage (IPH), and silent brain infarction (SBI).
Stroke
| https://doi.org/10.1161/STROKEAHA.119.028179
2020
Reduced Cognitive Assessment Scores Among Individuals With Magnetic Resonance Imaging–Detected Vascular Brain Injury
Silent brain infarctions (SBI), or silent strokes where symptoms are absent or unrecognized, are subcortical cavities (lacunes) or cortical areas of atrophy and gliosis, which are presumed to be caused by previous infarction.1 White matter hyperintensities (WMHs) are also presumed to be caused by brain ischemia.1 Prior epidemiological studies indicate these vascular brain injuries are associated with cognitive decline, incident stroke, dementia, and death.2–4 The presence of SBI is higher in people with traditional cardiovascular risk factors including hypertension, diabetes mellitus, smoking, and cholesterol.5–8 These risk factors are also associated with increased cognitive decline in older populations.4 However, the results of clinical trials using medications to alter cardiovascular risk factors have not consistently shown reductions in cognitive decline.9–12 We hypothesized that cardiovascular risk factors and silent vascular brain injury, as detected by magnetic resonance imaging (MRI), would be significantly associated with reduced cognitive function. Therefore, we investigated if scores on 2 tests, a cognitive screen and a test of processing speed, are lower in individuals with higher cardiovascular risk and those with subclinical vascular brain injury in a large population-based sample.
THE LANCET. PLANETARY HEALTH
| 10.1016/S2542-5196(19)30237-2
2019
Explaining The Variability In Cardiovascular Risk Factors Among First Nations Communities In Canada: A Population-Based Study
Historical, colonial, and racist policies continue to influence the health of Indigenous people, and they continue to have higher rates of chronic diseases and reduced life expectancy compared with non-Indigenous people. We determined factors accounting for variations in cardiovascular risk factors among First Nations communities in Canada.
CJC OPEN
| 10.1016/J.CJCO.2019.09.002
2019
"All About Us": Indigenous Data Analysis Workshop-Capacity Building In The Canadian Alliance For Healthy Hearts And Minds First Nations Cohort
Research collaborations between non-Indigenous and Indigenous researchers primarily have been led by non-Indigenous researchers with privileged locations in university settings. Recognition of the importance of data sovereignty and control to enable Indigenous self-determination requires building data management and analysis capacities among Indigenous research partners. The Canadian Alliance for Healthy Hearts and Minds First Nations (CAHHM-FN) cohort study, a collaboration of 8 First Nations and researchers at 8 universities, convened a 3-day data management and analysis workshop.
Cities & Health
| https://doi.org/10.1080/23748834.2018.1548071
2018
Environmental health assessment of communities across Canada: contextual factors study of the Canadian Alliance for Healthy Hearts and Minds
Cardiovascular risk varies substantially across Canadian communities, suggesting that contextual environmental factors may contribute to the development of cardiovascular disease risk factors. To characterize these influences, we conducted standardized audits of 2,074 urban and rural communities across Canada between 2014 and 2016, collecting objective measures of demographic characteristics, public transportation, tobacco availability, grocery environments, alcohol pricing, and healthy restaurant options. Audit reliability was assessed through duplicate evaluations of 209 communities.
