If your condition improves, you’ve got your answer.

But if your condition changes or a new problem develops, more medications may be prescribed, leading to a buildup of prescriptions over time. “That’s when things can become difficult for the patient,” said Dr. Lalitha Raman-Wilms.

Raman-Wilms, dean of the College of Pharmacy at Rady Faculty of Health Sciences, is also a pharmacist herself; she’s seen first-hand what happens when the medications meant to help start to become part of the problem.

During the early years of her career, Raman-Wilms worked in a long-term care facility in Thunder Bay where residents were often on a multitude of drugs for various conditions. “It wasn’t that unusual,” she recalls. But there was one patient that still stands out for her. “He was really passive and not able to do too many things for himself,” she said. “His family was very devoted and they came to see him regularly, but he never spoke.” Besides those visits, his life was limited to watching TV and not much else.

As a pharmacist, Raman-Wilms knew one way she could help was to review his medications to make sure they were being used correctly and effectively. That involved checking if he was taking the right amount of the correct medications, looking for any interactions between prescriptions and exploring better options for managing his conditions.

This process is called deprescribing – a full evaluation, changing or even removing medications. “Just because something was helpful at one point doesn’t mean it’s still helpful,” she said.

With careful monitoring and regular discussions with other health-care providers, the patient’s drugs were reduced again and again. One day, his family was astonished to hear him speak, something he hadn’t done in a decade.

“It’s never left my mind – we can do so much with medications to help patients, but we also need to think about when it’s time to reevaluate.”

Today, roughly 25 per cent of adults aged 65 or over are taking 10 or more medications at the same time. As dean of pharmacy, Raman-Wilms wants to ensure the next generation of pharmacists is ready for patients with multiple prescriptions, but she’s also keen to spread the word among other health professionals.

Raman-Wilms is a lead author on a recent article for Medical Science Educator that proposes a curricular framework for an interprofessional approach to deprescribing. She’s also authored a chapter on deprescribing for a new reference book, the Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy.

Other experts from Rady Faculty are also investigating this important facet of health care, including Dr. Alex Singer, associate professor of family medicine and director, Office of Research & Quality Improvement in the department and director, Manitoba Primary Care Research Network.

One study in progress is known as SPIDER: A structured process informed by data, evidence and research – a research and quality improvement collaboration supporting practices in improving care for complex elderly patients.

Not only does it explore some of the same points Raman-Wilms champions, such as patient safety, but it also looks at reducing risk and preventative care. Additionally, it explores the costs associated with polypharmacy.

“One thing to consider is that fewer people are showing up in the emergency department with adverse drug effects. First and foremost, that’s good for patients,” he said, adding that means less pressure on the system, which allows health-care professionals to work more effectively and incur fewer costs. “And that’s good for everyone.”

For more information, visit:

Choosing Wisely

Canadian Medication appropriateness and deprescribing network

One research team aims to better understand the lingering condition known as “long COVID” and the other to examine, at the cellular level, how a receptor for the disease-causing virus works.

Long COVID

The post-COVID-19 syndrome that some patients experience – a condition called long COVID – is poorly defined, said Dr. Alan Katz, director of the Manitoba Centre for Health Policy (MCHP) and professor of community health sciences and family medicine at the Max Rady College of Medicine in the Rady Faculty of Health Sciences.

Dr. Alan Katz

“This condition is really brand new, and clinicians just don’t know enough about it,” said Katz, the project’s nominated principal investigator. “I’m hoping that we can shine a light on these long-term effects of COVID-19 in a way that can help people deal with this in the future.” 

When a person visits their family doctor with long COVID symptoms – such as fatigue, shortness of breath or cough – it’s not easy for the physician to diagnose the syndrome because there is no test to confirm it, Katz said.

The goal of the study, which received $202,000 from the CIHR for one year, is to help clearly define the risk factors, determine who is more likely to get long COVID and describe the long-term effects of the syndrome. The researchers want to define the kinds of symptoms people are reporting, determine how frequent those symptoms are and provide guidance around diagnosing the condition.

To do this, they will study anonymized health data from the Manitoba Population Research Data Repository held at the MCHP. The researchers will zero in on patients with a COVID-19 diagnosis and follow them, analyzing whether there is an increase in visits to their doctors and tracking their symptoms.

The project’s other principal investigators are Dr. Lisa Lix, professor of community health sciences and Canada Research Chair in methods for electronic health data quality, Dr. Yoav Keynan, associate professor of internal medicine, and Dr. Alex Singer, associate professor of family medicine.

Viral signal transmission inside cells

Dr. Ruey-Chyi Su co-leads a team that will investigate how the binding of the spike proteins of various coronavirus variants to the host-cell receptor known as ACE2 affects viral spread and mortality rates. 

Dr. Ruey-Chyi Su

Little is known about what happens inside cells when the spike protein engages the receptor ACE2, said Su, a research scientist at the Public Health Agency of Canada and adjunct professor of medical microbiology and infectious diseases at the Max Rady College of Medicine.

“This is a much-understudied area,” Su said. “It’s very exciting for us because this grant allows us to study whether the engagement of coronavirus variants with ACE2 triggers different sets of events inside the infected cells, leading to increased viral replication and influencing the severity of the disease.”

The study, which received $430,000 from the CIHR for one year, aims to profile molecular changes caused by the viral spike protein binding to the ACE2 receptor and to identify the changes that are unique to the spike protein of each variant. These changes will be examined in cells from both men and women to determine whether sex has any influence.

The researchers also want to know if the cells of healthy people respond differently to the virus binding to the receptor than the cells of people with chronic diseases, such as diabetes.

“I believe what we find will open up a lot of questions, like, ‘Why do our cells respond differently during a viral infection, and what determines that difference?’” Su said. “The project will increase our knowledge of what to expect during a viral infection and also provide knowledge that might lead to treatments. It’s really a knowledge-building study.”

Su’s co-principal investigator is Dr. James Davie, distinguished professor of biochemistry and medical genetics. The co-applicants are Dr. Brad Doble, associate professor and Bihler Chair in Stem Cell Research in pediatrics, biochemistry and the regenerative medicine program, and Dr. Sandra Gonzalez-Diaz, Su’s post-doctoral fellow.

Group 4

• Delaney C.T. Coelho, BA (Adv)/11 
• Melinda Fowler-Woods – U of M staff, director, Ongomiizwin (Indigenous Institute of Health and Healing)
• Saroj Niraula – assistant professor, department of internal medicine
• Meaghan J. Pauls, B.Env.D/10, MLArch/16 
• Desiree Scott, BA/16

Delaney Coelho

Delaney Coelho would be very happy to shut down the Manitoba organization she founded.

But for now, she says, there’s a distinct need for Equal Voice Manitoba. It’s the provincial chapter of a multi-partisan national network focused on supporting the participation of women in politics.

“There’s a study out there … that says if things continue to go as they are, it’s going to be another 50 years before we see anything remotely close to [gender] parity,” in politics, Coelho said.

“I’m far too impatient for that. So the hope is that Equal Voice and organizations like Equal Voice can speed that up. I don’t want to be 70 or 80 before parity is achieved.”

To that end, Coelho, 30, founded Equal Voice Manitoba in 2016. It offers a range of programming for women interested in politics — either running as candidates themselves or working in roles such as campaign management. That includes full-day “campaign schools” that focus on tangible skills as well as networking.

The idea is to counter the under-representation of women in all levels of politics — something Coelho saw herself when she worked as a staffer for Manitoba’s previous NDP government.

“In my experience, I’d often be … the only woman in the room, or be at events with ministers from across the country where there were no women or people of colour represented,” said Coelho, who now works with Manitoba’s Human Rights Commission.

“It definitely feels isolating — like maybe your perspective isn’t being presented  or if it is [kind of the burden is on your shoulders to be the only one to speak for all women.”

That’s a problem, she says, when “obviously, women are pretty diverse in their perspectives and ideas, and if you’re kind of the spokesperson for all women, that’s maybe not the greatest fit.”

Equal Voice, she says, also has a role to play in fighting the harassment of women in politics — many instances of which have come to light in the wake of the #MeToo movement.

“One of the things we’ve tried to do is create a community in Manitoba, and more broadly, where people can speak up about these situations that are happening, and bring them … to the forefront. They’ve always been happening and continue to happen, but they maybe haven’t been talked about,” she said.

“And then also just creating a greater conversation about how, as the electorate, we’re just not going to accept that any more. It’s completely unacceptable to have an environment where … 51 per cent of the population is made to feel that they don’t belong.”

Meaghan Pauls 

Meaghan Pauls strives to create a community that is loving, accepting and one that creates space for otherness and difference.

Five years ago, she founded the Bell Tower Community Café. She describes the café as an urban food bank wrapped in a community café. By combining a food bank with a coffee house, she has helped create the most human food bank experience possible.

In addition to running the Bell Tower Community Café, she also volunteers at Madison House, St. Benedict’s Church and on the board for the housing co-op through All Saints Church, and is a successful professional designer.

Desiree Scott 

Winnipeg-born Desiree Scott is well known as one of the most decorated Canadian soccer players of her generation.

She played for multiple youth Canadian national teams before coming to the University of Manitoba to play as a member of the Bison women’s soccer team, having an illustrious five-year university career (2005-2009). She proved her fierce determination as a midfield asset and earned the nickname “The Destroyer.

In 2010, Scott was named to the Canadian women’s soccer national team and since then has appeared in 135 international matches. She has demonstrated her outstanding skills, earning back-to-back Olympic bronze medals at the 2012 London and 2016 Rio Olympics. She has also attained the highest level of women’s professional soccer playing for various international clubs.

An outstanding ambassador of our city, province and country, she has been an athlete ambassador for the Homeless World Cup and KidSport Winnipeg for several years and also makes frequent visits to clubs, schools, and other sports organizations. 

Additionally, she has taken several volunteer assistant coach positions for the clubs and teams she was a part of growing up. She also served as the honorary chair of the 2017 U Sports women’s soccer national championship, which was hosted by the University of Manitoba for the first time in our province since this prestigious tournament launched nearly three decades ago.

Group 3

• Kobra Rahimi [JD/17]
• Derrick Sanderson [BSc(Pharm)/08]
• Dayna Steinfeld [BA(Hons)/09, JD/12]

Kobra Rahimi

Kobra Rahimi lived the first 14 years of her life in a refugee camp in Iraq. Since arriving in Canada, she has committed herself to turning her family’s struggles into opportunities to be a positive addition to the Winnipeg community. 

Passionate about higher education, Rahimi completed a degree at University of Winnipeg and then moved on to study law at the University of Manitoba. She received the Emerging Leaders Award for displaying exceptional leadership qualities within the university community.

In the past few months, she has become both a lawyer and mother, receiving her call to the bar in June following articles at Legal Aid and celebrating the birth of her daughter in October. 

Rahimi sits on boards including the Social Planning Council and Islamic Social Services. In 2014, she co-organized a rally of over 1,000 people to demand clean drinking water for Shoal Lake 40 First Nation.

In 2016, she co-ordinated student placements at Welcome Place to assist asylum seekers, a program that continues. 

She regularly speaks at community events about her family’s story of displacement, loss and finding home and stability in Manitoba. Through her accomplishments, advocacy and daily work, Rahimi is an inspiration to young newcomer refugees.

Derrick Sanderson

Derrick Sanderson demonstrates exemplary leadership within the pharmacy profession.

As the regional pharmacy director of the Northern Health Region, he is one of only five pharmacy directors in the province and has many responsibilities looking after the large region. He has been in this role since April 2016 and he tirelessly advocates for health equity in the north.

He is a part of many provincial groups, including the group that helped to equalize the services received by care homes in the north, and the group that monitors and manages critical drug shortages for hospital patients. In 2014, he was elected to the board of the College of Pharmacists of Manitoba. He works diligently with the other board members to ensure that the mandate of public protection through safe pharmacy practices are met.

In an effort to decrease the opioid epidemic in Manitoba, Sanderson and the board made exempted codeine products (for example, Tylenol 1) available by prescription only and were awarded the Patient Safety Award in 2018.

He returned to his hometown after completing his pharmacy degree at University of Manitoba and has worked at The Pas Health Complex since 2008.

Dayna Steinfeld 

Dayna Steinfeld is a lawyer at Fillmore Riley LLP who uses her legal knowledge to give back to the community and to champion human rights. She practises in the areas of regulatory and administrative law and civil litigation, but she also makes the time to do pro bono work.

She’s currently acting as legal counsel for a coalition of organizations representing persons living in poverty, urban Indigenous people, persons living with mental illness and persons experiencing homelessness in the Supreme Court of Canada case R v. Le.

As a law student, Steinfeld was involved in the organization of the Truth and Reconciliation Commission of Canada’s first national event. Her brilliant legal mind led her to being chosen in the highly competitive process to work as a law clerk to a justice of the Supreme Court.

She now teaches a course on the Charter of Rights and Freedoms at the University of Manitoba law school.

Her passionate commitment to human rights and social justice issues will have a far-reaching impact for individuals in our community.

Group 2

• Janilyn Arsenio [BSc(Maj)/04, PhD/12], assistant professor, department of internal medicine and immunology, Rady Faculty of Health Sciences
• Derrek Bentley, master’s student in Peace & Conflict Studies
• Pamela Delisle [BFA/04, BSW/06]
• Angeline Nelson [BSc/09]
• Alex Singer, associate professor, department of family medicine, Rady Faculty of Health Sciences
• Amy Tung [BHEcol/07]

Janilyn Arsenio

Janilyn Arsenio is a scientist, Filipino-Canadian, devoted mom and wife. After completing her PhD at the University of Manitoba, she pursued post-doctoral training at the prestigious University of California San Diego, before returning back to the University of Manitoba. She is now an assistant professor in the university’s departments of internal medicine and immunology.

Her scientific expertise is with a cutting-edge technology that can investigate gene expression in a single cell. As the first person in Manitoba to use single-cell genomics, she is using her skill to study the function of immune cells and how they develop into specialized cell types like immune memory cells or the killer cells that attack cancers.

Her research will help to develop new strategies for vaccine design and in the treatment of infections, cancer, and autoimmune diseases. She is already having a broad impact on biomedical science in Manitoba. She has garnered recognition in the form of many local and national awards she has won as a young investigator.

Recognized as an emerging leader, Arsenio has been nominated for a prestigious Canada Research Chair. She is also passionate about diversity and inclusion in science. She is the vice-chair of the initiative WISDOM: Women in Science, Development, Outreach, and Mentorship, at the Rady Faculty of Health Sciences. She is a member of the Association for Women in Science (U.S.A.), and the Society for Canadian Women in Science and Technology. Through these venues, she works to promote greater engagement of women in science. 

Derrek Bentley

Derrek Bentley has devoted his life to social justice, education and helping others. While growing up francophone in Manitoba, he has dedicated his free time to bringing awareness to important causes. He founded the project A Homeless Night, which raises awareness of homelessness in Manitoba.

He continues to volunteer in many grassroots organizations, such as Conseil Jeunesse Provincial, and as a board member for Canadian Parents for French National, all while completing his master’s degree in peace and conflict studies. He works full-time at the Canadian Museum for Human Rights as an assistant manager, further educating the public on crucial social issues.

Bentley has accomplished all of this while trying to heal after the murder of his brother in 2014. Long before that, and ever since, he has dedicated his life to promoting peace and social justice.

Bentley’s passion for others truly fits the definition of perseverance and selflessness. He is just getting started.

Pamela Delisle

More than 1,700 gifts ago, Pamela Delisle founded You Can’t Spoil a Baby — a 100 per cent volunteer-operated project that provides custom-made gifts to Manitoba families in need after the birth of a baby. It started small — with giving away her own children’s outgrown clothes — and has grown into a team of over 75 volunteers co-ordinated by Delisle who collect, create and deliver beautiful custom gifts to new parents.

These gifts are not just newborn items — they include clothing and items for the first year of a baby’s life. Delisle saw a gap and she has worked tirelessly since 2011 to help close it to the benefit of those 1,770 babies.

Not only is she an innovator, an advocate and an inspiration, she is also warm, kind and compassionate. Her background as a social worker in the women’s health field, her commitment to environmentalism and her determination to help marginalized families feel valued and cared for was the perfect combination to grow YCSAB into the dynamic volunteer network it is today.

She is proof that one simple idea acted upon can create countless opportunities for an entire community.

Angeline Nelson

Angeline Nelson is a Muskego Anishinaabekwe from Bigaawinashkoziibiing, Roseau River Anishinaabe First Nation. Her interest in science, specifically in chemistry, from a young age led her to earn a bachelor of science in chemistry and zoology.

She has always wanted to create opportunities for other Indigenous youth to be engaged in science, have an opportunity to practise hands-on experiments and recognize their own potential. 

She considers herself a lifelong learner of Midewiwin teachings, Anishinaabemowin and cultural knowledge and the strength, resiliency and humility of Indigenous people who have a strong connection to who they are as Indigenous people. This has helped her to focus her efforts on language revitalization, creating opportunities for learning about culture, learning and teaching regalia making, and ensuring that programming for Indigenous youth is “Indigenized.”

Today, both her cultural connection and fascination with science have led her to her current role as the new director of community learning and engagement at the University of Winnipeg.

Nelson ensures that both Indigenous and non-Indigenous youth have multiple opportunities to be engaged in science, technology, engineering, arts and math (STEAM) programming from a young age, and that Indigenous people have opportunities to learn Indigenous languages and have a space to call their own on a university campus. Last year, she developed free women’s self-defence programming to create change for Indigenous women, especially for those who may be experiencing or have experienced violence. 

Dr. Alex Singer

Dr. Alex Singer is an associate professor in the department of family medicine at the University of Manitoba, where he leads the quality improvement and informatics curriculum. He trained at McGill University (Montreal) and University College Dublin (Ireland) before being recruited to Manitoba in 2010. 
 
Singer is Manitoba’s leading expert in electronic medical records (EMR). He is director of the Manitoba Primary Care Research Network, where his team is developing new ways of using EMR data to improve health-care delivery and advance health research in our province. For example, his team is using EMR data and cutting-edge machine learning technology to better define and treat post-traumatic stress disorder (PTSD) among veterans, families of military service members and the general population. He is also using EMR data to track and study chronic disease, and to support the Choosing Wisely campaign for responsible testing and prescribing patterns. 
 
Since 2014, Singer has served as the Manitoba eHealth Family Physician Champion, representing the needs and interests of all Manitoba family physicians and reporting directly to the chief medical information officer of Manitoba. 
 
Singer is known among his colleagues for his boundless energy and “out of the box” approach to tackling big problems and hard questions in health care. Through his multiple roles and tireless dedication as a practising physician, clinician-teacher, eHealth Champion and director of the MaPCReN research program, he is paving new ways to improve health for all Manitobans. 

Amy Tung

Amy Tung is an inspiring young woman spreading love throughout Winnipeg.

Through her volunteer work at West Broadway Youth Outreach and Big Brothers Big Sisters Winnipeg, she found many non-profit organizations lack funding, awareness and engagement. In early 2018, she took matters into her own hands and started a business that will sustain itself and support Canadian charities — the I Am Love Project.

Every month, volunteers come together to create crystal intention bracelets in support of a charity that is making a big impact in the community. They select a new charity on a monthly basis. The I Am Love Project hosts pop-up yoga classes featuring different local teachers and venues and at the end of the month they deliver all proceeds to their chosen charity.

Within the last four months, we’ve raised over $10,000 for the Women’s Health Clinic, Turning Pages of Mood Disorders Association of Manitoba, Make Music Matter and Westman Dreams for Kids Foundation.

“We create the chain of love with no beginning and ending. Love and support is continuous.”

Group 1

• Lyle McKinnon [PhD(MedMicro)/09], an assistant professor in the department of medical microbiology and infectious diseases
• Nathan Nickel, an assistant professor in the department of community health sciences 

Lyle McKinnon

Dr. Lyle McKinnon, born and raised in Winnipeg, is an assistant professor of in the departments of medical microbiology, infectious diseases and community health sciences at the University of Manitoba. He has made significant contributions to HIV-transmission research, including an assessment of HIV risk and incidence in male and female sex workers. He has published on specific immune responses to HIV crucial to HIV vaccine and disease progression research.

His body of research represents over 10 years of contributions to HIV immunology, particularly relevant to initial HIV infection with important implications for HIV prevention. Dr. McKinnon has published several research manuscripts in prestigious research journals in his field. He is currently studying HIV prevention and inflammation which has implications for inflammatory bowel disease.

While working in Kenya and South Africa, Dr. McKinnon engaged key populations around HIV research and prevention activities and as a result increased awareness of HIV risk and prevention measures. These outreach activities have brought international students to Manitoba, which increases the profile of medical microbiology research in Manitoba at the global level.

As a new investigator, Dr. McKinnon has already made leaps and bounds in our understanding of HIV risk and prevention and is rising star in the Canadian and international medical microbiology field.

Nathan Nickel

Dr. Nathan Nickel is an internationally recognized expert in population health research. As a scientist at the Manitoba Centre for Health Policy within the University of Manitoba, he uses big data to understand what works to promote health and well being among Manitobans. Dr. Nickel is the Population Health co-lead for the Manitoba DEVOTION Network, a team of researchers dedicated to understanding how early-life experiences shape lifelong health.

He developed an innovative new system to monitor and study infant feeding practices across Manitoba. He is a lead researcher for the Pathways to Health and Social Equity for Children (PATHS) program, studying over 600,000 children born in Manitoba over the past 30 years to understand the impact of social programs like full day kindergarten, social housing, and the Healthy Baby program.

Dr. Nickel is directing groundbreaking studies on substance use disorders and addiction. He led a 25-year study to inform Manitoba’s new mental health and addictions strategy, and is the Manitoba lead for the Canadian Student Tobacco Alcohol and Drug study.

He is currently leading a study of the health and social impacts of cannabis legalization. In 2017, Dr. Nickel was recognized as one of North America’s leading population health researchers with the Chipman Award for Health Research from the University of North Carolina. He serves on the executive council of the International Society for Research in Human Milk and Lactation and the Winnipeg Regional Health Authority’s health equity committee.