Open access (OA) and open scholarship encompass a wide variety of supports and initiatives that endeavour to make research, information, and creative works more accessible, more transparent, and more equitable. Benefits can include: 

• lower educational costs 

• increased student participation in learning 

• improved accessibility 

• flexibility 

• ability to reach a larger audience 

Physiotherapy open access volume finds home on eScholarship 

Inviting Movements in Physiotherapy: An Anthology of Critical Scholarship is a research publication of the international Critical Physiotherapy Network (CPN), in collaboration with the College of Rehabilitation Sciences. Produced with the support of the UM Libraries, it is now hosted on eScholarship. 

“The Critical Physiotherapy Network… has deep commitments to sharing ideas and conversations freely. We chose to publish our newest anthology with eScholarship because we are fundamentally committed to open access scholarship,” says Patricia Thille, the lead editor of the anthology and associate professor in the College of Rehabilitation Sciences at the University of Manitoba.  

The book was assessed through an open-identities peer review process, which the CPN used for its earlier volumes published by Routledge and Cappelen Damm. 

The skill and commitment of the eScholarship team, led by OER Specialist Glenn Bergen, was essential to this new volume’s successful publication, Thille says. “Glenn walked through the steps while also working with us to think through future opportunities for this book.”  

Future opportunities include presentations, podcasts, or workshops that could be added to the eScholarship portal to live alongside the book, “creating a cohesive and robust collection of resources,” says Thille. “Book publishing isn’t where eScholarship’s content needs to end.” 

New open educational resources support engagement with learning 

Open educational resources (OER) are teaching resources available in a variety of formats that have an open copyright license, which allows anyone to use, adapt and share them at no cost.  

Resources include: 

• open textbooks 

• online teaching resources 

• interactive lab manuals 

• an open educational resource to support patient and public partners in health research 

Learn more 

UM Libraries has long been an advocate and supporter of the creation and use of open educational scholarship and resources. The Libraries two-year pilot funding project Advance Open Ed has now become a permanent part of the library’s open publishing support system, after having supported 21 OER projects that will impact approximately 7,300 students each year. 

Learn more about supports for open at the University of Manitoba at Open@UM

Browse publications and open teaching materials on eScholarship 

Long COVID is a condition that affects people beyond their initial COVID-19 infection. The most common symptoms of long COVID are fatigue, shortness of breath, muscle pain and difficulty concentrating. Emerging evidence suggests that 10 to 30 per cent of individuals who have had a COVID infection experience long-COVID symptoms. 

“Given the number of confirmed COVID-19 cases, it is likely that thousands of Manitobans are affected by long COVID,” said Dr. Patty Thille, administrative lead for the project.

“Emerging international guidance recommends that policy-makers address long COVID through a multidisciplinary approach, including interprofessional rehabilitation services.”

Rehabilitation interventions like supervised conditioning programs, respiratory training, developing strategies for living with cognitive symptoms, and mindfulness and cognitive behavioural therapy for mental health concerns are among the important components of long COVID recovery, Thille said.

The group includes nine faculty members from the College of Rehabilitation Sciences, joined by one from community health sciences in the Max Rady College of Medicine and a PhD student in the Applied Health Sciences program.

PhD student Brenda Tittlemier works part time as a best practice coordinator at the Health Sciences Centre and was asked to take part to provide a health-care worker perspective.

“It is very exciting that some early research is showing that rehabilitation can help people with long COVID improve their function, and as such, rehabilitation for long COVID should be available to all Manitobans within our health-care system,” Tittlemier said.

Two group members, Dr. Sandra Webber and Dr. Diana Sanchez-Ramirez, have published papers on long COVID over the last few months. The group is also supported by two research staff, one of whom is also a master’s trainee.

Thille, an assistant professor of physical therapy, said long-COVID patients may be referred to rehabilitation programs that are not designed to meet their needs, as there are few existing programs for long COVID.

“To meet the demand of long-COVID clients, there was a big influx of referrals to the WRHA (Winnipeg Regional Health Authority) pulmonary rehabilitation program. While that may help people in the Winnipeg region with lung and breathing problems, it can’t help with the extreme fatigue some experience after exertion,” she said. “Many people with long COVID are not eligible for this and other existing rehabilitation programs, leaving them without any rehabilitation services at all.”

From July to October 2021, the group conducted an environmental scan to learn about long-COVID management across Manitoba, Canada and other countries with similar health systems. They found that Alberta, and Saskatchewan are the only provinces to currently have long-COVID frameworks in place, and only BC has an interdisciplinary care network for long COVID care.

They noted several provinces plan to manage long-COVID patients through existing systems, but that Manitoba lacks the capacity to do so due to consistently high demand of publicly-financed rehabilitation programs for people with non-COVID rehabilitation needs.

They also identified major gaps in Manitoba, including accessible community-based interprofessional care and services for youth and children.

“Rehabilitation programs specifically for people with long-COVID are being developed but are not yet funded,” Thille said.

The group is now meeting with Manitoba provincial health system leaders to facilitate efforts to support people living with long-COVID in Manitoba.  Among their recommendations are for decision-makers to ensure dedicated resources and funding specific to long-COVID patients, and that provincial health authorities coordinate to improve access to rehabilitation specialists with proper referrals.

Read the full report.

The event will take place Oct. 1-2, with 11 PhD students and 15 master’s students from UM and USask presenting their work on a variety of research topics in the fields of rehabilitation sciences and kinesiology, along with virtual podium presentations by researchers from both universities.

Dr. Catherine Donnelly, associate professor at the School of Rehabilitation Therapy, Queen’s University, will hold the keynote address, titled “Collaborating to support systems integration” on Oct. 1 at 4 pm. Donnelly’s educational research explores interdisciplinary education and the integration of theory to practice. She recently started a new position as director of the Health Services and Policy Research Institute at Queen’s University.

“Much of my work has been focused on how teams work together and provide care, and how patients are involved in that process,” Donnelly said. “I’ll be looking at heath systems and collaboration at the systems level, and how we can start to think more broadly about what collaboration can look like and how we can support care for patients by working across systems and sectors.”

Originally from Barrie, Ont., Donnelly has been at Queen’s University since 2004. She still works clinically one day a week at the Queen’s Family Health Team’s site in Bellville, Ont.

Following Donnelly’s presentation, the event will feature four virtual lounges. Hosts from UM include Dr. Patty Thille, assistant professor, department of physical therapy, Dr. Moni Fricke, director of the Office of Interprofessional Collaboration, and Dr. Laura MacDonald, associate professor at the School of Dental Hygiene. Dr. Cathy Arnold and Dr. Teresa Paslawski from USask will also host a session.

“These will be informal discussions led by experts, much like being in a lounge, but from the comfort of home,” said Dr. Jacquie Ripat, event chair and associate dean of research at the College of Rehabilitation Sciences.

The virtual conference will conclude on Oct 2 with a panel presentation discussion on delivering remote education and health care, and conducting research using remote and virtual means.

Registration is still open. For more information and to register, visit the UM events calendar.

However, the students said, working from home did not get in the way of their valuable experience.

PIKE-Net, housed at the Rady Faculty of Health Sciences’ Indigenous Institute of Health and Healing – Ongomiizwin Research, is a student mentorship network program that provides a variety of supports and opportunities for undergraduate and graduate students interested in Indigenous health research.

This year, 14 students took part in 13 different Indigenous health research projects with guidance from 18 mentors.

“When the order to stay home happened, we were just starting the matching process between our registered mentors and interns, and it quickly became a scramble to see how we could adapt the program,” said Ashley Edson, PIKE-Net program coordinator.

She said mentors adapted projects to focus on Indigenous health and wellness issues around COVID-19, supported flexible work hours, and shifted all workshops to online. “It was challenging because the heart of this program has always been the relationships we build and the mentorship shared between each other.”

Nichol Marsch

Nichol Marsch, a Metis UM fine arts graduate, is part of the program for her second summer, as she prepares to enter the occupational therapy program in the College of Rehabilitation Sciences.

“My background is in the arts, but I’ve always had an interest in science, and this program has been a really good entry point into that field,” she says.

Marsch is working with mentors Dr. Cara Brown, department of occupational therapy, and Dr. Patty Thille, department of physical therapy, on a scoping review for a project on self-management education and support in Indigenous communities.

“It’s about how to deal with chronic illness in day-to-day life, which is especially important for communities that don’t have constant access to health care,” she says.

Marsch, 28, is originally from Winnipeg and grew up near Stonewall, Man. While working on her arts degree, she worked part-time in medical device reprocessing, which led to an interest in prosthetics and orthotics. She learned about occupational therapy while in PIKE-Net last summer.

“I thought it seemed like a really cool profession that aligns with a lot of my interests,” she says.

“The one pitfall is that we didn’t get to go into the communities this summer, but the college has community partners that they work with and they’re always looking for ways to engage with them that are helpful.”

Jordan Gelowitz

Third-year Max Rady College of Medicine student Jordan Gelowitz also joins the program for a second year. Gelowitz is working with Dr. Kellie Thiessen, associate professor, College of Nursing on a project about wellbeing associated with maternity care in northern regions.

“Our big question for the moment has been, ‘how do you define wellness from an Indigenous context?’” he says, noting his role involves reviewing feedback from the communities. This includes mothers who have delivered in their communities, those who delivered in Winnipeg, policymakers and health-care staff. “They each have their own perspective on the issue, and that is important. It has really brought to mind that health care is really complex.”

Gelowitz, 26, says his interest in maternity care goes back to his childhood, growing up in Big River First Nation near Saskatoon.

Gelowitz said he’d recommend the program to any Indigenous students who are interested in research that will make an impact.

“PIKE-Net is designed to learn research in a fun integrated way,” he says. “I found in medicine there are a lot of different research opportunities, but the thing I wanted was something that had more flexibility and more of a focus on Indigenous health.”

Zoe Quill

Third-year faculty of science student Zoe Quill joins PIKE-Net for the first time. The genetics major is working with clinical researcher Dr. Alison Dart and pediatric endocrinologist Dr. Brandy Wicklow at the Children’s Hospital Research Institute of Manitoba on the iCARE study, the largest observational study of youth with type 2 diabetes in Canada.

Quill, a member of Sapotaweyak Cree Nation near Swan River, Man., says the research is of interest to her because she’s known many people affected by the disease.

“The study is kind of unique because it determines not only the biological risk factors, but also the psychological and social factors – so their overall wellbeing,” she says.

As part of the research, Quill, 20, is doing phone surveys with affected families to determine how they’ve been coping with the effects of COVID-19.

“It’s been really great,” she says. “I know the pandemic has caused us to work from home, but I still feel like I’m working in-person. PIKE-Net and iCARE have really stepped up to make the most of this experience.”

“We need to strengthen our research capacity, especially at a time when there is significant health system change underway,” said Dr. Patty Thille, one of the event’s organizers. “Research capacity, in simple terms, is the ability to carry out research. It involves a range of actions, like enhancing skills and confidence at the individual, teams and community levels.”

In late 2019, Thille, assistant professor of physical therapy in the College of Rehabilitation Sciences, and Dr. Gayle Halas, chair of interprofessional collaborative practice for the Rady Faculty of Health Sciences, co-facilitated a meeting, which was funded and supported by the Manitoba Primary & Integrated Healthcare Innovation Network (MPN). The two-day event that brought together 49 researchers, clinicians, policymakers and community partners from across the province to begin identifying priority actions to build research capacity.

Top priorities identified were a commitment to equity, the creation of a “centre of excellence” that would serve as a one-stop resource for primary health-care research, and establishing a cross-Manitoba network that brings patients, policymakers and community partners together with researchers.

“It is important to develop a health-care system that meets the needs of people wherever they are, as opposed to building models and systems that tend work best for people who already have a lot of resources,” Thille said. “It’s a really relevant topic in Manitoba, where we still have the legacies of colonial oppression and some pretty notable disparities.”

The original planning committee for the initiative that  includes Dr. Jamie Falk, assistant professor in the College of Pharmacy, Dr. Alan Katz, director of the Manitoba Centre for Health Policy, and Dr. Roberta Woodgate, professor in the College of Nursing, has expanded to include MPN’s Policy Lead, Janie Peterson Watt, policy analyst with Manitoba Health, Seniors and Active Living, and MPN’s Clinical Lead, Tamara Buchel, director of postgraduate medical education at the Max Rady College of Medicine.

Going forward, the committee has included two patient partners, Dennis Maione and Mpho Begin, who were part of a group of five that took part in the November workshop.

“Dennis and Mpho were equal members in the discussion with research, clinicians and policymakers,” said Alanna Baldwin, MPN research and operations officer. “They were fully integrated into every aspect of the event as ‘lived-experience-experts.’ They were widely accepted by the other attendees, their opinions were embraced, and they really enjoyed the experience.”

A second conference will be held in the coming months, with exact location and date to be announced soon. There will also be a series of one-hour online discussions, the first of which will take place March 31 and is open to anyone who is interested. Because the discussion is online, it will not be affected by the closures related to the COVID-19 social distancing measures, Baldwin said.

The event was an expansion of the annual MOT Research Symposium, which showcases projects from students in the Master of Occupational Therapy program. This year it also included projects from other CoRS departments.

Dr. Barbara Shay, head of the physical therapy, said it was worth experimenting with an expanded format this year, as the students will be embarking on inter-professional careers.

“Some students said they were interested and happy to learn about their colleagues’ research, and that they were surprised how much their interests overlap,” Shay said. “But that’s what it’s all about, isn’t it? If we want inter-professional collaboration we need to model it in our education.”

The day opened with a keynote address by physical therapy assistant professor Dr. Patty Thille, who discussed the human side of the roles of caregivers. Occupational therapy student Andreea Alexandresu found Thille’s presentation inspiring and immediately relatable.

“She emphasized the importance of hearing patients’ stories and their experiences, which is also what we took away from our project,” she said.

Alexandresu and her team presented an interactive session on their community-based program people living with HIV, and the barriers they face in professional settings.

“Through our research and the experiences of our participants, we learned more about what a complex decision it is to disclose your HIV status, as well as the importance of sharing experiences and how empowering that can be for people living with a stigmatized illness,” Alexandresu said.

A poster from respiratory therapy student Hailey Graboweski looked at the implications of electronic cigarettes on a user’s cardiopulmonary health.

“Many people think electronic cigarettes are harm-free but they’re actually not,” she said. “They have many byproducts that are harmful on their own – chemicals, known carcinogens and even things like metals from the devices themselves.” 

She said it remains unclear whether or not electronic cigarettes should be considered an effective tool for tobacco harm reduction. There does appear to be a potential for cardiopulmonary benefits, but longer studies are needed, she said.

“As with smoking, we know it takes time to build the negative effects and I think electronic cigarettes may be the same,” Graboweski said.

Physical therapy student Jas Gill was part of a team that examined the effectiveness of FIFA 11+, a fitness module created by the FIFA world soccer federation to reduce lower body injuries in male and female footballers. 

“The two things we looked at were performance and injuries,” he said. “In terms of performance we didn’t find anything statistically significant, but we found that it does prevent injuries if people were to comply with it twice a week.”

M.Sc. Rehabilitation Sciences student Brenda Tittlemier said the event was a great opportunity for her to share her research into clinical practice guidelines.

M.Sc. Rehabilitation Sciences student Brenda Tittlemier presented a poster about whether physiotherapists in Canada were following clinical practice guidelines for knee osteoarthritis (OA), the most common form of arthritis in the knee.

Her research analyzed data from 388 respondents across Canada. She discovered nearly 100 per cent of physiotherapists provided leg strengthening exercise and education to their patients, whereas 60 per cent prescribed aerobic exercise and 56 per cent discussed weight-loss.

She said the event was a great chance to not only liaise with faculty, staff, researchers and students, but also clinicians and other health-care professionals.

“It was a great opportunity to talk about and share my research,” she said. “Disseminating your findings is an important step in the research process, and the chance to do that at an event such as this was a valuable opportunity.”

The event, previously called the Master of Occupational Therapy Independent Study Symposium, has been opened up this year to include student presentations from all programs housed within the college: Master of Occupational Therapy, Master of Physical Therapy, Bachelor of Respiratory Therapy, Master of Science (Rehabilitation) and Applied Health Sciences PhD.

Dr. Barbara Shay, head of the physical therapy department and one of the event organizers, said the symposium will continue to include all programs in the future, as it enhances inter-professional collaboration and consolidates research.

“All of the professional programs have a capstone project requirement related to research, and there is a natural fit with the thesis-based graduate programs which highlights the students’ accomplishments,” said Shay.

The event will begin with a keynote address from Dr. Patty Thille, assistant professor in the department of physical therapy. Thille’s research focuses on stigmatization, clinical communication, health behaviour change and chronic disease management in primary care and rehabilitation settings.

The Student Research Symposium will feature over 50 paper, poster and interactive sessions in the Brodie atrium (morning) and College of Rehabilitation Sciences building (afternoon).

More information, including a downloadable program, is available here.

The following article from by Patty Thille, assistant professor in physical therapy at the University of Manitoba, was published online on The Conversation:

When Ellen Maud Bennett died a year ago, her obituary published in the local newspaper gained national media attention in Canada, though she wasn’t a celebrity.

Bennett’s obituary revealed she died from cancer days after finally being diagnosed — after years of seeking help.

Her diagnosis came so late, beyond the point where treatments were possible, because the 64-year-old woman was repeatedly told her health problems were caused by her weight — or more specifically, by the amount of fat on her body.

She died because of bad assumptions that caused poor quality care. And she used her own obituary to share her dying wish:

“Ellen’s dying wish was that women of size make her death matter by advocating strongly for their health and not accepting that fat is the only relevant health issue.”

How to know if this might be happening to you? When do you need to advocate for yourself? I studied the phenomenon of anti-fat stigma in Canadian primary care clinics for my PhD. Knowing how it happens might help.

Fatness as a sign of inferiority

Bodily fatness is a stigmatized body characteristic in Canada and other wealthy countries.

Within any given culture, some characteristics or histories are assumed to reflect a character flaw. The characteristic is treated as a sign of inferiority. The result is loss of social status and widespread societal discrimination.

With bodily fatness, the assumed character flaws are laziness, ignorance or weak willpower.

In a comprehensive review published 10 years ago, there was strong evidence of fatness-related discrimination in employment, while other sectors were less researched. Studies carried out since that time confirm the pattern — including within health care.

‘Just eat more salads’

Poor quality clinical care due to anti-fat stigma occurs when doctors or nurses assume the stereotype holds true.

One common way this happens: a clinician simply tells you to “lose weight,” as Bennett heard many times when seeking help. That’s like telling patients to “lose blood sugar.” Telling people to produce an outcome is not good quality clinical care.

This is especially awful when weight is not related to the topic at hand — an ear infection, for example. Sometimes, clinicians do this as “opportunistic counselling.” It’s done assuming the benefits outweigh harms — except we know that doing this for weight reduces trust in health-care providers. And reduced trust can lead to avoidance, for obvious reasons — needs aren’t met.

After years of feeling unwell & seeking help only to be told that the problem was simply her weight, Ellen Maud Bennett was diagnosed with terminal cancer & given only days to live. When fat people say fat hatred kills us, this is what we mean. https://t.co/mWhsocWJGo

— Dr. Nadia Mohd Rasidi (@nrasidi) 25 July 2018

This article is written in memory of Ellen Maud Bennett, with the permission of her sister.

“There are strong stereotypes around bodies that are thin or bodies that have visible fat,” Thille says. “And we know from qualitative studies that people experience poor treatment in health-care settings in relation to the fatness-related stereotypes.”

Thille, who grew up in Rosthern, Sask., has a physical therapy degree from the University of Saskatchewan, a master’s degree in women’s studies from a tri-university program in Halifax and a PhD in sociology from the University of Calgary. She recently joined the U of M in a position that allows her to dedicate 75 per cent of her time to researching the intersections of primary care and rehabilitation.

She was drawn to research on weight stigmatization through her clinical experience, as well as from being a patient. While practising as a physical therapist in Saskatoon from 1998 to 2002, she regularly witnessed weight-based stereotyping.

One incident involved an insurance company that tried to dismiss a 450-lb. man’s chronic pain as being due to his weight, rather than his car accident.

“If you insure people, you insure all people, and people come in all sorts of sizes, shapes and pre-existing histories,” Thille says.

The professor sees her research as part of a larger movement that can lead to a change in clinical culture, where professionals look past preconceived ideas about body type.

“A very common thing clinicians say is: ‘If you just lost weight, you would be healthier,’” she says, noting that in some cases, major health problems can be overlooked because of this mindset.

She points to the high-profile obituary of Ellen Maud Bennett, a British Columbia woman who died earlier this year from cancer that went undiagnosed because doctors repeatedly told her she simply needed to lose weight. In her obituary, Bennett advocated for “women of size” to not accept these harmful non-diagnoses.

“She was feeling very ill for years, and it was only when she was at the palliative point that somebody finally diagnosed her with cancer, and she died days later,” Thille says. “Her story is not an anomaly.”

Health-care professionals, Thille says, need to stop giving simplistic messages about weight, complete the same assessment as they would of others with thinner bodies, and shift toward an understanding that everyone is not built the same, for a variety of reasons.

“One of the ways things change is by showing that it can be done differently, and then you can figure out how to help people change their own practices,” Thille says.

In a study published this year in the journal Health Communication, Thille analyzed audio recordings of about 30 adult patients’ appointments at primary care clinics. Comparing what was said about blood pressure and weight, she found that doctors often mentioned a variety of factors that can affect blood pressure, but rarely did the same for weight.

When their weight was brought up, patients spoke in ways that tried to manage or deflect anti-fat stigma, regardless of their body size.

“We’ll make progress if clinicians and researchers recognize that patients’ defensiveness or sensitivity is a predictable response to a perceived stereotype threat. This is a learned response related to constant negative judgments about fat bodies,” Thille says. “It’s not a show of weakness or avoidance.”

Thille’s work has always had a strong grounding in patient experiences and concerns, as captured by other researchers. One of her next steps is to create a public engagement strategy for her own research.

“Working directly with the public to design research helps ground our work in community concerns,” she says. “And with involvement of the public, many exciting knowledge translation possibilities open up.”