Researchers Under the Scope University of Saskatchewan, OVDR, College of Medicine

 
Dr. Sabira Valiani was one of the frontline physicians working inside Saskatoon’s critical care units four years ago, during the initial lockdowns of the Covid-19 pandemic.
 
“It was really weird,” said Valiani.
 
Valiani said ‘a lot of light bulbs went off in my head’ amid the automated stillness of the unit, as she watched ventilators breathing for heavily sedated patients.
 
Covered in head-to-toe personal protective equipment, staff in the intensive care unit struggled to simultaneously treat patients, communicate with family members, and enforce hospital policies. 
 
“Those patients aren’t talking to us,” Valiani said.  “It was empty, it was overwhelming and it was disconnected all at the same time.”
 
Valiani has now spent seven years in critical care, a move that started with her enrolling in a critical care and ICU elective in Ottawa. 
 
“I loved it. I loved on the medical side, how you could see the life support that you were giving a patient immediately have a physiologic effect and stabilize that patient,” she said. 
 
Driven by her experiences during the pandemic, Dr. Valiani delved into research focused on improving patient and family experiences in the ICU. She collaborated with a multidisciplinary team and patient partners to understand the challenges faced by healthcare providers and families alike.
In this article for the Canadian Association of Critical Care Nurses, she and her colleagues examined the effect of visitor restrictions during the pandemic.
Valiani remembers tearful goodbyes, families gathered around screens, unable to hug or touch loved ones infected and dying with Covid-19.
"The family's role becomes significantly diminished,” she said. “So much of that was disrupted during that time." 
In the months and years that followed, visitor restrictions relaxed, but Valiani noticed communication between families, patients and staff still felt awkward.
 
Valiani and her colleagues turned their lens last year to key moments for Canadians of diverse ethnicities during the critical care journey, in the Canadian Journal of Anesthesia. The findings revealed the strain on healthcare providers playing multiple roles and families feeling disconnected from crucial information.
She estimates 30 per cent of Saskatoon’s ICU patients travel from remote communities, making it crucial to find ways to keep family members informed in a language they understand well.
 
“People kind of naturally turned towards communication technology in the pandemic,” said Valiani, noting a number of families cannot be present in-person during the day, as intensivists attend rounds. 
Clear and open communication between patients, care providers and families is the key, Valiani said.
 
“What if we could use artificial intelligence or AI to just translate a medical progress note into an understandable family update?” Valiani asked. 
“It doesn't have to be high tech, right? Like it can be a phone call.”
 
Together with the Saskatchewan Health Research Foundation, Dr. Valiani now works at enhancing patient-family engagement through practical solutions. She emphasizes the importance of involving families in care decisions, acknowledging their unique expertise in understanding patients' wishes.
Her team presented its findings in 2022 at Toronto’s Critical Care Canada Forum.
 
“We have this cohesive approach to defining the problems,” said Valiani. “Now we can take this to decision makers and say….these are the things people living this experience actually want.”

Daphne Yau can trace her interest in endocrinology back to a beta-cell physiology experiment during her master’s degree,  working with laboratory mice with Type 2 Diabetes.
“It was the part of the pancreas that makes insulin,” she said. “It was fascinating. It also made me realize that maybe pure laboratory research wasn't quite for me."
From there, her interest in hormones and fluctuating blood sugar levels grew.
Yau is no stranger to medicine. Her mother was a pharmacist, while her father and aunt both worked as physicians. Following in their footsteps, Lou completed her pediatrics residency at Queen’s University, with fellowship training at McGill. She then focused on congenital hyperinsulinism at the Children’s Hospital of Philadelphia and Royal Manchester Children’s Hospital.
She still remembers her residency, and meeting a premature baby with a rare genetic disorder  in neonatal intensive care.
“The blood sugars were horrendously low right from the start,” Yau said. “Their brain uses most of that glucose, so that's why it's so critical in that period that they get a steady supply.”
Together with an endocrinologist and a multi-disciplinary team, Yau and her colleagues traced back the root of the hyperinsulinism — the infant’s mother and grandmother also suffered from rare forms of diabetes.
Unregulated, plummeting blood sugar levels in infants can cause brain injuries and permanent neurological damage, Yau said.
“Your brain can't really store much in the way of glucose and it can't make it on its own the way some other tissues and organs in the body can,” said Yau.
“If you test a child who's had hypoglycemia when they're two or four, you may not actually pick up on this. Not till maybe later on, when they're in school and they're struggling.”
Yau joined the College of Medicine five years ago as a pediatric endocrinologist and assistant professor of pediatrics. Today, she’s based at the Jim Pattison Children’s Hospital. Her research focuses on understanding and addressing congenital hyperinsulinism, as well as screening for diabetes and other metabolic disorders.
In this episode, Dr. Yau pointed to recent success with a project inspired by Dr. Mark Inman. Together, their team is trying to improve diabetes screening and education in northern Saskatchewan, particularly for Indigenous children and teenagers.
She said the heel prick hospitals often perform on newborns inspired them.
“Could someone at home prick their finger, put some few drops of blood on this card and have their A1C measured that way as opposed to having to go to the lab?” Yau said.
The results to date show promise, which could make it easier to screen young patients in remote communities for diabetes.
Yau is also working with researchers in the United Kingdom who study blood sugar dysregulation in infants, exploring alternative treatments and lower doses of medications such as diazoxide, to mitigate side effects.
“What are the levels we really should be targeting to minimize the potential for long-term harms?”

Haissam Haddad inadvertently horrified his family when he signed up for engineering courses in his first year of university.
The teenager returned the next day to change his major to medicine -- a move he's glad he made.
Dr. Haddad practiced family medicine in Syria for three years, then arrived in Canada in 1986 to visit his wife's family, who urged him to stay.
Haddad faced an uphill battle when he investigated the possibility of becoming a Canadian doctor. One colleague even told him he’d be better off opening a Syrian grocery store.
“This gave me a lot of energy to prove him wrong,” said Haddad.
His early years in Canada were characterized by relentless perseverance, as Haddad confronted the arduous process of certification and integration into the medical system. He focused on learning English every weekday, picking up back-to-back twelve-hour shifts at a Halifax laundromat every weekend, to support his family.
“The first day it took me, like, almost 16 hours to read one page,” Haddad said. “I had no option to fail.”
After three years of English lessons and intensive studying, Dr. Sam Haddad earned a passing score on Canada’s medical licensing exam.
In this episode, Dr. Haddad recounts pivotal moments that steered him towards cardiology, including formative experiences in cardiac surgery during his residency at Dalhousie, which took place during the HIV epidemic.
“I’ve always liked the heart,” said Haddad. "I decided to do cardiology because it has less blood and less risk.”
Haddad’s dedication to improving patient outcomes through research soon became evident, as he tackled clinical gaps and treatment efficacy in heart failure management and heart transplant protocols.
“Almost on a weekly basis, you have a patient who did not respond to the usual treatment,” said Haddad. “This is the research question. How come this patient is not getting better?”
As his expertise grew, Haddad became one of only two Canadian cardiologists who were part of the National Institutes of Health Heart Failure Network. His patients took part in clinical trials that led to significant advancements. 
“A lot of our patients didn't have private insurance,” Haddad said. “We can do a lot of work to help patients who are not able to buy their own medication."
Haddad led the cardiac transplant and heart failure programs at the University of Ottawa’s Heart Institute, exponentially increasing the number of transplants performed. At the same time, he said at cardiovascular medicine was making revolutionary strides with artificial hearts and improved anti-rejection medications.
When he began, half of heart failure patients died within a year. Now, over 90 per cent survive.
After moving to Saskatoon to become Saskatchewan’s Provincial Head of Medicine in 2016, Haddad continued his clinical practice, taking on leadership roles in medical education and research.
Instrumental in recruiting almost half of the specialists practicing in Saskatchewan today, Haddad also established the University of Saskatchewan Cardiovascular Research Group, fostering a collaborative environment for innovative research initiatives.
Last year, Dr. Haddad was appointed as an Officer of the Order of Canada..
“Nothing comes easy,” said Haddad. “You have to work hard. You have to fail multiple times before you're successful.”

In this episode, we meet Dr. Stacey Love, Director of Virtual Physiotherapy and Rehabilitation at Saskatchewan's Virtual Health Hub, and an Assistant Professor at the University of Saskatchewan's School of Rehabilitation. She's also involved with the Saskatchewan Centre for Patient Oriented Research.
You can see more of her recent publications here, along with links to her labs:
Musculoskeletal Health and Access to Care: https://cchsa-ccssma.usask.ca/mhac/

Virtual Care and Remote Presence: https://research-groups.usask.ca/remote-presence/index.php#Healthcare

Stacey Lovo remembers the bitterly cold day in December 2012, when two Indigenous women from northern Saskatchewan stepped off the bus in Saskatoon. One had traveled 12 hours, the other seven, both to see physiotherapist Stacey Lovo for back pain.
 
“It was a big undertaking for them,” said Lovo. She said one woman was forced cut her appointment short, to catch the last bus returning north.
 
The other woman stayed in Saskatoon to treat spinal pain stemming from what Lovo characterized as a ‘very difficult and scary problem.’
 
“This was devastating for many reasons,” said Lovo who remembered her patient was distraught, unable to return home to care for her young children.
 
That glaring disparity in healthcare access propelled Dr. Lovo into action. She returned to the classroom, and earned her PhD in Rehabilitation Science, specializing in low back disorders.
 
“If you're rural and remote resident or if you're Indigenous, your chances of having back pain are 30 percent higher than an urban person who's non-Indigenous,” said Lovo.
 
Lovo said long waits for care and spending up to twelve hours in a vehicle to attend a one-hour physiotherapy consultation often aggravate spinal damage — rather than healing it.
 
“When we're traveling that distance, we're undoing everything that's done in the session,” she said.
 
Working closely with people in Pelican Narrows and the Peter Ballantyne Cree Nation, Dr. Lovo began testing virtual consultations and in-person treatments, advocating for a hybrid model of healthcare.
 
"These projects are all community driven,” she said. “They’re led and driven by the strengths and knowledges from the communities."
 
Her team’s innovative use of Remote Presence Robotics in partnership with local nurse practitioners  in Pelican Narrows demonstrated a successful model of team-based virtual physiotherapy, connecting patients hundreds of kilometres away from health providers with care.
 
Local health providers are the key, Lovo said.
 
“Taking reflexes and testing for sensation and muscle strength are done by the nurse on the other side,” said Lovo.  “They have incredible rapport with the patients. They know their families.”
 
When the pandemic amplified the need for virtual care, Dr. Lovo, Dr. Brenna Bath  and Dr. Lovo's graduate students met the challenge with innovation.
 
Participants in her back pain study reported their outcomes were noticeably better. Many asked to continue with more treatments.
 
Dr. Lovo's work goes beyond healthcare delivery; it is a commitment to fulfilling treaty obligations and ensuring equitable healthcare access for Indigenous Peoples.
 
“Canada's promise to First Nations peoples was that medical care would be taken care of, and so we are  working with communities to try things out that will allow us to provide it,” she said.

Dr. Angelica Lang knows most of the people she sees have to keep working, even if they have shoulder pain.
 
As an assistant professor at the University of Saskatchewan and director of the Musculoskeletal and Ergonomics Lab at the Canadian Centre for Rural and Agricultural Health, Lang’s goal is to reduce that pain — keeping patients on the job.
 
“A lot of daily life has to be done with your hands,” she said. “The base of that is your shoulder. It allows you to position your hand in all these different ways.”
 
Lang knows the importance of movement. She grew up in Melfort, Sask., playing hockey, soccer, volleyball, along with track and field. A Huskies track athlete, she found her calling in kinesiology, leading her to a specialization in the clinical biomechanics of the shoulder.
 
Her passion for understanding the shoulder, a joint unique in its movement and demands, drove her towards an MSc in Biomechanics under Dr. Clark Dickerson, a shoulder expert.
 
"This combines math, which I already liked, with movement, which I'm really getting into," she said. “How you perform your work, how you get injured at work, or how a different disorder might influence your movement, and then cause a functional problem.”
 
Lang said at least 40 per cent of people who suffer from a rotator cuff injury still endure shoulder pain up to a year later. That pain can cause sleep issues, and eventually it becomes unsustainable.
 
“My question is, does it matter how long you’ve had pain?” she said. “Is it the way that they move that’s setting them up to not necessarily get better?”
 
Her laboratory is one of the first to look at the time elapsed since an initial injury, and the role of ongoing shoulder pain as a confounding or influencing factor in that patient’s recovery.
 
“Once the pain happens, there's some sort of compensation to avoid these painful positions,” said Lang, whose research team is studying 60 people from Saskatoon and rural Saskatchewan, to assess differences in shoulder pain.
 
A significant part of Lang's work involves the musculoskeletal health of breast cancer survivors, particularly those who’ve undergone mastectomies and reconstructions.
 
"It's fairly well documented that breast cancer survivors have upper limb dysfunction after their treatment,” Lang said. “I’m interested in what that means for their functional abilities.”
 
Participants in those studies often make periodic trips to Saskatoon, for assessments at the Musculoskeletal and Ergonomics Lab at the Canadian Centre for Rural and Agricultural Health.
 
In this episode, Lang shows us the “Rotopod” farm equipment simulator, designed to simulate the seated position farmers often stay in for long hours during seeding, spraying and harvest.
 
Her team examines movement and biomechanics in agricultural settings, particularly how whole body vibrations from machinery affect farmers. They use advanced motion tracking systems, like the Vicon motion capture system and Inertial Measurement Units, to study body movement in various scenarios, both in the lab and when research crews drive to farms and mines across Saskatchewan, to observe work duties in the field.
 
Last summer, her team visited farmers on the job near Aylesbury, Biggar, Clavet, and Debden, Saskatchewan. They tracked their movement as they performed five tasks, including using an overhead drill, lifting a shovel, climbing and dumping a heavy bag, and pruning a shrub. Lang and a pair of graduate students watched farmers put cattle through a squeeze chute — a task that can be challenging for both the operator and the animal.
 
“It’s something we never would have been able to measure had we only had them come to the lab,” said Lang. “By being able to be specific to their job and make the recommendations specific to farming demands, hopefully that will help.”
Throughout the conversation, Dr. Lang credited

Dr. Munier Nour said osteoporosis is often seen as a disease that affects older adults. But compared to their peers, kids with Type 1 diabetes grow into adults eight times as likely to suffer bone fractures.
 
“Osteoporosis may actually have its origins during pediatric years,” he said. “Because Type 1 diabetes occurs so early in life ….. it influences that bone development that occurs during your peak growth.”
 
Now, Nour is a co-lead on a national team trying to figure out why.
 
The pediatric endocrinologist has always taken a logical approach to problem-solving. When he first enrolled at the University of Calgary, he took engineering courses, in case medicine didn’t work out.
 
Nour was accepted to medical school, where he found himself drawn to both pediatric intensive care and internal medicine, until one last-minute elective.
 
In this episode, Nour credits his supervisor, retired University of Calgary professor Dr. David Stephure, with changing his mind.
 
“It certainly wasn’t on my radar at all,” said Nour. “He was just a wonderful mentor. I think he really kind of sparked quite an interest and passion to pursue pediatric endocrinology.”
 
Nour completed his fellowship at the University of Calgary, along with his medical doctorate and master's degree in biomedical sciences. He completed his pediatric residency at Queen’s University, then joined the University of Saskatchewan’s College of Medicine in 2014. He spent his first year as the province’s lone pediatric endocrinologist.
 
Since then, the associate professor has embarked on a mission to understand why children with Type 1 diabetes exhibit a higher risk of impaired bone health and osteoporosis than their peers.
 
Nour said although it’s often overlooked as an endocrine organ, bone is ‘quite dynamic’, playing a crucial role in hormonal regulation.
 
“Some hormones produced by bone include things like fibroblast growth factor-23 (FGF23), which has a lot to do with our phosphate metabolism. As well, there's another hormone called osteocalcin, which actually has quite a role in diabetes as well,” said Nour.
 
Today, he and Dr. Saija Kontulainen are overseeing the Canadian Bone Strength Development in Children with Type 1 Diabetes Study: a national longitudinal study.
 
Using a grant of $1,352,140 from the Canadian Institutes of Health Research (CIHR) and with help from Diabetes Canada, they’re evaluating differences in bone development between children with Type 1 diabetes and their peers.
 
Dr. Nour said they’ll recruit up to 210 boys and girls between the ages of 10 and 12, tracking them over three years with annual bone health assessments. The study includes Saskatchewan patients, along with pre-teens in Calgary, Toronto and Ottawa.
 
Using high-resolution peripheral quantitative CT scans (HR-pQCT), hormonal measurements, muscle strength testing, bone density scans, and force plate tests, his team will assess key markers and differences in bone micro-architecture as the preteens’ radius and tibia grow.
 
“There's even fairly advanced engineering techniques that can be used to kind of simulate a fracture load and see when that bone would actually fail," said Nour.
 
Dr. Nour hopes this research will lead to interventions for children with type 1 diabetes that potentially strengthen their long-term bone health.
“So little is understood right now about what is different and why,” said Nour. “What can we do to prevent it?”