This page describes an event hosted by the Centre for Research in Women's Health. The researchers and research programs of the Centre are now part of the Women's College Research Institute (WCRI) which continues to host an annual Graduate Student Research Day.

CRWH held its fifth annual Graduate Student Research Day on Friday, May 12th. The day featured a dynamic program of young investigators as well as an invigorating keynote address by Dr. Anne Fausto-Sterling.

Dr. Anne Fausto-Sterling, a noted researcher and writer, who strives to engage scientific knowledge in social and political debates about gender and sexual identity. Her keynote - The Bare Bones of Sex - examined how nature and culture shape the development of our bones.

Use this link to review a Web cast of this keynote, The Bare Bones of Sex. (keynote begins as 11:20)

CRWH would like to thank the The Status of Women Office and the Women and Gender Studies Institute at the University of Toronto for co-sponsoring the keynote address.

The day continued with six multi-disciplinary presentations of student work, running in three concurrent sessions. A full schedule of the day's presentations is available here.

A number of students were honoured for their presentations at this year's Graduate Student Day. Abstracts of the student's presentation are linked to their name, below.

Content, Clarity, Context Awards
Hamid H Shariff
Paola Ardiles

Pushing the Envelope Awards
Helen Pearman Ziral
Loshi Shanmugathasan

A special award honouring the spirit and inspiration of Anne Fausto-Sterling was also presented to Yan Lu.

Imaging Breast Cancers using Radial Modulation Imaging, A New Ultrasound Contrast Imaging Technique
Shariff, Hamid H. (M.Sc Candidate), Department of Medical Biophysics, University of Toronto
Imaging Research, Sunnybrook and Women's Collage Health Sciences Centre, Toronto, Canada

Research Collaborators: Hamid H. Shariff (M.Sc Candidate, Presenter), Peter D. Bevan, Raffi Karshafian and Peter N. Burns

Mammography is now established as a gold standard in screening and diagnosis of breast cancers and use ionizing x-rays. Exposing women's breast to ionizing radiation may induce breast carcinomas that may appear in later years of their lives. Ultrasound imaging of breast is a non invasive and uses no ionizing radiation. Angiogenesis predicts the progression of solid cancer and describes the formation of new blood vessels that provide the blood containing oxygen and nutrients to the tumor. Detecting microbubbles where there is low blood flow such as in angiogenesis is challenging. Pulse inversion and other current contrast imaging techniques for ultrasound rely on same frequency to induce bubble resonance and to form the image, because these resonant frequencies lie between (2-4MHz), the resulting ultrasound images lack the spatial resolution needed to detect microbubbles in small blood vessels typically associated with angiogenesis in a superficial cancer. The principle of "Radial Modulation Imaging" a bubble driven by ultrasound below its resonance will oscillate out of phase with one driven above its resonance. Our in-vitro experiments with two-transducer model have shown the feasibility11 of this method and gave excellent contrast-to-clutter enhancement of 35dB and results showed extreme sensitivity to phase. When implemented by Doppler processing 'Radial Modulation Doppler' will make imaging human microcirculation a reality. Radial modulation offers a means of decoupling the imaging and excitation frequencies in contrast imaging for ultrasound, and hence a potential method for high frequency, high-resolution contrast imaging using currently available contrast agents. This may revolutionize the detection and diagnosis of breast cancers using ultrasound.

Acknowledgement: This work is supported by, the Terry Fox Programme of National Cancer Institute of Canada, Canadian Institute of Health Research and ORDCF.

The cultural context of postpartum depression in immigrant women: results from a qualitative and quantitative study.
Paola Ardiles (MHSc candidate), Public Health Sciences, University of Toronto

Research Team: L Mamisachvili, G Mancewicz, K Rabin, N Stuckless, S Thompson, L Ross (PI)

Background and objective of study:
Approximately 13% of women experience depression after giving birth. Little is known about variables that may influence the experience of postpartum depression (PPD) in immigrant women and women from diverse cultural backgrounds. A multidisciplinary team has designed this study to identify the role culture may play in the presentation of PPD, how women from various ethnocultural backgrounds perceive and attribute their symptoms of PPD, and finally, how culture can be appropriately addressed in PPD treatment programs.

Method:
Semi-structured interviews and self-report questionnaires were administered to clients of the St. Joseph's Health Centre, Toronto. Participants were identified as first generation Canadians (N=8) or second generation Canadians (N=6). Data were collected on these two groups of women based on: severity of depression, symptom presentation, perceived role of social support and culturally-specific traditions, barriers and responses to treatment.

Findings and Implications:
The following themes have been identified from the interviews:
1) stress about passing on culture to children,
2) lack of social support,
3) perceived importance of culturally based traditions,
4) conflicts about cultural traditions and beliefs,
5) mental health stigma, 6) race- and sex-based discrimination, and
7) language barriers.
Identifying the role culture plays in the presentation of PPD, and how women from diverse backgrounds perceive and attribute their symptoms of PPD, is critical in order to establish culturally appropriate guidelines for treatment options. Results from this study can be used to develop policies and resources for delivering culturally competent care for newcomer women dealing with PPD.

Acknowledgement: This work is supported by the St. Joseph's Health Centre Foundation

Creating WE: Integrated Healing Herstories
Helen Pearman Ziral (PhD Candidate), Adult Education Collaborative Program in Women and Gender Studies, OISE/UT

Doctoral work in progress
Discussion of Quilt as Metaphor, Method and Modality

My doctoral research explores the nature and consequences of spirit injury. Focus group participants, drawing on women's ways of knowing, were invited to co-create representations of their fragmented herstories into a tangible composition - a quilt. The quilt as metaphor, modality and method provided a medium to discuss intergenerational angst passed down within the female line. Traditionally, women engage in story sharing while performing routine, even creative tasks - such as preparing meals, or fashioning a quilt. Such stories are revealing. Through narrative discourse, with the co-created tapestry as catalyst, the women give voice to oft unspoken (spirit) injury.

This research represents the lived experiences of a group of women who design a thing of beauty that captures and helps heal and liberate their injured spirits. In Creating WE, I endeavoured to change the paradigm, and have us consider how to create an environment where the I can live in health as part of the WE.

When women use the co-creating process, they are liberated from languishing in solitary angst, and enter a space that enables each to give voice to pain previously suppressed. Is it that by focusing on the co-creative task, the I lives inside the WE? Therefore, through the modality of co-creation, the I contributes, has value, is appreciated, and experiences the beginning of spirit healing, joining the collective WE with a rejuvenated sense of inner strength.

A Retrospective Analysis Of Accuracy Of Antenatal Diagnosis And Characterization Of Practice Patterns In SPP And PDU, A Single Centre Study.
Loshi Shanmugathasan, Institute of Medical Science, Master of Science, University of Toronto

Supervisor: Peter Kim, Pediatric General Surgeon, Hospital for Sick Children

Work in Progress

Every pregnancy has a 3% risk of having a child with a major congenital abnormality. In Toronto, two departments the Special Pregnancy Program (SPP) and the Prenatal Diagnosis Unit (PDU) cares for a large number of Ontario's high risk pregnancy cases. The antenatal diagnosis is a predictive marker for postnatal outcome. To date, best practice guidelines and standards have not been determined in treating these patients in either department. As the first of its kind, the database will determine the accuracy between antenatal and postnatal outcome in pregnancies with congenital anomalies in both departments. Secondly, the database will help to understand the differences if any, in practice patterns between SPP and PDU and whether this affects the antenatal care a woman and her baby receives. Over 25 000 charts will be reviewed in generating a retrospective database of all pregnancies diagnosed antenatally with congenital anomalies for the years 2002, 2003 and 2004 in the departments of SPP and PDU. This study will provide novel results that will help to understand how to provide the best prenatal care for women with high risk pregnancies and how to set out the best postnatal management procedures for both the baby and the family.

Levels of Chronic Pain in Women Postmastectomy are Controlled by Inheriting Certain Variants of the COMT Gene
Yan Lu, Faculty of Dentistry, University of Toronto, Canada

Research Team:Y. LU1, I. BELFER2,3, E. GERSHON4, J. LIVNEH5,6, Y. SHIR7, J.-J. VATINE8, T. JABLONSKI-PERETZ9, R.M. PFEFFER6, H. HIPP3, M.B. MAX2, D. GOLDMAN3 and Z. SELTZER1 1Faculty of Dentistry, University of Toronto, Canada; 2National Institute of Dental and Craniofacial Research, NIH, Bethesda MD, USA; 3National Institute of Alcohol Abuse and Alcoholism, NIH, Bethesda MD, USA; 4Haifa University, Haifa, Israel; 5Faculty of Dentistry, Hebrew University, Jerusalem, Israel; 6Sheba Medical Center, Ramat Gan, Israel; 7McGill University, Montreal, Quebec, Canada; 8Faculty of Medicine, Tel Aviv University, Israel; and 9Sharett Institute, Hadassah University Hospital, Jerusalem, Israel.

Background: Catecholamine-O-methyltransferase (COMT) catabolizes several pain-suppressing neurotransmitters in the brain. Recent reports associated genetic variations in COMT with levels of acute pain. However, reports associating these variations with chronic pain presented conflicting results. Objective: We assessed whether variations in this gene are associated with a syndrome of chronic pain that develops in ~50% of women postmastectomy (PMPS). Methods: We collected DNA samples of 315 Israeli women >1yr following mastectomy/lumpectomy and lymph nodes dissection to treat breast cancer, and grouped them as having chronic pain or pain-free. COMT single nucleotide polymorphisms (SNPs) rs2097903, rs6269, rs4633, rs4818 and rs4680 were genotyped and examined for association with PMPS using multivariate logistic regression, adjusting for confounding covariates (age, ethnicity and surgery type). Haplotypes, reconstructed using PHASE software, were explored for association with pain chronicity. Results: Significant association was found between having PMPS and rs6268 genotypes (G_A vs. A_A; odds ratio (OR)=2.6, P=0.0084), rs4818 genotypes (C_G vs. C_C; OR=2.7, P=0.0047), and val158met rs4680 genotypes (G_A vs. A_A; OR=2.4, P=0.024). Linkage disequilibrium analysis confirmed the existence of two haploblocks, one of which contained the three significant SNPs. GCGG and ATCA hapolotypes accounted for >90% of COMT haplotypes. PMPS was significantly more associated with the GCGG_ATCA than the ATCA_ATCA diplotypes (OR=2.9; P=0.0086). Some of these results were still significant after adjustment using the False Discovery Rate. Conclusion: Risk for developing PMPS is significantly associated with certain COMT polymorphisms.

Acknowledgements: Canadian Foundation for Innovation, Ontario Innovation Trust, Algogene Pain Genetics, and Canada Research Chair Program.