Publications

Note: OA = Open Access. These articles can be accessed by any person in any location.

For all other articles, journals have subscription based access plans. Please see your local university library, purchase the article individually or contact the author(s) directly. If you have any questions about the process to access articles please contact Jenna Dixon.

GET-FACTS reports

Elliott, S.J., Burnett, L., Dixon, J. & Shantz, E. (2018). Performance Measurement Framework GET-FACTS integrated Knowledge Translation. [PDF]

GET-FACTS publications

OA - Dixon, J., Elliott, S.J. & Clarke, A.E. (2017). The Co-Production of Biomedical Ressearch in Canada: Are Scientists Ready to Take the Plunge? An Empirical Example from Food Allergy Research. Universal Journal of Public Health. doi: 10.13189/ujph.2017.050501

Abstract

End-user involvement in research through collaborative research models, known as Integrated Knowledge Translation (IKT) in Canadian health, can improve recruitment, quality, relevance and acceptability of research. Despite potential benefits, application to biomedical research remains rare. This study aims to explore baseline knowledge, attitude and practices of Canadian biomedical scientists towards IKT as a foundation for a funded program of research related to causes and treatments of an emerging public health epidemic. A qualitative methodology was used. Semi-structured in-depth interviews were conducted with all 16 scientists on the GET-FACTS project. Interviews were audio-recorded and transcribed verbatim. Thematic content analysis was performed on the data. Findings highlight the limited exposure of biomedical scientists to IKT activities. Though Knowledge Translation (KT) was a term familiar to participants, most described it as end of grant activity (not 'integrated'). A majority of participants expressed that their research could take on a new direction or focus with the input of end-users, would prove to be a valuable research tool, and that IKT could help researchers think creatively about problems. All participants acknowledged challenges associated with this approach to research. We argue that biomedical scientists are open and eager to engaging in IKT but are held back by a lack of concrete examples and experiences to draw on. Integrating end-users and research scientists is an important step in ensuring end-users receive the research knowledge they require and that research is created to address their pressing needs.

OA - Dixon, J., Elliott, S.J. & Clarke, A.E. (2016). Exploring knowledge-user experiences in integrated knowledge translation: a biomedical investigation of the causes and consequences of food allergy. Research Involvement and Engagement. doi: 10.1186/s40900-016-0043-x

Abstract

Background: Despite the burden of food allergic disease many questions remain as to its origins, determinants and best practices for treatment. Formed to tackle these very questions, the GET-FACTS (Genetics, Environment and Therapies: Food Allergy Clinical Tolerance Studies) research study centers around a novel concept in biomedical research: in order to make this science useful, knowledge creation must include meaningful interactions with knowledge-users, known as Integrated Knowledge Translation (IKT). In IKT, knowledge-users are present at every stage of the research and are crucial, central and equal contributors. This paper contributes to this exciting form of research by reflecting on the beginning of that journey from the perspective of the knowledge-users.

Methods: Semi structured in-depth interviews were conducted in year 2 of the 5 year GET-FACTS project with all (n=9) non-research members of the GET-FACTS steering committee, representing Canadian organizations that deal with patient advocacy and policy with regards to food allergy. Transcripts were coded and organized by themes developed both deductively and inductively.

Results: Steering committee members indicated a clear sense that scientists and knowledge-users are equally responsible for the translation of knowledge into action and the importance of consulting and integrating knowledge-users throughout research. Overall, these knowledge-users have very high expectations for the GET-FACTS IKT process; they feel that this model of doing science will create better scientists (e.g. improve communication skills) and make the resulting science more useful and relevant; indeed, they reported that this model of knowledge creation can be paradigm shifting.

Conclusions: This study highlights both the unique contributions that knowledge-users can offer to knowledge creation as well as the challenges of trying to unify members from such different communities (policy/advocacy and biomedical science). While our steering committee has a strong conceptual grasp on IKT and vision for their contributions, execution is not without challenges. There remains a real need to develop more touch points and opportunities for collaboration if true integration is to be achieved. Despite the obstacles, the GET-FACTS IKT model represents a new approach to knowledge creation in Canadian biomedical research and can help foster a culture of openness to participant involvement.

Plain English Summary

Food allergy is a serious public health problem in Canada and other high-income countries, as it is potentially life threatening and severely impacts the quality of life for individuals and their families. Yet, many questions still remain as to its origins and determinants, and the best practices for treatment. Formed to tackle these very questions, the GET-FACTS research study centers on a novel concept in biomedical research: in order to make this science useful, knowledge creation must include meaningful interactions with knowledge-users. With this, knowledge-users are present at every stage of the research and are crucial, central and equal contributors. This study reflects on the early part of that journey from the perspective of the knowledge-users. We conducted interviews with all non-research members of the GET-FACTS steering committee, representing Canadian organizations that deal with patient advocacy and policy with regards to food allergy. Steering committee members had a clear sense that scientists and knowledge-users are equally responsible for putting knowledge into action and the importance of consulting and integrating knowledge-users throughout research. They also have high expectations for the GET-FACTS integrated process; that this model of doing science will create better scientists (e.g. improve communication skills) and make the scientific output more useful and relevant. Our work highlights both the unique contributions that knowledge-users can offer to knowledge creation as well as the challenges of trying to unify members from such different communities (policy/advocacy and biomedical science). There remains a real need to develop more touch points and opportunities for collaboration if true integration is to be achieved. Despite the obstacles, this model can help change the way knowledge is created in the biomedical world.

OA - Rishworth, A., Elliott, S.J., Dixon, J., & Clarke, A.E. (2016). What do the people who use the research results think? Attempting integrated knowledge translation in the 'knowledge creation' phase. Universal Journal of Public Health, 4(3): 144-150. [PDF]

Abstract

Collaboration among researchers and knowledge users, referred to as integrated knowledge translation (iKT), (potentially) enhances the relevance and use of research, leading to improved policies and practice. However, iKT is often applied in idiosyncratic ways, limiting integration of both knowledge creation and action. Further, iKT is rarely used at the stage of knowledge creation. Rather, it is typically used at the stage of knowledge synthesis or dissemination. This paper reports results of one part of a larger research program undertaking iKT through the integration of knowledge users and scientists in the process of knowledge creation around food allergies in Canada. A focus group discussion with 14 knowledge users involved in an ongoing biomedical research project was conducted with the purpose to: (1) share results of recent national survey data describing the prevalence and determinants of food allergy in Canada; and (2) elicit input into the next wave of survey activity in order to ensure the relevance of the next round of data collection. Stakeholders reported a lack of relevant, credible data sources to establish accurate understandings of food allergy for constituents. Confusion and doubt around information resources underline issues of insufficient knowledge translation, hindering knowledge user's credibility as providers of important public health messages. Integrating knowledge users in the process of knowledge creation is essential to facilitate stronger communication between researchers and knowledge users, help modify approaches, and improve population health outcomes; in short, iKT makes science useful.

OA - Tunis, M.C., Carson, K., Veinotte, L. & Marshall, J.S. (2015). Toll-like receptor 2 activators modulate oral tolerance in mice. Clinical & Experimental Allergy, 45 (11), 1690-1702. [PDF]

Abstract

Background: Toll-like receptor 2 (TLR2) is a widely expressed pattern recognition receptor critical for innate immunity. TLR2 is also a key regulator of mucosal immunity implicated in the development of allergic disease. TLR2 activators are found in many common foods, but the role of TLR2 in oral tolerance and allergic sensitization to foods is not well understood. Objective: The purpose of this study was to evaluate the impacts of TLR2 expression and TLR2 activation on oral tolerance to food antigens in a murine model. Methods: Mice were fed ovalbumin (OVA) or peanut butter with or without the addition of low doses of TLR2 activators Pam3CSK4 or FSL-1. Oral tolerance was assessed by analysing antibody responses after a systemic antigen challenge. OVA-specific Tregs were assessed in the Peyer's patches, mesenteric lymph nodes, and spleen in wild-type and TLR2−/− mice. Low-dose Pam3CSK4 was also tested as an oral adjuvant. Results: Oral tolerance was successfully induced in both wild-type and TLR2−/− recipient mice, with an associated regulatory T-cell response. Oral TLR2 activation, with low-dose Pam3CSK4 or FSL-1, during oral antigen exposure was found to alter oral tolerance and was associated with the development of substantial IgE and IgA responses to foods upon systemic challenge. Low-dose oral Pam3CSK4 treatment also selectively enhanced antigen-specific IgA responses to oral antigen exposure. Conclusions and Clinical Relevance: TLR2 is not necessary for oral tolerance induction, but oral TLR2 activation modulates humoral IgE and IgA responses during tolerance development. Low-dose Pam3CSK4 is also an effective oral adjuvant that selectively enhances IgA production. These observations are pertinent to the optimization of oral allergen immunotherapy and oral vaccine development.

OA - Tunis, M.C. & Marshall, J.S. (2014). Toll-like receptor 2 as a key regulator of oral tolerance in the Gastrointestinal Tract. Mediators of Inflammation, 2014, Article ID 60638, 7 pages. [PDF]

Abstract

Food allergy, other adverse immune responses to foods, inflammatory bowel disease, and eosinophilic esophagitis have become increasingly common in the last 30 years. It has been proposed in the “hygiene hypothesis” that dysregulated immune responses to environmental microbial stimuli may modify the balance between tolerance and sensitization in some patients. Of the pattern recognition receptors that respond to microbial signals, toll-like receptors (TLRs) represent the most investigated group. The relationship between allergy and TLR activation is currently at the frontier of immunology research. Although TLR2 is abundant in the mucosal environment, little is known about the complex relationship between bystander TLR2 activation by the commensal microflora and the processing of oral antigens. This review focuses on recent advances in our understanding of the relationship between TLR2 and oral tolerance, with an emphasis on regulatory T cells, eosinophils, B cells, IgA, intestinal regulation, and commensal microbes.

Related publications of interest

The following is a collection of references representing previous or concurrent work from the investigators on the GET-FACTS project, as well colleagues working in food allergy and Knowledge Translation.

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