Arthritis Patients and We Win an Inaugural Ideator Award

By | Awards, Projects

In April, “four Canadian innovators received prestigious and valuable awards from the Arthritis Society to bring to life their solutions for fighting the fire of arthritis” — one is a project that Dr. Diane Gromala and Dr. Chris Shaw collaborate on with the Arthritis Research Centre (ARC), called OPERAS.

At the inaugural Arthritis Ideator Awards, Dr. Linda Li accepted the Olga Munari Arthritis Ideator Award for OPERAS at MaRS in Toronto. The award was based partly on the originality of the innovation, potential for significant and lasting outcomes for people with arthritis, and readiness for market.

Left to right: Winners Michelle Laflamme and Alex Fuentes of KneeKG, Matthew Rosato of PROVA Innovations, Lianna Genovese of Guided Hands, and Linda Li of OPERAS.

In addition to the $50,000 grant, the Arthritis Ideator Program gives innovators access to expert advice from the Arthritis Society and the broader arthritis ecosystem as they continue to develop their innovations, as well as to people living with arthritis who can support testing or provide feedback through focus groups or surveys.

“Arthritis is a huge challenge looking for bold solutions and we want to support bright minds as they create those solutions,” says Trish Barbato, President and CEO of the Arthritis Society. “We are embracing innovation like never before because we believe it is key to changing the lives of the six million Canadians living with arthritis.”     

OPERAS is an app-based program to empower active self-care, capturing information on the go, and providing trends on symptoms, disease activity and treatments. Says creator Linda Li, “With OPERAS, people with arthritis can monitor disease activity, keep track of medications, create action plans and collect and display physical activity data through an integrated physical activity tracker. It gives a detailed picture to help users lead healthier, pain-free lives.” 

OPERAS described: https://arthritis.rehab.med.ubc.ca/ 

https://arthritis.ca/about-arthritis/arthritis-in-the-news/news/arthritis-society-awards-$200,000-in-first-ever-arthritis-ideator-awards

https://www.globenewswire.com/en/news-release/2022/04/22/2427551/0/en/Arthritis-Society-awards-200-000-in-first-ever-Arthritis-Ideator-Awards.html

Dr. Xin Tong Earns a Doctorate, Postdoc at Stanford, and Canada’s Bill Buxton Award

By | Research, Awards, Graduation

In 2021, the Pain Studies Lab member Dr. Xin Tong had 3 significant achievements:

  1. she earned her Ph.D.,
  2. was awarded a postdoctoral fellowship affiliated with the Pervasive Wellbeing Technology Lab at Stanford University, and
  3. was the recipient of Canada’s prestigious Bill Buxton Best Canadian HCI Dissertation Award.
    This award recognizes the most outstanding doctoral dissertation completed at a Canadian university in the field of Human-Computer Interaction.

The Pain Studies Lab’s most recent Ph.D. graduate is Dr. Tong, is currently an Assistant Professor in Computation and Design at Duke Kunshan University (DKU).

Dr. Tong’s dissertation, Bodily Resonance: Exploring the Effects of Virtual Embodiment on Pain Modulation and the Fostering of Empathy toward Pain Sufferers, combined both technical and human aspects of research to explore how virtual embodiment — through the use of VR technology — can affect people’s perception of pain and address the biological, psychological and social challenges that chronic pain patients face. This work identifies factors that impact the effect of VR embodiment on pain, including features of avatars, combinations of multiple modalities to communicate pain, and the integration of narratives into games.

Findings from Dr. Tong’s studies led to a series of important design recommendations for using embodied VR to generate empathy. Building on those results, Dr. Tong proposes Bodily Resonance, a design framework for pain and VR for empathy. The framework connects the real body that is in pain, the VR content, the illusion of presence in the virtual world and the narrative to mediate the perception of pain and empathy.

The Pain Studies Lab Responds to Ensure Access to COVID-19 Vaccinations

By | Study, Research, Collaborations

We responded to the call to help with COVID-related vaccination software, especially for vulnerable and at-risk people, such as those who live with chronic conditions. What also differentiated our system was its technical integration with Electronic Health Records (EHR).

As the researchers on a Canada-wide project funded by the Supercluster, MITACS, and the Digital Health Circle, we collaborated with health tech companies Cambian, IBM, LifeLabs, TickIt, Well Health, and the non-profit Providence Health Care.
Our job as researchers was twofold:

  1. to identify the real needs of people identified as “vulnerable and at-risk” &
  2. to ensure the system was as inclusive and usable as possible.

We built on our technical and design expertise in designing, building and testing health tech for people who live with long-term, chronic conditions, their caregivers and their healthcare professionals.

Our patient-centred approaches and our interests in inclusive, individualized healthcare enabled us to uncover many of the specialized contexts and needs that would have otherwise remained invisible. 

To interact with as many people as possible, we first contacted numerous non-profit organizations, interviewed their organizers and staff, and focused on in-depth interviews, usability studies and discussions with their many members.

Next, we conducted usability studies to make sure the vaccination scheduling system would be usable by those who are aging, immuno-compromised, differently abled, living in remote areas, living with chronic conditions, or who could only access the online system via mobile phones.

Clockwise: Dr. Diane Gromala, PhD students Bahiravi Warke, Xin Tong and MSc student Amal Vincent worked with people who are considered “vulnerable and at-risk” to severe illness from COVID-19 as identified by Canada’s and BC’s Ministry of Health. This included seniors, those who have cancer, are immuno-compromised, or have chronic conditions such as insulin-dependent diabetes, cardiovascular disease, kidney conditions, blood and rare diseases, significant developmental disabilities or require respiratory support.

Our discoveries:

    • the crucial and diverse roles of diverse caregivers (a family member, friend or neighbor);
    • the roles and centrality of extended families, especially among many people new to Canada;
    • important gender, cultural and linguistic differences; and
    • that ease-of-use is essential, not a mere luxury.

An unexpected outcome was developing a just-in-time, rapid response method to communicate the results of our research in an accelerated but scientifically trustworthy way.

Project focus and findings:

UXUI:
Needs Analyses
Usability Studies
Patient-centred Design
Inclusive Design

Frontiers in Virtual Reality: Virtual Reality in Medicine

By | Study, Publications

In addition to our longitudinal fMRI studies with chronic pain patients who use our immersive VR for months, we are also conducting EEG studies.

For example, Pegah Kiaei worked with neuroscience experts to develop an EEG study that will form the basis of her MSc thesis.

This study was published in the journal Frontiers in Virtual Reality: Virtual Reality in Medicine.

Although chronic pain does not have biomarkers per se, integrating EEG data in biopsychosocial research methods that pervade pain research may enable us to make inferences about patients’ brain states before, during and after using VR.

This is important because although hundreds of studies show that VR can have analgesic effects, we aren’t sure yet how and why that happens.

If you are a chronic pain patient living in the greater Vancouver area and you would like to participate in such studies, please email:
Dr. Zahra Ofoghi – zahra_ofoghi@sfu.ca

Kiaei Ziabari, S., Ofoghi, Z., A. Rodrigues E., Gromala, D. & Moreno, S. (2021). “Investigating the role of having an avatar in virtual reality on pain alleviation and embodiment in patients with pain using electroencephalogram: a neuroimaging protocol,” in Frontiers in Virtual Reality, Special Issue: Virtual Reality in Medicine. 10 January 2022  https://doi.org/10.3389/frvir.2021.775764

FitViz: How objective data affects physiotherapist-patient conversations for arthritis patients

By | Study, Research, Projects

Dr. Linda Li, Professor Harold Robinson/Arthritis Society Chair, Canada Research Chair, UBC & Arthritis Research Centre.

We developed a web application called FitViz. It allows physiotherapists and patients to use the physical activity data collected from Fitbit fitness trackers during consultations.

Next, we conducted a four-week study with 20 patients (inflammatory and knee osteo-arthritis arthritis) and 7 physiotherapists to evaluate the feasibility of FitViz, and understand the experiences of the physiotherapists and the patients.

We used semi-structured interviews to understand how physiotherapists used FitViz, and if and how it changed the nature of their consultation.

“Oh, I didn’t do a good job: How objective data affects physiotherapist-patient conversations for arthritis patients.”

We found that the use of objective data allowed the physiotherapist-patient conversations to be patient-driven, and allowed goals to be realistic and data-driven. However, the use of objective data also caused some patients to feel guilty, which has implications on the use of pervasive healthcare technology in clinical settings.

After iterative improvements, we initiated a larger, longitudinal study.

 

References:

Ankit Gupta, Tim Heng, Chris Shaw, Diane Gromala, Jenny Leese and Linda Li. 2020.
“Oh, I didn’t do a good job: How objective data affects physiotherapist-patient conversations for arthritis patients.”
Proceedings of the 14th EAI International Conference on Pervasive Computing Technologies for Healthcare.
Association for Computing Machinery, New York, NY, USA, 156–165. DOI: https://doi.org/10.1145/3421937.3421991

Li LC., Feehan LM., Xie H., Lu N., Shaw C., Gromala D., Aviña-Zubieta JA., Koehn C., Hoens AM., English K., Tam J., Therrien S., Townsend AF., Noonan G., Backman CL. (2020). “Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial.”Arthritis Care & Research (Hoboken).
2020 Dec;72(12):1755-1765.    DOI: 10.1002/acr.24199.   PMID: 32248626 Clinical Trial.

Frontiers in Neurology publishes research results of VR work on Phantom Limb Pain

By | Research, Collaborations, Papers, Projects, Publications

“I Dreamed of My Hands and Arms Moving Again...”

Phantom limb pain (PLP) is a type of chronic pain that follows limb amputation, brachial plexus avulsion injury, or spinal cord injury. Treating it is a well-known challenge. Currently, virtual reality (VR) interventions are attracting increasing attention because they show promising analgesic effects. However, most previous studies of VR interventions were conducted with a limited number of patients in a single trial. Therefore, to investigate the effectiveness of VR interventions on patients’ phantom limb pain over time, PhD candidate Xin Tong and her supervisor Prof. Diane Gromala collaborated with Dr. Kunlin Wei from Peking University and Dr. Bifa Fan from the Chinese-Japan Friendship Hospital. They recruited five PLP patients who participated in multiple VR sessions over 6 weeks. In VR, patients “inhabited” a virtual body or avatar. Movements of their intact limbs were mirrored in their avatar, providing the illusion that their limbs responded as if both were intact and functional.
The researchers found that VR sessions repeated over time led to reduced pain — even in chronic pain that persisted for over 20 years — as well as improvements in anxiety, depression, and a sense of embodiment in the virtual body. Their findings also suggest that providing PLP patients with sensorimotor experiences involving the impaired limb in VR appears to offer long-term benefits for patients, and speculate that these benefits maybe related to changes in patients’ control of their phantom limb’s movement.
Future work to determine if such VR interventions may be detected in brain-imaging studies such as fMRI has been planned and recently funded.

Reference:

Tong, X., Wang, X., Cai, Y., Gromala, D., Fan, B., & Wei, K. (2020).
“I Dreamed of My Hands and Arms Moving Again”:
A Case Series Investigating the Effect of Immersive Virtual Reality on Phantom Limb Pain Alleviation”

Frontiers in Neurology, 11, 876.
https://www.frontiersin.org/articles/10.3389/fneur.2020.00876/full

Redefining Citizen Science: the Pain Studies Lab & the Arthritis Research Centre ‘In the Wild’

By | Study, Research, Collaborations

An innovative Citizen Science workshop led to a study ‘in the wild,’  an academic-industry initiative, and a province-wide initiative about ‘the burden of pain symptoms’ — a first.

Academic researchers—from the Arthritis Research Centre of Canada (ARC) and Simon Fraser University’s (SFU’s) Pain Studies Lab and BioV Lab—partnered with award-winning industry partner Tactica Interactive to develop a web portal for all citizens of British Columbia (BC). In November 2019, SFU researchers then subjected it to testing ‘in the wild’ of a result of a collaborative effort between ARC and SFU’s Pain Studies and BioV Labs that started with an innovative ‘design thinking’ workshop last April.

Objective: In the web portal, the research teams will ask all citizens of BC about how ‘the burden of pain symptoms’ might affect their lives, from their ability to sleep and function at work and in ‘ordinary, everyday life,’ to their quality of life.

(Photos courtesy: D.Gromala, 2019)

Bhairavi Warke and Ankit Gupta, PhD students and researchers from the Pain Studies & BioV Labs at the School of Interactive Arts & Technology (SIAT) at SFU led the mall study. Researchers: Sherry Wang, Gary Li, Pegah Kaiei, Celia Zhang, Dr. Diane Gromala & Dr. Chris Shaw.

After months of working closely with Tactica Interactive on designing the web portal, the research teams did what tech professionals are taught to do: to test it with some of the people it was designed for — citizens. Such testing is an ideal. However, in industry, ‘user testing’ can be difficult because of its cost or time it requires, or both.

University researchers usually manage to conduct such studies, but more often than not, they’re conducted in a laboratory because labs offer tightly controlled conditions. Studies done ‘in the wild’ — outside of research labs — aren’t as tightly controlled, but they can reach a larger cross section of future ‘users.’ Because the web portal is meant for all citizens of BC, the researchers insisted on testing the web portal in a mall in Surrey.

Results: The web portal’s usability, acceptability, appropriateness, legibility and readability were tested by people in the mall who were generous enough to spend time using the website and answering researchers’ questions. The results were transcribed, analyzed and communicated to the web portal’s designers and to the research teams.

Stay tuned: The web portal is now scheduled to launch in May 2020.

Pain Studies Lab’s Research at PAINWeek 2019

By | Conferences, Events, Publications

On Sept 2-7, 2019, members of the Pain Studies Lab presented 5 posters at PAINWeek 2019, Las Vegas. PAINWeek is a multidisciplinary conference for frontline clinicians focusing on pain management.

PhD student Bhairavi Warke discusses results of the Pain Studies Lab’s research to a PAINWeek 2019 attendee.

Each poster articulates the results of our scientific and clinical studies. Many of these studies are with our long-time collaborators at the Arthritis Research Centre of Canada (ARC) and the BC Support Unit, and use cutting-edge design know-how and interactive and/or immersive technology newly built for helping patients with chronic conditions. The research studies that each poster describes is affiliated with a Pain Studies Lab project:

As-If 

The aim of this Virtual Reality (VR) platform is to raise empathy of aging people who live with chronic pain. In this VR game, a player “inhabits” a full-size 3D character or “avatar,” a grandmother who is struggling to accomplish everyday tasks. Players must strive to accomplish these tasks “as” this character. As they do so, their physical range of motion is restricted as their arm and wrist joints become red, and they hear the aging grandmother’s inner self-talk.

Players in the VR game As If “inhabit” the avatar of an aging chronic pain patient. From this first-person perspective, they try to perform everyday tasks as if they were that patient. The goal is to motivate empathy for chronic pain patients. After much testing, the initial version evolved into the VR version.

Tong X, Kiaei P, Gromala D, Shaw C. The Design and Evaluation of AS IF for Sharing Chronic Pain Patients’ Experience in VR Settings, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1), 21. doi:10.1080/00325481.2019.1655695

LumaPath

This VR game is intended to promote Range of Motion (RoM) exercises for aging chronic pain patients with Rheumatoid Arthritis (RA) or Osteoarthritis (OA). In a pilot study, patients were unaware that the range of motion gameplay in LumaPath conferred about 30% aerobic benefit. The older the patient, the higher the aerobic benefit.

Initially, the designers weren’t sure why aging adults were so enthusiastic about this steampunk-styled VR game until patients remarked that LumaPath’s ship bears a strong resemblance to the Beatles’ Yellow Submarine of their youth.

Tong X, Gromala D, Pam S, Kim D. A Serious Immersive Virtual Reality Game for Promoting Chronic Arthritis Pain Patients’ Physical Activity and Range of Motion, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1), 19-20. doi:10.1080/00325481.2019.1655695

Tong X, Machuca F, Feng N, Gromala D, Li L, Aceves-Sepulveda G. Promoting Physical Activity and Movement for Arthritis Patients through a Virtual Reality Game, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep1;131(sup1), 120-121. doi:10.1080/00325481.2019.1655695

The Burden of Pain Symptoms

In a collaborative project, researchers from ARC, the BioV Lab and the Pain Studies Lab explored what “Citizen Science” might mean in health domains. Instead of asking people to count birds or measure water levels, the researchers considered engaging ways that citizens of British Columbia in Canada might share their pain symptoms, and how they would ensure that such data was anonymized and kept private and secure. Next, they partnered with Tactica Interactive to design and build a public health data-hub. The protoype web portal was tested “in the wild,” and is scheduled to launch in spring 2020.

Bhairavi Warke discusses an innovative new ‘citizen science’ project with an attendee at PAINWeek 2019 in Las Vegas.

Warke B, Li R, Gromala D, Li L, Shaw C, Gupta A, Hoens A, Koehn C, Currie L, Mamdani H, Cooper D, Loo S. The Burden of Pain Symptoms: A prototype for citizens of British Columbia, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1): 10–11.  doi:10.1080/00325481.2019.1655695

The Virtual Meditative Walk

This immersive VR system incorporates bio-sensors and its Vocal Coach teaches chronic pain patients to learn Mindfulness-based Stress Reduction (MBSR), a well-validated method that has long been used to help chronic pain patients manage their long-term pain. The benefit of this VR system is the biosensors provide real-time feedback so patients know if their efforts are indeed having observable effects on their mind and body. Pain Studies Lab researchers are now looking at its potential long-term neurological benefits.

In the Virtual Meditative Walk, as patients reduce their stress levels by focusing on their inner states — like their heartrate and breathing — they see and hear changes in the “weather”: fog and clouds gradually disappear, and birds and insects become more active in the virtual forest.

Li R, Warke B, Gromala D, Garrett B, Taverner T. Does Immersive Virtual Reality Modulate Chronic Pain: A Longitudinal Study Design, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1), 20–21.  doi:10.1080/00325481.2019.1655695

FitViz

In collaboration with ARC, researchers from SFU’s BioV Lab created and clinically tested FitViz, an app that uses a FitbitTM to help patients with Rheumatoid Arthritis (RA) and Osteoarthritis (OA) and physiotherapists to track & monitor their physical activity levels.

FitViz also determines and recommends the frequency and exercise level for individual patients, termed “bouts.” In this way, patients can get a sense of how much exercise is best for their specific needs and can monitor their own progress, while their physiotherapists can follow and adjust their recommendations.

Tong X, Heng T, Gupta A, Shaw C, Gromala D, Li L. FitViz-Ad: A Non-Intrusive Reminder to Support and Encourage Rheumatoid Arthritis Patients with Physical Activity, PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1), 121-122. doi:10.1080/00325481.2019.1655695

The Pain Studies Lab’s researchers also presented results of VR studies that lab member Xin Tong conducted over several months in Beijing:

  • A study among participants in Beijing exploring body ownership, sense of agency and heat pain perception using VR and Leap MotionTM sensors.

Tong X, Diao H, Gromala D, Wei K. Exploration of Body Ownership, Agency and Heat Pain Perception in Virtual Reality (VR), PAINWeek Abstract Book 2019. Postgraduate Medicine. 2019 Sep 1; 131(sup1), 19. doi:10.1080/00325481.2019.1655695

The research results that lab members presented raised interest among the attendees, many of whom are pain clinicians and some researchers from laboratories and pain research institutes across the U.S.

upcoming

The Canadian Pain Society’s (CPS) Annual Scientific Conference 2020 will feature AS IF, and recent research results will also be shown at the International Association for the Study of Pain’s (IASP) upcoming conference this summer in Amsterdam.

At PAINWeek 2019, graduate student Ruoyu (Gary) Li explains our longitudinal VR “dosage” study design for chronic pain patients who used VR in their homes three times per week, at a minimum.

SFU’s Chronic Pain Research Institute named Founding Member of the International VR & Healthcare Association (IVRHA)

By | Collaborations, Lab Updates, Other News

“We know from decades of research that virtual and augmented reality (VR/AR) technologies can address the most difficult problems in healthcare. Ranging from mood disorders such as anxiety and depression to post traumatic stress disorder (PTSD), addiction, autism, cognitive aging, as well as neuro and physical rehabilitation,” said Dr. Walter Greenleaf of the Virtual Human Interaction Lab at Stanford University and the Association’s Founding Advisory Board Chair.

“The Association will play a critical role as the coordinator for the design, development and promulgation of industry standards and best practices for the use of VR/AR technology as part of the next generation of digital medical systems.”

“VR/AR technology will have impact by enabling objective clinical assessments as well as providing for improved skill training and procedure planning. Personal health and wellness can also be improved by using immersive systems to promote better nutrition, engender healthier lifestyles, and to reduce personal stress and anxiety. As the cost of healthcare rises, VR and AR can serve as an effective telemedicine platform to reduce the costs of care delivery and improve clinical efficiency in both urban and rural settings.”

Founding members are from 13 universities and research institutions and from 27 technology companies.
University organizations include:

  • The Centre for Aging + Brain Health Innovation at the University of Toronto
  • Surgical Neuro-Oncology, School of Medicine & Health Sciences, George Washington University
  • The Brain Performance Institute at the University of Texas, Dallas
  • The Arizona Center for Advanced Biomedical Innovation at the University of Arizona
  • The National Mental Health Innovation Center at the University of Colorado
  • The U.S. National Institutes of Health’s (NIH’s) NIAID

Founding members from industry include Dr. Gromala’s collaborator, Frances A. Ayalasomayajula, Head of Population Health Worldwide at HP; as well as hardware companies such as Polhemus and CleanBox Technologies; and health-related software companies, including MyndVR, BehaVR, and Health Scholars, to name a few. European industry members are from the UK (Playing Forward, Sine Wave Company), France (SimforHealth) and Switzeland (MindMaze, Lavendr by Ricolab, Virtual Switzerland).

For a full list of Founding Members and announcement, please visit: the PRWeb website.

Redefining ‘Citizen Science’: Pain Studies Lab with the Arthritis Research Centre

By | Workshops, Collaborations, Events

An innovative workshop redefines what ‘Citizen Science’ can mean in health domains

On April 18th, 2019, Dr. Diane Gromala, Dr. Chris Shaw, Ankit Gupta, Bhairavi Warke and Sherry Wang from SFU’s Pain Studies Lab led a co-creation workshop with their long-time collaborators from the Arthritis Research Center: Dr. Linda Li, Hussein Mamdani and Juliane Chien at University of British Columbia in Vancouver. In this innovative workshop, health researchers and their patient-partners got together to explore new approaches to collecting information about ‘the burden of symptoms’ from patients in British Columbia (BC), Canada.

(Photos courtesy: Bhairavi Warke 2019)

Participants shared their experiences of trying to define and articulate their ‘burden of pain’ symptoms on their biopsychosocial realities, as well as their abilities to function and their quality of life.

The objective: to question what ‘Citizen Science’ might mean in health domains. Instead of asking citizens to count birds or measure water levels, we plan to ask citizens of BC about their pain symptoms — whether or not they have been diagnosed with a particular condition(s). For health research, this may prove to be an innovation since research often follows a diagnosis, and is usually categorized according to a diagnosis or disease.

The workshop was derived from ‘design thinking’ approaches. It structured the way we explored different methods for collecting the pain-related data, including: a standard medical classification list of symptoms, the well-known McGill Pain Questionnaire, information from questionnaires about function and quality of life, ‘Mood Cards’ and lots of post-it notes, tags and writing implements.

In addition to ARC’s patients-partners, the health researchers participating in the workshop played the role of citizens who would be contributing information about their health anonymously. By doing so, we all got a deeper understanding of how rich pain-related data could be, and how complex it is to communicate.

A participant selecting “Mood Cards.”

The workshop comprised four phases:

  1. choosing medically classified symptoms,
  2. annotating a human figure with those symptoms,
  3. describing how their symptoms impacted work, family, life and social contexts, and
  4. choosing “mood cards” to help articulate psychological contexts.

Outcomes of the research revealed a high level of complexity required for such a system and helped identify the needs not only of the citizens who would be contributing their information but also the health researchers who would use that information. The teams plan to further refine their approach and test for security, privacy, usability, compliance, and effectiveness.

Left to Right: Juliane Chien, Alison Hoens, Delia Cooper, Cheryl Koehn, Hussein Mamdani, Ankit Gupta,  Diane Gromala, Chris Shaw, Leanne Currie, Abdul-Fatawu Abdulai, Sherry Wang, Linda Li.