Canada’s public health system faces serious systemic challenges for adequately meeting the health needs of the population. To help guide a plan for improvement and renewal of public health services in BC, the BC Ministry of Health has developed a Framework for Core Functions in Public Health. This framework defines the core activities of a comprehensive public health system, and serves as the roadmap by which the province is planning and investing in public health services. By studying the implementation and outcomes of the Core Functions Framework, this team will contribute new knowledge for BC and Canada regarding ways for public health system renewal to improve population health, reduce health inequities, and better integrate with health services. This team received an MSFHR Team Planning Award in 2006. MSFHR’s Team Start Up grant will now support the team — which comprises academic researchers and key decision-makers at the provincial, regional, and national levels — to further develop its productivity and competitiveness.
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Optimization of Trauma systems
Every year approximately 400,000 British Columbians suffer a traumatic injury — the leading cause of mortality and morbidity in Canada. The development of trauma systems to improve the access of injured patients to timely, and often life saving care is a health care priority. Unfortunately, access to timely and appropriate trauma care is not universal in BC. For example, injured patients in rural communities typically face economic, social and geographical barriers to care. In contrast, injured patients in urban communities are typically in close proximity to several hospitals; however, the trauma capabilities within in each hospital are highly variable, so choice of hospital may impact survival. This team of trauma surgeons, trauma care providers, geographers and epidemiologists is building a comprehensive dataset to investigate the performance of, and identify gaps within, the delivery of trauma care in rural and urban communities. The team’s goals will be to create evidence-based solutions where population vulnerabilities exist, and increase the reach and capability of the BC’s trauma system to address disparities in trauma outcomes across the province.
Health Innovation Design and Evaluation Research Team
In their ongoing efforts to improve health outcomes, decrease health care costs, and increase administrative efficiency, health care agencies are increasingly investing in information-based technologies (IT). Recently, the Canadian government highlighted the need for developing new methods for evaluating new health sector technologies in order to provide insight into the challenges associated with increased use of IT in health care settings. This award supports the development of a team that is researching the use of IT for epidemiological data collection (EDC), also known as e-epidemiology. The team’s goals include: identifying technological, organizational, governance and implementation challenges associated with the increased use of IT for EDC; addressing data quality issues arising from increased use of IT for EDC; and improving collaborations among researchers, decision makers and technology developers across disciplines who share an interest in e-epidemiology. The team hopes to improve the quality of evidence used in decision making about information technologies used for collecting epidemiological data in BC.
Neuroethics for British Columbia
Neuroethics is a relatively new field of study that focuses on the ethical, legal, social and policy implications emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience). This award supports the creation of a team focused on working with practicing neuroscientists, physicians and clinical researchers, ethicists, and health policy-makers in BC to ensure that advances in neuroscience are aligned with societal and individual human values. The team will work towards identifying educational, research and clinical needs in neuroethics in BC, and encouraging collaboration between additional teams involved in complementary research activities.
Functional Lung Imaging for Radiation Therapy
Lung cancer is the leading cause of cancer death in Canada. Patients who undergo radiation therapy (RT) for lung cancer face only a 14% chance of surviving for five years. In addition, they are likely to experience significant radiation-related health effects, such as impaired lung function. While current therapy attempts to reduce injury by limiting the amount of lung tissue treated, it is difficult to predict how much function will be lost. Researchers believe radiation therapy could be given at higher, more effective doses if accurate ways were identified to measure lung function within the affected area prior to treatment, and to predict how the region will be affected by radiation. Currently, as functional imaging methods such as perfusion SPECT and hyperpolarized 3He MRI (He-MRI) are being developed, predictors of radiation lung damage are emerging. FLIRT — a multidisciplinary team of radiation oncologists, and radiotherapy and imaging physicists — is researching the potential to combine these two diagnostic techniques to improve the planning, delivery and outcome of RT for lung cancer patients.
VITALiTY Team
Catastrophic disability is the rapid onset of disability and loss of independence in three or more basic activities of daily living. The six leading causes are stroke, congestive heart failure, pneumonia and influenza, ischemic heart disease, cancer, and hip fracture. Within the next 25 years, the number of people aged 65 years and older in British Columbia will double, resulting in a significant burden on the health care system. Novel strategies are needed to reduce both the risk of catastrophic disability, and the related increased care needs. This award funds the creation of a research team focused on developing interventions that identify and minimize risk for catastrophic disability and promote healthy aging in older adults. The team’s objectives are to determine which inflammatory markers predict catastrophic disability, relate these markers to other identified risk factors, and develop targeted, effective interventions.
Collaborative research group for the study of human vaginal microbiota in health and disease
Under normal circumstances, the vagina is home to many different microorganisms. A shift in the balance of vaginal microbiota can result in infections such as bacterial vaginosis (BV), the most common cause of vaginal infection. BV and other infections are associated with early pregnancy loss, preterm labour, and an increased risk for HIV. Our primitive understanding of the complex microbial ecosystem of the genital tract greatly hampers our ability to identify and describe normal vaginal microbiota. This hinders the development and evaluation of appropriate, focused therapies for genital infections. The use of high throughput molecular methods promises to be very effective for characterizing vaginal microbiota. This award supports the development of a multidisciplinary, team of researchers, with links across Canada, to apply molecular methods for microbial species identification. Their comprehensive description and monitoring of vaginal microbiota will facilitate the development of new diagnostic technologies and therapies for infection-related problems in obstetrics and gynecology.
Workplace Traumatic Exposure Team
One of the most serious effects of occupational stress is mental illness — a prominent health issue in terms of both financial and human costs. It is estimated that mental injury claims are approximately 50 per cent more costly than physical injury claims, since workers with a mental injury are typically absent from work longer than those with a physical injury. Post traumatic stress disorder (PTSD) and anxiety disorder are the most significant mental injuries originating in the workplace. The majority of workers will encounter an emotionally traumatic work event at some point in their career. Despite the negative implications for the worker and for society, workplace traumatic exposure has not yet been extensively studied in BC. This award supports the development of a team consisting of researchers at UNBC and UBC who are working to pool their individual expertise in workplace traumatic exposure. The team will develop their research around description/understanding, prevention, remediation and policy/knowledge translation.
Improving Access to Quality Cancer Care using Operations Research Methods
Radiotherapy is used for curative and palliative (symptom relief) purposes for patients with cancer, with 30 to 40% of patients receiving radiotherapy during some point in their illness. Wait times for radiotherapy have been shown to lead to poorer outcomes for those treated as part of curative treatment, and to increased suffering for those treated for palliative reasons. Wait times occur either because of equipment and/or staff shortages, or due to resources not being used in the most optimal manner. Demand for radiotherapy fluctuates over time, leading to unpredictable surges in demand that are difficult to meet in a timely fashion.
Dr. Scott Tyldesley is working to improve understand of the root causes of the fluctuation in demand for radiotherapy, and to develop approaches to predict and address demands. He, and his colleagues, are creating a detailed model of the radiotherapy system, which will allow him to simulate current cancer patient flow, and to test proposed improvements to the system. Development of the model will also allow the group to explore how the radiotherapy system can improve how it forecasts demand for services, and how it deploys its resources. These results will be tested in system-wide models and then considered for implementation at the BC Cancer Agency (BCCA). The research team is a unique collaboration between specialists in operations research from the Sauder School of Business at UBC and clinical decision-makers and administrators from BCCA. The results of Tyldesley’s research will directly affect clinical practice for patients with cancer and be transferable to other health care environments.
Bioinformatic approaches for the interpretation of cancer genomes
The rapidly developing field of genomics is providing increasingly powerful tools to investigate our genetic make-up and provide a fundamental understanding into how cells and organisms function. Previously funded by an MSFHR Scholar award, Dr. Steven Jones’ ongoing research focus is to apply genomic and bioinformatic technologies to cancer research. Next-generation DNA sequencing machines at Canada’s Michael Smith Genome Sciences Centre provide the underlying technology platform for Jones to conduct a number of studies that will expand our knowledge about the fundamental mechanisms underlying health and disease. Jones will develop a number of studies around three key themes: • Understanding the genetic changes present in human cancer cells, as compared to the normal human genome, to improve drug screening and testing methods. • Investigating the changes that occur in cells in response to drug treatments to identify ways to improve the efficacy of these drugs. • Using the mouse liver as a model, identifying active regions of the genome in order to further understand the functional elements within our genetic material and how, in concert, they are able to coordinate and maintain the activity of a tissue or organ.