Over 80% of patients who are treated in the intensive care unit (ICU) for a life-threatening illness face reduced physical health, emotional wellbeing and quality of life. Up to half of patients discharged from the ICU are readmitted to hospital within a year with complex medical conditions. This is a tremendous cost of cure for survivors and their family caregivers. Services for patients with complex medical conditions and/or frail patients is a BC Health System Priority.
This research aims to identify patient- and family-perspectives for designing healthcare services that meet their needs. The primary study will involve interviewing ICU patient survivors, their family members and healthcare providers to map the causes of hospital readmission.
These results will inform the design of services to reduce hospital readmissions. The results of these studies will be shared with national and international researchers and clinicians to benefit patients across Canada.
My career goal is to improve the health and quality of life of older Canadians through applying innovative health economic methods to lifestyle interventions among older adults at risk of falls as well as cognitive and functional decline. I propose a multi-disciplinary research program that advances health economic methods for clinical research studies.
Theme 1 of my research program will advance health economic evaluation methodology by answering the question: “Can artificial intelligence combat current methods limitations of economic evaluation?”
Theme 2 will utilize patient outcomes assessed by patients to explore how patient perspectives may optimize adherence to lifestyle interventions to promote quality of life and maintenance of functional dependence. Hence, I plan to advance methods for clinically applied economic evaluation and explore the utility of patient reported outcome measures to efficiently improve health related quality of life.
These methods advancements will provide a new prototypes useful for
- clinical trials with concurrent economic evaluations and
- patient reported outcome measures that promote adherence and resultantly, health related quality of life — ultimately helping older adults “age in place”.
Our goal is to use smartphones and artificial intelligence to improve pain management for children having surgery. This is needed because many children still have a lot of pain even a year after surgery. The pain affects their daily life, and might cause them to return to hospital. A child’s pain is affected by many things, like their biological sex, anxiety, coping skills, pain level, and type of surgery. Importantly, some of these can be altered.
We will collect data to identify patterns that predict which children
- do well after surgery, so we can learn from them or
- do not do well/have significant pain, so we can help sooner or even prevent it. We will involve families and children having surgery now, to collect data for a pain risk score to help future children.
We will design a tool to share pain risk data with families and doctors and test these tools in children coming to hospital for spine, tonsil or dental surgery. We hope that using these tools (pain prediction models) will improve the child’s individual care. Identifying children at high pain risk will allow us to intervene before their surgery. This will lead to quicker recovery, less time in hospital, and less chance of addiction to painkillers (opioids).
The trajectories of people's lives are often shaped by things that fall outside of their control, having more to do with unearned disadvantages than with their own behaviours or biology. Despite solid evidence and practical policy solutions, systematic differences in health and health outcomes persist both within and between countries. Evidence shows the distribution of power, resources, and wealth along social gradients are causes of these inequities. Many people working in health and health research, and particularly in public and global health, describe their work as reducing health inequities or advancing health equity; but research shows their efforts are often poorly aligned the evidence, focusing on symptoms and not causes.
This program of knowledge translation science supports researchers, students, and professionals in different settings (e.g., rural communities, municipalities, health systems) to align their equity intentions with evidence about causes of health inequities. By supporting people to integrate evidence-informed strategies and principles, efforts to improve population health can move toward more productive health equity action that focuses on addressing the causes, rather than symptoms, of inequities.
Marginalized cisgender (cis) and transgender (trans) women experience high levels of gender-based violence, defined as violence perpetrated against someone based on their gender, gender expression, gender identity or perceived gender, as well as multiple forms of stigma. With the overarching aim to optimize trauma- and violence-informed approaches to enhance access to sexual and reproductive care and HIV prevention and treatment, this research program aims to work closely with marginalized cis and trans women to:
AIM 1. Launch a program of research that will i) develop an evidence base to describe complex relationships between and mechanisms linking gender-based violence and multiple forms of stigma with sexual and reproductive health access, and access to HIV treatment and care; and ii) develop innovative metrics, methodologies and tools to advance an understanding of gender-based violence and stigma and trauma- and violence informed care and practice;
AIM 2. Create a research and training platform to develop and inform innovative community-based interventions tailored for and with marginalized women to inform program and policy interventions.
Canada is experiencing an unprecedented demographic shift with the aging of the population. Older adults face major stressors and life transitions (e.g., retirement, bereavement, caregiving), in addition to accumulated biological wear-and-tear due to a lifetime of exposure to stress.
Yet, the impacts of stress vary between people and across situations. It is therefore important to identify protective factors that may promote more adaptive stress responses, particularly in midlife and late adulthood when risks increase for aging-related diseases.
The proposed program of research will focus on stress resilience factors in daily life (positive events and sleep) that may mitigate the impacts of stress on health and aging. Research studies will examine the stress-buffering effects of daily positive events and sleep, positive events as protective factors for aging and health disparities, and the development of a mobile intervention to cope with stress as it unfolds.
This research will contribute to a better understanding of stress resilience and health in the context of adult development and aging. Findings will inform strategies to reduce stress-related health conditions and to promote optimal aging among Canadians.
Feeling down or worried happens to everyone, but for some people these feelings are very strong, long-lasting, and can be damaging to them and their families. Mental illnesses, such as depression or anxiety, may include feelings of hopelessness, helplessness, guilt, or even suicide. Worldwide, mental illness affects one in five people aged 60+.
However, problems faced by older adults impacting their mental health are often overlooked, such as loneliness, loss of a spouse, or ill-health. We need to change the way we treat mental health, with services that consider older adults' specific needs and situations.
To this end, we will bring together an advisory board of older adults to help inform the project, providing insights into what contributes to their mental health and what sorts of technologies promote better mental health. Using these insights we will identify factors that contribute to older adults’ poor mental health.
Additionally, we will work with older adults to test technology-driven interventions, for example mobile apps, that best suit the needs of older adults in improving their mental health.
British Columbia, Canada, continues to grapple with an overdose epidemic. Substantial gaps remain in the implementation and scale up of overdose prevention strategies, including attention to gender equity. Little has been said regarding how marginalized women (trans inclusive) are impacted by the crisis, or how they might be differently navigating overdose risk environments or access to life-saving health services.
The ultimate goal is to generate new evidence to reduce overdose-related harms among women who use drugs and increase the responsiveness of existing and emerging overdose interventions to gender inequities. The objectives of this research program are to:
- Identify how women’s overdose risk is shaped by evolving individual, social, structural, and environmental factors;
- Investigate factors that create barriers to (or that facilitate) women’s engagement with existing, novel and emerging overdose prevention interventions; and
- Document perspectives, experiences, and impact of women who use drugs working in overdose-related interventions to inform how best to optimize their engagement in ongoing and future initiatives.
Rural and northern areas in BC cover large areas and support more and more older adults. Older adults may face unique challenges due to the geography, population, and resource availability. These places commonly lag behind urban centers in accessibility to healthcare services, and face healthcare workforce shortages. Innovative solutions are urgently required to support older adults to age safely with quality healthcare services. Technology solutions to support older adults exist and continue to be developed. However, there is a gap between technology development and its implementation and sustained use, especially for older adults in rural and northern areas.
My research program builds upon existing partnerships to address this gap through the creation of the Centre for Technology Adoption for Aging in the North (CTAAN)-A collaborating center for innovations in technology development and implementation to support older adults in rural and northern communities.
Through a range of technology focussed projects, my role as the academic lead of CTAAN is to enhance uptake of technologies supporting adaptation, piloting, and implementation of existing technologies from Canada and beyond and to support older persons to age gracefully.
Human cells are fascinating and complex: they reproduce, break down food to create energy and communicate with each other. The ‘skin’ of the cell, the cell membrane, plays a crucial role in choreographing interactions between a cell and the outside environment, for example by allowing or prohibiting the access of drugs from the cell exterior to the cell interior.
I design and build lab-on-a-chip devices, which are plastic chips the size of a postage stamp inside of which I can manipulate tiny amounts of liquids. I use these lab-on-a-chip devices to create artificial cells to be able to study how the cell membrane regulates access to the cell interior. Human cell membranes have lots of different components that are used to transport drugs into and out of the cell.
Since the cell membrane is complex, we do not always know exactly which component is interacting with the drug molecule, and what effect it has. The cost of developing a new drug is around 2.6 billion USD and a significant proportion of drug candidates fail because we cannot predict how they interact with cells.
My research will help design drugs that can interact with cells more efficiently, so that they can get inside the cell in order to work properly.
