This program of research will seek to understand how youth and young adults (YYA) with mental health (MH) disorders make decisions about seeking MH services at YYA centres such as Foundry BC. Foundry BC provides health and wellness services to YYAs through integrated service care in communities across BC. Nearly 75% of MH disorders develop before the age of 25, yet less than 20 percent of Canadian YYAs receive appropriate treatment. This can cause serious problems such as relapse, rehospitalisation, increased suicide risk, and can interrupt critical identity development. Currently, there is little to no research that understands how Canadian YYAs making decision about accessing and staying engaged MH services.
This program of research will work closely with Foundry BC to:
- To develop a theoretical framework of service use decision-making and engagement among Canadian YYAs living with MH disorders using mixed-method approaches; and
- Explore barriers that marginalized YYAs with MH disorders face when accessing digital information using mixed method approaches. Ultimately, this research will lead to the development of a YYA MH service use lab in BC that uses mixed-method approaches and an innovative decision-making framework to develop interventions to increase service use among this vulnerable group in BC. This research will work closely with YYAs and parent knowledge users as part of the research team, and mentor highly qualified students to become MH leaders.
One million Canadian women are affected by endometriosis annually. There is little investment in research, and socioeconomic cost, >$4 billion annually in Canada, continue to climb owing to lost productivity, sick days, treatments for frequent pain, infertility and depression. Most critically, affected women may have up to a 10-fold increased risk of developing specific types of ovarian cancer. There are no biological features that predict if endometriosis will result in severe or chronic pain, infertility, or cancer.
In 2017, my work identified cancer mutations in the DNA of endometriosis, a feature seen only in cancer.
Since then, I have established a research program with two goals:
- to examine association between specific mutations and types of endometriosis.
- to understand how other biological features, such as the immune-system, may be affected by mutations and contribute to the establishment of endometriosis, and progression to cancer. Cancer mutations are present in all types of endometriosis, including those with no risk of cancer. Additional work is needed to understand how these mutations influence the biology and symptoms of both endometriosis and their associated cancers, as well as establish management strategies.
Metastasis, which is the spread of cancer cells from a primary tumor to other areas in the body, remains the main cause of cancer related death. Awareness of the clinical importance of metastasis and our basic scientific understanding of the metastatic process has improved substantially over the past few decades. However, many aspects of metastasis are still not well defined and our ability to identify patients at high risk for cancer spread is limited. In addition, cancer treatments are not metastatic-specific, so despite aggressive treatments many patients still progress to a metastatic disease state. Dr. Williams' research aims to address these issues by identifying aggressive disease early and uncovering key regulators of metastasis for inhibitor development.
Cancer cells are constantly shedding small fragments, which can be readily detected in the blood. This project will develop a test that analyzes these fragments, identifying cancer patients and determining the aggressive nature of their disease. It also aims to uncover how cancer cells move and grow within the body by forming tiny 'feet-like' structures called invadopodia. Understanding their role in cancer progression will shed light on how cancer cells move and grow within the body, validating them as targets for metastatic inhibitor development. Overall, this research program will make powerful strides towards ending metastasis, the most significant cause of cancer mortality.
British Columbia is facing an unprecedented and escalating opioid crisis, underscoring the urgent need for innovative science-driven solutions. There is critical implementation gap of evidence-based care for opioid use disorder (OUD), this research will seek to narrow this gap.
First, Dr. Socias will seek to advance the implementation of evidence-base treatments for OUD, by leading a series of ongoing and planned clinical trials evaluating innovative and promising models of care (e.g. take-home strategies) and alternate treatment options (e.g. slow-release oral morphine).
Second, leveraging vast data from two long-standing cohort studies of over 3,000 people who use drugs, she will apply innovative quality metrics (i.e., cascade of care framework) to evaluate the impacts of addiction health system implementation efforts in BC over time. Identifying individual-, social- and structural-level facilitators and barriers to uptake and effectiveness of novel interventions, as well as to how these new addiction programs may impact health care access and outcomes of OUD care and related comorbidities (e.g. HIV, hepatitis C) will be key to informing efforts to improve the delivery of addiction care in BC.
End of Award Update – April 2024
Results
Findings from the OPTIMA trial showed that more flexible approaches to opioid use disorder care are similarly effective than more traditional approaches requiring people to go to the pharmacy every day. This has important clinical and policy implications as there is substantial evidence, including from my own research, that rigid models of care are one of the main barriers to retention in treatment, and that discontinuation from treatment increase the risk of overdose and death. We are now evaluating the effectiveness of novel pharmacotherapies in real-world settings.
Impact
Findings from my research have informed clinical guidelines, and policy decisions (re-introduction of methadone formulation in the OAT program in BC).
Potential Influence
I expect that findings from my research evaluating slow-release morphine will have implications to better understand its benefits and risks in the continuum of care of opioid use disorder.
Next Steps
I will continue with research to close the implementation gap in substance use care, including opioid use disorder, but also using some of the learnings to address alcohol use, which has a substantial burden of disease.
Acute spinal cord injury (SCI) is a devastating neurological condition resulting in permanent morbidity and impaired quality of life. In spite of advancements in the acute treatment of SCI, preventing neurological deficits in affected patients is highly limited. The hemodynamic management of acute SCI patients to maintain blood supply and maximize oxygenation of the injured spinal cord tissue is currently one of the few aspects of critical care in which clinicians can improve neurologic outcomes. However, optimizing the hemodynamic management in acute SCI is limited and challenging due to the lack of a real-time means for monitoring spinal cord blood flow, oxygenation, and hydrostatic pressure.
The overall objective of Dr. Shadgan's research is to develop a novel optical method, using an implantable optical sensor and system that work based on near-infrared spectroscopy (NIRS) to provide real-time measurements of spinal cord hemodynamics in acute human SCI. Such a tool would provide information to guide clinicians in their treatment decisions and allow them to personalize the hemodynamic management of acute SCI patients to optimize neurologic outcomes. This program includes a sequence of preclinical studies aimed to translate this approach to human SCI patients. Dr. Shadgan's research program will also include the training of highly qualified personnel, intellectual property protection of the method and system, and knowledge translation.
Stroke is a leading cause of death and disability in Canada, costing our economy $3.6 billion per year. More than 405,000 people are currently living with the effects of stroke. This number is expected to rise to 720,000 by 2038.
We all know that a stroke is an emergency health issue requiring immediate medical attention. Fewer people, however, know that strokes also have long-term health effects that patients live with on a daily basis, including muscle weakness and balance and coordination issues. Unlike other diseases with long-term health effects, such as heart failure and diabetes, there has been little research to improve the health services provided to stroke patients after they return home from the hospital. As a result, it is common for these people to have another stroke, have many hospital visits, and report other health issues. More research is needed to improve the access to and delivery of health services to stroke patients to better manage their health over time.
The purpose of this five-year research project is to improve long-term care for stroke patients. Dr. Sakakibara will work with stroke patients to ensure the research focuses on what is important to them, and then evaluate new programs (delivered using mobile technologies and the internet) to help patients plan their return home from hospital; improve lifestyle behaviours to prevent other health issues; and better manage their health and well-being for long-term health benefits.
Dr. Sadarangani's research focuses on preventing severe illness and death in children by ensuring best use of vaccines to protect against three serious infections (meningococcal, pneumococcal, pertussis) which cause blood poisoning, meningitis and whooping cough.
Vaccines have reduced these infections, but we dont know if we are usng the optimal number and timing of dses. Sadarangani's goals are to ensure optimal use of these vaccines and aid development of future vaccines.
The project will:
- Compare the current three doses of pneumococcal vaccine given to infants against two doses. If there is no difference using two doses would mean fewer injections and lower cost.
- Compare the response to meningococcal vaccine in adolescents who have received 1, 2 or 3 previous doses, and compare the three available vaccines to identify any differences between them.
- Compare the effectiveness of pertussis vaccinefor whooping cough at different times of pregnancy to confirm the best time to immunize to protect the infant
- Examine the genetics of the pneumococcal bacteria to understand its transmission and evolution.
This research will improve vaccine schedules and help design future vaccines, ensuring that children continue to be protected against these devastating infections.
Chronic obstructive pulmonary disease (COPD) affects 300 million people worldwide and is the third leading cause of death, responsible for over 3 million deaths per year. It is the number one reason why adults end up in hospitals. However, we do not have good drugs to treat patients with COPD. This is because we do not fully understand how and why COPD develops and progresses.
Smoking can cause COPD but not all smokers get the disease; our genes also play a role. Identifying which genes cause some people to get COPD or lead to disease worsening over time will allow us to understand these processes more and to develop new drugs to treat the disease.
This project will use sophisticated analysis tools called integrative genomics. First, we will identify regions of our DNA that are important for COPD risk and worsening over time. This will be done through studying DNA regions from thousands of subjects with and without the disease and on whom we have information on how well their lungs work. We will then identify the function of these DNA regions by uncovering their effect on gene products and proteins in tissues that are important and relevant for COPD such as lung and blood. These genes and their products will be tested in laboratories to confirm the findings. The goal is to use this information to monitor disease and will additionally allow us to interfere with these gene products to treat disease.
Nearly half of Canadians will be diagnosed with cancer during their life. Healthy eating, a healthy body weight, and regular physical activity can prevent one-third of cancers. Yet, many Canadians do not engage in these lifestyle behaviours. New approaches to improve diet-cancer research are needed to move the field forward and reduce the burden of cancer on Canadians.
Dr. Murphy's research focuses on modifiable risk factors for cancer; nutrition and body weight. The goal is to provide new insight on how and why these factors contribute to cancer development using data from large populations of Canadians and innovative approaches such as lifestyle biomarkers that may explain why factors lead to cancer development.
Advances in cancer prevention are needed to promote the health of people in BC and nationwide. This research will provide new insight into modifiable factors for cancer that may help encourage lifestyle changes and development of new strategies to prevent cancer.
The transition to high school is a challenging developmental period, during which prevalence rates of depression more than double. In fact, by the end of the first year of high school, 11.5% of adolescents will have experienced a depressive episode in the last year, and many more adolescents will have experienced elevated depressive symptoms that interfere with school performance, social friendships, or physical health. Despite the importance of this transition, little is known about predictors of depression during it, and most students report feeling insufficiently supported to cope with it. Thus, the proposed research will work towards answering two questions critical to Canadian youth:
- What causes adolescents to develop depression during the transition to high school?
- What can we do to help students better cope with this transition and to mitigate risk for depression during it?
Findings will be critical to improving students' emotional health during the high-school transition. Knowledge translation activities will inform future research, practice, and policy.
