Anemia is a condition in which there is a decrease or destruction of red blood cells causing inadequate transport of oxygen throughout the body. It is a major public health problem affecting ~25% of the global population, or ~9 million Canadians of all ages.
In infants and children, anemia can impair brain development and decrease learning ability. In adults, it can cause fatigue, lower work capacity and increase the risk of adverse pregnancy outcomes (e.g. low birthweight). Causes of anemia can include micronutrient deficiencies (e.g. iron or folic acid), infection and disease, and genetic hemoglobin disorders (e.g. thalassemia). Understanding the causes of anemia is critical to inform appropriate strategies to prevent and treat anemia, and to reduce the risk and burden of disease.
Dr. Karakochuk's research program will seek to improve diagnostic methods and investigate novel biomarkers for anemia and iron deficiency, and assess the risk-benefit of iron and folic acid supplementation programs designed to treat anemia and other chronic diseases. The ultimate goals are to reduce the burden of anemia and to inform safe and effective nutrition policy, programs and interventions for individuals and populations in Canada and globally.
Mental health and substance use (MHSU) challenges are leading health issues facing youth globally. In Canada, 20% of the youth population experiences mental health disorders, and youth aged 15-24 have the highest rates of past year substance use and related harms. To address these concerns, MHSU researchers and advocates argue for a population health approach incorporating promotion, prevention, and treatment within a 'healthy public policy' framework. Yet while much research has focused on the prevention and treatment of youths' MHSU challenges, there has been limited focus on mental health promotion.
Further, while there is growing recognition of the importance of engaging youth in matters that affect their lives, there is a paucity of evidence-based guidance on how to do this effectively. This study contributes to addressing these substantial gaps by exploring how to meaningfully engage youth in the policymaking process to promote MHSU outcomes. Participatory approaches and mixed methods are being used to generate knowledge and inform a framework to guide youth-engaged research and action to better tackle the MHSU needs of Canadian youth.
Infectious diseases remain a serious and constant threat despite the high standards of sanitation and health care enjoyed by the British Columbians. Moreover, British Columbians, living in a major port of entry to Canada, face an increased risk of contact with emerging infectious diseases as exemplified by SARS. An effective disease surveillance system requires multiple health organizations to work together and share information with each other. Advances in genomic technology have improved the detection and characterization of disease-causing microbes and provide public health practitioners a better surveillance tool. Yet, genomic data is voluminous and complex, creating a challenge for our health care system and practitioners. Moreover, contextual data needed to interpret genomic data often contain sensitive and private information making sharing of contextual data across jurisdictions a challenge.
Dr. Hsiao's research program builds innovative technology solutions to improve organizational efficiency, trust, and capacity of BC's public health surveillance network. Our work will stop the spread of diseases, reduce the overall disease burden and health care cost, and ultimately improve the health and well-being of British Columbians.
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.
