All of the cells in our body are coated with a dense layer of sugar molecules. Cells in our immune system constantly “taste” these sugars. Some types of sugar taste good to our immune system, signaling that our cells are healthy. Other sugars (like those attached to invading bacteria, viruses or cancer cells) taste bad to our immune cells, triggering them to activate and try to protect us from disease. Sometimes, our own cells can become altered in ways that lead them to produce abnormal types of sugar molecules on their surface. When this happens, it can allow cancer cells to evade detection and destruction by the immune system. Our group applies powerful genomics technologies to better understand how human cells generate these immune-regulatory carbohydrates. This information allows us to predict when cell-surface sugars may become chemically altered and identify specific molecules that can be targeted for manipulating immune activity. The insights generated from our research directly impact the design of new immune-targeted cancer therapies.
Program: Scholar
Transforming health services following traumatic brain injury through peer-support
Traumatic brain injury affects approximately 450 people every day in Canada and is a leading cause of disability nationally and globally. These injuries can lead to life-long disability and health problems, and people who sustain them often experience decreased quality of life, poor mental health, and long-term unemployment.
There is a critical gap in the development and delivery of programs and services that help people with traumatic brain injury to improve their health. Current health services focus on areas of impairment rather than personally-important priorities for rehabilitation. In addition, participatory research, which engages people with traumatic brain injury and community organizations as active partners, is underused in the development of rehabilitation programs.
My goal is to implement a peer support program for people with traumatic brain injury. I will use a partnered approach, in which people with traumatic brain injury and members of their community are leaders in the project. This will ensure that the research answers to their needs and values. Ultimately, this research will improve the access to services, health, and quality of life of people with traumatic brain injury in Canada.
Targeting neuronal maturation to promote axon regeneration after spinal cord injury
Spinal cord injury leads to permanent and severe paralysis and loss of sensation. The principal reason for this is that nerve cells connecting the brain with the rest of the body lose the capacity to regenerate their processes (axons) as they mature during development. Despite decades of progress, no regenerative therapy for the injured spinal cord is available today, making a regenerative treatment for spinal cord injury a major unmet need of the British Columbia healthcare system. In this project, we will focus on the fundamental processes through which maturation suppresses axon regeneration. We have discovered a molecular switch that is turned off in mature neurons and that we hypothesize is critical for nerve cells to regrow axons. We will study how this molecular switch is turned off during maturation, the processes that it controls to enable growth and test whether re-activating it in mature neurons can promote regeneration and functional improvements following spinal cord injury. Collectively, this work will provide critical insight into why mature nerve cells fail to regenerate. We anticipate that this work will be a major steppingstone towards the development of a treatment that regenerates the injured human spinal cord.
Errors, Uncertainties, and Ambiguities in Wearable Health Monitoring Systems
Healthcare and diagnostics have recently undergone a paradigm shift with a greater focus on remote health monitoring through wearable technologies. Advances in miniaturized electronics, wireless communications, and big data analytics are all converging in this space to take health monitoring out of the clinic and into the home. However, while the exponential increase in wearable technologies is driving excitement in this field, such technologies have found limited success in clinical integration. While consumers might find a plethora of smart gadgets from watches to rings that can track activity and heart rate, little of this information is getting utilized by clinicians. This is in part due to the lack of transparency and perceived inaccuracy of wearable monitoring systems. We will address this limitation by characterizing errors in measured real-world health signals, accounting for errors in user-device interactions, and capturing uncertainties and ambiguities in decisions that will allow wearable sensors and underlying machine learning algorithms to provide more contextual and nuanced information for clinicians. This will help clinicians decide when and how to apply wearable data to clinical decisions.
Evaluating microstructural changes in multiple sclerosis with magnetic resonance imaging
Multiple Sclerosis (MS) can be difficult to detect, diagnose, and treat. It is often initially assessed by excluding other potential disorders and diseases as well as (where possible) a confirmatory magnetic resonance imaging (MRI) exam. While MRI can confirm the presence of MS lesions in the brain, the exam is of limited use in explaining or predicting symptoms or prognosis.
Following the initial diagnosis, there are a number of medications that can be used to attempt delay the progression of the disease. However, it is challenging to assess the efficacy of a particular course of treatment unless disease progression is detected through the accumulation of additional disability or a follow-up MRI exam confirms the presence of new lesions.
There may be other changes to the brain which may help scientists and physicians to understand how and why MS progresses and identify how well medications are working for a particular individual. Thus, the objective of this work is to leverage the power of a safe, non-invasive, imaging tool (MRI) to detect and evaluation changes to the brain that can help us better treat patients with MS.
Beyond Sex and gender: advancing a biosocial understanding of affective processes.
Affective processes such as stress and emotion are at the heart of how we understand ourselves and interact with the world around us. Human and animal research supports the role of sex and gender-related factors in affective processes; however, the neurobiological mechanisms that influence affective processing remain unknown. While sex and gender are traditionally defined, respectively and separately, as biological and social dimensions of a person, alternative approaches rooted in interdisciplinary research rather conceptualize our biologies as inseparable from our social experiences. The proposed program of research aims to explore how an interdisciplinary gender/sex approach (as opposed to the distinct gender and sex approach) influence the neurobehavioural processes of stress and emotion. This research will expand our understanding of how context shapes biological and subjective experiences of stress and emotion and advance the development of integrated theories that will shape the future of gender/sex research.
Organ-sparing minimally-invasive endoscopic resection techniques program: incorporating high-quality endoscopic management into everyday clinical practice
Colon cancer is a leading cause of death, disability and healthcare costs in BC. This emphasizes the importance of removing polyps during colonoscopy, which are pre-cancerous growths in the colon that develop into cancer over time.
Large polyps (LPs) are especially important. They are common and are more likely to be cancerous at the time they are removed. A number of techniques have been created to safely remove LPs during colonoscopy, including those which can cure early cancers. These techniques, called minimally-invasive endoscopic resection techniques, stop patients from undergoing unnecessary surgery which can lead to disability and death. However, many patients with LPs are still undergoing unnecessary surgery in BC and worldwide.
We propose a research program on LPs with two key goals: 1) identifying the best techniques to safely remove LPs; 2) Incorporating these techniques into everyday clinical practice. These goals will be achieved by collaborative research projects with national and international experts within this field including the BC Colon Screening Program.
Achieving these goals has the potential to improve the health of patients in BC and reduce healthcare costs.
Nini nanaghintsan ?anh (is your mind tired?): The Healing Journeys of Indigenous Adolescents Navigating Pathways to Urban and Online Wellness Supports
Due to the historical and ongoing effects of colonization, Indigenous youth experience higher rates of mental illness. As Indigenous youth, it is particularly difficult to access mental health care in Canada. Many Indigenous youth are reluctant to seek help when they are in crisis. Indigenous youth and families advocate it would be better if more culturally-responsive wellness supports were available. This research project will use oral traditions and storytelling to ask Indigenous youth (aged 12 to 24) about their healing journeys when accessing wellness supports in urban and online spaces. This project will work in partnership with Foundry BC to collaborate with local Indigenous communities. In Phase 1, Indigenous youth will join Sharing Circles to create collective stories about what holistic wellbeing means to them and how they access wellness supports in community and online settings. In Phase 2, Indigenous youth will be asked to complete a survey about their mental health care access, cultural identity, technology use, and holistic wellbeing. The findings from this study can inform culturally-resurgent practices to help transform the way Indigenous youth are engaged in wellness supports across urban and online spaces.
Promoting integrated mental health care services and supports for refugees in BC
Approximately 84 million people worldwide were forcibly displaced during 2021, including refugees, who have been forcibly displaced by conflict. It is estimated that 1 in 5 people in settings affected by conflict have a mental disorder. Evidence shows that many refugees require mental health support post migration as a result of trauma, and post migration stress. Mental health conditions such as depression, anxiety, Post Traumatic Stress Disorder, and psychosis are much more prevalent among refugees than among host populations. Post migration, refugee mental health is determined by stressors of acculturation such as employment, housing and access to health care.
Limited knowledge exists on how mental health services work to promote refugee mental health in high income countries like Canada. Barriers to mental health care include service fragmentation and provider knowledge about the determinants of refugee mental health. The goal of my research is to develop and conduct an evaluation of existing mental health services and supports for refugees in BC. Findings will inform primary health care services, mental health services and settlement services about what promotes integrated mental health care for refugees in BC.
Moving online: Developing physical activity interventions with and for young people diagnosed with cancer
Physical activity is safe and beneficial for children, adolescents, and young adults diagnosed with cancer. However, few physical activity programs are available for young people diagnosed with cancer. This is partly because cancer is rare in young people, and so it is hard to create programs that can be accessed by everyone. In my research, I create and test physical activity programs that consider the needs of young people diagnosed with cancer. Over the next 5 years, I will work with children, adolescents, and young adults diagnosed with cancer and their parents, cancer support organizations, fitness professionals, healthcare providers, and researchers to create online physical activity programs that are safe and accessible. I will then implement and test these physical activity programs with young people diagnosed with cancer across Canada. My work will lead to new physical activity opportunities with the potential to improve the health of young people diagnosed with cancer across the country.