Stressors encountered in daily life such as family conflicts contribute to the risk of experiencing mental health issues such as anxiety. Conflicts between parents and their children increase in adolescence, but research has focused primarily on its mental health implications for adolescents and not also parents. Parents of adolescents go through their own developmental transitions (e.g., midlife) that bring significant stressors with them. Therefore, both parental and adolescent developmental status and mental health need to be understood to help families develop healthy communication and conflict skills, which may benefit the mental health of both individuals. We need to identify which types of emotion patterns are associated with increased risks, or protection from, the development of mental health issues in response to stressors. We aim to identify parent-adolescent emotion dynamics in the context of stress that are associated with both parents’ and adolescents’ anxiety. The primary impact will be to refine an existing community-based intervention for parents of anxious adolescents and to promote its accessibility by involving families and counsellors in the redevelopment process.
Program: Scholar
Mucus-directed therapeutics to prevent and treat chronic microbiota-dependent diseases of the gut
The colon is teeming with life, not just due to our own cells, but also due to a rich and diverse community of microbes. Remarkably, this community is a virtual organ, helping to digest food and fight inflammation. Unfortunately, this “organ” can malfunction and cause chronic diseases like inflammatory bowel disease (IBD), which affects thousands of Canadians. How to promote the benefits and prevent the harmful activities of our microbiota is a central question. One major factor is gut mucus, a sugar-rich gel-like layer that surrounds the microbiota to act as a barrier to prevent their invasion. This mucus layer is defective in IBD. The objective of my research is to develop new ways to capture the protective power of human mucus to prevent and cure IBD. To do this I will use a new approach my lab developed to extract and purify human mucus to test its protective abilities in mouse models of IBD. We will also learn how microbes control mucus production so we can target these pathways in patients. Last we will use human colon cells to generate a “mucus factory” that can produce mucus with enhanced protective properties. The results of this research will illuminate new paths to restore healthy host-bacteria relationships in IBD.
Co-Developing a Learning Health System with People with Lived/Living Experience of Substance Use: a response to the toxic drug poisoning crisis
Walk With Me was developed by Dr. Karsten and her research team throughout the past four years with intent to combat stigma and create systems change in relation to the toxic drug poisoning crisis – a public health emergency that has enacted more deaths in BC than suicides, car accidents and homicides combined. This team has been working in Vancouver Island communities of various sizes, and within Island Health acute care facilities, to better understand the ways in which the drug poisoning crisis is impacting communities and systems. Through deep listening, peer engagement and leadership, and collaborative design, the team has developed recommendations designed to close service gaps and reduce stigma. In the summer of 2022, Island Health released its first Harm Reduction Policy. Stemming from this release is an opportunity to deepen this existing partnership, through the co-creation of a Harm Reduction Learning Health System. This system, developed through patient/peer insights and leadership, and alongside clinicians, management and staff, will enable Island Health to respond effectively to a rapidly-evolving public health crisis.
Integrating functional glycomics and genomic screening to reveal new targets for cancer immunotherapy
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.
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.