Genomics is the study of how the information contained in a genome gives rise to organisms and their functioning. This relatively new field of research analyzes vast amounts of data to uncover biological trends that help scientists understand how genes function in living systems. Dr. Jenny Bryan is working to develop new quantitative methods and statistical frameworks required for analysis of large functional genomics data sets. Her work addresses how researchers can find patterns and themes in complex, multidimensional genomic data. With colleagues, Dr. Bryan has pioneered methods of statistical gene expression analysis and has created a software program to implement these methods. Her software is currently being used by the world’s second largest biotechnology company. After she completed her PhD in 2001, Dr. Bryan elected to join Vancouver’s burgeoning computational biology and genome sciences community. Along with her dual appointment in the UBC Biotechnology Laboratory and Department of Statistics, she is also a faculty member in the MSFHR/CIHR Strategic Training Program in Bioinformatics.
Program: Scholar
Children’s mental health: Linking research evidence and policy making
How can we ensure that public policies in children's mental health reflect the best available research evidence about what works to help children. This is the research focus for Dr. Charlotte Waddell, who is exploring ways to strengthen the links between new research knowledge and policy making. At any given time, up to 20 per cent of children experience mental health problems that affect their emotions, learning and behaviour, and interfere with their development. This creates a large burden of suffering for these children, their families and their communities. However, there are often few links between the realms of research evidence and policy making in children's mental health: research evidence is often poorly communicated to policy makers, and policy makers often make decisions that contradict the best available research evidence. Dr. Waddell is investigating the respective needs and working cultures of researchers and policy makers, and will suggest and test new ways for these two groups to share information better. The goal of her work, supported by MSFHR, the Canadian Population Health Initiative and the BC Ministry for Children and Family Development, is to ensure that more effective interventions are available to help children at risk. Her findings will apply to many other health arenas where improved links between research and policy making are also needed.
Studying the health care workers: A program of research on the relationships between work and health
The face of health care and the working environment for health care workers in Canada is changing, bringing increasing job complexity, an aging work force, changes in the delivery of patient care, and concerns for employee recruitment and retention. These changes have been coupled with cost containment strategies – such as restructuring – that alter the resources that staff have available to do their work. Dr. Mieke Koehoorn’s research focuses on how the work environment affects the health and well-being of health care workers in BC. She is using the BC Linked Health Database in conjunction with hospital employee and survey data to create a comprehensive population-based, person-specific, longitudinal database of health care workers. The database, recording information such as health care utilization, workers’ compensation and long-term disability records, is unique in its depth and breadth. Dr. Koehoorn is using this information to describe the health and health care utilization of health care workers and investigate the workplace practices and conditions that predict health outcomes. By understanding the complex determinants of health for health care workers, Dr. Koehoorn hopes to help inform industry decision-makers to allocate resources and implement workplace policies and procedures that improve employee health and performance and reduce work-related disability.
The impact of changing work and community conditions on the health of workers and their children in BC resource dependent communities
Health research has established a strong link between socio-economic status and health outcomes. However, in BC’s resource-dependent communities, the income and social status situations for many workers vary throughout their working lives as a result of changing technologies and labour market conditions. Downsizing and restructuring in the labour market often results in greater frequency and duration of unemployment. Workers who retain their jobs often experience increased work stress in adapting to new on-the-job requirements, and entire resource-based communities are affected when industries downsize and restructure. Dr. Aleck Ostry is focusing on the health of workers in resource-based industries, and the health of their children. Dr. Ostry is studying the health outcomes of more than 28,000 sawmill workers between 1950 and 1998 in 14 BC sawmills, as well as approximately 23,000 of these workers’ children. He will explore to what extent labour market experiences at work and in the community affect the health outcomes of workers, and how these experiences also affect the health of their children. As changing market conditions in the global economy affect workforces throughout the world, this research is gaining national and international recognition.
Ecological approaches to understanding health behavior and outcomes among youth
In spite of prevention programs that target risky sexual behaviours in youth, many BC teens continue to experience serious health and social problems related to sexually transmitted diseases (STDs) and unplanned pregnancies. However, there are significant variations in the incidence of teen pregnancy and STDs among rural and remote BC communities. Terrace, for example, has relatively high rates, while 100 Mile House has lower rates than the provincial norm. Dr. Jean Shoveller is studying the factors that contribute to this variation in sexual health outcomes among youth. In addition to personal behaviours among teens, she is investigating how other factors – such as relationships with family and peers, community social norms and the influence of institutions including education, health and religion – may contribute to decisions they make around their sexual health. Through her five-year study of three rural/remote BC communities, Dr. Shoveller hopes to provide significant insight into how communities can help prevent adverse sexual health outcomes among their youth.
Community partnership research in population health promotion: The development of tools and measures for planning and evaluation
Strong evidence suggests that the health system is not the primary factor determining the health of Canadians. Non-medical factors – such as income, social support, education, employment, housing, health practices, child development, gender and culture – are crucial determinants of health and quality of life. Regional health authorities across BC are increasingly taking a population health approach, which addresses these non-medical factors, in community-based initiatives. However, these efforts are often complex and involve diverse participants from within and outside the health system, making it difficult to evaluate their effectiveness. Dr. James Frankish is studying how health authorities are addressing non-medical determinants of health. He is developing and testing tools to provide evidence-based evaluation of community-level effects resulting from population health initiatives. A particular focus is inclusion of vulnerable populations in these initiatives and related policy and practice implications. Dr. Frankish is also the leader of the MSFHR/CIHR program for Transdisciplinary Training in Community Partnership Research: Bridging Research to Practice, which is co-funded by the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research.
Paracrine processes in prostate cancer progression
Prostate cancer is the second leading cause of cancer-related deaths in men. Advanced prostate cancer is often treated with androgen withdrawal therapy, which blocks the growth-promoting effects of androgens (such as testosterone). Unfortunately, the cancer eventually progresses to an androgen-independent state, allowing for tumour growth without androgens. Dr. Michael Cox is studying how prostate tumour cells with neuroendocrine characteristics contribute to the disease’s progression to androgen independence. His research aims to understand how these cells develop within prostate tumours, what effect such cells have on the growth rate of prostate tumours, and how hormones secreted by these cells influence therapeutic resistance and metastatic preferences during disease progression. Dr. Cox is also working to determine the molecular mechanisms by which prostate tumour cells develop genetic mutations and become less susceptible to cancer treatment. He is identifying how tumour cells respond to growth factors in the presence or absence of testosterone and the cellular changes that allow prostate tumour cells to utilize these growth factors to aid development of testosterone independence.
Molecular basis of toxoplasma pathogenesis
While there has been significant research conducted about how bacteria and viruses cause disease, in comparison, relatively little is known about eukaryotic pathogenic processes – specifically, the disease-causing mechanisms of parasitic protozoans, which are single-celled, nucleated organisms. Dr. Michael Grigg is investigating the protozoan parasite Toxoplasma gondii, a common eukaryotic pathogen capable of infecting essentially any nucleated cell in most warm-blooded species. This highly successful parasite currently infects close to one-third of the human population. There are only three main strains of the parasite in nature and each line causes profoundly different disease in animals. Toxoplasma is known to stimulate a variety of immunological responses in infected hosts. Hosts are unable to clear the parasite, resulting in a life-long infection. Dr. Grigg is studying the immunological and molecular interactions that modulate Toxoplasma pathogenesis in an animal model of the disease, and identifying the virulence factors that are essential to the success of particular strains of the pathogen. From his work, he hopes to uncover new mechanisms and principles of pathogenesis.
Molecular study of interaction between mycobacterium tuberculosis and the macrophage endosomal compartment: An approach to identify mycobacterial virulence factors
Much of the resurgence of tuberculosis during the past decade can be attributed to the fast spread of new bacterial strains that are resistant to the conventional anti-tuberculosis drugs. New therapeutic strategies are urgently needed, requiring a better understanding of the interaction of the causal agent, Mycobacterium tuberculosis, with the host cells. Monocyte/macrophages are the principal targets for mycobacterium. These cells possess a powerful intracellular killing mechanism and play an essential role in the clearance of bacteria. However, one of the major features of tuberculosis pathogenesis is the residency of bacteria in an intracellular vacuole that evades intracellular killing. Mycobacterium tuberculosis interacts with specific cell surface molecules, acting as “”an entrance gate”” and ultimately producing factors that inhibit the intracellular killing. Dr. Zakaria Hmama’s research focuses on the molecular mechanisms regulating the entry of the bacteria into macrophages and the resistance to intracellular killing. Such studies will provide a rational basis for the development of new drug strategies.
Improving patient safety: Costs and effects count
Health economist Dr. Rebecca Warburton is analyzing the costs and effects of interventions to reduce the accidental harm caused by health care. Her research aims to provide a rational basis for establishing priorities among policies and programs for reducing errors. The US Institute of Medicine’s estimate that 44,000 to 98,000 Americans die every year as a result of preventable hospital mistakes has raised public awareness of errors in health care and focused attention on reducing risks and harm to patients. However, most Canadian hospitals are overwhelmed by the number of safety improvements suggested by experts or demanded by regulatory bodies. Limited resources, and lack of information about the likely costs and benefits of proposed changes, means that few safety strategies are actually implemented, and most changes are not well evaluated. Dr. Warburton’s research, conducted in partnership with the Vancouver Island Health Authority, compares the costs of patient safety improvements with the outcomes in terms of standard units such as life-years or quality-adjusted life years gained. Before joining the University of Victoria in 1999, Dr. Warburton spent 11 years in policy and research positions with the BC Ministry of Health. She is currently assessing the effectiveness of BC’s Premium Assistance Program, which subsidizes medical premiums for low-income residents, and assisting in the evaluation of BC’s Clinical Practice Guidelines and Protocols.