Group sex is an important health phenomenon, with an estimated one-in-ten people engaging in group sex at some point in their life. Group sex can be a source of pleasure and belonging but may increase risk of sexually transmitted infections (STIs). Despite its estimated prevalence, there has been little research on STI prevention and care among people who have group sex. Most group sex research has been done outside Canada and has focused only on men who have sex with men, excluding other sexualities and genders. My goal is to improve the STI outcomes for people who have group sex in Canada and beyond. My research focuses on 1) community-based knowledge around what makes group sex uniquely risky when it comes to STIs, 2) what STI prevention strategies people use during group sex and how effective they are, and 3) the barriers that healthcare providers face in providing STI care to people having group sex. Based on my findings, I will work closely with group sex community members to develop educational materials and support resources to improve STI prevention and care. Ultimately, I hope to reduce STIs and their negative impact on the health of this diverse stigmatized population.
Program: Trainee
Matriptase-Selective Radiotheranostics for Metastatic Carcinoma
Metastatic cancer, in which cancer cells invade healthy distant tissue, is the leading cause of death in Canada. Epithelial breast, colon, and prostate cancer of the outermost tissue lining are the most prevalent forms of metastatic cancer and require better tools to prevent life-threatening outcomes. Treatments such as surgery and chemotherapy are either impractical for metastases, invasive, or toxic. The goal of this work is to develop a radioactive molecule that targets matriptase, an enzyme which supports tumor growth and metastasis. A set of molecules will be made, labelled with a radioactive tag, and screened for binding. Conveniently, the radioactive source is interchangeable for imaging or targeted radiotherapy. Using a specialized camera, tumor radioactivity can be noninvasively tracked to classify disease progression. Using a different radioactive tag, radiation can also be delivered to exclusively kill matriptase-positive tumor cells. The lead candidate is expected to enable tumor staging and improve patient outcomes by impeding tumor growth and spread. It may also be used to monitor response to therapy and guide clinical decisions, representing a major advance in the management of metastatic epithelial cancer.
Equitable health measurements to inform age-friendly community initiatives in diverse populations
The Age-Friendly BC initiative was initiated in 2007 to make communities (e.g., cities and towns) better for older adults. Improvements in programs and environments for older adults has been a major part of this effort. Surveys are a valuable tool for assessing the well-being of older adults in these communities. However, people from different backgrounds (e.g., gender, culture, age) might understand and answer survey questions differently. This project aims to understand differences in how people interpret survey questions and explore ways to adjust survey scores for these differences, with the objective of providing an accurate picture of older adults’ well-being. Communities can be designed to be fair to everyone if we acknowledge different ways in which people think about their well-being. We will work with older adults and policymakers from the beginning to the end of the project. They will help us create an analysis plan and understand findings. We will also work with them to figure out the best way to share what we find.
From Data to Dinner Plates: Empowering Equitable Transitions to Healthy and Sustainable Diets through Behavioural and Data Sciences
This research program aims to tackle the challenge of improving the overall health of the Canadian population, focusing on nutrition. The approach involves using methods from behavioral and data sciences. The study will investigate how small, non-economic encouragements (nudges) and financial incentives can influence people to make healthier and more sustainable food choices over the long term. For example, placing healthy food options prominently at the checkout is a type of nudge. The research involves creating an underlying technological infrastructure, connecting it with data from a grocery store loyalty card program, and analyzing how nudges and economic incentives affect shopping habits over time. The analysis will consider their impacts on total food intake, nutrients consumed, and the environmental impact of food choices. Additionally, the research will examine these influences across different socioeconomic groups to understand and address nutrition disparities. The ultimate aim is to offer practical insights for policymakers and businesses to promote fair, healthy, and sustainable diets.
Surgical, oncologic, and patient reported outcomes following breast conserving surgery versus mastectomy: a longitudinal study
Several trials have established breast conserving surgery (BCS) followed by radiation has equivalent or improved survival to mastectomy for early breast cancer, yet mastectomy rates are rising globally. It is thought patients perceive mastectomy to improve survival and reduce worry of recurrence, however recent advances in patient-centered care have measured patient reported health-related quality of life (HRQoL) among breast cancer patients, and early studies report higher HRQoL among BCS patients.
BCS rates in British Columbia are below the national average. Further clinical and HRQoL data are needed to understand factors influencing the BC mastectomy rate and inform clinical recommendations for BCS.
A patient cohort will be recruited from Providence Breast Centre and classified into BCS, mastectomy by patient preference, and mastectomy medically necessary to compare postoperative complications, oncologic outcomes, and patient reported psychosocial and HRQoL outcomes.
By linking oncologic and HRQoL outcomes, this study will provide novel information to facilitate more informed preoperative surgical counselling, and guide institutional and provincial policy for development of Canadian breast cancer surgery quality indicators.
Integrating Exercise Snacks into Type 2 Diabetes Care: feasibility and management of cardiovascular risk factors
Most people living with type 2 diabetes (T2D) do not achieve enough physical activity and miss benefiting from the powerful health benefits of exercise. “Exercise snacks” are short bursts of exercise lasting 1 minute or less, which can be done sporadically throughout the day. These snacks can be easily performed anywhere using stair-climbing or simple body weight exercises. Incorporating exercise snacks into the daily routine could help to break up sedentary time, regulate blood sugar, and improve blood pressure and fitness levels. This research program aims to explore the positive effects of exercise snacks in individuals living with T2D. Through a combination of lab-based studies and a real-world clinical trial that will deliver an exercise snacks intervention via a Smartphone “app”, we will test if exercise snacks can lower blood sugar and improve cardiovascular health in people with type 2 diabetes. In order to maximize the reach and impact of our research, we will also develop infographics and videos to help teach individuals with T2D how to incorporate exercise snacks into their day. This research aims to empower people living T2D to improve their health, one exercise snack at a time!
How do neurons in breast cancer tumours control anti-tumour immune responses?
Immune cells can be very effective at killing cancer cells, but tumours have the ability to suppress the immune system. This is why some of the best cancer therapies work by turning the immune system back on. To do this, it is key to understand what controls immune responses in the tumour. In inflammation, it has been shown that neurons can control the immune system. Interestingly, there is evidence that by removing neurons, cancer growth is reduced. We have discovered that when the “heat sensing” TRPV1 neurons are removed in mice, the tumor will grow much slower. We will looked at changes in immune cells using flow cytometry, which allows us to measure over 20 different immune cell types and discovered that these mice may have lower numbers of a rare cell type called ILC2. Next we are trying to understand how neurons are affecting these cells and the tumor growth. Finally, we will design a cell culture system where neurons and mini-cancers will be grown together to see if the tumors are secreting something that changes the expression of genes by neurons. This will lead to the development of novel therapies that activate the immune system by targeting neurons and provide new information on therapeutic avenues for breast cancer.
Exploring the natural history of chronic disease self-management and health resource utilization after stroke
The ability to effectively self-manage may empower people with stroke to optimize their recovery, health and wellbeing, and in doing so reduce healthcare costs. However, little is known about how people with stroke self-manage their recovery after hospital discharge, as well as how sociodemographic factors such as biological sex, age, stroke severity, and number of comorbidities impact how stroke survivors self-manage different areas of their lives. Therefore, this one-year longitudinal study aims to explore changes in self-management abilities among people with stroke after they have been discharged from hospital. We will also observe changes in health behaviours, emotions and life roles over the course of one year. Finally, we will also explore the association between self-management abilities, health resource use and costs over time. We hope to inform the development of targeted self-management interventions that consider the optimal timing after stroke to deliver such programs, and that allocate resources effectively for people with stroke that would optimally benefit from self-management support. This research will be presented at scientific conferences and will engage a patient partner in the translation of study findings.
Impact of TSC2-deficient neural cells on microglial structure and function in an induced human pluripotent stem cell model of tuberous sclerosis complex
Tuberous sclerosis complex (TSC) is a rare genetic disease caused by mutations in the TSC2 gene. The TSC brain develops malformed tissue clusters called cortical tubers (CTs), which cause epilepsy and cognitive problems. CTs result from abnormal cell differentiation, where clusters of enlarged neural stem cells, astroglia, and hyperactive neurons form. CTs notably present markers of cell stress and inflammation, which are known to affect organelles, cell differentiation, and neuron function in CTs. CTs are surrounded by microglia, the resident immune cell of the brain, required for proper brain function and the main drivers of inflammation. Though known to be a feature of TSC brain lesions, the role of microglia in CT formation is completely unknown. Therefore, I will investigate if microglia contribute to CT formation and, study for the first time, how the interaction with TSC2 mutant cells affect microglial function. Using advanced molecular and imaging techniques, I will study if microglia affect CT formation in a co-culture model of human pluripotent stem cell-derived microglia and TSC2 mutant neural cells. Our results will finally elucidate the role of microglia in CTs, a critical advance to uncover novel treatments for TSC.
Promoting the sustainability of digital interventions for sexually transmitted and blood-borne infections in Canda: A multi-methods study
More and more people are using digital tools to get tested for STIs. But we don’t know much about how to ensure that the public health benefit of these tools last for a long time. We call this sustainability. In this project, we want to learn how to make the benefit of these tools last. Here is what we will do:
• Review existing research to find out what things people think about when they want digital STI tools to be sustainable.
• Explore the experiences of digital STI testing programs, like BC’s GetCheckedOnline (GCO) and other similar programs. GCO is a program that lets people get tested for STIs online. We will review program documents. We will also interview the people who run the program and those who work with them. We will document the processes and factors that have made their programs sustainable so far.
• Review GCO’s data to see how people use the program. This is important because some people worry that too many people using the program too often might make it hard to keep it going.
Our project will help GCO and other programs like it plan for the future. It will also help us make a plan for how to make these programs sustainable.