Program: Trainee

Counteracting the “Jumping to Conclusion” bias in schizophrenia with a combination of neuromodulation and metacognitive training

In Canada around 1% of the population is diagnosed with schizophrenia, roughly corresponding to 40 000 people in British Columbia. One typical feature of Schizophrenia is making hasty decisions without weighing evidence; this is known as the “Jumping to Conclusion” (JTC) bias. The bias can be understood as a tendency of quickly committing a final decision based only on the first available evidence. One of the most successful forms of treating the bias in schizophrenia is Metacognitive Training. During this therapy, patients try to question the logic of their own decisions. The goal of this project is to enhance the beneficial effect of this treatment and establish methods for objective monitoring of successful therapy. The previous research of Prof. Woodward lab showed that is possible to track neural connections of brain regions involved in the JTC bias. Here, we plan to identify these networks in each of our patients. Next, using a new technology for safe electric modulation of neural connectivity, we will strengthen connections in the network. Through multiple testing sessions we will monitor changes in the brains of patients and thus the progress of therapy. This project can help us improve the treatment of schizophrenia.

 

 

End of Award Update – June 2025

Results

They were able to focus on exploring the connections between schizophrenia symptoms and cognitive challenges such as problems with thinking, memory, and attention. A key aspect of the project involved using transcranial alternating current stimulation (tACS), a form of brain stimulation that may enhance brain function in individuals with schizophrenia. They also established a new lab at the University of British Columbia (UBC), where they trained undergraduate students in EEG (brainwave) recording and brain stimulation techniques—many of whom have gone on to pursue graduate studies in psychology and neuroscience, contributing to the future of mental health research in British Columbia.

 

Another significant achievement was the development of a new method for analyzing complex behavioral data, which enhances understanding of how schizophrenia symptoms relate to cognitive difficulties. This advancement has the potential to inform more effective psychological and brain-based treatments. They have published one scientific paper with collaborators and have another under review, contributing to global efforts to improve outcomes for individuals with schizophrenia. The award also helped solidify their long-term research goal: to continue investigating the links between symptoms and cognitive function in schizophrenia and to develop new strategies to improve quality of life for those affected.

 

Impact

The Research Trainee award has already had a meaningful impact in several key areas. It enabled them to train and mentor undergraduate students at the University of British Columbia (UBC), many of whom have continued their studies in psychology and neuroscience—contributing to the development of the next generation of mental health researchers in British Columbia.

 

Their research has advanced understanding of how symptoms of schizophrenia—such as difficulty expressing emotions and communicating—are connected to memory problems. This insight is crucial for developing more targeted and effective treatments, including therapy, medication, and brain stimulation approaches.

 

The award also facilitated the development of strong collaborations with researchers both in Canada and internationally. These partnerships have already resulted in one published research article and another in progress, further contributing to efforts aimed at improving the lives of people living with schizophrenia.

 

Potential Influence

This award has helped lay the foundation for a long-term research career focused on understanding the connection between symptoms and cognitive difficulties in schizophrenia. Looking ahead, they plan to continue this work by exploring brain-based treatments—such as transcranial magnetic stimulation (TMS)—to address symptoms like reduced emotional expression and limited conversational flow.

 

The insights gained from their research may improve the identification of specific brain networks involved in these symptoms, enabling more precise and personalized interventions. By building on the progress made during the award period, they aim to contribute to improved mental health care both in British Columbia and globally.

 

Next Steps

As a next step, they are actively applying for prestigious European research grants to continue their work on the connection between symptoms and cognitive difficulties in schizophrenia. These include:

  • MSCA Global Fellowship (Horizon Europe): Previously awarded the Seal of Excellence and planning to reapply in 2025.
  • Swiss Postdoctoral Fellowship (SNSF): A proposal has been submitted to continue their research in Switzerland.
  • Ulam NAWA Programme: A competitive grant in Poland supporting international researchers.

Through these funding opportunities, they aim to expand their research and develop brain-based treatments—such as transcranial magnetic stimulation (TMS)—to alleviate symptoms and improve cognitive function in individuals with schizophrenia. They also intend to disseminate their findings through scientific publications, conferences, and public outreach, ensuring the knowledge benefits both professional and community audiences.

Investigating what matters to youth: A mixed-methods study of youth-centred opioid treatments and their outcomes

Since 2016, approximately 1,200 youth in British Columbia (BC) between the ages of 15 and 24 have died from opioid-related overdoses. This has left families and communities to mourn the loss of their loved ones.

These overdose deaths can be avoided by getting youth the help they need, as early as possible. However, most of the currently available help has focused on adults, under the assumption that what works for adults will also work for youth. Unfortunately, research in BC has recently found that this is not the case. Instead, existing options for help do not meet youths’ opioid treatment needs.

The main goal of this study is to determine how to best help youth who use opioids. To meet this objective, we will engage youth, parents/caregivers and service providers in a research study. This study will explore priorities for opioid use treatment delivery. It will also determine how to best define the benefits of opioid use treatment for youth.

The findings of this study will help service providers and policy makers to deliver opioid treatments in a way that will better meet youths’ unique needs. The findings will also help future researchers to make sure that they are studying what matters most to youth.

End of Award Report – June 2025

 

Results

My multi-methods research has generated the following key findings related to youth-centred approaches to reducing the harms of non-medical opioid use:
(1) Youths’ substance use service needs significantly increased during the pandemic;
(2) The diagnostic incidence of mental and substance use disorders has increased among youth in BC, particularly among females;
(3) Youth using non-medical prescription opioids in BC have complex health and social care needs, which may be addressed by comprehensive care models, like Integrated Youth Services;
(4) Opioid agonist treatment remains an acceptable and effective evidence-based intervention for youth using non-medical opioids; however, a developmentally-appropriate approach is needed to improve youths’ engagement with this treatment;
(5) A developmentally-appropriate and youth-centred model of care for opioid agonist treatment delivery includes four foundational pillars: (1) trusting and collaborative relationships; (2) adaptable and flexible services; (3) low barrier services; and (4) holistic services.

 

Impact

My research has been shared with several provincial institutions and organizations who lead development and implementation of programs and policies for youth substance use health in BC, including Foundry, BC Children’s Hospital, the BC Centre for Disease Control, and the BC Ministry of Health, leading to the identification of several priority areas, including early intervention for substance use, youth overdose research and prevention, and expansion of opioid agonist treatment.  My research has culminated in a draft youth-centred model of care for opioid agonist treatment that will be validated and implemented across the network of 17 community-based Foundry centres in BC. My research is informing the development of a comprehensive substance use service strategy across the network of 17 community-based Foundry centres in BC. My research has provided opportunities for training and capacity building among youth (n=4) with lived/living substance use experience and several undergraduate (n=1) and graduate students (n=7).

 

Potential Influence

My research has the potential to improve the quality of care for youth substance use and youths’ substance use health outcomes. My research has identified promising practices for earlier identification and intervention of youth substance use, developing a youth-centred model of care for delivering and implementing opioid agonist treatment, and informing directions for ongoing monitoring and evaluation of these practices.

 

Next Steps

My five-year research vision is to lead a multi-methods program of research focused on the individual, community, and systems-level impacts of Integrated Youth Services. This research will be hosted at the University of British Columbia’s School of Population and Public Health (SPPH) where I will hold the position of Assistant Professor (Partner), in collaboration with Foundry (BC’s Integrated Youth Service initiative). My research will use integrated knowledge translation, qualitative methods, and quantitative methods to study these impacts. This program of research offers substantial training opportunities in health services research and youth mental health and substance use for graduate students and postgraduate fellows/trainees.

Portable MRI for multiple sclerosis: Feasibility establishment and technical development for clinical and research applications

Magnetic resonance imaging (MRI) is an important tool for diagnosing and monitoring multiple sclerosis (MS), a disease which affects millions of people. Unfortunately, current clinical MRI scanners are expensive to purchase and operate, have long wait times, and are often inaccessible for people in remote areas or with mobility issues. Recently, the world’s first portable and easy-to-use MRI scanner was developed by a commercial company (Hyperfine), and it will be available at the UBC MRI Research Centre in early 2021. Because this portable MRI scanner has a very low magnetic field and a small size, it has few safety concerns and can be easily brought to people anywhere. This platform will vastly improve MRI accessibility for clinical use, and make large-scale MS research possible. However, the portable MRI scanner’s ability to detect MS lesions in the brain needs to be tested. My project will compare the portable MRI scans with standard clinical MRI scans in terms of image quality for MS brains, and come up with a guideline for the use of portable MRI in MS. This work will be the first application of portable MRI to MS clinical care and research, and the ultimate goal is to bring MRI technology to everyone with equal opportunity.

Understanding the link between lung genomics, transcriptomics, and sex differences in COPD

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that causes respiratory symptoms such as shortness of breath and is the fourth leading cause of death worldwide. While COPD affects both males and females, females, in general, have worse symptoms and more COPD complications compared to males. We still do not have a good understanding as to why COPD behaves differently in females versus males. COPD was thought to mainly affect elderly males who were cigarette smokers; thus, most of the research have focused on males rather than females. To shrink this gap in knowledge, it is necessary to include females in biomedical and clinical studies and investigate the biological reasons behind why sex might affect how COPD develops. We hypothesise that some of the genes associated with COPD have different effects on males and females. In this project we will use a patient’s genetic code and how their genes behave to determine sex-specific signatures in their lungs and airways, and then measure how these signatures can predict the development of future COPD. This project can potentially contribute to the improvement of COPD treatment (particularly in females) and to identify new therapeutic targets for COPD.

Movement and young minds: Co-designing and integrating physical activity programming into health services for young people experiencing mental health and substance use challenges

In Canada, mental health and substance use (MHSU) disorders affect 25 percent of young people aged 12 to 24 years. Foundry is an organization in British Columbia (BC) made up of a number of centres across the province that offer a variety of services to young people with MHSU disorders. A service not yet offered is physical activity, which can be used to manage mental and physical health. An ideal time to help people develop healthy habits, including being physically active, is while they are still teenagers or young adults.

This study will explore how physical activity programming can be included as a service offered through Foundry centres. This will be done by using photographs to understand youth needs; development of a working group to consider how to add a service; and, co-creation of a physical activity program. This work will be done collaboratively with diverse youth, service providers, and researchers. The long-term goal is to improve the quality of care, and the health of young people with MHSU disorders living in BC, Canada and across the world.

The impact of the loss-of-function ankyrin-B p.S646F variant on cardiomyocyte and neuronal excitability: Implications for diagnosis and treatment of heart disease

The electrical rhythms underlying heart and brain function are sustained by proteins that form pores in cellular membranes that flux ions like calcium and sodium. These pores are anchored in place by a molecule called ankyrin-B (ANKB). We discovered a genetic change in the Gitxsan Nation of Norther BC that results in a version of ANKB (ANKB p.S646F) associated with heart defects at birth, arrhythmias, sudden death, seizures, and cerebral aneurysms. We showed that this version of the ANKB molecule is mishandled by immature heart cells; however, we do not fully understand how this ANKB version contributes to clinical manifestations. As a clinician-scientist and expert in microscopy-based measurement of cellular excitability, I am well-positioned to bridge this important knowledge gap. By imaging calcium and voltage changes in living cells, I will study the impact of partial loss of ANKB and expression of disease-associated ANKB p.S646F versions on heart and brain cell excitability. I will also compare heart cell excitability data with patient electrocardiograms to help understand the connections between fundamental laboratory and clinical observations.

Ventilation heterogeneity in asthma, COPD and asthma-COPD overlap: oscillometry and pulmonary MRI

Airways disease is a hallmark finding in both asthma and chronic obstructive pulmonary disease (COPD). Although tobacco cigarette smoking is the largest known cause of COPD, recent studies have revealed that 10% of patients with life-long asthma may develop COPD later in life without ever smoking. The mechanisms underlying asthma transition to COPD are unknown. To better understand this transition, this proposal will use 129Xe magnetic resonance imaging (MRI), computed tomography (CT) imaging and oscillometry to measure airway abnormalities in patients with asthma, COPD, and asthma-COPD overlap. These measurements will provide a better understanding of airway abnormalities that contribute to development of COPD in these patients with asthma. COPD is the most common cause of hospital admission in Canada and treatment costs in BC alone are estimated to be over $600M/year. The results generated from this proposal may identify new ways to treat COPD or halt its development in patient with asthma, contributing to reduced hospital admissions and costs related to COPD.

 

End of Award Update – March 2024

 

Results

With the emergence of long COVID, we pivoted our novel lung imaging methods to investigate the lungs of people who experienced COVID-19 infection with persisting, long term symptoms over 1-year after infection. In collaboration with colleagues at the University of Kansas Medical Center and Duke University, we created a multi-centre dataset of patients with long COVID to better understand how long COVID may differ across different patients. We used xenon gas magnetic resonance imaging (MRI) to measure how effectively the lungs of patients with long COVID were performing gas exchange (the main function of the lungs). Our results showed that there are 4 different sub-types of long COVID that have different lung abnormalities. We anticipate that the xenon MRI results can be used to help determine appropriate treatment for patients experiencing long COVID.

 

Impact

In our centre, the xenon MRI results have been used to help determine appropriate for different patients with long COVID. Our results uncover the lung-specific abnormalities that are related to long COVID.

 

Potential Influence

We anticipate these results will help to better understand and classify patients with long COVID, towards appropriate treatment and alleviating patient symptoms.

 

Next Steps

We are using similar xenon MRI methods to investigate other forms of lung exposures including cigarette smoking, cannabis smoking, and vaping.

 

Useful Links

https://erj.ersjournals.com/content/early/2024/02/02/13993003.02301-2023

Vitamin C-induced epigenomic remodeling as a preventive therapy for leukemic transformation

Despite the overall improved diagnostics, standard of care and therapeutic options, most acute myeloid leukemia (AML) patients suffer from severe therapy-related side effects and still only 28% of them reach 5-year overall survival. The hypothesis that drives my project is that mutations which affect DNA-modifying enzymes disrupt a methylation-based control mechanism that regulates gene expression in a way that halts the normal cellular differentiation process. The discovery that vitamin C acts as an enzymatic co-factor that is able to revert this methylation defect in affected cells, provides a unique opportunity to transfer this knowledge to the development of novel, less toxic treatment strategies for patients that harbour these mutations. Within the scope of this project, I plan to explore whether and to which extent I can restore the normal DNA methylation signature in patient-derived leukemic cells in mice, either through vitamin C treatment alone or in addition to Health-Canada approved AML drugs. Further, I will explore the potential of vitamin C treatment to delay or prevent the transformation of not yet leukemic cellular states towards myeloid malignancy.

 

 

End of Award Update – August 2023

Most significant outputs

The most exciting results are yet to come: two manuscripts are currently in preparation to be submitted to Genome Biology and Leukemia within the year.

 

Impact

Despite the overall improved diagnostics, standard of care, and therapeutic options, most acute myeloid leukemia (AML) patients suffer from severe therapy-related side effects and only every third patient reaches 5-year overall survival. An observation that formed the foundation for this project is the frequent occurrence of mutations in AML cells which affect enzymes that contribute to a special control mechanism that regulates if and how much of a gene is read from our DNA to produce functional proteins. This control mechanism involves the precise placement and removal of “methylation marks” – either directly on top of the DNA strands or at proteins that help to organize the DNA into the three-dimensional structure we call chromosomes. If the placement or removal of these methylation marks is altered, protein production and cell survival mechanisms are disturbed as a consequence – a characteristic which we often observe in cancer cells. In the past, our lab contributed to the discovery that vitamin C acts as a co-factor that helps to re-activate the enzymes that deposit and remove methylation marks, even despite their mutations. Thus, treating affected AML cells with vitamin C can help to revert their methylation defect, which directs their gene expression to a healthier state and causes cancer cells to die under controlled laboratory conditions. As vitamin C is a non-toxic, well-tolerated, widely available, and cost-effective substance, its potential anti-cancer effect provided us with a unique opportunity to test whether this knowledge could be translated into effective but less toxic alternative treatment strategies for AML patients who harbour these mutations.

 

Within the scope of this Health Research BC and Lotte and John Hecht Foundation co-funded project, we have created murine leukemia model systems that allowed us to confirm the vitamin C anti-leukemic effect in living organisms. Interestingly, while studying these models more deeply, we observed that not all cells within a pool of leukemia cells responded equally to vitamin C – whereas most cells matured and died, there seemed to be some cells that were able to survive the treatment despite carrying the same disease-initiating mutations. This observation directly impacts the potential to utilize vitamin C in a therapeutic setting, arguing that even among AML cases that display the same disease-driving genetic abnormalities, not all patients will respond to vitamin C. Also, these findings are consistent with clinical observations, where historically, vitamin C was reported to be both highly effective and not effective at all in a series of trials in the 1970’s and 80’s that assessed the activity of vitamin C against terminal stage solid cancers.

 

Potential Influence

In the remaining months of finalizing this project, we are focusing on identifying what makes some cells sensitive and others tolerant to vitamin C, despite the presence of the same disease-driving mutations. Therefore, we have selected individual cells from a pool of mutation-positive AML cells which display the ability to produce a leukemia-like myeloid cell hierarchy in a culture dish. Through repeated treatment and testing, we could identify both model hierarchies that repeatedly tolerated or succumbed to the presence of vitamin C. As each cell within a model hierarchy stem from a single ancestor cell, we hypothesize that it is the maturation state of the ancestor cell – in combination with the present mutations – that mediates the observed differential vitamin C responsiveness. Further, we argue that we will be able to observe this difference in maturation state in a cell or a hierarchy’s DNA methylation patterns. We are working to confirm this hypothesis to define a diagnostic molecular signature (a so-called biomarker) that might help decide which AML patients can benefit from vitamin C in a clinical setting.

 

Next Steps

This research will be continued in the Hirst lab; however, I will move on to a new position soon as the time I am allowed to work as a postdoctoral fellow in Canada is coming to an end

Resisting Vascular Cognitive Impairment: The Effects of Resistance Training on Myelin and Blood-based Biomarkers of Neuroplasticity in Older Adults

We are studying if strength training exercises can reduce myelin loss and preserve cognitive abilities in adults with cognitive impairment due to vascular risk factors (e.g., high blood pressure), also known as vascular cognitive impairment (VCI).

Worldwide, VCI is the second most common cause of dementia and it is associated with myelin loss. Myelin is a component of neurons critical for transmission of brain signals. Thus, myelin is important for the maintenance of cognitive (i.e., thinking) abilities. Animal studies suggest myelin loss may be minimized with physical exercise. The objective is to determine whether strength training (e.g., lifting weights) is an effective strategy for slowing down myelin loss in persons with VCI.

We will conduct a 12-month study with 88 adults with VCI; half will receive strength training and half will receive balance and stretching exercises. At the end of study, the two groups will be compared on myelin content and cognitive function. Reducing myelin loss could preserve cognitive abilities in adults with VCI and reduce their risk of dementia. Our proposal is also timely as the prevalence and burden of VCI will only increase with the world’s aging population.

End of Award Update – May 2024

Results:
Our main goal in this project was to measure the effect of resistance exercise (e.g., lifting weights) on myelin levels in the white matter. Myelin is the fatty tissue layer that covers axons in the white matter of brain, which is related to faster neuronal signal transmission. Myelin loss is very common in older adults living with cerebral small vessel disease. This condition causes a series alterations in the white matter, which may lead to declines in brain functioning and increase dementia risk. We first showed that higher levels of physical activity (e.g., waking, gardening, etc) were associated with greater levels of myelin in a few important structures in the white matter, including a region called corpus callosum in people with cerebral small vessel disease. We then tested whether 12 months of  the exercise program, resulting in no major changes in myelin. We compared resistance training group to a balance, stretching and toning group. Contrary to our hypothesis, the resistance group did not lead to changes in myelin, but the balance, toning and stretching group resulted in greater myelin levels measured in the deep white matter of the brain. This indicated that for these deep regions, including the fornix and corpus callosum, an exercise program focusing on balance, toning and stretching exercise may benefit myelin. The effects of resistance exercise may be more visible in other regions, which we have not yet looked in this study. Candidate regions include those that are linked with important cognitive abilities, such as the anterior cingulate cortex. I am currently investigating changes in these regions.
Impact:
Our research so far has received good attention from the scientific community, with two papers from the project being published in high-quality journals. I have also been able to present the findings from our work at international meetings, wherein I had the opportunity to exchange knowledge and gain new ideas for future projects.
Potential Influence:
The support I received from Health Research BC on this project allowed me to grow as a researcher, teacher, and mentor. The knowledge gained, connections formed, and experiences collected have been crucial in shaping the next steps in my career. This award provided me with the unique opportunity to work with and learn from an internationally recognized researcher and inspiring mentor in Dr. Teresa Liu-Ambrose and incredible co-mentors like Dr. Roger Tam. I also formed meaningful friendships with lab mates and very productive collaborations with colleagues at UBC, across Canada, and at international institutions from places like the US, Germany, and Spain. The Health Research BC award was instrumental in completing my postdoctoral fellowship and will have a long-lasting impact on my career. I am hoping to soon start my own research lab and continue investigating the role of exercise and other lifestyle interventions in promoting brain health and overall healthy aging.
Next Steps:
I will continue to investigate the impact of exercise on myelin and other clinically meaningful outcomes in people with cerebral small vessel disease, working alongside Dr. Liu-Ambrose and Tam at UBC. We are organizing the knowledge translation activities at UBC such as the Brain Health Symposium to take place in the summer. Our work will also be showcased at upcoming Alzheimer’s Association International Conference in Philadelphia. I will present on findings from my postdoctoral research at a Featured Research Session as well as in a Perspective Session, which Dr. Liu-Ambrose and I organized with colleagues from Spain and the US.

Promoting mental health in immigrant, refugee, and non-immigrant children: A British Columbia intergenerational population cohort study

Mental health problems are estimated to be the most common disabling condition among adolescents worldwide, with children growing up in socially disadvantaged homes having up to three times the risk of mental health problems compared to children without such disadvantage. Studies show a high degree of intergenerational stability in these patterns, with social stressors putting particular subgroups of children at higher risk from the earliest stages of development. Immigrant and refugee children make up a significant proportion of the BC child population, and have a unique set of circumstances that may increase or decrease their risk of mental health problems as they reach adolescence. In BC, an established system of child development monitoring paired with new data linkages to provincial health, immigration, and Statistics Canada records create a globally unique opportunity to investigate continuities from maternal mental health problems to childhood emotional symptoms and adolescent mental health problems, for immigrant, refugee, and non-immigrant children. The purpose is to identify opportunities to break these continuities, informing the timing and design of preventative interventions to promote population mental health.

End of Award Update: December 2022

 

Most exciting outputs

This project opened a door for me to contribute to two integrated knowledge translation studies monitoring family, child, and youth
mental health during the COVID-19 pandemic. Working together with researchers and stakeholders from public mental health and
government, we brought urgent attention to pandemic-related population mental health trends among BC families and young people
through research reports, a policy brief, an op-ed, media interviews, and eight published articles. I was excited to at the same time
complete my original study on mental health among immigrant, refugee, and non-immigrant children and present these results at the
International Population Data Linkage Network Conference in 2022. Findings from this study suggested that BC children with
immigration backgrounds enter school with lower emotional health than children with non-immigration backgrounds and are likely to
benefit from increased social supports.

Impacts so far

Our research on child and youth mental health during the pandemic was referred to during a Debate of the BC Legislative Assembly
and referenced in a BC Ministry of Education report on Key Principles and Strategies for K-12 Mental Health Promotion in Schools. I
also had the opportunity to present this research to over 100 health professionals through the Centre for Health Evaluation and
Outcome Sciences Work in Progress seminar series, drawing attention and inviting conversation around the pandemic recovery
response for supporting the mental health of families and young people in BC.

Potential future influence

The connections I have made with researchers and stakeholders through this award have initiated a pathway for what I hope will be
many future opportunities to synergize between research, health services, and policy to make collective population health impacts at a
systems level.

Next steps

I will continue collaborating with colleagues and bridging connections between research and practice in my new role in a health
services research and evaluation position. Results from the immigration mental health study have been selected for submission to a
journal special issue and will hopefully become available in 2023!

Useful links

Related videos

Watch this presentation on the mental health impacts of the COVID-19 pandemic on students, parents, and teachers, produced for the Centre for Health Evaluation and Outcome Sciences (CHÉOS) Work in Progress Seminar Series, featuring Anne Gadermann, Kimberly Thomson, and Monique Gagné Petteni.