Cognitive functioning impacts older adults’ wellbeing, quality of life, and ability to live independently. As the proportion of people over 65 increases, and urban populations grow, it is important to ensure that everyday environments support healthy cognitive aging. Urban environmental factors are known to influence cognitive health or decline, but practical tools to assess neighborhood environmental supportiveness for brain health are lacking.
This project will develop an index of environmental factors that support healthy cognitive aging, for ages 65+. From frameworks for healthy aging, expert consultation, and location-based environmental measures, an index will be developed and mapped across Canadian and US cities. Links between index scores at participant home locations and measures of cognitive function will be examined, using data from the Canadian Longitudinal Study of Aging, and Health and Retirement Study.
This research will advance knowledge of urban exposures and cognitive functioning in later life. The index will allow assessment of everyday local exposures linked to cognitive aging and enable evaluation of equitable access to urban environments that support healthy cognition.
Program: Trainee
Personalized nutrition for inflammatory bowel disease: Predicting dietary responses based on gut microbiome and baseline factors
Every patient with inflammatory bowel disease (IBD) wonders what to eat to improve their symptoms. Many believe that diet affects disease progression and no one-size-fits-all diet exists for everyone. Our controlled trial in adults with IBD supported this idea when the symptoms of almost 50% of adults with IBD in either standard dietary therapy or the Mediterranean-style diet group were ameliorated, though to varying extents. This variability arises because each patient’s biology and lifestyle are unique. People’s gut microbiota, trillions of microbes living in intestine, is highly personalized and can mediate their physiological responses to diet. However, remaining concern is that chronic inflammation in IBD disrupts the gut microbiome, allowing harmful bacteria to thrive and beneficial ones to vanish. Diet alone or conventional probiotic treatments can’t fix this imbalance. I will investigate how patients’ specific characteristics and gut microbes influence their response to certain diets and how these synergize with a newly engineered probiotic designed to thrive in an inflamed gut. These findings will be used for a future clinical trial using our derived algorithm to prescribe personalized diets and a bioengineered probiotic.
Building Capacity for Research Partnerships: A Health Learning System Approach
People with SCI often struggle to find research that reflects their needs. One way to improve this is through research partnerships, where researchers and people with lived experience work together. However, many researchers do not have the training or support to build strong partnerships, and research institutions do not have systems in place to make engagement easier. This project will help change that by developing a long-term support system for research partnerships at ICORD. The first step is launching a training course to help researchers and trainees learn how to work meaningfully with partners. I will also work with ICORD’s Meaningful Engagement Committee to create ways for the institution to better track, support, and strengthen partnerships over time. Finally, I will connect with other SCI research institutions to see how this approach can be adapted beyond ICORD. This work will help make research partnerships more effective, ensuring SCI research is relevant, useful, and impactful for the people it is meant to serve.
The Hepatitis C Cascade of Care among people in the Downtown Eastside in Vancouver, British Columbia: a population-based study
The Hepatitis C virus (HCV) care cascade in British Columbia (BC) revealed gaps in testing, treatment initiation, and key disparities among priority populations. The introduction of Direct Acting Antivirals and policy changes, such as removing liver fibrosis stage as a treatment criterion, improved all stages of the care cascade by 2018 compared to 2012. However, limited data exist on high-priority populations, particularly those with high HCV prevalence and follow-up challenges, such as Vancouver Downtown East-Side (DTES) residents.
This study will assess the updated HCV care cascade in BC among individuals living and accessing services in the DTES, including priority subgroups. It will evaluate cascade steps over time and progress to date. We will engage stakeholders, including provincial/national initiatives and a DTES-focused social service agency, throughout the research process.
We anticipate lower HCV testing and care linkage rates among DTES residents and persistent gaps in high-risk groups.
Findings will inform health services and policies to advance Canada’s goal of eliminating HCV as a public health threat by 2030, reducing mortality, and improving outcomes for vulnerable populations.
Novel STI Care and Prevention for Group Sex Communities
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.
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!