Rising Up: Collaborating with Chinese Families and Communities to Promote Mental Health Literacy

Many Chinese families living in BC struggle in silence to support their child’s mental health. Most resources are available only in English and were developed without cultural knowledge about mental health or related considerations of stigma. In this project, we begin to address this gap by partnering with Chinese families and community agencies to co-design resources that are culturally-meaningful, engaging, and effective. To start, we will work with a committee of Chinese caregivers and community providers of children aged 3-13y to promote mental health awareness early on in childhood.

We will co-host workshops with 2 activities to gain information and feedback about (i) existing resources, and (ii) what mental health information is needed and how they wish to receive it. The workshops will be offered both in-person and online, across daytime, evening and weekend hours, so people from different locations and schedules can attend. We will make special efforts to include a balance of mothers, fathers and grandparents. We will identify key themes and top priorities from the discussions to guide future steps towards co-developing culturally appropriate mental health resources for Chinese families.

Partnering to improve early identification and early intervention for children with developmental coordination disorder

Developmental Coordination Disorder (DCD) is a common condition that significantly interferes with a child’s ability to learn motor skills. Without treatment, these motor challenges can persist into adulthood and limit job opportunities, affect physical and mental health, and impact quality of life. Early identification and intervention are crucial to change this negative trajectory.

More than 50,000 children in BC may have DCD, but most of these children are unlikely to have a diagnosis or receive therapy. Our survey of BC parents of children with DCD showed that they first identified concerns about their child’s motor skills at age 3 years, but did not receive a diagnosis until age 8, missing a critical window for early intervention. Parents also identified significant barriers to accessing therapy for their child.

In this project, we will bring together a diverse group of parents, researchers, health organizations, and clinicians to determine how to streamline early identification and improve access to early intervention. We will hold a series of meetings with these key partners to identify research objectives and co-develop a grant application to implement and evaluate early interventions for children with DCD.

Drawing Attention to an Invisible Injury: Increasing Awareness and Reducing the Burden of Concussion among Workers and Workplaces in British Columbia

Concussion, or mild traumatic brain injury, is the most common form of brain injury, causing physical, emotional, and mental health symptoms, with the potential for long term impacts, particularly if not managed properly. Concussion can happen to anyone, anywhere, and is a top five cause of workplace time-loss. In BC, from 2017-2021, concussion accounted for 4.8% of all time-loss claims and 8% of claims by retail salespersons, mostly among young workers. The aim of this project is to increase concussion awareness and education within the retail industry by highlighting key messages from the evidence-based online resource, the Concussion Awareness Training Tool for Workers and Workplaces. By leveraging existing partnerships, we will engage a large retailer to promote concussion education within their workforce. Information sessions will be delivered on concussion prevention, recognition, recovery, management, and Return-to-Work. We will create a concussion infographic and recruit a worker to share their personal story via video for wide dissemination. Not only will this initiative create awareness and change attitudes about concussion at work, but the safety messages will be applicable to workers’ lives beyond the workplace.

Co-developing knowledge translation tools to enable rapid mobilization of vaccine research to policy in BC

As BC strengthens its immunization policies and programs to respond to the challenges and learnings from the pandemic as well as health needs of British Columbians, it is essential for research to be a central pillar of decision-making. This project will co-develop, test and disseminate knowledge translation (KT) tools to support seamless integration of research into immunization policy and program implementation in BC. During phase 1, we will conduct an environmental scan to address the knowledge gap on effective KT strategies for moving research into evidence-informed policies and programs. During phase 2, researchers and research users will be invited to participate in a forum to inform the design of the KT tools. The tools will include knowledge product templates (e.g. policy briefs) and a guide to orient researchers to the immunization policy and implementation landscape in BC. Additionally, they will provide an overview of effective KT strategies and appropriate policy and implementation target audiences for disseminating a variety of vaccine research. During the final phase, we will design and disseminate the KT tools through workshops, webinars and social media. We will evaluate the process and impact of the new tools.

Team members: Monika Naus (BC Centre for Disease Control); Gabrielle Gaultier (UBC); Julie Bettinger (UBC); Bonnie Henry (Ministry of Health); Susan Hollenberg (UBC); Bryce Wong (BC Pharmacy Association).

Smart Discharges for Mom+Baby: Saving mother-newborn dyads by developing a predictive risk model to identify vulnerable dyads and guide delivery of post-discharge care

The risk of a mother or baby dying is highest in the first six weeks after birth. The World Health Organization (WHO) recommends regular follow-up visits for all mothers and their newborns. This is not always possible. In resource-constrained countries, a lack of money and nurses at hospitals and limited time and money at home often stops mothers from seeking care. In our study, we will build a score to identify mother-baby pairs that are most at risk of getting sick or dying in Uganda. The health of a mother impacts the health of their baby, and vice versa. Our risk score combines the risk of the mother and baby so that both can get care when they need it. A nurse can use this score to guide the number of follow-up visits recommended for the pair. In this way, mothers and babies at higher risk receive more visits. We will also talk to parents and nurses to determine what stops mothers and babies from receiving a follow-up visit. We will work with our Ugandan partners to remove these barriers so that improvements in care are long-lasting. In the future, we can use this approach to improve the health of mothers and babies in smaller, remote towns in BC, where specialized care for mothers and babies is not always readily available.

Defining optimal pregnancy weight gain ranges for Canadian women

Maternal weight gain is closely monitored during pregnancy because as weight gain increases, so does the risk of excess postpartum weight retention, diabetes, and high blood pressure. While lower weight gain may prevent these complications, it also increases the risk of poor fetal growth and stillbirth. Pregnancy weight gain recommendations that balance these risks are important. The goal of this project is to establish the optimal range of pregnancy weight gain for Canadian women. We will use existing medical records from approximately 560,000 women who delivered in BC between 2004 and 2018. We will obtain information on pregnancy weight gain, and link this with short- and longer-term health complications for mother and newborn, such as excess postpartum weight retention, maternal diabetes and heart disease, poor fetal growth, and stillbirth. We will use statistical models that enable us to consider all health complications at the same time, while accounting for the fact that some complications are more serious than others. Our findings could provide the basis for new public health recommendations on pregnancy weight gain, which could help to reduce overweight and obesity in Canadian mothers and their children.

Examining stress mediated profibrotic response in HCM associated TNNT2 variants

The heart beats 100,000 times a day, and cardiac contractile proteins are essential to facilitate oxygen-rich blood circulation. Hypertrophic cardiomyopathy (HCM) is an inherited heart disease that promotes enlargement of the heart and fibrotic scars, leading to arrhythmias and sudden cardiac death (SCD). In Canada, all age groups are affected by HCM, especially children and youth, including elite athletes. The cardiac troponin T (TNNT2) gene variants account for 15 to 20 percent of HCM in humans. TNNT2 mutations can cause increased cardiac contractility and impaired heart relaxation, leading to structural remodelling and triggering arrhythmias and SCD. Currently, no specific medication is available to treat HCM patients. Previously, mouse or rabbit heart muscle cells were used for studying these TNNT2 mutations, which is not closely relevant to human physiology. Therefore, I aim to test TNNT2 mutants in human induced pluripotent stem cell-derived heart muscle cells (hiPSC-CMs) with different physiological and pathological stress conditions compared to normal hiPSC-CMs. Our research outcome will help us refine the profibrotic mechanism behind arrhythmias and SCD in HCM patients and timely intervention to manage patient care better.

Regulation of anabolic metabolism in anti-tumour T cells

Our immune system protects of our body by detecting and destroying cells that are potentially cancerous. Sometimes, our immune system fails to detect a problem, leading to cancer. In pediatric cancer, CD8 T cells fail to destroy cancer cells. CD8 T cells are white blood cells specialized in the detection and attack of cancer cells. Like us, CD8 T cells need to “eat” to stay alive, to move, and to function. Without nutrients, they can’t fight off cancerous cells. In cancer, there is a fight for nutrients between CD8 T cells and cancer cells. CD8 T cells have to quickly adapt to make sure they can maintain their protective functions. We know that CD8 T cells can rapidly switch from using nutrients to grow, to burning them to make energy, but we do not know how it is regulated. The aim of my project is to study how CD8 T cells know which nutrients are around them, and how they “choose” to switch between growing and burning. Why is it important? If we grow CD8 T cells in a laboratory setting, restrict their food, and re-feed them, they provide better protection against cancer. Understanding how CD8 T cells “eat” and use nutrients to grow or burn energy to kill cancer cells will help develop better therapies to treat pediatric cancer.

The links between nutrient sensing, cell intrinsic metabolism and T cell function in immune-related diseases

Our focus is on the cellular fuels and building blocks that change immune cell functions. Our immune system normally defends us against infections. In a healthy person, T cells (a type of immune cell) recognize infected or cancerous cells and remove them from the body. Normally, immune cells know the difference between healthy and infected or cancerous tissues. When this recognition is lost, it can lead to the development of attack of healthy tissues by immune cells (autoimmunity), the growth of cancer, or to persistent infections. This dysfunction of the immune system can lead to devastating diseases in children. My research aims to better understand how this happens. By comparing the way that biological fuels (sugars, fats and other building blocks) are used by immune cells from healthy people and patients with immune system associated diseases, we will define the cellular the pathways that maintain health or cause disease. This will allow us to target and “dial down” pathways that are driving cells to attack our tissues, or turn these pathways on to help immune cells fight persistent infections and cancerous cells. Ultimately, we hope to help develop new treatments.

Genomic mechanisms underlying the prenatal and early childhood origins of mental illness in children

The last decade has seen an explosion of genomic and health-related data. These data can advance precision medicine, but only if we apply the right analyses. I use statistical methods that link together many different types of large genomic and health datasets. My research identifies genomic mechanisms that lead to disease, which is the first step towards improving patient care. A primary goal of my research is to learn about the genes that cause mental illnesses like attention-deficit / hyperactivity disorder (ADHD) in children. We know that genes are important to ADHD risk. We also know that babies born small are at increased risk of ADHD, and that the placenta influences a baby’s growth in the womb. What we do not know, however, is how genes that are important to placenta function also affect a baby’s future risk of ADHD. Answers to this question will help us understand ADHD biology so that we can develop better prevention and treatment strategies and give all children the best start in life.