The pandemic has posed significant challenges to people globally. These dynamics have been complicated and prolonged by “Long COVID”, where those previously infected with the SARS-CoV-2 virus continue to experience symptoms for weeks to months after infection. Long COVID also affects unpaid care providers, including family and friends, who care for those with Long COVID. Beyond the many challenges that unpaid care providers face — such as lack of time and resources — the heightened uncertainty around Long COVID poses additional barriers to accessing information and supporting care providers and recipients. Our goal is to begin to address this important issue by convening a group of unpaid care providers, health care professionals (e.g. doctors, nurses), and research scientists in BC. Through knowledge synthesis and convening activities, we will identify priority research areas that will serve as the basis for co-created, collaborative research programs to bridge the gap in care provider access to information and Long COVID resources in the province. With an emphasis on relationship-building and strengthening, we will promote opportunities for continued collaboration among stakeholder groups beyond this proposal.
Team members: Stacey Dawes (Family Caregivers of British Columbia); Julia Smith (Simon Fraser University); Kiffer Card (Simon Fraser University); Anne-Marie Nicol (Simon Fraser University); Gina Ogilvie (UBC); Esther Khor (Provincial Health Service Authority); Niloufar Aran (Simon Fraser University); Alice Murage (Simon Fraser University).
South Asians make up 60 percent of the Canadian immigrant population, with Punjabis being the fastest-growing subpopulation of this demographic in BC. Because many Punjabi women have low health literacy skills and face cultural stigmas around mental health, community-based health promotion (CBHP) programs are needed; however, such programs have typically focused on supporting White affluent groups. This project will address these gaps and examine the CBHP program — Healing Through Ancient Teachings — developed for Punjabi women aged 50+ to develop coping mechanisms to manage their mental health. The 13-week program was originally created by community advocate Ms. Jas Cheema who has been serving the Punjabi community in BC for 35+ years. As a certified yoga teacher, Jas includes light yoga, meditation, and discussion in her CBHP program. The proposed project will provide an opportunity to convene the CBHP program to work with research users to collaboratively identify recommendations for future programs. Based on the findings, a report will be co-created with research users to inform the development of culturally appropriate and linguistically acceptable CBHP programs for Punjabi women and other growing ethnocultural communities in BC.
Team members: Sandeep K. Dhillon (Simon Fraser University); Jas Cheema (BC Association of Community Response Networks); Sherry Baker (BC Association of Community Response Networks); Eman Hassan (BC Centre for Palliative Care); Gary Thandi (Moving Forward Family Services); Theodore D. Cosco (Gerontology Research Centre).
Some people faint often, negatively impacting quality of life. Fainting occurs when the heart cannot pump enough blood to the brain. Standing still pulls blood into the lower body reducing its return to the heart. However, even when standing still, our body sways and these movements may prevent fainting by pushing blood to the heart. Water drinking might also help by stretching the stomach, raising blood pressure. Also, seeing blood/having blood drawn can cause fainting, suggesting the brain may trigger a faint, not the heart. We will examine: i) the role sway plays in fainting, ii) if fizzy water drinking wards off fainting, and iii) brain activity during emotional triggers. Using wearable sensors, we will compare heart rate, blood pressure, and sway patterns in the lab and in soldiers who faint on parade. We will test if drinking fizzy water increases blood pressure more than still water. We will also compare blood pressure, heart rate, and brain activity in fainters and non-fainters while participants watch a video of a blood draw to show the role of the brain in initiating faints. These studies will help us better understand fainting, relieving the healthcare burden and improving quality of life for people who faint.
The ongoing drug toxicity and overdose (OD) crisis has ruined the lives of many people in British Columbia (BC). Opioid agonist therapy (OAT) reduces the risk for an OD, but not everyone who needs OAT has access to and is taking OAT. People living with HIV (PLWH) are disproportionately affected by the OD crisis and may be less likely to have access to OAT. This project aims to contribute to a strategy to connect people who visit an emergency department (ED) or a hospital due to a nonfatal opioid OD (NFOOD) with primary care and OAT. I will use routinely collected health data on all PLWH and a 10 percent random sample of the general population in BC, between 1992 and 2020. I will investigate — of everyone who visited an ED or a hospital after a NFOOD — who is most at risk of 1) not being connected to primary care and OAT, and 2) a repeated OD. I will compare people living with and without HIV. I also will have conversations with professionals from various backgrounds and individuals with lived and living experience. Through these, I hope to learn more about barriers to care. Based on what I learned, I will formulate recommendations on how to help people that experienced a NFOOD connect with care that best suits their needs, including OAT.
Dementia is a growing health challenge that affects over 500,000 Canadians today, which is estimated to grow to 900,000 by 2030. Alzheimer’s disease, the most common form of dementia, is characterized by protein misfolding in the brain. This process can start over a decade before the occurrence of significant cognitive decline making it possible to diagnose at an early stage when treatment strategies are most effective. Biomarkers are measurable indicators that help determine if a person may have or be at risk of developing a disease. Researchers have identified phosphorylated tau (p-tau) proteins and small proteins called cytokines to be promising biomarkers for Alzheimer’s disease. To detect these biomarkers in blood samples, very sensitive detection methods are needed but existing methods have drawbacks such as being expensive and time consuming, and need to be performed in a laboratory, limiting their availability to Canadians. We have developed a new sensor that can detect proteins at ultra-low concentrations using a simple and rapid test. Our goal is to make a rapid and easy-to-use tool that can be used by clinicians to help diagnose Alzheimer’s disease and patients for personalized health monitoring.
Antisense oligonucleotides (AON) are short lengths of RNA or DNA molecules which are used to change gene expression to treat diseases like cancer and Parkinson’s disease. Like DNA, AONs are made up of chains of nucleotide units, but to make them useful as drugs, these nucleotides have to be structurally changed. Locked nucleic acids (LNAs) are a very useful type of altered nucleotide unit, since they are not broken down as quickly in the body, and attach strongly to the gene they are targeting. The problem with LNAs is that they are very difficult to make, so it is hard for chemists to make a lot of different changes to the structure of LNAs in order to find the best one to use in AONs.
The Britton research team recently discovered a new way to make LNAs very quickly and easily, in large amounts, from simple compounds. Using this new technology, we want to make a large number of structurally unique LNAs and, test them to find the best ones to use in AONs for the treatment of cancer.
The rhythmic beating of the heart requires coordinated electrical activity that causes the heart to contract and relax. The electrical activity is controlled by proteins in the membranes of heart cells that form ion channels. Failure of channels to work properly is associated with abnormal heart rhythm, heart attack and sudden death. Long QT Syndrome (LQTS) is a condition that affects 1:2000 people and often results from inherited mutations in one of the heart channels. However, determining whether a mutation will cause the individual serious heart problems is still a major challenge. By using cutting edge technology, like induced pluripotent stem cells and CRISPR, we can recreate patient mutations in cells in the lab and turn them into beating heart cells. Specific techniques can be used to look at individual heart cells, as well as heart cells in a layer that beat together. The properties of the cells can be measured so that the effects of the mutations can be understood, and so that newer specific drugs can be tested to see if they are effective against different mutation types. The results from this research will help inform clinicians on how to better help patients with LQTS and potentially identify new, better treatments.
Alzheimer’s disease is the most common cause of dementia and a leading cause of death in Canada. Unfortunately, there are currently limited treatments available for this devastating disease. Recently sleep has been shown to regulate important aspects of Alzheimer’s disease pathology and is emerging as a promising target for novel interventions to prevent and slow disease progression.
To identify how changes in sleep and the body’s biological clock contribute to the cognitive deficits associated with Alzheimer’s disease, we will conduct a combination of preclinical experiments to evaluate causal mechanisms and clinical studies to evaluate the same processes in patients diagnosed with Alzheimer’s disease.
The ultimate goal is to determine whether treating specific aspects of sleep disruption is an effective therapy for Alzheimer’s disease, which will help identify new treatments to prevent the progressive memory loss, improve the health and quality of life of patients and their families, and reduce the economic burden of the disease.
Primary care is the foundation of strong health systems, ensuring people stay healthy and get care when needed. However, timely access to high-quality primary care is an ongoing problem in British Columbia and other provinces.
My program of research aims to ensure that all British Columbians can access quality primary care how and when they need it. The central project I lead uses information from interviews with health professionals (physicians, nurse practitioners and nurses) and patients; data from the health system; and provincial policy documents to study access to, experiences with, and outcomes from virtual primary care. Complementary research will inform modernization of the primary care workforce and informing ideal deployment of providers in team-based models in the context of COVID-19 and beyond. Finally, I lead work about implementation of “learning health systems” to support continuous improvement and innovation in primary care and across the health system more broadly.
My work follows an integrated knowledge translation model; I work with a team of researchers, policy makers, clinicians and patient partners to co-produce knowledge and address important and relevant questions that are driven by their combined input.
Although researchers have identified tens of thousands of disease-associated genetic variants, the mechanisms driving most of these variants remains unknown. Most variants are believed to affect regulatory elements. However, regulatory elements are incompletely annotated and understood. Large-scale projects have recently generated thousands of epigenomic data sets. These data sets measure the regulatory activity of the genome in human cells. However, computational methods are needed to understand the link between genetic variation and disease.
We previously developed a computational method, Segway, that annotates genomic regulatory elements on the basis of epigenomic data sets. Enabled by new epigenetic data sets, this project will annotate the genome in hundreds of human cell types, and use these annotations to understand disease-associated genetic variation.
Additionally, we will develop computational methods that improve our ability to identify genomic elements. This outputs of this project will come in three forms:
- General-purpose software for annotating the genome.
- Easy-to-use reference data sets.
- Insights into the link between genetic variation and chronic obstructive pulmonary disease (COPD).
