As people age, they can end up taking many medications. Certain medications might have made sense when they were started. But as people get older, some medications may no longer be needed, or may be unsafe. It makes sense to consider stopping such medications. It can be tough for prescribers and patients to decide when and how to stop a medication. From 2014 to 2017, we developed guidelines and resources to help patients and prescribers make decisions about stopping medications. Our guidelines and resources are used in Canada and across the world. However, guidelines and resources need to be up to date with the most current evidence. There also needs to be ongoing strategies to ensure guidelines are used in the real world. This project, led from UBC Vancouver, will first survey patients and prescribers to assess needs and priorities for guidelines on stopping medications. We will then update our guidelines based on needs and current evidence. Finally, we will design knowledge translation materials together with patients and prescribers (called “co-design”), and spread the word about our updated resources. We strive to help patients/prescribers decide when and how to stop medications and improve well-being of older adults.
Alzheimer’s disease is a major crisis and a huge burden on healthcare system. It causes a decrease in memory and affects women more than men. The memory decline in Alzheimer’s is linked to poor blood supply to the brain. The causes for poor supply are unknown but it starves brain cells of essential materials leading to improper function. I will study how a molecule present in the cells of the brain called metabotropic glutamate receptor 5 (mGluR5) contributes to the poor blood supply to the brain and the development of Alzheimer’s symptoms. My group at UBC is interested in mGluR5 because it attaches to the “toxic molecules” commonly found in Alzheimer’s brain. I will use mice sick with Alzheimer’s and samples from Alzheimer’s patients to study how the attachment of the “toxic molecules” to mGluR5 can lead to the short supply of blood to the brain and memory loss. I will also study if the role of mGluR5 in Alzheimer’s is different between males and females. In addition, I will test if the drugs that act on mGluR5 can help Alzheimer’s patients by correcting blood supply to the brain and improving memory. I also will work with patient and community partners to help interpret and communicate my findings and guide future work.
Around 375,000 Canadians live with heart failure with reduced ejection fraction (HFrEF). HFrEF worsens quality of life, and leads to hospitalizations and death. There is no cure for HFrEF, but it can be managed with medications. Many people with HFrEF are unaware of the medications available to treat HFrEF and do not receive the best medications for them. Decision aids are tools that can help inform patients about available treatment options so they can be better involved in shared decisions about their health. This study will be conducted at UBC and will recruit from five Canadian HF clinics. This study will help us better understand what matters most to people with HF when making decisions about their medications, and use this to develop an effective decision aid to support shared decision-making. To do this, we will conduct interviews of people with HF and their healthcare professionals. After this, we will ask people with HF to complete a special online survey called a discrete-choice experiment to understand what matters most to them, and by how much, when making decisions about their HF medications. Then, we will develop a web-based decision aid and test how it improves the quality of medication-related decisions and quality of life.
The transition from elementary to secondary school is a challenging time for children as many obesity-related behaviors tend to worsen in this period. My research will examine how the familial environment can support a healthy transition; specifically, how parenting practices influence children’s choices with respect to diet, physical activity and sedentary time. I will first synthesize the published literature about how mothers’ and fathers’ parenting practices relate to children’s obesity-related behaviors. To gather real-world data, I will then use a combination of interviews, surveys, and wearable tech (accelerometers) with 150 British Columbian families to assess their parenting practices and children’s obesity-related behaviors daily for 14 consecutive days during elementary school, and again in secondary school. These data will be analyzed to identify how variations in parenting practices affect children’s behaviors day-to-day before and after the school transition, and the interviews will help understand more deeply how familial factors influence children’s behaviors. Together, my findings will guide the development of parenting interventions to help children maintain healthy behaviors during adolescence.
Approximately one in five men struggle with mental health challenges each year; however, men often experience unique barriers that prevent them from seeking help or accessing treatment. The COVID-19 pandemic has placed additional pressure on many men and efforts are urgently needed to tailor services and norm men’s mental health help-seeking. While asking for help may be viewed by some men as a sign of weakness, helping others is often perceived as a strength that aligns with masculine ideals. By emphasizing the benefits of mutual help, it may be possible to equip men with the skills and confidence to support other men’s mental health challenges, as well as their own. The aims of this research are to explore men’s mutual help for mental health challenges and develop an online intervention to promote mental health and social connection through shared activities (e.g. physical activity). We will conduct interviews with Canadian men and use the findings to inform the development of the e-intervention. Men will be recruited to test the intervention and provide feedback. Findings will provide important information about men’s mutual help for mental health challenges and opportunities to norm mental health promotion.
Mealtimes in long-term care (LTC) homes are important for visible minority (e.g. Chinese, South Asian) residents’ well-being and keeps them connected with their families who help at mealtimes. Visiting restrictions during the COVID-19 pandemic meant that some families could not provide mealtime care which had negative effects on residents and families. There is very little research on the mealtime experience for visible minority residents and families and even less on their experiences during the pandemic, even though almost one-quarter of Canadians are from a visible minority group. It is important to understand these experiences to improve mealtimes in LTC homes. This qualitative study will answer the question: what are the mealtime experiences of visible minority residents and their families in LTC? The objectives of this study are to: 1) understand the mealtime experiences of visible minority residents and their families; 2) understand how these mealtime experiences are impacted by social, political, and economic factors; 3) identify ways to improve mealtime care for visible minority residents and families; and 4) share the research findings with stakeholders to improve mealtime care in LTC homes.
Global COVID-19 vaccine distribution has been inequitable, with high-income countries afforded widespread access to vaccines and boosters, while among the low-income countries only 2 percent of individuals are vaccinated. Consequently, over 50 percent of the world’s population remains unvaccinated. Fortunately, however, data from vaccinated cohorts can inform the most efficient and effective community-level vaccination strategies for the unvaccinated populations. Currently approved mRNA vaccines were initially tested with dosing intervals of 21-28 days; however, this may lead to suboptimal immunity. Further, data informing the optimal timing and frequency of booster doses is lacking. This project will answer critical questions regarding the optimal vaccination strategies to achieve a robust long-lasting immune response. In this study I will employ data from a prospective national cohort of adult paramedics, providing sociodemographic data and serum blood samples. I will identify the optimal vaccination strategies to achieving a robust immune response at 12, 18 and 24 months, including examining differences between sex, race, and age. These data will inform ongoing global vaccination efforts, to maximize efficiency and long-term protection.
People with spinal cord injury (SCI) who live with chronic pain report poorer mental health (e.g. depression and anxiety symptoms) than those without disability. Poor mental health can further limit social participation (including employment) and physical functioning, and increase the use of health care services. Therefore, there is a need for safe, accessible, and affordable strategies to improve pain and mental health in this population. Exercise may be an effective strategy, but it’s not known if people with SCI living with chronic pain also benefit. Forty-two adults with SCI reporting chronic pain will receive a personalized exercise prescription and weekly exercise counselling. An equal group will go on a waitlist. After six months, we will test for differences in mental health between the groups, and if changes in fitness, pain or social factors can explain these differences. We will interview participants to gather their perspectives on the program, and what we can do better to improve mental health. This study will be the first to test if exercising improves mental health, how much exercise is needed, and the processes by which exercise may improve mental health in people living with SCI and chronic pain.
People with inflammatory bowel disease (IBD) are six times as likely to develop Alzheimer’s disease and on average seven years sooner than people without IBD. IBD will affect 1 percent of Canadians in the next 10 years and there is no cure for this illness. IBD causes intestinal microbiome, neural, immune, and endocrine dysregulation, but the exact mechanisms that drive the development of Alzheimer’s and other dementias are unknown.
The goal of my research is to elucidate the mechanisms by which IBD increases the risk of Alzheimer’s and dementia with the long-term goal of developing pharmacological interventions.
Stroke is a leading cause of long-term disability in Canada that causes movement impairments on one side of the body. In cases of severe movement impairment, there is often extensive damage to the primary descending motor pathway in the brain originating from the opposite side of the body. When this pathway is damaged, secondary motor pathways are altered which may support recovery in these individuals. Several of these secondary motor pathways originate from the same side of the brain as the impaired limb and are therefore undamaged in cases of stroke. My research aims to comprehensively investigate the role of the secondary motor pathways in motor function with chronic stroke survivors that have severe movement impairments. This research will use a combination of state-of-the-art brain stimulation and brain imaging techniques to gain novel insight into the relationship between the secondary motor pathways and the control of voluntary movement. My research will provide valuable insight into the role of the alternative motor pathways. In turn this information can be used in clinical practice to implement rehabilitation strategies that lead to better recovery and improved quality of life in individuals with severe strokes.