Rural, remote and marginalized people in areas of suboptimal healthcare service delivery are at increased risk of poor health outcomes during and after pregnancy, such as high blood pressure. Eating nutritious foods during pregnancy has been recognized to support healthy development of the baby, but less is known about the impact on the health of mothers, especially after childbirth. This gap limits the ability to make evidence-based recommendations and contributes to a lower prioritization of mothers’ well-being.
The proposed research seeks to answer the following research questions:
1. What is the current evidence on the impact of nutrition on women’s health during and after pregnancy?
2. Is there a relationship between maternal diets with imbalanced nutrients in sub-Saharan African countries and developing high blood pressure between 20-34 weeks of pregnancy, after 34 weeks, and/or after childbirth?
3. What strategies can be co-designed with community partners to strengthen maternal nutrition and health capacities of vulnerable pregnant populations?
Findings aim to support maternal interventions to support gender equity and reduce health inequities for rural, remote and marginalized populations in Canada and globally.
Research Location: University of British Columbia - Vancouver Campus
Engagement and citizenship in long-term care: An exploration of resident and family councils
Resident and family councils refer to groups within long-term care (LTC) homes composed of residents and/or family members who meet on a regular basis to discuss matters of concern. In B.C., LTC residents and their family members have the right to participate in these councils, providing a potential avenue to influence decision-making. However, little is known about these councils, how they work, and whether they enable residents and families to influence change.
My postdoctoral research aims to address this knowledge gap through a qualitative study exploring how LTC councils work, how they engage residents and families in decision-making, and the broader contexts in which they operate. First, we will analyze the legal frameworks governing resident and family councils across Canada and compare how they define councils and the specific rights they afford. To explore how councils operate in practice, we will conduct ethnographic fieldwork in two LTC homes. Researchers will observe council meetings and conduct in-depth interviews with residents, family members and staff. Findings from the study will be used to create user-friendly resources highlighting promising approaches and policy recommendations.
Understanding sex differences in beta-cell resilience to stresses in type 1 diabetes
Type 1 diabetes (T1D) involves the loss of insulin-secreting beta-cells, the main cell type in the pancreatic islets. A special feature of beta-cells is that they must make large quantities of insulin protein, which is very demanding and leaves them vulnerable to stress. Stressed islets are less functional and may die. Islets from females appear more resilient than islets from males to stresses relating to insulin production. However, we lack knowledge on how female islet cells achieve this, and preclinical research rarely studies both sexes. This project will characterise the mechanisms that occur in male and female islets in response to T1D-related stresses. We will generate and analyse large datasets to identify key stress response events in mouse and human donor islets. Results will be presented at scientific conferences. By understanding these mechanisms, we will likely identify therapeutic targets that can lead to future drug and cell therapies for T1D. A focus on sex differences is also key to ensuring appropriate research translation to a wider population. Finally, a fundamental understanding of sex differences in protein synthesis has implications for studies in other cells and organs, as all cells need to make protein.
Structural and Functional Investigation of Neuronal Calcium Channel Modulation
Cells contain highly complex protein structures that allow signals to be relayed from the outside environment using signaling receptors to proteins inside of the cell. One mechanism involves assembling protein complexes across different cell layers linked by proteins such as junctophilins (JPH). JPH proteins are found in the brain and muscles and work by interacting with receptors on the outer layer while simultaneously interacting with proteins on inner cellular structures such as the endoplasmic reticulum (ER). Thus, JPH places the outer layer of the cell and the ER in proximity allowing for a direct exchange of signals. This is essential for muscle contraction and memory and is linked to human genetic diseases. However, the interaction sites between these JPH proteins and their effect on receptors, such as voltage-receptor channels (Cav2), remain elusive. Here, we want to use X-ray crystallography and electron microscopy to solve the protein structure of JPH and find how it interacts and regulates Ca¬v receptors. This work will provide insights into JPHs’ molecular structure, cellular function and role in genetic diseases. The JPH-Cav molecular complex will serve as a resource for future mechanistic studies and drug designs.
Strengthening mental health in Horn of Africa (IGAD region) and Somalia (MH Care-Somalia).
Globally mental, neurological and substance use disorders (MNS) affect 10%, but jumps to 22% in conflict settings while 75% of persons with MNS in conflict settings such as Horn of Africa region lack access to mental health care. The region has faced decades of conflict and climactic shocks that eroded resilience and coping mechanisms. While the mental health services including its workforce are almost non-existent, it is unlikely the region will be able to train sufficient mental health specialists. That is why we propose developing of regional mental health strategy and enhance capacity through task-sharing using WHO Mental Health Gap Action Program (mhGAP) to train frontline workers. mhGAP is designed to support non-specialist to provide MNS services for conflict-affected communities
The research and KT activities include; regional stakeholder engagement, contextualized training materials, trainers of trainees to ensure local capacity and website/social media presence
The anticipated outcomes and; increased access to services, improved awareness and enhanced workers capacity
Potential impacts. The project aims to strengthen mental health through policy and capacity building with potential to cascade across the region
Optimization of cardiovascular health in postpartum women with reproductive and pregnancy-related risk factors
Heart disease is the number one killer of women worldwide and the leading cause of premature death in Canada. In recent years, heart disease related death and illness has increased in women after childbirth. Besides well-known risk factors, women after childbirth face an additional burden of pregnancy-related risk such as high blood pressure and diabetes during pregnancy, however, the risk often gets unrecognized in primary care. Though there are many risk prediction models, they are designed to predict risk in general population and do not take into account the reproductive risk factors that limits their use in women after childbirth. My program of research on Women’s Heart Health, aims to answer the following questions: 1) What are the contribution of reproductive and pregnancy-related risk factors in predicting the heart disease risk in women after childbirth? 2) What is the feasibility and acceptability of using risk prediction tool in primary care? 3) What is the effectiveness of risk prediction tool in screening heart disease risk in women after childbirth? The proposed local research in BC will aid in solving a problem in Canada by recommending a heart disease risk assessment and risk management of women after childbirth.
The Lifetime Exposures and Asthma Outcomes Projection Model (LEAP): A Platform for Improving Asthma Prevention in Canada
Asthma is the most common chronic disease among children in Canada. It has several main causes that occur in utero and early in life. These ‘risk factors’ can be reduced through public health interventions that prevent asthma before it develops. Despite the opportunity to drastically reduce asthma in Canada, little progress has been made on asthma prevention due to a poor understanding of which interventions to invest in and when they should be applied. My objective is to provide high quality evidence to patients, providers and policy makers on how healthcare resources can best be used to prevent asthma in children. My research program will accomplish this objective using a computer simulation model of asthma (the Lifetime Exposure and Asthma Outcomes Projection [LEAP] model), which simulates the development and life trajectory of asthma. I will evaluate a series of preventative interventions that patients and knowledge users have identified as priorities, and determine their lifetime health benefits and impact on the healthcare system. I will work closely with patients, providers and policy makers to make sure the resulting policy recommendations are aligned with their values and can be implemented in healthcare systems.
Healthcare ethics and health equity: Improving access to care through equity-focused ethical reasoning and participatory ethics research with health professionals and equity-deserving groups in BC
Uncertainty about how to ethically provide healthcare services can create barriers to care, as access to care is slowed or stopped while ethical concerns are addressed. These barriers to care can affect the health of members of equity-deserving groups, such as people who use drugs and Two-Spirit, transgender, and nonbinary people. This research focuses on gaps in knowledge about unresolved ethical issues affecting equity-deserving groups in British Columbia. Ethical issues will be addressed by: designing and testing strategies to enhance ethical reasoning skills among health professionals; working with members of equity-deserving groups and health professionals to resolve ethical dilemmas; developing a new method for ethical analysis; and openly sharing resources and resolutions. It is anticipated that the ability of health professionals to respond to ethical dilemmas will be enhanced and access to care will improve for members of equity-deserving groups. Enhanced ethical reasoning and expanded access to ethical resolutions will change practice through reducing barriers to care and support evidence-based policy, while developing a participatory empirical ethical analysis method will support future research in healthcare ethics.
Bridging KT Connections: Using the social drivers of knowledge translation (KT) to improve health care service delivery
In health care, knowledge translation (KT) is the process of moving knowledge into action to improve health systems, health services and health outcomes. KT is a social process that connects people to knowledge and supports. My area of expertise, implementation science, examines the factors that influence the use of knowledge from research and lived experience. My research program focuses on the importance of connections between people and organizations that can support KT. I use theories and evidence to design strategies to improve the use of best practices by health care providers, leaders and patients. I apply this research in health care centres, research institutes, community organizations, government, rehabilitation, and other settings. Our team is identifying and then testing a range of socially based strategies to strengthen connections between researchers, health care providers and families that can help move knowledge into action. This work will confirm the best approaches to use in different health care and research settings to improve care. The impact of this research will be to improve access to the safest, most effective health care for children and their families.
Investigating the role phagocytic immune cells play in developmental programming during gestation
Microglia, the resident macrophages and phagocytic immune cells of the brain, play an important role in neurodevelopment—yet a fundamental question is whether these same roles have evolved in other regions of the fetus. My research is targeted at addressing this question by studying the contribution of macrophages to processes that shape the development of the skull and face (i.e., craniofacial morphogenesis), and whether distinct populations of these immune cells signal locally to contribute to normal development. During pregnancy, disrupting macrophage functions results in craniofacial and dental abnormalities. To explore the developmental contribution of these immune cells to the craniofacial region, we will use our established pharmacological mouse model alongside state-of-the-art expression profiling and imaging technologies. By studying how macrophages contribute to normal development of craniofacial tissues, this research will lead to advancements in our understanding of how maternal insults like maternal periodontal infection—a prevalent condition associated with adverse pregnancy outcomes—disrupts developmental programs. Overall, this research will broaden our knowledge of maternal-fetal interactions to benefit Canadians.