University of British Columbia – Page 13

Studying the role of modifiable risk factors: Nutrition and body weight for the prevention of cancer

Nearly half of Canadians will be diagnosed with cancer during their life. Healthy eating, a healthy body weight, and regular physical activity can prevent one-third of cancers. Yet, many Canadians do not engage in these lifestyle behaviours. New approaches to improve diet-cancer research are needed to move the field forward and reduce the burden of cancer on Canadians.

Dr. Murphy's research focuses on modifiable risk factors for cancer; nutrition and body weight. The goal is to provide new insight on how and why these factors contribute to cancer development using data from large populations of Canadians and innovative approaches such as lifestyle biomarkers that may explain why factors lead to cancer development.

Advances in cancer prevention are needed to promote the health of people in BC and nationwide. This research will provide new insight into modifiable factors for cancer that may help encourage lifestyle changes and development of new strategies to prevent cancer.

Predicting depressive symptoms during the transition to high school

The transition to high school is a challenging developmental period, during which prevalence rates of depression more than double. In fact, by the end of the first year of high school, 11.5% of adolescents will have experienced a depressive episode in the last year, and many more adolescents will have experienced elevated depressive symptoms that interfere with school performance, social friendships, or physical health. Despite the importance of this transition, little is known about predictors of depression during it, and most students report feeling insufficiently supported to cope with it. Thus, the proposed research will work towards answering two questions critical to Canadian youth:

What causes adolescents to develop depression during the transition to high school?
What can we do to help students better cope with this transition and to mitigate risk for depression during it?

Findings will be critical to improving students' emotional health during the high-school transition. Knowledge translation activities will inform future research, practice, and policy.

Imaging repair: Developing and applying unconventional neuroimaging methods for quantitative assessment of tissue health

Magnetic resonance imaging (MRI) is a powerful tool for measuring changes in the brain and spinal cord that occur over the course of neurological disease. Unfortunately, conventional MRI is qualitative, so the biological cause of the changes seen on MRI is difficult to determine.

Damage to myelin, the substance that surrounds the nerve fibres (axons) of the brain and spinal cord to speed up signal transmission and protect the axons themselves, is a common feature for many neurological diseases. While myelin can be repaired, axonal damage is irreversible.

Dr. Kolind is focused on developing and applying advanced MRI techniques that provide measures related to myelin loss or axonal damage. The greater sensitivity and specificity afforded by these advancements provides critical information regarding the underlying processes in neurological disease. This insight is needed to understand such diseases and target treatment development. Further, the quantitative nature of these techniques may dramatically reduce the number of patients and time period required for successful demonstration of new therapies. This approach has tremendous potential for clinical trials and research studies in countless neurological diseases and injuries.

Platelet signaling in chronic inflammation

Proper function of the immune system is essential for protection against infectious disease and maintaining human health. During the onset of infection, white blood cells and platelets release signaling molecules known as cytokines, which orchestrate a protective inflammatory response. When cytokine release is de-regulated, excessive inflammation causes cell and tissue death and loss of function. This is seen in gum disease (periodontitis), which is characterized by gum inflammation and destruction of tooth-supporting connective tissues and bone. This research will uncover the mechanisms responsible for maintaining the health of periodontal tissues.

Platelets, in addition to regulating blood clotting, are emerging as pivotal components of the inflammatory response. Dr. Kim and team will study how periodontal infection causes cytokine release from platelets, focusing on:

How human platelets respond to periodontal infection and determine how platelet function correlates with clinical gum disease status.
How the cell's structural framework mediates the release of cytokines from platelets.

An improved understanding of platelet function could have important implications for rational treatment of inflammatory diseases, including gum disease.

Population-based ‘big data’ research to improve women’s health

Dr. Hanley's research in women's reproductive health uses the large population-based datasets that already exist in British Columbia, and is driven by diverse training in population and public health, health services research, and economics.

Specifically, Hanley will study whether removing a woman's fallopian tubes at the time of other routine gynecologic surgeries is a safe, effective and cost-effective ovarian cancer prevention strategy. This will provide much needed and timely evidence on the effectiveness of removing the fallopian tubes as an ovarian cancer prevention strategy. Known as the British Columbia protocol, this practice has been adopted in many countries around the world.

Hanley will also examine the safety of using psychotropic medicines during pregnancy, specifically whether using antidepressants during pregnancy may increase a child's risk for autism spectrum disorder and social and emotional and motor development in early childhood. This will generate evidence that can be used to minimize or avoid adverse outcomes from maternal mental illness and use of prescription drugs to treat that illness in pregnancy.

This focus on women's reproductive health and the use of the large linkable population-based datasets in BC will generate evidence on improving population health, improving patient care, and reducing health system costs. This research has already, and will continue to, guide patient care in British Columbia.

Mental health trajectories of immigrant and refugee children: An ecological population-based approach

Canada’s immigrant and refugee population is growing rapidly, representing over 20% of the population. Despite the significance for Canadian society, little is known about mental health and risk factors among immigrant and refugee children and youth. Such knowledge is, however, critical to understand how we can support them in adapting to Canada, and enhance their well-being. This project aims to create actionable evidence that health professionals, educators, and decision-makers can use to implement initiatives that can support the mental health of immigrant and refugee children and youth.

This research will:

Use statistical analyses of multiple databases, linked at a population-level across 10 school districts of BC, to examine how child, family, school, and community factors relate to immigrant and refugee children’s mental health outcomes, and how these children and youth are using health services in BC.
Ask immigrant and refugee youth about their perspectives on factors related to their mental health and access/barriers to mental health services, via interview focus groups in school and mental health clinic settings.

This is the first study in BC to combine province-wide data with children’s own perspectives to identify which factors may need to be addressed and what future prevention and intervention efforts are needed to support long-term health outcomes for immigrant/refugee children and youth in Canada.

End of Award Update – June 2023

Most significant outputs

This project allowed us to study and identify population-level diagnostic prevalence of mental health disorders across immigrant, refugee, and non-immigrant children and youth in British Columbia (BC). In this research, we found notable differences in the diagnostic prevalence rates of conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and mood/anxiety disorders across immigrant, refugee, and non-immigrant children and youth, as well as across factors such as sex, age, and immigrant/refugee generation status.

This project also allowed us to delve more deeply into the factors that might impact the emotional health of refugee children. This research identified that specific factors associated with refugee children’s perceptions of their social context (e.g. a supportive school climate, support from adults at school) were associated with better emotional health.

Impact

To our knowledge, our research is the first to provide population-level mental disorder prevalence estimates that compare immigrant, refugee, and non-immigrant groups in BC. This provides important information to our understanding of the mental health status of immigrant and refugee children and youth in BC.

Potential Influence

We hope that this work will be the impetus for additional research examining the unique mental health patterns and needs of diverse child and youth sub-populations that tend to be underrepresented in mental health research. Understanding the unique needs of Canada’s diverse sub-populations is particularly important for health service planning and informing health policies.

Next Steps

With the support of a Tier 2 Canada Research Chair and funding from the Canadian Institutes of Health Research and Social Sciences and Humanities Research Council of Canada, we are continuing our work to deepen our understanding of the developmental trajectories and unique mental health needs of diverse children and youth in BC.

Improving youth mental health and substance use outcomes through primary-care based health services

Mental health and substance use (MHSU) disorders affect 1 in 4 Canadian youth. Of all age groups, young Canadians (ages 15 to 24) have the poorest access to health services. In response, British Columbia (BC) established a primary health initiative called 'Foundry' to promote and support early treatment for young people with MHSU disorders. Foundry is comprised of seven centres that provide integrated, coordinated health services for young people. The aim of my five-year research program is to improve health outcomes for youth accessing Foundry services through enhanced patient-centred assessment and evidence-based care tailored to the specific needs of young people experiencing MHSU challenges.

The key elements of this research program include:

Enhancing the role of youth in MHSU research.
Measuring and understanding the health needs of young people with MHSU disorders.
Developing tailored and accessible treatments for youth with MHSU, including employment support.

Over the next five years, Dr. Barbic will work collaboratively with Foundry and other community organizations across BC to identify the health priorities of youth with MHSU disorders, and use new methods to measure these priorities and demonstrate how patient-centred assessment can drive meaningful care. By engaging youth, families, clinicians and trainees, this research program will address a national priority to improve the health outcomes of young people with MHSU disorders.

BC’s Primary Health Care Research Network – Phase 1

Health Research BC is providing match funds for this research project, which is funded by CIHR’s Strategy for Patient Oriented Research (SPOR) Primary and Integrated Health Care Innovations (PIHCI) Network initiative.

BC’s Primary Health Care Research Network (BC-PHCRN) was launched in November 2013, and is one of 11 networks across Canada that have an initial focus on individuals with complex health needs for whom integrated care is critical to improve patient experience and health, health equity, and health system outcomes.

The BC-PHCRN is designed to support evidence-informed transformation of the delivery of primary and integrated health care, and its goal is to encourage, facilitate, and support collaborations between government, health authorities, health professionals, patients and researchers. The BC-PHCRN aims to seek out, develop, and facilitate adoption of health care innovations to improve BC’s health care delivery system.

As part of our work, the BC-PHCRN supports the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), Canada’s first and only multi-disease electronic record surveillance system. CPCSSN is a multi-faceted tool, providing users with:

Data for development and effective evaluation of Primary Care Networks and Patient Medical Homes.
Quality improvement dashboard for physicians and other clinicians.
Chronic disease surveillance across the clinic, provincial and national levels.
The ability to support crucial primary care research in BC and in Canada.

The BC-PHCRN is led by a Tripartite Leadership, including the Science Lead, Dr. Sabrina Wong, Clinical co-Leads Drs. Fiona Duncan and Anne Junker, and Policy co-Leads, Shana Ooms and Heather Davidson.

The effects of balance training with or without cognitive training in older adults with MCI and impaired mobility

Mild cognitive impairment (MCI) is an intermediate stage between normal cognitive function and dementia. The rate of progression of MCI to dementia in older adults has been found to be between 10-12% per year, whereas those without cognitive impairment acquire dementia at a rate of only 1-2% per year. MCI has been linked to poor dual-tasking, impaired balance and functional mobility, and is a significant risk factor for falls. Individuals with MCI need preventive therapies that target both the cognitive and mobility-related outcomes. Dr. Jehu has identified pairing targeted dual-tasking training with balance and mobility training as a promising preventative therapy.

In recent research, balance and mobility training (BMT), and balance and mobility plus cognitive training (BMT+C) programs have been shown to improve dual-tasking and functional mobility in the healthy older adult population; however no previous interventions have targeted dual-task training in individuals with MCI. Dr. Jehu will extend this work to individuals with MCI in order to improve cognitive and mobility outcomes. The BMT and BMT+C interventions will determine whether individuals with MCI can reverse cognitive and functional declines and improve to healthy older adult norms.

The timed up & go (TUG) is a commonly used clinical functional mobility assessment tool. TUG has been shown to be an independent predictor of cognitive decline following an ischemic stroke, and has accurately differentiated between healthy older adults and older adults with MCI. Dr. Jehu aims to use TUG to improve the diagnostic interpretation of important clinical measures used to evaluate individuals with MCI.

Dr. Jehu’s research may serve to improve the interpretation of clinical diagnostic tools, which could revolutionize the prescription of exercise in older adults with MCI and improve the overall interpretation of commonly used clinical assessment tools.

End of Award Update: April 2022

Most exciting outputs

In our study Sex differences in subsequent falls and falls-risk: A prospective cohort study in older adults (Gerontology, 2021), we found that modifiable risk factors related to cognition, physical function, psychological wellbeing, and health status predicted subsequent falls. In males, better mobility was not as protective of falls compared with females. This may be due to males’ poorer executive function, contributing to decreased judgement or slowed decision-making during mobility. These results may inform efficacious sex-specific falls prevention strategies.

Impacts so far

I would not have obtained a position as an assistant professor without my Health Research BC / Vancouver Coastal Health Research Institute Research fellowship. I am confident that the experience I had working with Dr. Teresa Liu-Ambrose provided me with the skills I needed to secure a job.

Potential future influence

During my fellowship, I learned the skills needed to become an independent researcher. Some skills include randomized controlled trial design, implementation science methods, how to conduct systematic reviews, skills in cognitive testing, grant writing, and working with patient populations such as older adults who fall and those with cognitive impairment

Next steps

I am now an assistant professor at Augusta University in Augusta Georgia. I was recently awarded an intramural grant to examine the effects of 6 months of exercise on cognition among people living with dementia. I am thrilled to be leading a team of interdisciplinary researchers and healthcare professionals.

Useful links

Development of a novel biotherapeutic fusion protein inhibitor for treatment of advanced prostate cancer

Recent advances in targeted therapies have transformed the treatment of several types of cancer. Numerous agents, including small molecule drugs and therapeutic antibodies targeting receptor tyrosine kinases (RTKs) such as EGFR, Her-2 and MET, are currently in clinical trials or have received regulatory approval. These agents are exhibiting impressive clinical responses demonstrating that these RTK pathways are clinically validated drug targets and key drivers of multiple cancers such as breast, lung and colorectal cancers.

Dr. Ong’s lab has discovered that SEMA3C drives prostate cancer growth and treatment resistance through activation of multiple RTKs via Plexin B1. He has developed a plexin B1 receptor, called Fc fusion protein, that not only is able to inhibit SEMA3C induced activation of EGFR, HER-2 and MET but is also able to inhibit activation of these RTK by their cognate ligands, EGF and HGF.

Importantly, Dr. Ong has found that PB1SD-Fc potently inhibited progression of LNCaP xenografts post castration in vivo. Currently, effective therapeutics used for treatment of advanced prostate cancer has been limited to AR pathway inhibitors. This fusion protein represents a new multi-RTK inhibitor drugs that may also show activity in treatment of prostate and other cancers driven by EGFR, HER-2 or MET. Thus, Dr. Ong’s findings may have transformative impact on clinical management of prostate and other cancers.