Civility matters: Co-creation of an online toolkit for long-term care home staff

In long-term care (LTC) homes, the number of staff working on a shift is essential to quality care provision; however, it is increasingly apparent that who is on shift is just as important. Quality care is difficult to achieve when staff do not routinely engage with one another in a positive, or civil, manner. Our research, conducted pre-pandemic, revealed the impact of uncivil workplace behaviours on care delivery and staff well-being, an impact that has only been exacerbated by COVID-19. A positive workplace culture requires the cooperation of front-line and leadership staff and access to professional development opportunities that help staff instill and contribute to a collaborative and respectful workplace. Comprised of researchers and union and industry partners, our project team will co-create an online toolkit to support staff to address workplace (in)civility in LTC and promote supportive and collaborative workplace relationships at their worksites.

Specific objectives include: 1) Raising awareness about the nature and impact of workplace incivility in LTC on staff well-being and care delivery; 2) Creating opportunities for staff to engage with practice-based scenarios and resources for addressing workplace (in)civility.


Team members: Saleema Dhalla (SafeCare BC); Jennifer Lyle (SafeCare BC); Leah Laing (UBC); Heather Cooke (UBC); Rhonda Croft (BC Nurses’ Union); Hanif Karim (BC Nurses’ Union); Lisa Kelly (Sienna Senior Living); Cina Oppel (BC Government & Service Employees’ Union); Megan Scott (BC Government & Service Employees’ Union); Georgina Hackett (Hospital Employees’ Union); Anne Bull (Hospital Employees’ Union)

 

Developing educational resources to support patients and clinicians to identify and use self-management apps for bipolar disorder

Over half a million Canadians live with bipolar disorder (BD), a long-term, serious mental health condition that causes extreme mood swings from depression to mania. With optimal treatment, care, and empowerment, people with BD can flourish, but this requires more than just medication. Mobile phone applications (‘apps’) can deliver knowledge on effective self-management strategies for BD and provide real-time support. Despite high interest in mental health apps, a CREST.BD survey showed that in practice few people with BD are using such tools, and clinicians do not feel well equipped to recommend apps to their patients.

This project will develop a suite of patient and clinician-facing educational resources (e.g. webinars, videos, blog posts) in collaboration with people with lived-experience and clinicians. A co-ordinated social media strategy will be developed to increase awareness of these resources.

Expected outcomes include: patients will better understand the potential benefits and risks of mental health apps; patients will improve their digital health literacy by learning strategies to identify safe and secure mental health apps; clinicians will improve knowledge about app evaluation frameworks and informed decision making.


Team members: Natalie Dee (CREST.BD); Emma Morton (UBC); John Torous (Beth Israel Deaconess Medical Centre); Rosemary Xinhe Hu (CREST.BD); Caden Poh (UBC); Laura Lapadat (UBC); Linda Yang (UBC)

 

Tokes in the throat: Health practitioner education on the effects of smoking cannabis in the upper airway

Cannabis was legalized in Canada with the introduction of the Cannabis Act in 2018. This rapid legalization has led to a knowledge gap in doctors. Although most users smoke cannabis, few doctors know the health effects of smoking cannabis in the upper airway. In previously funded work, our team has reviewed the scientific literature and summarized these health effects, both positive and negative. During the COVID19 pandemic, innovative knowledge translation activities are needed. We propose a two-part initiative to educate health practitioners about cannabis, targeting family doctors who are the patient’s gateway to the Canadian health system. First, we will co-design a webinar with the research users on our newly launched provincial ENTCME.org platform. This event will be recorded for asynchronous access. Second, we will co-create infographics to summarize the information and launch a social media campaign on Facebook, Twitter, and Instagram. Reach and effectiveness will be assessed by registration for the webinar and pre- and post-engagement surveys. Performance data from each social media platform will also be analyzed. Our goal is to help doctors guide patients to make informed, evidence-based choices on cannabis usage.


Team members: Brenna Lynn (UBC); Andrew Thamboo (UBC); Emily Deane (UBC); Joel Howlett (UBC); Jobanjit Phulka (UBC); James P. McCormack (UBC); Dinusha Peiris (BC Cancer Agency); M-J Milloy (British Columbia Centre on Substance Use and UBC); Christie A Newton (UBC)

 

Developing a method to implement patient-centered social robotics for pediatric mental health within the BC healthcare system

Could a small, interactive robotic character or pet be used in a hospital to help support children’s mental health? While children are often interested in interacting with robots, the design of these devices rarely incorporates patients and families’ needs and values. For social robots to be ethically implemented in healthcare, they must be developed according to patients’ priorities, supported by high-quality scientific evidence, and well-suited to implementation by real-world healthcare providers.
To address this, I will hold co-creation workshops with children and families with a lived experience of a childhood mental health disorder to identify goals for and barriers to social robot interventions. I will also interview key health services stakeholders who would be most involved in using a robot in the hospital — nurses, CLSs, and others — about advantages, concerns, and obstacles to deploying a social robot for pediatric mental health, as well as proposing a Health Technology Assessment.
Taken together, these research findings will facilitate the development of practice and policy for the evidence-based, patient-centred deployment of social robots to improve the wellbeing of BC children experiencing mental health challenges.

Physical exercise to mitigate the effects of physical inactivity on brain health

Problem: Many older adults experience prolonged bed rest as a result of injury, surgery, or hospitalization and this may have detrimental effects on both their cognitive (i.e. thinking) and physical abilities. Ensuring older adults engage in daily exercise during bed rest may counteract the negative consequences of physical inactivity on cognitive abilities.
Research Overview: Maximizing on an opportunity provided by CIHR and the Canadian Space Agency, we will determine: 1) the effects of 14 days of bed rest on cognitive function in adults aged 55 to 65; 2) the impact of daily sessions of physical exercise in counteracting the effects of bed rest on cognitive function; 3) the mechanisms (i.e. how) by which bed rest and impacts cognitive function and its influencing factors (e.g. sex). Participants will be randomized to a group with either 14 days of bed rest with three physical exercise daily sessions (total of 60 minutes) or a control group (bed rest only).
Potential Impact: Promote the development of novel interventions and rehabilitation strategies to counter the adverse effects of physical inactivity, including bed rest, on cognitive health in older adults during transitions in care.

Programming bordetella pertussis to produce novel vaccines

Pertussis (whooping cough) continues to be a problem despite high vaccination coverage against Bordetella pertussis, the bacterium that causes the disease. Annually, there are 24 million cases of pertussis and ~160,700 deaths worldwide. Pertussis is a respiratory disease that is transmitted from person to person through airborne droplets and poses a threat to unvaccinated infants and children whose immunity has dropped. Currently, there are two forms of the vaccine in use. The first is the killed whole-cell vaccine (wP), which is effective, but has side-effects such as swelling at the site of injection and fever. These adverse effects have diminished its acceptance in high-income countries and led to its replacement by the acellular vaccine (aP) that only contains purified components of the organism. While the aP vaccine protects against getting pertussis, it does not prevent transmission of the disease and fails to provide long-term immunity.
We aim to develop two new vaccine candidates: a revised wP and a novel aP to control the re-emergence of pertussis. This will be done through modifying some of the structural components of the bacteria to either alleviate the side effects or overcome the deficiencies of the wP and aP vaccines.

Engineering Platelets using therapeutic mRNA

Platelet cells are routinely transfused during treatment of a range of conditions, due to their specialized roles in hemostasis. Despite the significant potential to enhance the efficacy and applicability of platelet transfusions, no techniques have yet been developed to engineer modified platelets. mRNA therapeutics is a promising novel class of nanomedicine with broad clinical applicability, capable of enhancing the physiological function of target cells by modifying cellular protein expression. The therapeutic potential of mRNA editing is particularly relevant to transfusion science, where the mechanisms of delivery to patients are well established. By engineering platelets using gold standard mRNA transfection strategies, their therapeutic potential can be maximized for diverse applications.

Engineered platelets will be created using cutting-edge mRNA lipid nanoparticles. Successful mRNA editing will create platelets with enhanced biochemistry and improved hemostatic function. Results generated from this project will address knowledge gaps in platelet translation mechanism, and guide forthcoming research on the next generation of blood products, improving current standards of care in blood transfusion.

Optimizing protection against Respiratory Syncytial Virus in infancy

Respiratory Syncytial Virus (RSV) is the number one cause of hospitalizations and death for severe respiratory infections in young infants across the world. Antibodies made by our immune system are important to help fight viruses like RSV. Newborns lack their own antibodies at birth and rather obtain them from their mothers during pregnancy. To increase antibody levels at birth in babies, researchers have proposed to vaccinate mothers against RSV during pregnancy. We do not completely understand how much antibodies are critical for protection against RSV infection in early life. We also do not know which function(s) of RSV antibodies are associated with protection from RSV disease in young infants. Infants’ samples obtained at delivery will be tested for levels and different functions of RSV antibodies and this will be correlated with the risk of infection in infants. Data from these projects will inform RSV vaccine design and development, especially in pregnancy as the levels and functions of RSV antibodies after vaccination should be similar to the levels and functions that protects from RSV disease.

Development of a non-invasive diagnostic to detect bacterial pulmonary infections in patients with cystic fibrosis

Cystic fibrosis (CF), once known as an untreatable fatal disease in early childhood, is now recognized as a fairly manageable disease but with a primary morbidity dominated by persistent lung infections. Our team and others have shown that bacterial volatile molecules in human breath represent a substantive diagnostic potential for lung infections. The focus of almost all breath research in CF, including ours, has been on two bacterial pathogens (Pseudomonas aeruginosa and Staphylococcus aureus). Here, we propose to target three additional pathogens (Haemophilus influenza, Stenotrophomonas maltophilia, and Burkholderia cepacia complex) that are common for patients with CF and are also broadly relevant to pneumonia in children. My scientific approach spans the careful testing of the molecules produced by bacterial cultures as well as breath of patients with CF. The expected outcomes (biomarker signatures) will provide clinical utility in the diagnosis of these pathogens as well as monitoring antimicrobial therapy efficacy. In addition, the signatures will likely provide a greater understanding of pathogen metabolism.

Counteracting the “Jumping to Conclusion” bias in schizophrenia with a combination of neuromodulation and metacognitive training

In Canada around 1% of the population is diagnosed with schizophrenia, roughly corresponding to 40 000 people in British Columbia. One typical feature of Schizophrenia is making hasty decisions without weighing evidence; this is known as the “Jumping to Conclusion” (JTC) bias. The bias can be understood as a tendency of quickly committing a final decision based only on the first available evidence. One of the most successful forms of treating the bias in schizophrenia is Metacognitive Training. During this therapy, patients try to question the logic of their own decisions. The goal of this project is to enhance the beneficial effect of this treatment and establish methods for objective monitoring of successful therapy. The previous research of Prof. Woodward lab showed that is possible to track neural connections of brain regions involved in the JTC bias. Here, we plan to identify these networks in each of our patients. Next, using a new technology for safe electric modulation of neural connectivity, we will strengthen connections in the network. Through multiple testing sessions we will monitor changes in the brains of patients and thus the progress of therapy. This project can help us improve the treatment of schizophrenia.