A hot topic: Defining vulnerability, capturing resilience and learning lessons to support vulnerable groups adapt and respond to extreme weather in Victoria’s capital regional district

The summer 2021 heat wave caught British Columbians and many policy-makers by surprise. This project seeks to develop a research agenda and build community-engaged research partnerships to identify ways in which service providers, private businesses, governments and individuals can support vulnerable communities to avoid negative health outcomes associated with future heat events that occur in the Capital Regional District (CRD). Guiding questions include: Who in the CRD is most vulnerable to negative health impacts related to extreme heat events? What does the experience of extreme heat look like for these vulnerable groups? What recommendations do they have for supporting other members of their group during extreme heat events? These questions will be answered through secondary and primary research. Following a community-engaged research approach, the most appropriate methodology will be determined in collaboration with service providers and individuals with lived experiences to ensure we are accounting for diverse experiences of trauma and resilience. Project outcomes will include policy recommendations, data and stories for decision-makers to craft messages and communicate with the public to avoid heat-related harm.

Team members: Kirsten Mah (Capital Regional District; Summer Goulden; City of Victoria); Kristie Signer (City of Victoria); research trainee (University of Victoria).

A multi sector World Cafe to promote mental health of refugees in BC: A participatory realist evaluation project

The purpose of our project is to convene and collaborate with service users, health practitioners, settlement service providers, and policy makers in a series of deliberative dialogues and a multi-sector World Cafe to co-develop a program theory about integrated mental healthcare services for refugees. The global humanitarian refugee crisis has highlighted refugees as one of the most vulnerable population groups requiring integrated mental health services and supports. However, the COVID-19 pandemic has stressed healthcare systems in providing equitable, gender sensitive, language appropriate and trauma and violence informed care to diverse refugees resettled in Canada. Integrated care can improve clinical and organizational outcomes for more effective health services but limited knowledge exists on what promotes integrated mental health care for refugees, how it works, for whom and in what contexts. Convening multidisciplinary stakeholders is an important step to building a program theory and how it works. Our approach will develop an evidence informed model that will later be used and tested across multiple primary health care and social service settings to improve mental health service and promote refugee mental health.

Team members: Simon Carroll (University of Victoria); Suzanne Huot (UBC – Faculty of Medicine); Anita David (patient partner); Cindy Quan (University of Victoria); Eliseo Verdugo (University of Victoria); Maura Macphee (UBC); Sara Hosseina (New Canadian Primary Care Clinics); Karen Davison (Kwantlen Polytechnic University – Health Sciences); Vidhi Thakkar (University of Victoria; Victoria Hospice Society); Mikhail Torban (Ministry of Mental Health and Addictions); Brandon Hey (Mental Health Commission of Canada); Niels Agger-Gupta (Royal Roads University); Frank Cohn (VAST Refugee Mental Health Services Vancouver); Pamela Toor (REACH Community Health Centre).

Building Roads Together in BC

Building Roads Together (BRT) is an intergenerational trauma-informed peer-led walking/rolling group program implemented in public urban greenspace, that trains and mentors migrants living in low-income urban neighbourhoods to promote social inclusion, equitable healthy aging, and mental health in their communities. Our Building Roads Together-Global (BRT-G) Solutions Network is adapting, scaling, evaluating, and sustaining BRT in three cities (Surrey, BC; Toronto, ON; Bogota, Colombia). This C2 award is to establish a Victoria site team for our Building Roads Together-Global Solutions Network to adapt, scale, evaluate, and sustain Building Roads Together in low-income, migrant-receiving neighbourhoods in Victoria. We will: 1) Build a new community-university-health system partnership in Victoria; 2) Develop a research agenda to integrate Victoria community partner priorities into BRT-G Solutions Network research objectives; 3) Begin the installation phase of implementing BRT in a low-income, migrant-receiving neighbourhood in Victoria; 4) Co-develop a training strategy for career development in inclusive implementation science; and 5) Build inclusive implementation science capacity among trainees.

Team members: Paola Ardiles (Bridge for Health); Nancy Clark (University of Victoria – School of Nursing, Faculty of Human and Social Development); Fiona Stevenson (DIVERSEcity Community Resources Society); Florentien Verhage (Inter-Cultural Association of Greater Victoria); Sureya Ibrahim (Centre of Learning & Development); Adriana Diaz del Castillo H. (Ensamble Investigaciones).

Staying apart together: Harnessing the power of community-based knowledge and social networks through communication technologies

We wish to create a video that bolsters an increased awareness of how the CanConnect assistive technology can improve the quality and accessibility of virtual social communications, and thereby contribute to the improvement of older adult’s (OAs) wellbeing and mental health. Our research showed that OAs became more interested, engaged, and curious about CanConnect when they saw their friends having positive experiences with loved ones using the technology. In choosing a video as a vehicle for KT, we seek to appeal to viewers and potential research users on a more emotional, intellectual, and communal level, showing the power of using CanConnect technology with family members and friends in everyday interactions. We also believe that showcasing these positive interpersonal interactions on video establishes further trust between researchers and the community. Video represents an opportunity to tell the stories of real people, in real places, living their real lives; and these stories can invite conversation between existing narratives and our own experiences. In consultation with local community partners, within this proposed project, we see an opportunity to re-visit, and potentially re-write stories, together.

Team members: Matilde Cervantes (UVic); Robin Syme (CanAssist); Karen Kobayashi (UVic).

The impact of olfactory dysfunction on social and mental health

Our sense of smell enriches our lives—from enhancing pleasures (e.g. aroma of coffee) to signalling danger (e.g. smoke). Loss of smell is related to a range of social and emotional impairments, including elevated rates of depression, social isolation, and relationship difficulties. The COVID-19 pandemic causes transient smell loss, providing a novel opportunity to study one of our least understood senses. My first aim is to examine pathways linking olfactory loss to social and emotional impairments. I will recruit a prospective cohort of adults with recent onset of olfactory dysfunction and no flu-like symptoms (N=300) as well as a control cohort (N=100). Participants will be assessed over eight weeks, covering the typical period for olfactory recovery in COVID-19 patients. This data will provide a first-ever look at how within-person changes in olfaction relate to changes in social and emotional wellbeing. My second aim is to develop a brief, behavioral intervention by conducting a randomized trial focused on the benefit to participants from an online intervention. After refinement, this intervention will be offered freely, and findings will inform efforts to improve mental health for people with olfactory dysfunctions.

Fibrinogen promotes a microglial-mediated inflammatory response following adolescent repetitive mild traumatic brain injury

Concussions are a major health issue in Canada. Adolescents are an at-risk population for concussions because they are in an age range that is often engaged in contact sports and high-risk activities. Microglia, the brain’s resident immune cells, respond to these injuries, causing an inflammatory response. Concussions can damage brain blood vessels, promoting the release of fibrinogen, a protein not present in the healthy brain. Fibrinogen interacts with microglia, promoting an inflammatory profile that can alter neuronal functioning, leading to behavioural deficits. This project will block fibrinogen’s interaction with microglia using an ecologically valid rodent model of concussion. We will assess short- and long-term memory with well-known behavioural tests. In addition, we will assess microglial activation and type using immunohistochemistry, and assessing neuronal connectivity using field electrophysiology. Adolescence is a period of significant development marked by rapid learning and substantial brain growth/maturation. As such, expanding and fully characterizing changes in brain circuitry mediated by fibrinogen/microglia interactions following concussion may provide avenues for preventative and therapeutic interventions.

Outcomes of a ketogenic dietary intervention on the gut microbiome-microglial brain axis and schizophrenia-like behaviour in mice exposed to a double-hit immune challenge

Alterations in microorganisms present in the gut are associated with various mental health disorders. It is possible that this is due to changes in microglia, the immune cells that fight infections in the brain. Microglia can consume neurons, which are the cells that talk to one another in the brain. It is possible that changes in gut microorganisms make these immune cells to eat up brain cells excessively and uncontrollably, which causes mental illness. To understand this, we will infect laboratory mice with infectious agents during pregnancy and expose them to stress during adolescence. After testing the mice for behavioral alterations, we will use imaging techniques to assess how gut microorganisms can influence microglia. We will then determine if ketogenic treatments with a clinically approved high fat and low carbohydrate diet, showing benefits on the gut and brain, can reverse harmful effects on these immune cells in the brain. Together these investigations will provide novel insights into how the gut microorganisms can affect the brain immune cells and alter behavior, resulting in mental illnesses. This research may provide new targets for the therapeutic management of mental health conditions that include schizophrenia.

Cost-efficient approach for phenotyping cells in large cohorts and relating them with COPD clinical outcomes

In Canada, over 2 million people suffer from COPD, costing over $1.5 billion per year in direct expenditures. However, no existing therapy can reverse COPD’s disease progress. Alveolar macrophages (AMs) are the lungs’ dominant immune cells and perform critical functions, including fighting infection and tissue repair. Single-cell genomics technology can characterize AM phenotypes and reveal their roles in COPD. However, validating the relation between AM phenotypes and COPD clinical outcomes requires many patients, making the unscalable single-cell technology impractical to study such large cohorts. This issue motivated me to develop a cost-efficient approach to discover cell-phenotype biomarkers, using both high-resolution single-cell and low-cost bulk genomic technologies. I will develop novel statistical methods and software tools for this novel approach. The key deliverables are: 1) an experiment protocol, novel statistical methods, and the first software pipeline for cost-efficient deep-phenotyping of large clinical cohorts, to discover biomarkers for ANY diseases; 2) novel AM phenotype biomarkers as drug targets of immunotherapy for COPD or a genomics diagnostic test (medical device) to guide personalized COPD treatment.

Improving access to culturally safe, gender affirming, and trauma-informed abortion services and support for Indigenous women, Two-Spirit and LGBTQIA+ people in Canada

While Canada is currently one out of four countries globally to have no national restriction in law, the 2016 UN Human Rights Commissioner’s report indicated a lack of access to abortion due to cost, knowledge, and geography. For Indigenous Women, Two-Spirit, and LGBTQIA+ people in Canada, additional barriers exist including colonialism and racism. Yet there is an alarming gap in the literature surrounding Indigenous peoples and abortion services — despite knowing that one in three people in Canada will experience an abortion in their reproductive lifetime. The goal of this program of research is to build on existing community knowledge and strengths, advance knowledge around, and remove barriers to abortion services for Indigenous Women, Two-Spirit, and LGBTQIA+ people in Canada. Guided by an Indigenous feminist framework that acknowledges the intersectional experiences of Indigenous women, Two-Sprit, and LGBTQIA+ peoples and abortion access, this program of research will apply an Indigenous methodology to investigate experiences, gather knowledge, and co-develop resources to improve the abortion access gap among Indigenous peoples.

Risk and protective factors for cognitive health across the adult age span: Impacts of physical and mental health and illness on cognitive outcomes

The virus causing COVID-19 can invade the brain, raising concern over long-term impacts on thinking abilities. We aim to identify long-term impacts on these cognitive abilities in those who have had COVID-19, and pinpoint factors that predict long-term outcomes. Adults positive for COVID-19 and those with no evidence of infection, are completing a series of cognitive and psychological tests in a current study. The proposed project will follow these individuals over time, with one and three-year follow-ups to examine changes in cognition across time. We will examine group differences in cognition, mental health, and other factors at each time point, determine if one or more cognitive profiles (clusters) characterize COVID-19 positive individuals, examine changes in these profiles across time, and test a screening measure to detect these cognitive difficulties. Findings will inform clinicians (e.g. neurologists, rehabilitation specialists) on trajectory of recovery of function and inform healthcare service provision in BC. Results will help ensure long-term impacts of infection are appropriately addressed, so those affected can efficiently resume complex activities requiring cognitive effort (e.g. employment, academic pursuits).