A desperate need exists to develop technology to regenerate sperm that can be used for in vitro fertilization (IVF) among men who lack sperm production, such as pediatric cancer survivors. In Canada, approximately 2,440 boys aged less than 15 will be diagnosed with cancer each year. Fortunately, the field of oncology has made significant improvements in survival rates, which are estimated to be 83%. However, treatments will render up to 97% of paediatric cancer survivors infertile with no sperm production, despite over 75% eventually desiring to have biological children. While stem cells (sperm precursors) can be retrieved prior to cancer therapies, no technology currently exists to regenerate sperm, which is required to achieve a pregnancy. This project proposes to utilize single cell sequencing and along with state-of-the-art computational modelling to reveal molecules and pathways that are key regulators of developing sperm from stem cells. These findings will be screened and tested to identify critical molecules that help generate sperm in 3D bioprinted structures. Results from this study will contribute to developing the understanding and technology to regenerate sperm for men lacking any ability to father biological children.
Research Location: Vancouver Coastal Health Research Institute
Reimagining gynecologic cancer survivorship: Creating a provincial strategy for survivorship research and care in British Columbia
In Canada, two-thirds of people diagnosed with cancer today will be long-term cancer survivors. With advances in early detection and improved treatment, and an ageing population, this number is expected to continue to rise highlighting the urgency for improved strategies to enhance the well-being of individuals, and their families, living with and beyond cancer. In partnership with patients and families, and the clinical and scientific community in BC, we plan to hold a series of stakeholder events and surveys that will address the impact of a gynecologic cancer diagnosis and treatment on the mental health, cognition, financial burden, and sexual health of those affected. We will also examine the impact of hereditary cancers and patient education/navigation to improve upon a patient’s journey through their cancer diagnosis and treatment. Through this work, we will map out the clinical and research resources available across the province to support a long-term research strategy and plan. By putting patient and family voices and experiences at the centre of the strategy, it will enable our research team to develop a provincial strategy that is biologically-relevant and socio-culturally informed.
Team members: Siv Klausen (UBC); Nancy Cleveland (Gynecologic Cancer Initiative); Nicole Keay (Gynecologic Cancer Initiative); Stephanie Lam (UBC); Jocelle Refol (Simon Fraser University); Gavin Stuart (UBC); Michelle Woo (UBC); Nicole Prestley (Women’s Health Research Institute); Lori Brotto (Women’s Health Research Institute); Janice Kwon (UBC)
Digital health to guide the transition to menopause: Recognizing normal and abnormal changes during reproductive aging
During the years leading up to menopause, women often experience menstrual cycle and flow changes. This is usually part of normal aging, but can also be the first symptom of endometrial cancer, the most common gynecological cancer in Canada. Few women are aware of the risk factors for endometrial cancer, can recognize abnormal bleeding, and/or seek medical help. Predicting cancer risk and determining which abnormal bleeding is associated with endometrial cancer is a top priority for clinicians and women alike, because if detected early, this cancer is curable and has exceptional outcomes. Digital health technology (e.g. mobile phones apps) and analytics can help women track and monitor risk factors and symptoms and be alerted when suspicious patterns arise. In this project, we will collaborate with women in the community, patients, clinicians, and women’s health researchers to co-design digital health tools that can help women learn about and assess their risk factors for endometrial cancer, discern symptoms of cancer from those of normal aging, and provide opportunities for education, prevention, and early detection, especially among women at high-risk for cancer.
Team members: Jerilynn Prior (UBC); Lauren Tindale (UBC); Malak Ibrahim (UBC); Lori Brotto (UBC); Gurm Dhugga (UBC); Shirley Weir (Community Partner); Ali Zentner (Revolution Medical Clinic); Elise Abi Khalil (UBC); Shanzhao Wang (OVCARE, BC Cancer Agency); Sabrina Wong (UBC); Candice Taguibao (Women’s Health Research Institute); Nicole Prestley (Women’s Health Research Institute)
Mobilizing falls prevention knowledge with patients and clinicians in British Columbia
Effective approaches to prevent falls exist, yet barriers to their uptake exist. These barriers include: 1) patient knowledge of best-practices for falls prevention; 2) geriatrician time and a geriatrician shortage in British Columbia (BC); and 3) access to Otago Exercise Program (OEP) training across BC. To mitigate some of these barriers, we propose a series of videos guided by patient, clinician and physiotherapist champions. The Falls Prevention Clinic team includes patient partners, geriatricians, and physiotherapist champions who deliver the OEP. A primary goal of this video series will be to: 1) increase awareness using accessible language of best practices for falls prevention; 2) increase referrals to physiotherapists for falls risk assessment from geriatricians; and 3) provide access to resources for physiotherapists who would like training in the delivery of the OEP. The intent of these videos is to prevent falls and thus promote healthy aging by: 1) facilitate improved patient understanding of how to prevent falls; 2) address the geriatricians capacity burden through increased physiotherapist referrals for falls risk assessment; and 3) foster translation of the OEP to physiotherapists across BC.
Team members: Tracy Dignum (UBC); Teresa Liu-Ambrose (UBC); Linda Li (UBC); Kenneth Madden (UBC); Naaz Parmar (UBC); Larry Dian (UBC); Catherine Chan (UBC); Alison Chan (UBC); Lillian Morishita (Retired); Cassandra Adjetey (UBC); Eleanor (“Jean”) Ko (Retired); Mohammed Esfahaad (Retired)
An iKT, interpretivist, feminist, multi-method study examining the experience of, and models of treatment for, acute postpartum mental illness
Postpartum depression is common, affecting 10-15% of women, and increases risk for suicide. Postpartum psychosis is rarer (approximately 1/1000 women), but is a psychiatric emergency. Women with postpartum psychosis or severe postpartum depression need care in hospital to protect their health, and the health of their families. Currently in Canada, these hospital stays separate women from their babies, which can be traumatic for mother and baby. In other countries, Mother-Baby Psychiatric Units (MBUs) admit both mother and infant for care. This study will investigate whether MBUs are suitable for Canada, or whether another model of care would be better for Canadian families. To do this, we will conduct three sub-studies. Sub-study 1 will amplify women’s stories of the experience of a hospital stay for postpartum mental illness in Canada. Sub-study 2 will describe the frequency and predictors of hospitalization for postpartum mental illness. Sub-study 3 will provide a rich picture of the MBU model of care through a case study of five international MBUs. By understanding how to best meet the needs of women and families living with serious postpartum mental illness, we aim to improve mental health outcomes across generations.
Implementation of a Canadian willingness to cross program: A strategy to increase access to kidney transplantation for highly sensitized patients
More than 20 percent of candidates on the kidney transplant waitlist are considered difficult-to-match for the already scarce resource of kidne y organs. This is because their immune system has previously been activated through pregnancy, blood transfusion, or prior organ transplants to produce a broad range of antibodies that limit their chances of finding compatible donors. These “highly sensitized” patients (HSP) face prolonged wait-times, reduced access to transplant, and an increased risk of death on the waitlist.
The main objective of this research is to implement a first-of-its-kind Willing to Cross (WTC) program. Under this national initiative, patients will be able to be transplanted across known antibodies against donors that are deemed to be at low risk of causing rejection. This strategy is anticipated to improve the chances of receiving a transplant while maintaining good patient outcomes. In addition, the study will follow patients with two cutting-edge immune assays that have been shown to detect rejection before kidney injury occurs. Recognizing that we serve a diverse patient community with different values and beliefs, we will also evaluate patient perception and readiness to adopt this new kidney allocation system.
AIRWISE – A risk communication strategy for the prevention and early detection of respiratory illness
Respiratory illnesses, such as asthma, chronic obstructive pulmonary disease, and lung cancer account for the leading causes of preventable deaths in British Columbia. Scientists can now identify people who are at a high risk of developing these devastating illnesses early on when it is possible to prevent, cure or slow the progression of disease. Prevention and early detection programs, however, don’t reach all members of the population equally. In addition, environmental radon and air pollution increase the risk of developing respiratory illnesses for people living in some areas of the province. This study is motivated by the need to expand the reach of prevention and early detection programs through risk communication. Our experienced team of researchers, community stakeholders, trainees, and knowledge translation specialists will define the risk information that is needed for future research and for communicating in clinical and community-based settings. Together, we will convene an advisory committee to design the first version of the AIRWISE risk communication platform and establish community coalitions to evaluate and implement it.
What gynecologic cancer patients want to know about gynecologic cancer research: Disseminating timely research evidence through recorded conversations between patients and research experts
Patients with gynecologic cancer have articulated a strong desire for accessible research evidence. We are proposing to work with patients to develop five short videos on gynecologic cancer covering topics in prevention, diagnosis, treatment and living well with, and beyond, gynecologic cancer. These videos will be ‘hosted’ by the patient partner, and will consist of recorded, structured conversations (taking place virtually using zoom) between a gynecologic cancer patient and a gynecologic research expert. Where necessary, additional information will be interspersed using PowerPoint slides and infographics to improve clarity and maximize evidence sharing. By having our patient partners ‘host’ these conversations, it will ensure that content is relevant to patients. We hope that these videos will improve the lives of gynecologic cancer patients in BC by:
- Making it easy for patients to access information on the research happening here in BC that is directly relevant to their cancer care and journey.
- 2) Increasing awareness of opportunities to participate in gynecologic cancer research in BC.
- Providing easy access to the stories and experiences of other gynecologic cancer patients.
Publication: Outcomes From Opportunistic Salpingectomy for Ovarian Cancer Prevention
Video: Beyond the Stories – Opportunistic Salpingectomy as a Strategy for Ovarian Cancer Prevention
CoBrA Community Brain Art initiative: Co-created brain health promotion with the Downtown Eastside community
Brain disorders are underappreciated, modifiable drivers of daily challenges. Our team’s research includes the ten-year observational Hotel Study, which engages Downtown Eastside (DTES) residents affected by precarious housing, and has found high rates and significant consequences of traumatic brain injury, stroke and mental illness. To engage the community during the COVID-19 pandemic, innovative knowledge dissemination activities are needed. The two-part Community Brain Art (CoBrA) initiative is co-created with residents, healthcare providers and researchers in the DTES. CoBrA aims to share local brain health research and community resources with DTES residents. First, we will co-design art kits with knowledge users, containing art supplies and brain health infographics. These kits will be distributed to residents to facilitate dialogue and visual expression of their experiences with brain wellness and injury. Submitted art and health resources will be shared on our website. Second, we will co-produce a mural with local artists to convey brain health recommendations. Reach and effectiveness will be assessed by kit participation, website access and pre- and post-engagement surveys by text message and peer-facilitated sessions.
Utilizing a multimodal optical device to detect cancer
Two out of every five individuals will develop cancer during their lifetime. My research program focuses on cancer prevention and diagnosis, using skin cancer as an initial platform. Skin cancer accounts for two thirds of all cancer cases and is an easily accessible organ to study using optical devices. Biopsies are typically used to detect skin cancers. Disadvantages of skin biopsies include possible disfigurement and complications, lengthy processing time, and occasionally inaccurate or inconclusive results. As well in some patients that are at high risk, taking multiple biopsies may not be practical and is costly. In this proposal, we will determine if an optical device combining different optical methods can readily and accurately detect skin cancer.
Ultimately, we expect this optic device to provide a noninvasive and instantaneous diagnosis that would be available to the patient and clinician at the bedside. This novel method of combining different spectroscopy methods to be able to collectively evaluate skin lesions and help in the diagnosis of skin cancer would be a significant achievement in the screening of cancer. Early and improved detection using a noninvasive method would help to improve morbidity and mortality in those affected with cancer.