Pathological gambling is an addictive disorder characterized by repeated problematic gambling despite severe negative consequences, often linked to poor decision making and impulsivity. Research into gambling disorders has been facilitated by using rodent tasks that are directly translated from tasks used in humans. Traditional analyses for these tasks result in simplistic measures linked to decision making deficits and impulsive behavior. More recently in clinical research, computational modeling has been applied to data from human tasks to allow more sophisticated, in-depth analysis of the psychological and cognitive processes underlying these behaviors. Despite many parallels in task measures and structure, computational approaches are much less frequently used in the analysis of rodent behavioral data. Using multiple large datasets from rodent gambling and decision making tasks, this project proposes to use computational modeling to investigate the underlying cognitive processes involved in performance on these tasks. This will improve translatability of findings from preclinical research, and enable the generation of testable hypotheses for novel therapeutic/behavioral interventions to address problematic gambling behavior.
Year: 2020
Understanding counsellor-client interactions in spinal cord injury exercise counselling: a novel method to explain outcomes of randomized controlled trials by assessing intervention fidelity
Behavioural interventions often consist of conversations between counsellors and clients and can be a successful way to promote a healthy lifestyle. However, controlled intervention outcomes are not always successfully translated to real-world settings. A possible reason for this poor translation, is that researchers do not use information on how counsellors and clients interact with each other to explain intervention outcomes. Recently, a new method, called state space grids, has been developed to study and visualize how a counsellor and client interact with each other over time. This study will use state space grid methods to study conversations about health-enhancing exercise between counsellors and clients with spinal cord injury (SCI) to explain health outcomes. Participants receive tailored exercise counselling. Recordings of the sessions will be analysed using state space grids. The findings will help us to better study and understand how, when and why counselling is successful in changing health behaviour. These new insights can be used to develop training guides for counsellors and improve exercise counselling. In turn, understanding and improving effective exercise counselling will enhance lives of many people with SCI.
Understanding the challenges and opportunities in communicating vaccine risks and benefits to midwifery clients
Studies have shown that vaccinating pregnant mothers protects both mothers and children. Yet, recent surveys suggest that one third of Canadian parents are unsure about vaccinating. Mothers often decide how they feel about vaccines during pregnancy, and healthcare workers play an important role in helping them make these choices. More and more new parents in Canada choose to give birth with the help of a Registered Midwife (RM). Unlike other healthcare providers, RMs, following the guideline of Informed Choice, encourage their clients to make choices for themselves using the best available information. Because of this, some RMs feel that they should not make a strong pro-vaccine recommendation. This research project will focus on creating midwife training resources that are compatible with the model of Informed Choice. Using interviews with midwives, educators, and professional associations, we will develop tools for continuing education adapted to the RM profession. By better understanding the challenges midwives face when talking about vaccines, this study will help RMs enable their clients in BC and Canada to make better informed decisions about vaccination.
End of Award Update: October 2022
Most exciting outputs
Our research aimed to better understand how midwives discuss vaccination in pregnancy (and infancy) with their clientele. Through interviews with midwives and other professionals we learned more about vaccine conversations in pregnancies and some of the related challenges. We published research showing how Informed Choice conversations aimed to inform and empower pregnant people about vaccine decisions and described what changes could be made to better support midwives who discuss vaccination and provide vaccines to their clients.
Impact so far
We have created a vaccine communication training module with the Continuing Professional Development program at UBC, which is available in French and English to midwives across the country. Our team also published results from our interviews in international peer reviewed journals to reach a wide audience.
Potential influence
Hopefully, this research has shed light on how midwives are capable vaccine counsellors, with the training and expertise to engage and inform vaccine hesitant populations.
Next steps
This research is being continued by my colleagues at the Vaccine Evaluation Center at the BC Children’s Hospital Research Institute. Our team is continuing to collect data to develop and test a clinical intervention package that will provide communication tools like pamphlets and informative videos to be used in midwifery clinics in Canada.
Useful links
Identifying Complex Associations between Biomedical HIV Treatment and Prevention Strategies, Condom Use Behaviors, and STIs in Gay, Bisexual, and other Men who have Sex with Men
Across Canada, the rate of sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (gbMSM) has significantly increased. Public health officials have suggested that the increasing STI rates are a result of decreasing condom use, motivated by the utilization of biomedical HIV treatment and prevention strategies (henceforth: biomedical strategies), like Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylais (PEP). However, our understanding of associations between gbMSM’s biomedical strategies, condom use behaviors, and STIs is limited because: 1) research has yet to assess how individual, interpersonal, and social factors shape the relationship between gbMSM’s biomedical strategy choices and condom use, and 2) research has yet to confirm that gbMSM’s biomedical strategies shape condom use choices in ways that actually predict a subsequent STI. My research will address these limitations by analyzing the rich and exciting data of the Engage Study, a four-year long Canadian study of gbMSM’s sexual health and behaviors (see: https://www.engage-men.ca/). This research will inform newer, more effective STI interventions for gbMSM that incorporate sexual health practices of the modern age.
Exploring Altered Cortical Activity Dynamics in Huntington’s Disease
Huntington’s disease (HD) is a fatal inherited neurodegenerative disorder caused by a single gene mutation. Most patients present with disordered cognition and movement in middle age due to striatal and cortical neuron degeneration. However underlying HD processes begin earlier and are incompletely understood. Although striatal projection neurons are most vulnerable, cortical pathology likely primarily drives cognitive dysfunction in HD and may impact striatum health via extensive cortical-striatal projections. Using voltage-sensitive dye imaging, we monitored the activity of cortical neurons in HD-model mice, where we found sensory-evoked signals spread more extensively. This suggests an excitation/inhibition imbalance, the details of which we are clarifying with additional experiments. Ultimately, the above could affect motor and cognitive performance in HD and contribute to neuronal toxicity mediated by excessive excitatory neurotransmission. This research furthers our understanding of early brain circuit changes in HD and how they contribute to neurodegeneration; hopefully these findings will inform future early HD treatment interventions. Results will also be published in scientific journals and communicated to the media.
Effect of Diesel Exhaust on the Respiratory Microbiome in COPD Airways.
Some of the lung bacteria protect the lung against bad germs. Tests have shown that people with sick lungs often do not have these ‘good’ bacteria in their lungs. Our team has shown that breathing air pollution causes the lungs to be irritated, leading to inflammation. Inflammation of the lungs can make it hard to breathe, especially for people who have lung problems. We think that polluted air could change the lungs’ bacteria. To understand this, we asked healthy volunteers and people with lung sickness called chronic obstructive pulmonary disease (COPD) to participate in a study. They sat in a room for 2 hours and breathed either clean air or air with diesel exhaust that is a model of air pollution like that found in big cities around the world (i.e. Mexico City, or New Delhi). A doctor checked them and took small samples of fluid from within their lungs. We will use these samples to examine the lung bacteria and evaluate the effect of these bacteria on lungs’ health. This study will help uncover how air pollution affects our lungs and bacteria that are inside the lung. This study will help doctors and governments make decisions about traffic-related air pollution and respiratory health.
Harm Reduction into Action: Supporting Nurses to Provide Culturally Safe Care with a Harm Reduction Lens to People who use Drugs
Nurses often have stigmatizing attitudes towards people who use illicit substances that make it difficult for them to provide harm reduction services. This study will look at the state of harm reduction in an acute care hospital. Specifically it will examine the attitudes of acute care nurses towards addiction and harm reduction and whether they are willing to provide harm reduction services. The study hospital has recently changed its substance use policy which now directs nurses to provide clean needles. However, there is no evidence to indicate whether nurses have taken up this policy. The findings will help administrators and educators determine what support front line acute care nurses need to change their opinions about addiction and their preparation and willingness to provide harm reduction services.
Role of myelin pathology in vascular cognitive impairment
Vascular cognitive impairment (VCI) is caused by cerebral small vessel disease and is associated with cognitive and physical impairments in aging. Cerebral small vessel disease can lead to different types of brain damage, including myelin loss. Myelin is critical for proper brain function because it allows different brain regions to communicate with each other and intact myelin is vital for optimal human function. It is crucial for us to measure myelin loss and understand how myelin loss may be associated with cognitive and physical outcomes in older adults with VCI.
The goals of this study are to: 1) determine whether myelin loss is associated with cognitive and physical function in VCI and; 2) determine whether myelin imaging is better than other imaging techniques at assessing cognitive and physical outcomes in older adults with VCI.
The results of this study will: 1) help us understand how myelin loss affects cognitive and physical function and; 2) help us determine whether myelin imaging can be used as an additional tool to monitor disease progression and assess the efficacy of clinical intervention studies.
Genome-wide screen to identify genetic modulators of glucocerebrosidase activity
Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Despite PD affecting millions of people worldwide, no disease-modifying treatment is available yet. As the progress of the disease is closely related to aging, improving our knowledge of the mechanisms and factors leading to PD is of great interest. Mutations in the gene GBA, which encodes the enzyme glucocerebrosidase (GCase), are the greatest genetic risk factor for PD. The link between GCase and PD however, remains poorly understood. Here, we propose to use a chemical genetic screening approach to identify new genes that affect GCase activity. As a pilot study, we will target known PD-associated genes and evaluate their effects on GCase activity using a new GCase activity-based assay in live cells. A complementary approach using genome-wide screen will be carried out to identify candidate genes in an unbiased way. Candidate genes from these screens will be validated with downstream experiments leading to two valuable outcomes. First, the discovery of new genes that regulate GCase could provide new targets for potential treatments. Second, we expect these findings will uncover new fundamental understanding regarding the mechanisms contributing to PD.
Connecting clinical research and economic evaluation by mapping lung function to EQ-5D-5L in patients with interstitial lung disease
Interstitial lung disease (ILD) is a group of diseases that cause inflammation and scarring of the lungs. It is important to identify ways to improve quality of life (QoL) for patients living with this chronic condition. This research will explore how QoL changes over time in ILD and identify factors that can potentially be modified to improve QoL.
Mycophenolate mofetil (MMF) and azathioprine (AZA) are two common medications used to treat certain ILDs and improve QoL. Despite MMF being better tolerated, only AZA is initially covered by PharmaCare in BC. This research will determine whether MMF is more cost-effective than AZA and could inform drug reimbursement policies.
Economic evaluations are used by funding agencies in Canada to determine whether a drug should be funded or not. However, economic evaluations for ILD drugs are limited because clinical trials do not provide the required information. This research will create an algorithm that allows economic evaluations to be completed even when these required data are not available. These economic evaluations can then be used to guide decisions on funding effective treatments in ILD.