Exploring the role of insulin in regulating female reproductive health and age-related reproductive decline

Female reproductive decline (indicated by rising rates of infertility, birth defects, and miscarriage) is an early sign of aging, and is largely due to deteriorating quality of oocytes, or egg cells. Identifying the signaling pathways and mechanisms that control oocyte quality and reproductive decline is essential for better addressing female reproductive health issues, and can also provide key insights into other aspects of aging.

Our research focuses on the ties between nutrients, reproduction, and aging. In organisms ranging from worms to humans, signaling pathways that detect nutrients — such as the insulin signaling pathway — seem to play crucial roles in coordinating metabolism, reproduction, and lifespan. We will use a mouse model of genetically reduced insulin to determine how lowering insulin affects oocyte quality and reproductive success during aging. We will also study how insulin levels determine features of polycystic ovary syndrome, a common hormonal disorder, and evaluate long-term consequences of temporary nutrient excess or depletion.

We anticipate that this research will inform effective strategies to better manage female reproductive health, as well as to improve health during aging.

Addressing food insecurity and the double burden of malnutrition in a changing climate

Malnutrition is a serious public health concern in Inuit and northern regions of Canada, driven by a complex array of social and ecological determinants, including poverty, food insecurity, and climate change. In northern communities, country foods (wild foods harvested from the lands and waters) often comprise an integral component of food systems and contribute to food security, nutrition, and social and cultural integrity. Yet, many country foods are also high in environmental contaminants (e.g., mercury and persistent organic pollutants), which have negative implications for health. Meanwhile, due to transportation challenges, available retail foods in northern and Inuit communities tend to be pre-packaged, processed, and expensive.

In this research program, I will use existing health survey data to evaluate dietary patterns in Nunavik (northern Quebec) and associated nutritional benefits and health risks. Through interviews and community workshops, I will also identify political, social, geographical, and environmental factors that impact food access, affordability, and desirability. Findings will be shared with decision-makers to generate evidence for sustainable and healthy food systems in northern regions across Canada.

The impact of parasites and microbes on immunity at mammalian mucosal surfaces

Under normal healthy circumstances our intestines are home to hundreds of species of microbes, collectively termed the microbiota. Our intestines can also be colonized by parasites, such as parasitic worms (helminths). Both the microbiota and helminths can affect the functioning of our immune system, which in turn, can influence our susceptibility to a variety of infectious, allergic, and inflammatory diseases. Research in my laboratory is focused on understanding the mechanisms by which helminths and the microbiota affect immune system functioning during normal development and during states of disease.

The incidence of allergies and inflammatory bowel diseases has increased dramatically in Canada over recent decades, and there is an urgent need both to understand the factors driving disease development and to identify new treatment strategies. My laboratory uses the mouse model system where the molecular mechanisms of interaction between components of the immune system, the microbiota, and helminths can be identified. Understanding the mechanisms by which the microbiota and helminths can influence immune system functioning may reveal new ways to treat or prevent allergic and inflammatory diseases.

Childhood obesity management using innovative digital technology

Childhood obesity is a major public health challenge in Canada. Without intervention, overweight children will likely continue to be overweight during adolescence and adulthood. Family-based lifestyle programs delivered at local communities can be effective. However, many families cannot attend these in-person programs due to travel distances and program availabilities. The current situation has turned increasingly dire in the COVID-19 landscape, where face-to-face, group, and facility-based interventions are no longer viable. With continued improvements in the sophistication and access to digital communication technology (e.g. Internet, wearables, smartphones), delivering tailored lifestyle programs using these tools may be well-suited to meet these challenges.

The goal of this project is to evaluate the long-term efficacy and the cost of delivering a stand-alone web-based and a blended in-person and web-based program in improving health-related outcomes in children who are overweight or obese in British Columbia (B.C), Canada. This project can be incredibly impactful for B.C. residents as this web-based program can improve the access, reach and personalization of family-based childhood obesity management programs.

Honouring all our relations: Advancing health and wellness of uncounted Indigenous peoples in BC through addressing gaps in population health and wellness reporting

This Health System Impact Fellowship is co-funded by CIHR, MSFHR, and BC Office of the Provincial Health Officer (health system partner), to help build BC’s health policy research capacity for the integration of policy research into decision-making.

Reporting on the health and wellness of populations is vital to monitor trends, identify priorities, track progress towards targets, and address inequities. All Indigenous peoples — including those who do not have ‘Status’ under Canada’s Indian Act — have the right to be counted. Their perspectives and priorities must guide how data is collected, used, and reported. Yet, at present, First Nations, Metis, and Inuit peoples who do not have ‘Status’ or are not registered with Metis Nation BC are ‘invisible’ and ‘uncounted’ within population health and wellness reporting in British Columbia (BC).  Responsibility for reporting on health of BC residents lies with the Office of the Provincial Health Officer (OPHO). Through agreements with federal, provincial, and Indigenous governments, the OPHO’s responsibilities include collaboratively reporting on health and wellness of diverse Indigenous peoples living in the province. Currently, there is no process in place to report on health and wellness of “uncounted” Indigenous peoples. This work must be done in partnership with Indigenous collectives representing this population. Current gaps include:

  • No strengths-based, self-determined terminology to refer to diverse Indigenous peoples who are uncounted in population health data.
  • Lack of formal relationships with Indigenous collectives representing uncounted Indigenous peoples.
  • No way of identifying this population in existing BC population health data.
  • Absence of research frameworks that reflect uncounted Indigenous peoples’ perspectives of health and wellness.
  • No implementation plan for province-wide population health reporting led by uncounted Indigenous peoples, on their terms .

The goal of this project is to support the health and wellness of uncounted Indigenous peoples living in BC by addressing current gaps in population health reporting, through partnerships that uphold Indigenous self-determination, decision-making, and perspectives of health and wellness.

Source: CIHR Funding Decisions Database

Disseminating research outputs on actions to modernize gender, sex, and sexual orientation documentation in Canadian electronic health records

Co-lead: 

  • Jody Jollimore
    Community-Based Research Centre for Gay Men's Health

Team members:

  • Roz Queen
    UVIC
  • Marcy Antonio
    UVIC
  • Kelly Davison
    Canada Health Infoway
  • Karen Courtney
    UVIC
  • Aaron Devor
    UVIC

In this REACH project, we will share our prior research and engage stakeholders to discuss A) how our prior research output can address the needs of sexual and gender minorities (SGM) through improved gender, sex and sexual orientation (GSSO) documentation in electronic health records (EHRs), and B) how the prior output and action plan may be transformed into setting-specific knowledge tools.  

Our research team worked with Canadian stakeholders to improve the definition, collection and use of GSSO data in EHRs and generated the following outputs:

  1. An environment scan of how GSSO data are defined in EHRs
  2. Literature reviews of GSSO documentation — current approaches, gaps, needs and improvement efforts
  3. GSSO terms people commonly use to identify themselves
  4. An action plan with a set of broad, equity-oriented clinician-focused interventions to improve GSSO documentation in EHRs

In partnership with the Community-Based Research Centre, we will translate these findings into appropriate media and forms for dissemination to our diverse stakeholder groups. The expected outcomes of this project are enhanced dissemination to stakeholders and SGM-tailored knowledge translation tools in different healthcare contexts in BC.

Tracking the Prevalence and Incidence of Modifiable Suicide Risk Factors During the COVID-19 Pandemic to Inform Targeted Suicide Prevention in British Columbia

Problem: Half of Canadians report worsened mental health since the COVID-19 pandemic began disrupting our lives this Spring. These impacts, combined with rising prevalence of known suicide risk factors such as unemployment and financial hardship, social isolation, alcohol and substance use, relationship strain and domestic violence, have raised concerns that of rising suicide risk in the Canadian population. Canada loses 3,800 to 4,500 lives to suicide each year. Suicide death and bereavement confer long-term psychological and social risk to families and communities. A small increase in suicide rate can thus result not only in excess loss of life, above and beyond the direct impacts of the pandemic, but also confer long-term vulnerability in our communities.

Research: In collaboration with an international team of researchers led by investigators Shanaya Rathod and Peter Phiri in the UK, our Canadian team aims to characterize the specific mental health and related cognitive impacts of the COVID-19 pandemic to inform evidence-based policy that can mitigate secondary mental health and suicide risk. We will conduct three pan-Canadian general population surveys, in September 2020, December 2020, and March 2021. For each survey, we will recruit at least 5,000 community adults, balanced by sex, age, and geographic region. Surveys will focus on Canadians' emotional, physical, and cognitive wellbeing across distinct phases of the pandemic. In addition, we will work with mental health service leaders, providers and users to co-create supplemental surveys to assess the mental health experiences and needs of three potentially vulnerable groups: frontline health workers, Indigenous peoples, and people living in rural or remote areas. Our results can inform mental health strategies by identifying where, with whom, and what kind of intervention is needed to effectively reduce suicide risk in the population. Support from MSFHR and the BC Ministry of Health will enable us to over-sample British Columbians so that we can understand mental health needs within this province and identify sectors or populations with mental health needs.

Research Team: Our interdisciplinary research team, led by Co-PIs Brianna Turner, Theone Paterson, and Chris Lalonde, includes psychology, social work, and sociology researchers, as well as community knowledge users representing the United Way of the Lower Mainland, the Ontario Association of Social Workers, and the Canadian Mental Health Association.

Website: https://onlineacademiccommunity.uvic.ca/covidmentalhealth

Funding Competition: CIHR Operating Grant: COVID-19 Mental Health & Substance Use Service Needs and Delivery Funding Opportunity

Funders: CIHR; MSFHR

Keywords: Suicide Prevention, Mental Health, Sleep, Depression, Substance Use, Social Connectedness, Public Health, Survey

The Role of Microglia in Chronic Stress-Induced Cognitive Impairment

Chronic stress is associated with cognitive impairment. It is possible that this is due to the brain's immune cells, microglia. Microglia can engulf and chew up neurons, which are the cells in the brain that talk to one another. It is possible that chronic stress makes these immune cells more likely to engulf neurons, which leads to cognitive deficits. To understand this, we will use live imaging to look at how microglia act in the brain of chronically stressed laboratory mice. We will then see if treatments that can reverse chronic stress induced cognitive deficits, such as probiotics, cannabinoids, omega-3 supplementation or ketogenic diet, work through altering these brain immune cells (microglia). Together these data will better inform how chronic stress leads to alterations in cognition and may provide a new target for therapeutics of cognitive deficits observed in stress-associated disorders, including depression and anxiety disorders.

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.

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.