Biomarkers and interventions for mild traumatic brain injury and intimate partner violence

Mild traumatic brain injury (mTBI; e.g. concussion) results in a range of symptoms that disrupt daily life, and many mTBI patients go on to suffer persistent post-concussion symptoms (PPCS) that last for months to years. There are no reliable biomarkers for mTBI and PPCS, or interventions known to improve recovery.

This project will therefore assess the use of blood biomarkers as diagnostic and prognostic methods for mTBI and PPCS, and also investigate whether exercise intervention early after mTBI improves recovery. This project will also examine a grossly understudied cause of brain injury — intimate partner violence (IPV). Despite evidence of mTBI in approximately 90 percent of IPV survivors, the nature of this brain damage and how it contributes to their lived experience is poorly understood. Therefore, another goal of this project is to investigate the neurological health and a range biomarkers reflective of brain injury in women with a history of IPV.

In partnership with knowledge users (e.g. clinicians, nurses, patients, scientists), the findings from this project will facilitate the development of evidence-based interventions, education programs, and changes in practice and policy that improve the care of those who have suffered mTBIs.

Couples’ perinatal sexual health and well-being

Over 380,000 Canadian couples become pregnant each year. Of these, 20-68 percent of mothers and 22-45 percent of partners will experience distressing sexual health problems (e.g. low sexual desire, pain) that begin in pregnancy and that may continue up to 12-months postpartum. In turn, poor sexual health has many known consequences for overall health and well-being and is linked with increased use of health services. Yet, most new parents receive no information about sexual health during this period, in part, due to limited knowledge about who is most at risk and a lack of evidence-based interventions to address perinatal sexual health problems. Using a variety of research methods we will:

  1. Identify factors associated with who is most likely to experience perinatal sexual health problems.
  2. Use these factors to pilot a novel couples-based psychological intervention to improve sexual health.

In addition to benefits for couples’ sexual health, this research will also enhance couples’ general well-being, by reducing the psychological and relational burdens during an already vulnerable period. This knowledge will be shared with perinatal healthcare providers in order to improve perinatal healthcare practices.

Investigating the role of sleep disruption in the progressive memory loss associated with Alzheimer’s disease

Alzheimer’s disease is the most common cause of dementia and a leading cause of death in Canada. Unfortunately, there are currently limited treatments available for this devastating disease. Recently sleep has been shown to regulate important aspects of Alzheimer’s disease pathology and is emerging as a promising target for novel interventions to prevent and slow disease progression.

To identify how changes in sleep and the body’s biological clock contribute to the cognitive deficits associated with Alzheimer’s disease, we will conduct a combination of preclinical experiments to evaluate causal mechanisms and clinical studies to evaluate the same processes in patients diagnosed with Alzheimer’s disease.

The ultimate goal is to determine whether treating specific aspects of sleep disruption is an effective therapy for Alzheimer’s disease, which will help identify new treatments to prevent the progressive memory loss, improve the health and quality of life of patients and their families, and reduce the economic burden of the disease.

Physical activity and the clinical management of chronic diseases in children who reside in rural and remote communities in BC’s Interior

Physical activity is a cornerstone of health and wellbeing for all children. This includes children who live with chronic conditions such as congenital heart disease and diabetes. Oftentimes, these children and their families have unanswered questions regarding the safety and importance of physical activity participation. This is partly because physical activity is not regularly discussed during clinical appointments with specialist doctors, as other clinical topics take priority.

In my research, I will work with children who live with chronic conditions, and their families, to better understand their physical activity behaviours and reasons for them. I will also work with clinical care providers to learn about their current practices and attitudes around physical activity promotion. I will then bring everybody together to develop and implement new approaches that can help children with chronic conditions to lead more active lives.

Exploring mechanisms, pathways, and mitigation strategies to prevent loneliness, social isolation, and their deleterious health impacts

We experience hunger so we eat, thirst so we drink, tiredness so we sleep, and loneliness so we find social connection. Social needs are fundamental to humans and when we are lonely the body’s central stress response system is dysregulated. As a result, our capacity to manage stress, inflammation, and energy reserves is reduced. The end result: lonely people live shorter and sicker lives.

In the wake of COVID-19, which itself manifested in an era of already increasing social isolation, it has never been more important to study loneliness. Yet, while a robust literature base has examined loneliness in older adults, we still know very little about what we can do to respond to experiences of loneliness across the life-course. This is particularly true in marginalized populations, such as gay, bisexual, and other men who have sex with men (gbMSM), who are especially vulnerable to social exclusion and related stressors, but they also exhibit unique coping strategies that may buffer these effects.

My research will help us better understand the epidemiology of loneliness among gbMSM in order to prevent its deleterious effects on these individuals, their communities, and the broader population in the wake of COVID-19.

Informing the future of primary care: Virtual care, workforce optimization and the learning health system

Primary care is the foundation of strong health systems, ensuring people stay healthy and get care when needed. However, timely access to high-quality primary care is an ongoing problem in British Columbia and other provinces.

My program of research aims to ensure that all British Columbians can access quality primary care how and when they need it. The central project I lead uses information from interviews with health professionals (physicians, nurse practitioners and nurses) and patients; data from the health system; and provincial policy documents to study access to, experiences with, and outcomes from virtual primary care. Complementary research will inform modernization of the primary care workforce and informing ideal deployment of providers in team-based models in the context of COVID-19 and beyond. Finally, I lead work about implementation of “learning health systems” to support continuous improvement and innovation in primary care and across the health system more broadly.

My work follows an integrated knowledge translation model; I work with a team of researchers, policy makers, clinicians and patient partners to co-produce knowledge and address important and relevant questions that are driven by their combined input.

AI-driven integration of omics and histopathology for biomarker discovery in cancer

Tumors of the same cell type, origin, and stage have unique genetic features that impact course of disease and treatment response. However, management of cancer is still largely dictated by a patient’s tumor cell type and stage without further refinement.

We intend to take advantage of the unique opportunities afforded by BC’s cancer care system (with a single payer system and uniform treatment protocols, together with high quality patient outcome data) to build an artificial intelligence (AI)-based cancer biomarker discovery platform. The proposed platform will integrate the images of the tumor tissues along with their genetic markers through AI to identify novel biomarkers for cancer patient risk stratification and management. Our program will:

  1. Improve efficiency in pathology laboratories.
  2. Identify tissue image features that correlate with tumor genetics which can rapidly and accurately classify patients into clinically relevant groups.
  3. Generate new biomarkers for precision medicine by combining tumor genetics and tissue imaging.

Ultimately, this program will improve patient outcomes, alleviate the need to perform expensive genetic profiling tests, and lead to significant cost-savings in the healthcare system.

Molecular mechanisms of sensing and repairing dysfunctional mitochondria

Mitochondria are factories in our cells that produce energy and building blocks. Constant delivery of proteins, the factory “workers”, to mitochondria from other parts of the cell is important for proper function of these factories. Defects in delivery occurs in many diseases, including diseases involving nerve cell death (neurodegenerative) like Alzheimer’s. It is thus extremely important and timely to gain more knowledge on how cell health is maintained when protein delivery into mitochondria is damaged.

I discovered a new mechanism, the mitochondrial compromised protein import response (mitoCPR), which protects mitochondria and cells when protein delivery is damaged. I showed that such damage leads to proteins getting stuck and clogging entry sites into mitochondria. My research aims to gain a deeper understanding of how the mitoCPR unclogs mitochondria entry sites and helps them recover under disease and physiological conditions. Using molecular biology and advanced technologies such as gene editing, proteomics, and microscopy, my lab will reveal how the cell keeps mitochondria healthy. This research may uncover new treatment strategies for neurodegenerative and other diseases, caused by improper mitochondrial function.

SCI pharmacovigilance: A drug safety platform to improve neurologic outcomes in spinal cord injury

Individuals with spinal cord injury experience various secondary complications including pain and muscle spasms. These complications are treated simultaneously with various medications resulting in “polypharmacy.”

The goal of my MSFHR work is to apply advanced analytical techniques to understand the neurologic effects of commonly used medications. This work challenges longstanding assumptions regarding the acute pharmacological management of spinal cord injury. Ultimately, this will yield new insights into neurologic drug safety, which in turn will optimize recovery from spinal cord injury. This will also lay the foundation for a pharmacovigilance (drug safety) platform in spinal cord injury — the first of its kind in the field.

Responding to the truth and reconciliation calls to action in healthcare through the arts as a way of knowing, disrupting and healing

The 2015 Truth and Reconciliation Commission calls for Indigenous knowledge and practices to be included in healthcare. But as can be seen in recent, troubling news stories and reports, Indigenous peoples often face racism and barriers to care. People are becoming interested in using storytelling and the arts to listen to Indigenous peoples’ views so we can change healthcare to better meet their needs and priorities.

The purpose of these studies is to work together with Indigenous and non-Indigenous peoples to create more meaningful paths towards reconciliation and equitable healthcare through the arts. First, I, together with a team of Indigenous and non-Indigenous partners, will look at the research using storytelling in Indigenous health research. Then, I will lead three studies to investigate arts-based strategies to support healthcare students in responding to the Missing and Murdered Indigenous Women and Girls Report; explore First Nations peoples’ cancer experiences using digital storytelling; and develop arts-based programs to support Indigenous patients facing illness. The findings will help us to include Indigenous perspectives and practices in healthcare to move towards reconciliation and address differences in health.