Game on: Disseminating research for improving hospital dementia care

Co-leads:

  • Habib Chaudhury
    Simon Fraser University
  • Jan Robson
    Alzheimer Society of BC

Trainee:

  • Lillian Hung
    Simon Fraser University

Approximately 40 percent of older people in hospitals have dementia. Research suggests that hospital staff are ill-prepared to provide dementia care. There is an urgent need to increase dementia knowledge among hospital staff because an aging population is giving rise to patients with dementia. A literature review has identified three key challenges in hospital dementia education: (a) staff struggled to find time to attend workshops due to schedules and staffing shortage, (b) managers with tight budgets could not pay for conferences, workshops for staff education and replacement, (c) staff found classroom learning boring and difficult to retain.

To address these challenges, in 2017, the BC Patient Safety & Quality Council funded the development of an online game based on the PhD research findings of Lillian Hung in hospital dementia care. The game development was a collaboration between a team of clinical experts, VCH Learning & Technology, and a game design student at BCIT. Over 70 interdisciplinary VGH staff members participated in PDSA cycles to co-develop the game, called the ART & SCIENCE of Person-Centred Care, showing 10 dementia care approaches applicable in the hospital setting. The game was launched on the LearningHub, an online platform that enables staff in all BC health authorities to have free access, anywhere, anytime.

This project aims to facilitate a wider uptake of research in hospital dementia care by using gamification principles to motivate staff engagement in learning. This project integrates the expertise of researchers (Habib Chaudhury and Lillian Hung), research user co-lead (Jan Robson, Alzheimer Society Provincial Educator), and research users (local experts and decision makers) in BC health authorities — Fraser Health, Providence, Interior Health, Island Health, Northern Health, and Vancouver Coastal Health.

A knowledge translation workshop will bring researchers and research users together to work with a knowledge translation specialist (Lupin Battersby) from the BC SUPPORT Unit and a patient partner (Jim Mann) to co-develop a knowledge translation plan.

In the knowledge translation workshop, the team will:

  • Develop communication tools and key messages.
  • Determine strategies to problem solve local barriers.
  • Agree on knowledge translation processes, products and evaluation plan.

Expected outcomes:

  • An opportunity for provincial cross health authorities collaboration in knowledge dissemination.
  • Improving dementia care through increasing awareness and using the educational game for staff training.
  • Contribution to the science of knowledge-to-action by identifying lessons learned in this innovative project.

#LifeAndLoveWithHIV: A social media initiative to support the sexual health needs of women living with HIV

Co-leads:

  • Angela Kaida
    Simon Fraser University
  • Margarite Sanchez
    Positive Living Society of BC
  • Lori Brotto
    University of British Columbia

Trainee:

  • Allison Carter
    Simon Fraser University

Research on the sexual quality of life for women diagnosed with HIV is gaining momentum. Recent studies in BC and globally show that people with HIV, with undetectable levels of the virus in their blood, have a near-normal life expectancy and effectively no risk of sexual transmission of HIV. This project, #LifeAndLoveWithHIV: A social media initiative to support the sexual health needs of women living with HIV, aims to move this research evidence, along with lived experience perspectives about sexuality and relationships in HIV, directly into the hands of women living with HIV, including those who love and support them, by combining storytelling with online social media and activism.

This inter-disciplinary team of researchers and research users (including women living with HIV and care providers) has been working closely the past seven years to create new knowledge on sexual health and rights of women living with HIV. With support from an SFU Student Social Innovation Seed Grant and a CIHR Knowledge Synthesis Grant, a new open-access resource, www.lifeandlovewithHIV.ca (launched July 2018) was built to share this knowledge with women, partners, care providers, HIV policy makers, and the general public. This Reach award will allow the team to:

  1. Hire and mentor five women living with HIV as feature writers on this online magazine and blog; they will collectively produce 25 blog articles on sexuality and relationships, and be grounded in lived experiences and supported by research evidence.
  2. Implement and evaluate a social marketing initiative to promote uptake of this information, through a collection of YouTube videos, Facebook polls, Instagram images, Twitter parties, and hashtags such as #UntoldDesiresInCanada (which generated >20K impressions).

The dissemination plan includes measuring and evaluating the outcomes of this work. Through this initiative the aim is to reduce HIV stigma, support the sexual health needs of women living with HIV, to not only save, but also improve the quality of, women’s lives.

Novel retinal biomarkers for Alzheimer’s disease

Dr. Faisal Beg is one of five BC researchers supported through the British Columbia Alzheimer’s Research Award. Established in 2013 by the Michael Smith Foundation for Health Research (MSFHR), Genome British Columbia (Genome BC), The Pacific Alzheimer Research Foundation (PARF) and Brain Canada, the goal of the $7.5 million fund is to discover the causes of and seek innovative treatments for Alzheimer’s disease and related dementias.

Millions of people worldwide are afflicted with Alzheimer’s disease (AD). In the absence of a complete understanding of the disease, therapeutic trials have been unsuccessful and there remains no cure. Detecting the onset of AD is difficult as the changes in behavior are subtle and hidden. Biomarkers that can reliably detect AD at the earliest possible stage are essential for disease monitoring and treatment to improve the quality of life for patients.

Imaging shows that the brain has a protein called amyloid, which accumulates beyond normal amounts in AD. However, brain imaging exams for amyloid are expensive, can be invasive, and not easily available, and as a result, cannot be used for general screening. Studies suggest that amyloid also accumulates in the retina of individuals with AD, but this has not been proven.

Dr. Faisal Beg, a biomedical engineer and professor in the School of Engineering Science at Simon Fraser University (SFU), is leading a multi-disciplinary team of researchers from SFU, the University of British Columbia (UBC) and McGill University to find the connection between the eye and AD by investigating it as a potential source for the earliest biomarkers for the disease.

The team is developing computational tools and image processing technologies to examine chemical biomarkers, structural degradation, and functional loss in the eye that may be associated with AD. This work could be the basis for a new retina imaging device using laser light that can show the presence of amyloid in the retina. The technology would improve understanding of the disease mechanisms underlying the accumulation and serve as an early indication that the protein is also accumulating in the brain.

Beg’s research could lead to an inexpensive, non-invasive retina exam for use in clinics to screen everyone on a regular basis for the earliest signs of amyloid. Besides having the potential to aid in the early diagnosis of the disease, the imaging techniques may also be able to track the progression of AD and assess the efficacy of treatments under development.

Cellular resolution OCT for clinical ophthalmology

Two of the leading causes of irreversible vision loss in developed countries are age-related macular degeneration (AMD) and diabetic retinopathy (DR). These diseases lead to the death of photoreceptors, the light-sensitive cells in the retina located at the back of the eye.

Treatments are currently available for “wet” AMD and DR, but there are currently no effective treatments for “dry” AMD. The key to preserving sight is early diagnosis, and monitoring the effects of the novel therapies in development.

The current technologies for non-invasive retinal imaging systems include flood illumination fundus photography, confocal scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT). The resolution attainable with these techniques doesn’t permit visualization of the photoreceptor mosaic. The limiting factor to this ability is the eyes themselves—the cornea and lens that focus light onto the retina do not have microscopic abilities.

Dr. Sarunic has developed a novel instrument combining wavefront sensorless adaptive optics (SA) with OCT to correct ocular aberrations. This novel SAO OCT can achieve cellular resolution imaging of the retina, visualizing the individual photoreceptors that form a mosaic pattern on the retina (akin to looking at the pixels in a camera). This SAO OCT design is compact and clinically friendly, and with further investigation and commercialization, could lead to improved diagnosis and treatment for those with vision loss.

An advanced wearable robotic exoskeleton for assisting people with lower limb disabilities

Human locomotion is influenced by many factors, including neuromuscular and joint disorders that affect the functionality of joints and can cause partial or complete paralysis. Reduced mobility is estimated to affect over 1.5 million people in the United States alone. Many individuals require mobility assistive technologies to keep up with their daily life, and the demand for these devices increases with age.

A wearable robotic exoskeleton is an external structural mechanism with joints and links corresponding to those of a human body. It is synchronized with the motion of a human body to enhance or support natural body movements. The exoskeleton transmits torques through links to the human joints and augments human strength. 

Dr. Arzanpour has developed a novel wearable robotic exoskeleton for assisting people with lower limb disabilities, such as spinal cord injury patients. The robot is highly versatile and capable of guiding the lower limb joints to perform all normal and complex movements. The technology is light, modular, portable, programmable and relatively inexpensive, and is particularly innovative in its versatile hip, knee and ankle joint mechanism, such that the normal range of motion of the natural joints is preserved.

So far, a proof-of-concept prototype of the proposed lower limb exoskeleton has been fabricated and successfully tested on an anthropomorphic test dummy. With further progress this technology could help people with lower limb disabilities to walk again and greatly improve their quality of life.

Neuromodulation research program for youth addiction and mental health

Each year, approximately 1 in 5 Canadians experiences a mental health or addiction problem. Young people aged 15 to 24 are more likely to experience mental illness and substance use than other age groups.

Depression is one of the most common mental illness, but current treatments are either ineffective or lead to side effects in up to 50% of youth. In youth, medications are often borrowed from adult population not accounting for age-related brain differences. New solutions are needed to address major gaps in treatment of youth mental health.

Dr. Farzan is collaborating with physicians, neuroscientists, engineers, and health authorities to develop and apply more precise and innovative methodologies to study the brain and address this gap. She is combining non-invasive brain stimulation and brain monitoring technologies to study what may underlie depression in young age, and how each treatment affects the brain. She is also developing non-invasive brain stimulation technologies for youth that do not respond to medications or behavioral therapy. This research has tremendous potentials for leading to introduction of a new therapy for youth who are failing currently available treatments.

Orthogonal multicolour high-affinity tags for RNA imaging and manipulation

RNA plays a very important role in the regulation of gene expression. Yet, the spatial and temporal dynamics of RNA are still poorly understood, mainly due to the scarcity of effective and simple RNA imaging and purification techniques.

The development of technologies that simultaneously allow imaging, purification and manipulation of multiple RNAs in live cells promises to enable the study of RNA in development, metabolism and disease, which is essential for understanding the control of gene expression in diseases such as autism, cancers and type II diabetes.

Dr. Dolgosheina will develop a multicolour RNA-based imaging method that will allow researchers to simultaneously visualize two RNAs in living cells, while concurrently purifying and/or manipulating RNA interactions with other biomolecules. This new technology will build on, and dramatically increase the capabilities of the bright, high affinity RNA Mango system that she developed during her PhD.

The proposed project is working on an outstanding international problem, and since these tools are urgently needed, the research has attracted significant national and international attention.

This research project will 1) result in international level talks and publications, 2) bring together some of the best international researchers in RNA biophysics and 3) result in intellectual property development, industrial research and training and commercialization via a rapidly growing Canadian biotechnology company, Applied Biological Materials (Richmond, BC).

Novel 18F-fluorinated amino acids as oncological PET radiotracers

Positron emission tomography (PET) is a non-invasive imaging technique used to detect tumours and provide information about a patient’s response to treatment. PET generates a 3D image of the inside of a patient’s body and highlights the location of tumors through detection of a radiotracer administered before generating the image. One of the most common forms of radiotracers are small, drug-like molecules containing a radioisotope that bind to or accumulate in cancer cells, precisely locating tumours. 

While many radioisotopes can be used for PET imaging, [18F] is arguably the most desirable due to its high positron output, small atomic size, metabolic stability and worldwide network of production facilities. Despite these advantages, the synthesis of [18F] radiotracers presents many challenges that have limited the scope of radiotracers available for oncological PET imaging. Thus, the majority of oncological PET imaging relies on a single radiotracer: [18F]-FDG, a sugar analogue that preferentially accumulates in cells that have increased metabolism (i.e., cancer cells). 

Unfortunately, [18F]-FDG is not cancer-specific and also tends to bind to other tissues such as brain and bladder, and at sites of inflammation, limiting its utility for detecting tumors in those areas. In recent years there has been considerable interest in identifying complementary radiotracers to FDG, and much attention has focused on the synthesis of 18F-labelled amino acids, which also accumulate in rapidly dividing cancer cells. Dr. Britton’s lab has recently discovered a method for incorporating the [18F] radioisotope into complex drug precursors without the need for elaborate precursor synthesis. 

Dr. Britton aims to:

  • Rapidly expand the number of available amino acid radiotracers using new unique capabilities.
  • Evaluate promising lead radiotracers for oncological PET imaging.
  • Advance selected radiotracers into preclinical animal studies.

In addition to these research aims, Dr. Britton has filed a provisional patent application and will work with the SFU Innovation Office to identify an industrial partner for this new technology. These new amino acid radiotracers could have a profound impact on the early detection of cancer and positively impact the lives of many British Columbians.

Elucidating the effect of O-GlcNAc modification on protein stability

The glycosylation of proteins with O-GlcNAc is a ubiquitous post-translational modification found throughout the metazoans. Deregulation of O-GlcNAcylation is implicated in several human diseases including type II diabetes, Alzheimer’s disease, and cancer.

However, the basic biochemical roles of O-GlcNAcylation remain largely unanswered. Several recent studies have demonstrated a clear link between O-GlcNAc and cellular thermotolerance.

It is likely that a basic function of the O-GlcNAc modification prevents the unfolding or aggregation of target proteins. Dr. King will investigate its role in protein stability through series of biochemical and biophysical experiments to probe the effect of O-GlcNAc on protein unfolding, folding, and aggregation. The results of this research will provide important insights into the basic molecular mechanisms governing O-GlcNAc deregulation in human disease. 

Development of improved substrates for live cell imaging to aid in discovering new glucocerebrosidase therapeutic agents

Parkinson’s disease (PD) is a neurodegenerative disorder that affects millions of people worldwide, with no standard treatment currently available. Therefore, there is a major need for new therapeutic agents to treat or prevent the progression of PD. One promising solution involves targeting the protein glucocerebrosidase (GCase) encoded by the gene GBA1. Studies have shown small molecules that increase GCase activity could help prevent the progression of PD.

Dr. Ashmus will use a combination of organic chemistry, chemical biology, and cell biology to discover new therapeutic agents that increase GCase activity. Fluorescently-quenched substrates will be chemically synthesized and used in enzymatic assays to monitor GCase activity in vitro and in neuroblastoma cells. The assay will then be adapted and optimized for use in a high-throughput screen of compounds from the Canadian Glycomics Network and from a natural products collaborator, Roger Linington, at SFU.

The results of this research could produce new lead compounds that increase GCase activity. In addition, the compound screen could aid in identifying new therapeutic targets for PD, which would drive preclinical translation research in this area.