Group sense making and model building for mapping systems for the promotion of population physical activity in British Columbia

The COVID-19 pandemic and climate crises highlighted the need for renewed and strengthened systems to promote population physical activity (PPA) in BC. This need, coupled with calls for using complex systems methods, forms the basis for the proposed activities. Complexity can be seen as the context where numerous interacting elements (i.e. people, entities) in a system make it hard to see, describe, and assess what is happening in the whole. Complex systems methods are a way to gain clarity on complex problems by focusing on the patterns of what the system does or how it behaves. After the completion of a formative scoping review and interviews with stakeholders to assess the current state of systems for PPA in BC, we now plan to invite partners and stakeholders from many sectors and facilitate online group sense making sessions. These sessions will involve participatory processes to develop understanding of the current state of the systems for PPA. A second session will focus on identifying directions for strengthening systems for PPA in terms of policy, practice and research. The project team will provide recommendations for potential roles and responsibilities for the BCCDC to strengthen systems for promoting PPA.


Team members: Drona Rasali (BCCDC); Lori Baugh Littlejohns (BCCDC); Geoff McKee (BCCDC); Daniel Naiman (BC Ministry of Health).

Building partnerships for improving chronic pelvic pain care in gynecology: A needs assessment of health professionals-in-training

Chronic pelvic pain affects ~15 percent of women and an unknown number of gender diverse people. Despite its common and devastating effects, chronic pelvic pain is too often dismissed or mismanaged, which is in part due to physicians’ lack of education on the topic. This study will identify knowledge needs about chronic pelvic pain of BC health professionals-in-training, which will guide the development of a future online resource. To do this, we will 1) Convene a group of experts interested in improving education and care for people with chronic pelvic pain; 2) Assess the knowledge level and attitudes towards chronic pelvic pain in gynecology using a baseline survey completed by medical and nurse practitioner students; and 3) Collaborate with experts to review the needs assessment and co-create a plan for a future resource. We aim to improve the understanding of chronic pelvic pain in health professionals-in-training and ultimately improve care for people with this complex condition by addressing the specific knowledge needs and identifying meaningful information to be included in a future resource to address gaps in medical education.


Team members: Natasha Orr (UBC – School of Nursing); Paul Yong (UBC – Faculty of Medicine); Leanne Currie (UBC – School of Nursing); Karim Qayumi (UBC – Faculty of Medicine); Margaret Carlyle (UBC – Okanagan; Faculty of Arts & Social Sciences, Department of History and Sociology); Rachel Langer (UBC – Endometriosis and Pelvic Pain Laboratory); Lan Randhawa (UBC – Endometriosis and Pelvic Pain Laboratory); Helena Daudt (Pain BC); Jennifer Krist (UBC – School of Nursing).

Remission Possible: A knowledge translation project to inform British Columbians with Type 2 diabetes that remission is possible

Type 2 diabetes (T2D) is traditionally viewed as a chronic, progressive condition that someone has for life. Our research, and that of others, now shows it is possible to drive T2D into remission through specific diet and lifestyle changes. T2D remission means that blood sugars are back in the normal range with no medications needed; it represents a new way of viewing T2D which provides hope for those affected. Research shows T2D remission is achievable, but now we need a public outreach program to alert as many British Columbians as possible to this news and connect them with helpful resources. We will implement a KT initiative including: 1) Video and graphic media products that we create; 2) Earned mainstream media coverage; and 3) A social media campaign, which amplifies the first two elements and drives viewers to a web platform, RemissionPossible.ca, which will connect them with T2D remission resources. Given how broadly T2D affects British Columbians and what a “feel good” story this is, we anticipate significant interest with mainstream and social media. By carefully tracking results (impressions and web traffic), we will improve our reach and learn valuable lessons to inform future KT initiatives.


Team members: Damien Gillis; Barbara Oliveira (UBC Okanagan); Tom Elliot (UBC); Sean McKelvey (Institute for Personalized Therapeutic Nutrition, not-for-profit); Marc Pelletier (Institute for Health Systems Transformation and Sustainability, not-for-profit); Deanne Taylor (Interior Health); Kathleen Martin Ginis (UBC Okanagan and Centre for Chronic Disease Prevention and Management); Krista Lamb; JJ Belanger; Chris Xi.

Knowledge translation and mobilization to support exercise recommendations for people with bone metastases

The objective is to develop a knowledge translation and mobilization plan for exercise recommendations for people with bone metastases. In advanced cancer, cancer can spread to bone, called ‘bone metastases’. This makes bones weaker and more likely to break, leading to pain and disability. Physical activity can help people living with bone metastases to maintain their independence and engage in more activities they enjoy. However, health care professionals, exercise professionals and people living with bone metastases (user groups) are uncertain about how to safely engage in physical activity. In 2022, expert recommendations were published on physical activity specifically for people with bone metastases. Without specific tools for user groups and communication plans, it could take years for these recommendations to be taken up into practice. We will bring together people who are part of the intended user groups across British Columbia to “co-design” the best way to get information about the recommendations to people who need it, in the most useful way possible. This project aims to raise awareness about the recommendations and start the process to increase use of the recommendations for people living in British Columbia.


Team members: Christine Simmons (BC Cancer Agency); Alan Bates (BC Cancer); Cathy Clelland (BC Cancer); Sian Shuel (BC Cancer); Leah Lambert (BC Cancer); Sarah Budding Smith (BC Cancer); Chiara Singh (Fraser Health & Physiotherapy Association of British Columbia); Hardip Jhaj (British Columbia Association of Kinesiologists); Rebecca Tunnacliffe (BC Recreation and Parks Association); Tracy Torchetti (Canadian Cancer Society); Sarah Weller (BC Cancer); Stephanie Skourtes (Women’s Health Research Institute); Kirstin Lane (Exercise Science, Physical & Health Education University of Victoria); Sarah Neil-Sztramko (National Collaborating Centre for Methods and Tools); David Langelier (University of Toronto and Princess Margaret Cancer Centre); Michelle Nadler (Princess Margaret Cancer Centre); Samantha Myers (UBC – Rehabilitation Sciences).

Multimodal characterization and classification of bio-signals to predict cardiac arrest

Sudden cardiac arrest (SCA), due to abrupt disruption of cardiac function, is a major health problem globally. SCA can happen to anyone at any age who may or may not have been diagnosed with heart disease. SCA has a poor survival rate of about 10 percent, with an estimated 35,000 deaths in Canada annually. With an increasing rate of cases (16 percent from 2017 to 2020), SCA remains a major public health issue in British Columbia. The most effective strategy to improve survival is to achieve rapid SCA recognition, given that for every minute without cardiopulmonary resuscitation (CPR) survival rates drop by 10 percent. Wearable devices may play a major role in decreasing SCA mortality, providing real-time cardiac information for early SCA detection. My aim is to develop a wearable SCA device with embedded sensors, and use their real-time physiological data combined with artificial intelligence algorithms, to make an accurate SCA detection system. This SCA detection system will be designed to identify SCA and alert Emergency Medical Services with the individual’s location (via GPS), enabling them to provide life-saving interventions in a timely manner.

Mitotic bookmarking by transcription factors as a mechanism of transcriptional memory

Cells that are the building blocks of the organism come in different forms and functions. Stem cells are a unique type of cells, because of their ability to change (differentiate) or maintain their state. Because of this ability to differentiate into any type of cell, stem cells are on the frontiers of regenerative medicine, which is aimed to restore damaged cells, tissues or organs. The cell division (mitosis) poses a challenge for cell identity. During mitosis, the DNA is condensed into characteristic mitotic chromosomes, the nuclear membrane, separating DNA from rest of the cell, is fragmented, and the gene expression ceases. How then cells memorized which genes were expressed, to continue their expression after mitosis? The mitotic memory has been proposed as a mechanism for the maintenance of cell identity after mitosis. One arm of this mechanism, called bookmarking, is the binding of transcription factors (proteins regulating gene expression), to mitotic DNA. This project aims to establish the molecular mechanisms of mitotic bookmarking in mouse embryonic stem cells. Using methods, such as gene editing, genomics, and imaging, I will solve how stem cells maintain their identity after countless number of cell division.

The role of Baf53b in regulating neuronal gene expression and autism behaviours across development

Autism spectrum disorder (ASD) is characterized by impairments in social communication and restricted interests. Several genes have been implicated in ASD, but a group of genes in the neuronal nBAF complex have emerged as promising candidates. The nBAF complex changes the structure of DNA to influence the way several genes are expressed in a cell. To date, no research has been conducted on the role of nBAF within neuron subtypes. I will investigate the loss of the nBAF complex specifically in parvalbumin (PV) neurons in mice. PV neurons are the most abundant type of inhibitory neuron in the brain and are frequently impaired in ASD. I hypothesize that loss of the nBAF complex will alter gene expression that is necessary for proper neuron function and resulting in ASD-like behaviours. Mice lacking the nBAF complex will undergo behavioural tests that can be used as a proxy to study ASD. Next generation sequencing will be employed to investigate alterations in gene expression. This work will be the first to test how loss of the nBAF complex specifically in PV neurons might lead to behavioural changes relevant to ASDs, providing the foundation for potential treatments.

Proteome-wide mechanisms of hyperinsulinemia and sucrose-induced, tissue-specific insulin resistance

During the development of Type 2 diabetes, the body often makes more of the blood sugar-lowering hormone insulin than normal. Recent research suggests excess insulin may cause weight gain and insensitivity to insulin. Studies from our lab showed that preventing this increase of insulin can reduce weight gain and extends lifespan in mice. Too much sugar consumption also contributes to obesity and diabetes, but how this happens is still unclear. Therefore, we aim to find out whether reducing insulin can prevent the detrimental effects of high sucrose and identify the underlying causes of obesity and diabetes. So far, our experiments with mice who were given sucrose drink in place of water, have revealed that mice given that have been genetically modified to produce less insulin are protected from higher body weight and blood sugar levels. With funding from Health Research BC, we will analyze the liver, muscle, and fat of these mice using powerful techniques that can profile thousands of genes and proteins in these tissues, rather than just a few at a time. These analyses will reveal the detailed changes in the cells in response to sucrose and insulin, which will tell us how they cause obesity and diabetes and help us develop strategies for preventing diabetes.

Exploration through movement variability: How does the presence of pain affect the movement variability-adaptation process of walking?

When we walk, our bodies take each step slightly differently. This variability is how the brain explores movements so we can adapt to changing environments (e.g. bump in the sidewalk) or new challenges (e.g. painful motion). Pain from injuries or disease can lower this natural exploration because our brain avoids painful movements, ultimately limiting our ability to adapt. My study aims to understand how pain affects this variability-adaptation process in walking. In these studies, we will use electrical stimulation to create artificial knee pain, since naturally occurring pain fluctuates and is difficult to control. By synchronizing the painful stimulation with walking motions, we can precisely control the timing and severity of pain so we can measure the variability-adaptation process in real-time. First, we will test how knee pain changes movement variability. Then, we will measure how adaptation is affected by lower variability created by the pain. To conduct these projects, we will develop new wearable technology that combines electrical stimulation and motion tracking devices to perform this work in places outside the lab. The results will inform how movement variability can affect rehabilitation of painful conditions.

A novel stem cell model for human islet development and cytoarchitecture

The cultivation of stem cells to insulin-producing beta cells offers an unlimited source of transplantable material for diabetes treatment. However, currently manufactured beta cells do not function precisely like the healthy ones in our bodies. Human islets are cell clusters mainly comprised of a mix of endocrine cell types, and interactions among them are critical in controlling insulin secretion. However, this point has been overlooked by current manufacturing methods that typically attempt to make clusters enriched only for beta cells. The absence of other islet cell types may therefore be a leading cause of the failure to obtain properly regulated insulin production. We recently developed a method to coax stem cells into islet clusters that are enriched for major endocrine cell types. Interestingly, these islets formed through an essential but unidentified “budding process” and self-organized into distinct cellular arrangements over time. Our goal is to elucidate the mechanisms that regulate islet formation, including the ways in which the cells assemble and impact islet function. Success could facilitate methods to manufacture islet cells with more robust insulin production and guide cell replacement strategies for diabetes.