Advanced pulmonary diagnostics in paediatric respiratory medicine: From technical development to clinical implementation

Chronic lung diseases present a serious health challenge for Canadian children and youth. For example, cystic fibrosis (CF) shortens life expectancy and carries an enormous treatment cost (>$250,000 per person per year). Another example is asthma, which affects nearly 1 in 7 Canadians under age 20. Improving the lives of people with these conditions is possible but requires accurate detection and close monitoring of their lung disease.

Unfortunately, the tests available to paediatric respiratory physicians are often difficult for children to perform and not sensitive enough to detect or subtle disease. This significantly limits physicians’ ability to detect, treat and monitor lung disease in children and must change.

My research program focuses on the development of easy-to-perform and sensitive tools to help physicians diagnose and monitor lung disease in children. Specifically, I am an expert in techniques known as hyperpolarised xenon lung MRI (XeMRI) and multiple breath washout testing (MBW).

During tenure of this Health Professional-Investigator award, I will lead research focused on improving the XeMRI and MBW techniques and using these new tools clinically to improve the health of children with lung diseases.

Evaluating the use of prescription psychostimulants for the treatment of methamphetamine use disorder

Crystal meth is a powerful stimulant that is increasingly implicated in the ongoing overdose crisis in BC. Despite steadily increasing rates of crystal meth detection in overdose deaths, little is understood about the specific role that it may be playing in the overdose crisis, and treatment options for those suffering from crystal meth use disorder (MUD) are limited.

One class of medications that has previously shown some promise in the treatment of MUD are prescription stimulants such as those used to treat ADHD. While research in this area remains inconclusive, there is some suggestion that these medications may play a helpful role in the treatment of MUD, especially among patients with an overlapping diagnosis of opioid use disorder.

This proposal will employ a variety of research methodologies to explore two related questions: (1) Can we identify patients who use crystal meth and opioids that are at particularly high risk of overdose, and (2) Are prescription stimulants a helpful tool in the treatment of MUD in a population of patients who use opioids? These results will have significant implications for both healthcare providers and those suffering from MUD, at a time where new tools are sorely needed.

Redesigning health care for concurrent disorders: The role of multimorbidity in complex co-occurring psychiatric and substance use disorders

Individuals with both psychiatric and substance use disorders, defined as concurrent disorders, are more complex to diagnose and treat due to several interacting health and social challenges. In the absence of appropriate treatment people with concurrent disorders are at high risk for increased morbidity and mortality. A growing body of evidence recommends abandoning the traditional single-disease health model in favour of a multimorbidity approach to care. Despite available evidence, important gaps persist in our understanding of how individual and health system context influence service utilization and outcomes for people with complex multimorbid disorders (e.g. concurrent disorders). The proposed research will establish a prospective cohort of individuals with a concurrent disorder. Individuals will complete a series of brief questionnaires and provide consent to use their personal identifiers for linkage to a number of health databases. This research offers a unique opportunity examine health outcomes associated with multi-morbidities and understand patterns of health care utilization overtime. This research will advance knowledge to inform best practices and service reforms for the optimal delivery of care in BC.

Does timing matter? A trial of intermittent fasting in haematological malignancies

Does when we eat make a difference to our health? We know that food choices can impact cancer risk but what if the timing plays a role as well? Evidence shows that fasting may slow cancer growth through a process called autophagy. Through an interdisciplinary research team, I am currently running a small trial testing the effects of intermittent fasting (IF) in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) at BCC-Victoria who not on anti-cancer treatment. Specifically, I am asking whether IF regimens, differing in fasting timing and duration, stimulates autophagy, improves quality of life, impacts gut microbiome, and/or results in clinical benefit (i.e. reduced lymphocyte count). I am also following participants’ safety, ability to follow the fast, and fasting preferences. While early results look promising, I propose growing this study into a larger trial with three phases to clarify the effects of IF on cancer and the microbiome. Understanding these effects may help discover simple diet recommendations for patients with cancer that cause a response in cancer cells or slow cancer progression, are safe and reduce treatment side effects when used alongside current, standard treatments.

Neuropsychological functioning in treatment resistant schizophrenia

Schizophrenia is a severe and disabling psychiatric illness involving primary symptoms of psychosis (hallucinations, delusions, disordered thinking and behavior). Unfortunately, as many as 30% of patients respond poorly to standard antipsychotic medications and are considered to have treatment resistant schizophrenia (TRS). Neuropsychological impairment is an important clinical feature of schizophrenia, as cognitive deficits predict poor treatment response, daily functioning, and disability. However, very little is known about cognitive functioning in the clinically complex subset of patients with TRS. The aims of this project are therefore to investigate the severity, pattern, and variation in cognitive functioning among individuals with TRS, and to determine whether cognitive difficulties predict treatment response and functioning. This will be achieved by analyzing clinical and neuropsychological data that has been collected on TRS patients who have been treated within the BC Psychosis Program since 2012. Findings using this unique dataset will have a direct impact on shaping assessment and treatment strategies, improving prognosis and ability to predict functioning, and improving clinical decision-making and planning.

Design and pilot of a culturally resonant intervention to treat substance use disorder among South Asian men

Substance use disorder is a growing problem affecting racialized men in Canada. There is increased awareness and understanding about why and how racialized men use substances, yet little is known about effective treatments and interventions. The project will use anti-racist research methods to design and study an intervention to support a racialized group, South Asian men who use substances. The team will consist of Punjabi men who use substances, community organization members, health care providers, and researchers. Using a rigorous facilitated approach that highlights evidence from literature and draws upon members’ life experiences, the team will design an intervention to support South Asian men who use substances in the Lower Mainland. Once the design is complete, the intervention will be studied in a feasibility study and pilot randomized controlled trial (RCT) in preparation and justification for a full scale RCT.

Perinatal anxiety screening study

Anxiety disorders are the most common of all mental health conditions. They affect 20 percent of pregnant and postpartum people, and are associated with significant distress and life interference for sufferers, as well as negative consequences for the fetus and infant.

Little, if any, routine screening for these disorders is conducted. This is mostly because accurate screening tools have yet to be identified. The majority of screening studies have used poor quality research methodology or have assessed measures which appeared to perform too poorly to be recommended for widespread use. The result of this is that perinatal anxiety disorders often go unidentified, resulting in continued suffering and life impairment.

The purpose of this research is to identify one or more accurate and reliable perinatal anxiety disorder screening tool(s). To do this, we will conduct a large scale study of pregnant and postpartum people in which we assess the accuracy of the most promising perinatal anxiety disorder screening tools.

This research will provide important information to inform healthcare providers, policymakers and scientists, about the most effective approach to screening for anxiety disorders during pregnancy and the postpartum period.

Understanding and mitigating the impact of COVID-19 on the mental health of parents and caregivers of children and youth with support needs in British Columbia

This Child, Youth & Family Mental Health Impact Grant is co-funded through a partnership between Mental Health Research Canada, Michael Smith Health Research BC, and the BC Ministry of Children and Family Development.

While COVID-19 has affected the mental health of all Canadians, those with complex family needs have struggled even more. The strain is especially great on parents and caregivers of children and youth with support needs experiencing (or at risk of) developmental delay or disability.

Research studies about the impact of the pandemic on parental mental health tend to view parents of children with support needs as a homogenous group, or they tend to explore separate diagnostic categories (such as Autism Spectrum Disorder and medical complexity).

Lead investigators Dr. Jennifer Baumbusch and Angela Clancy will not replicate existing studies but will extend what is currently known, particularly in the context of British Columbia.

The investigators and their team will compare mental health impacts with a larger pan-Canadian sample. They will also compare mental health impacts within the sample of parents of children with support needs based on diagnostic categories, individual factors of parent and child (such as gender, age, race, ethnicity, education, family structure and household income), and community factors (such as geographic location and size of community) — and compare between these categories.

The goal is to identify specific strengths and vulnerabilities of different sub-groups that can be used to customize supports.

The BC research team will also explore existing knowledge about programs (such as peer-to-peer and one-on-one counselling) and promising practices (such as virtual/tele-health and enhanced respite) that help mitigate mental health impacts and foster family resilience.


Progress Update – March 2022

Lead investigators Dr. Jennifer Baumbusch and Angela Clancy, together with Chelsea Jokisch, a patient with lived experience, share their key discoveries and insights so far, in this webinar hosted by Mental Health Research Canada.

Co-creating Fraser Health’s partner-centred long-term care and assisted living research priorities

The COVID-19 pandemic has shown failings in the care provided to older adults in care homes and a clear need for the voices of residents and their family to inform positive change. A group of residents, their family and friend carers, staff, physicians, nurses, leaders and researchers in care homes at Fraser Health will work together to agree on the most important research questions for people that live and work in care homes to improve the care that is given. Priority setting activities will be held with the goal to discuss key research topics and decide together the most important research questions in care homes at Fraser Health. Undertaking these activities also will build strong relationships between the different partners. The activities will be conducted so that the different partners in care homes, such as residents, their family and friends and staff, can contribute to the talks about research that is most important to them. The different research partners will also talk about plans for ongoing research projects to answer the top research questions together in the care homes at Fraser Health.


Team members: Adriaan Windt (Fraser Health); Laura Kadowaki (Simon Fraser University); Lucy Kervin (Simon Fraser University); Emma Leong (Kwantlen Polytechnic University); Annette Berndt (Fraser Health); Catherine Youngren (Fraser Health); Akber Mithani (Fraser Health); Suzanne Fox (Fraser Health); Clayon Hamilton (Fraser Health and Simon Fraser University); Valorie Crooks (Simon Fraser University); Nick Petropolis (Fraser Health); Amber Jarvie (Fraser Health); Gita Rafiee (Fraser Health); Anita Wahl (Fraser Health); Dan Levitt (Tabor Home Society)

A provincial evidence-based approach to better support people experiencing bereavement in British Columbia

The impact of COVID-19 pandemic on the scale of bereavement and those bereaved is becoming apparent, with an estimated 9 people affected by bereavement for each COVID-19 death. Social distancing measures have decreased opportunities for people who are dying to connect with their loved ones, and for bereaved people to access social supports such as traditional rituals and support groups. A potential impact of this is prolonged or complicated grief.

This project aims to help bereaved people access effective supports. We propose hosting a provincial roundtable discussion, where every participant can contribute equally to a structured conversation on how existing bereavement services could be improved. We will invite service providers, bereaved people, policy makers, researchers, and others doing relevant work to participate in the roundtable. The discussion will be guided by recently collected information from bereaved people and service providers in BC about their experiences and views of bereavement care.

After the discussion, the participants will work together to recommend actions to improve the bereavement experience in BC. The recommendations can also be used to inform the development of supportive policies and future research.


Team members: Marney Thompson (Victoria Hospice Society); Kathleen Yue (BC Centre for Palliative Care); Rachel Carter (BC Centre for Palliative Care); Nicolas Starkes (UBC Okanagan); Heather Mohan (Camp Kerry Society); Jessica Lowe (BC Bereavement Helpline); Shelly Cory (Canadian Virtual Hospice); D’Arcy Wingrove; Annette Berndt