News Article | December 13, 2016
Follicular lymphoma (FL), the second most common form of non-Hodgkin lymphoma, is a largely incurable disease of B cells, yet in many cases, because of its indolent nature, survival can extend to well beyond 10 years following diagnosis. Yet in a small number of cases, histological transformation - where fast-growing cells outnumber the smaller, slow-growing cells - or early progression to aggressive lymphoma occurs. The events leading to this increased and early mortality are poorly understood. In a study published in PLOS Medicine, Sohrab Shah and colleagues from the BC Cancer Agency in Vancouver, Canada, investigate the molecular events underlying transformation and progression and show that disparate evolutionary trajectories and mutational profiles drive these two distinct clinical endpoints. Using whole genome sequencing, the authors analyse the genome sequence of tumours and matched normal specimens from 41 patients and classify them according to their clinical endpoints: 1) patients who presented with transformation, 2) patients who experienced tumor progression within 2.5 years after starting treatment, without evidence of transformation, 3) and those who had neither transformation nor progression up to 5 years post-diagnosis. In addition, the authors use targeted capture sequencing of known follicular lymphoma associated genes in a larger cohort of 277 patients to investigate discrete genetic events that drive transformation and early progression. The authors show that tumors that progress early evolve in different ways than those that transform. Assessing mutations at two time points and following treatment they show that for tumours that transform, the cells or clones which constitute the majority of the aggressive tumour were extremely rare at diagnosis, if at all present. In contrast, for early progressive disease the clonal architecture remains similar from the time of diagnosis to relapse, indicating that the diagnostic tumour may already contain the properties that confer resistance to treatment. Analysis of the larger cohort pinpointed key genes and biological processes that were associated with transformation and progression. These findings provide a basis for future research on prognostic assay development and potential strategies for monitoring and treatment of patients with FL. This study was supported by a Program Project Grant from the Terry Fox Research Institute, Grant No. 1023) to SS, MM, RDG, CS and JC. We also wish to acknowledge generous long term funding support from the BC Cancer Foundation. SS is supported by a Canada Research Chair and a Michael Smith Foundation for Health Research, MSFHR scholar award. RK was supported by a Postdoctoral Trainee Fellowship Award from MSFHR. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. I have read the journal's policy and the authors of this manuscript have the following competing interests: SPS is a founder and shareholder of Contextual Genomics Inc., developer of clinical genomic tests for cancer. Kridel R, Chan FC, Mottok A, Boyle M, Farinha P, Tan K, et al. (2016) Histological Transformation and Progression in Follicular Lymphoma: A Clonal Evolution Study. PLoS Med 13(12): e1002197. doi:10.1371/journal.pmed.1002197 Centre for Lymphoid Cancer, BC Cancer Agency, Vancouver, British Columbia, Canada Bioinformatics Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada Department of Molecular Oncology, BC Cancer Agency, Vancouver, British Columbia, Canada Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, British Columbia, Canada Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, British Columbia, Canada Jewish General Hospital, Montreal, Quebec, Canada Translational Cell and Tissue Research Lab, Department for Imaging and Pathology, University of Leuven (KU Leuven), Leuven, Belgium Department of Pathology, Universitaire Ziekenhuizen Leuven (UZ Leuven), Leuven, Belgium Department of Laboratory and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America Departments of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:
News Article | November 29, 2016
UBC researchers have demonstrated that simple, cost-effective email messages can help improve the health habits of Canadians. Mary Jung, an assistant professor of health and exercise sciences at UBC's Okanagan campus, recently completed a nationwide study with more than 730 Canadians who were not meeting Canada's recommended dietary intake for calcium. Participants received an email--with evidence-based daily tips and strategies on how to increase calcium intake--four days in a row. Jung, a Michael Smith Foundation for Health Research Scholar Professor, wanted to determine if targeted messaging--making particular outcomes relevant to the population of interest--could be a feasible public health strategy for improving calcium intake. "Just four targeted messages made a remarkable difference in the consumption of calcium-rich foods," says Jung. "The majority of our participants increased their calcium intake by one serving of dairy a day--pretty good results." Rather than tailoring messages to each individual, which can be costly and intrusive, the messages in this study highlighted outcomes Jung had found relevant to her targeted audience. Specifically, she used evidence-based information including the suggestion of being a positive role model for one's children, understanding the health benefits of consuming enough calcium as we age, and strategies to keep up the required daily consumption. Despite the known health benefits of getting enough calcium, such as bone health, less than 40 per cent of Canadians between the ages of 30 and 50 consume the right amount. Jung notes that this age group tend to encourage their children to drink milk, but forget the importance of ensuring they get enough calcium. Other than dairy products, calcium can be found in green leafy vegetables like kale and broccoli, as well as in almonds and canned fish with bones. Jung says her four emails, arriving in email boxes early each morning, resulted in an increase of more than 200 milligrams of calcium each day in participants--which was maintained four weeks after the emails were sent out. "This study demonstrates that providing salient information, along with relevant how-to strategies, is an effective way to promote calcium intake in Canadian adults," says Jung. "These findings hold promise for future public health campaigns on a shoestring budget. By making messages meaningful to the targeted audience, cost-efficient messages can change health behaviours." Jung's research was recently published in the journal Annals of Behavioral Medicine.
Henrich N.,Center for Health Evaluation and Outcome science |
Henrich N.,University of British Columbia |
Holmes B.,University of British Columbia |
Holmes B.,Michael Smith Foundation for Health Research
PLoS ONE | Year: 2011
During the 2009 H1N1 pandemic, a vaccine was made available to all Canadians. Despite efforts to promote vaccination, the public's intent to vaccinate remained low. In order to better understand the public's resistance to getting vaccinated, this study addressed factors that influenced the public's decision making about uptake. To do this, we used a relatively novel source of qualitative data - comments posted on-line in response to news articles on a particular topic. This study analysed 1,796 comments posted in response to 12 articles dealing with H1N1 vaccine on websites of three major Canadian news sources. Articles were selected based on topic and number of comments. A second objective was to assess the extent to which on-line comments can be used as a reliable data source to capture public attitudes during a health crisis. The following seven themes were mentioned in at least 5% of the comments (% indicates the percentage of comments that included the theme): fear of H1N1 (18.8%); responsibility of media (17.8%); government competency (17.7%); government trustworthiness (10.7%); fear of H1N1 vaccine (8.1%); pharmaceutical companies (7.6%); and personal protective measures (5.8%). It is assumed that the more frequently a theme was mentioned, the more that theme influenced decision making about vaccination. These key themes for the public were often not aligned with the issues and information officials perceived, and conveyed, as relevant in the decision making process. The main themes from the comments were consistent with results from surveys and focus groups addressing similar issues, which suggest that on-line comments do provide a reliable source of qualitative data on attitudes and perceptions of issues that emerge in a health crisis. The insights derived from the comments can contribute to improved communication and policy decisions about vaccination in health crises that incorporate the public's views. © 2011 Henrich, Holmes.
News Article | December 8, 2016
New research from North Carolina State University and the University of British Columbia finds that a woman's lifetime history of drug use can help predict whether the woman will suffer from problems with stress and anxiety after childbirth. The finding could help health-care providers screen pregnant women for mental health problems and provide relevant treatment. "There's been a lot of attention recently on the need to incorporate mental health screening into prenatal care, and it has largely focused on identifying women who are at risk of postpartum depression," says Sarah Desmarais, an associate professor of psychology at NC State and co-author of a journal article on the work. "Our study has two important findings that are relevant to that discussion," Desmarais says. "First, we found that women are at risk of significant postpartum mental health problems other than depression - stress and anxiety are serious issues that merit attention. Second, by incorporating questions about a woman's history of drug use, we can help health-care providers more accurately identify women who are at risk of postpartum stress and anxiety - and take steps to provide the necessary care." The study was not designed to focus specifically on drug use, but was instead aimed at answering the broader question of whether women's use of alcohol and drugs at any point in their lifetime predicted mental health challenges after childbirth. "Historically, a lot of research focused on women's substance use during pregnancy," Desmarais says. "We thought that may not be a reliable way of capturing women's substance use, because women are likely less willing to admit to substance use during pregnancy - they're concerned about losing parental custody, dealing with social stigma, or biasing their treatment and care. What's more, pregnancy is not when women begin using drugs or alcohol; that's something that carries over from a woman's behavior before pregnancy." To examine these issues, researchers used data from interviews with 100 women in British Columbia who had given birth in the previous three months, were largely from higher socioeconomic backgrounds and were not considered at high risk of postpartum mental health problems. The study participants were recruited to join a broad health and wellness study, which was not specifically focused on substance use. In those interviews, women were asked about their history of alcohol use and their history of drug abuse. "The key finding is that asking about lifetime drug use really helped us predict whether a woman would experience postpartum mental health problems," Desmarais says. "The best predictor of postpartum mental health problems is still whether a woman has a history of mental health problems," Desmarais adds. "But when you include a history of drug use, the likelihood increases significantly." Specifically, prior drug use was associated with heightened symptoms of stress and anxiety after childbirth. Drug use was not associated with postpartum depression, and prior alcohol use was not associated with any postpartum mental health problems. The paper, "Lifetime substance use as a predictor of postpartum mental health," is published in the journal Archives of Women's Mental Health. Lead author of the study is Betty-Shannon Prevatt, a Ph.D. student at NC State. The paper was co-authored by Patricia Janssen of UBC. The work was done with support from the British Columbia Mental Health and Addictions Research Network, the Social Sciences and Humanities Research Council of Canada, and the Michael Smith Foundation for Health Research.
Holmes B.J.,Michael Smith Foundation for Health Research |
Schellenberg M.,Mental Health Commission of Canada |
Schell K.,Michael Smith Foundation for Health Research |
Scarrow G.,Michael Smith Foundation for Health Research
Implementation Science | Year: 2014
Background: Health research funding agencies are increasingly promoting evidence use in health practice and policy. Building on work suggesting how agencies can support such knowledge translation (KT), this paper discusses an online survey to assess KT training needs of researchers and research users as part of a Canadian provincial capacity-building effort.Methods: The survey comprised 24 multiple choice and open-ended questions including demographics, interest in learning KT skills, likelihood of participating in training, and barriers and facilitators to doing KT at work. More than 1,200 people completed the survey. The high number of responses is attributed to an engagement strategy involving partner organizations (health authorities, research institutes, universities) in survey development and distribution. SPSS was used to analyze quantitative results according to respondents' primary role, geographic region, and work setting. Qualitative results were analyzed in NVivo.Results: Over 85 percent of respondents are interested in learning more about the top KT skills identified. Research producers have higher interest in disseminating research results; research users are more interested in the application of research results. About one-half of respondents require beginner-level training in KT skills; one-quarter need advanced training. Time and cost constraints are the biggest barriers to participating in KT training. More than one-half of respondents have no financial support for travel and almost one-half lack support for registration fees. Time is the biggest challenge to integrating KT into work.Conclusions: Online surveys are useful for determining knowledge translation training needs of researchers, research users and ultimately organizations. In this case, findings suggest the importance of considering all aspects of KT in training opportunities, while taking into account different stakeholder interests. Funders can play a role in developing new training opportunities as part of a broad effort, with partners, to build capacity for the use of health research evidence. Survey results would ideally be complemented with an objective needs assessment based on core competencies, and should be acted on in a way that acknowledges the complexity of knowledge translation in healthcare, existing training activities, and the expertise stakeholders already have but may not refer to as knowledge translation. © 2014 Holmes et al.; licensee BioMed Central Ltd.
Audette M.C.,King's College |
Challis J.R.G.,King's College |
Challis J.R.G.,University of Toronto |
Challis J.R.G.,Michael Smith Foundation for Health Research |
And 5 more authors.
Endocrinology | Year: 2011
Clinically, approximately 30% of women who receive synthetic glucocorticoids (sGC) for risk of preterm labor carry to term. In vitro studies have shown that sGC acutely regulate the placental system A amino acid transporter, but there are no comparable data in vivo. Hence, the objective of our study was to examine the acute [embryonic day (E)15.5] and longer-term (E17.5 and E18.5) consequences of midgestation antenatal sGC [dexamethasone (DEX); 0.1 mg/kg on E13.5 and E14.5] on placental system A-mediated transfer in the mouse (measured in vivo as maternal-fetal unidirectional 14C-methylaminoisobutyric acid transfer per gram of placenta). System A transfer and Slc38a mRNA expression significantly increased from E12.5 to E18.5 (P < 0.05), corresponding to increased fetal growth. DEX treatment had no acute effect at E15.5 or longer-term effect at E17.5 but significantly decreased system A-mediated transfer before term (E18.5; P < 0.05) in placentae of male and female fetuses. There was no effect of DEX on Slc38a gene expression. Administration of DEX in this regime had no effect on birth weight. We conclude that sGC treatment in midgestation leads to a substantial decrease in placental system A-mediated transport in late gestation, suggesting that prenatal sGC therapy may lead to a reduction in availability of neutral amino acids to the fetus if gestation persists to term. Copyright © 2011 by The Endocrine Society.
Petraglia F.,University of Siena |
Imperatore A.,University of Siena |
Challis J.R.G.,University of Toronto |
Challis J.R.G.,Michael Smith Foundation for Health Research
Endocrine Reviews | Year: 2010
The complex mechanisms controlling human parturition involves mother, fetus, and placenta, and stress is a key element activating a series of physiological adaptive responses. Preterm birth is a clinical syndrome that shares several characteristics with term birth. A major role for the neuroendocrine mechanisms has been proposed, and placenta/membranes are sources for neurohormones and peptides. Oxytocin (OT) is the neurohormone whose major target is uterine contractility and placenta represents a novel source that contributes to the mechanisms of parturition. The CRH/urocortin (Ucn) family is another important neuroendocrine pathway involved in term and preterm birth. The CRH/Ucn family consists of four ligands: CRH, Ucn, Ucn2, and Ucn3. These peptides have a pleyotropic function and are expressed by human placenta and fetal membranes. Uterine contractility, blood vessel tone, and immune function are influenced by CRH/Ucns during pregnancy and undergo major changes at parturition. Among the others, neurohormones, relaxin, parathyroid hormone-related protein, opioids, neurosteroids, and monoamines are expressed and secreted from placental tissues at parturition. Preterm birth is the consequence of a premature and sustained activation of endocrine and immune responses. A preterm birth evidence for a premature activation of OT secretion as well as increased maternal plasma CRH levels suggests a pathogenic role of these neurohormones. A decrease of maternal serum CRH-binding protein is a concurrent event. At midgestation, placental hypersecretion of CRH or Ucn has been proposed as a predictive marker of subsequent preterm delivery. While placenta represents the major source for CRH, fetus abundantly secretes Ucn and adrenal dehydroepiandrosterone in women with preterm birth. The relevant role of neuroendocrine mechanisms in preterm birth is sustained by basic and clinic implications. Copyright © 2010 by The Endocrine Society.
Henrich N.,Providence Health Care Research Institute |
Holmes B.,Michael Smith Foundation for Health Research |
Prystajecky N.,BC Public Health Microbiology and Reference Laboratory |
Prystajecky N.,University of British Columbia
PLoS ONE | Year: 2015
In association with the development of new microbial tests for source water quality (SWQ), focus groups with members of the public were conducted to gain insight into their perceptions of SWQ, behaviours and contaminants they think pose the greatest threat to its quality, and what/how they want to know about SWQ. Discussions revealed a low concern about SWQ in general, and in particular about microbial contamination. Participants identified behaviours that threaten SWQ, barriers to changing behaviour and suggestions for inducing change. A strong desire was expressed for water quality information to be interpreted and communicated in terms of how SWQ may impact human health and how their actions should be altered in response to test results. The information can be used to inform communication strategies and possibly impact policies associated with water quality testing and implementation of new tests. More broadly, awareness of the publicâ€™s understanding and beliefs about source water can be used in working with the public to adopt water-friendly behaviours, influence the content and methods of communicating with the public about water issues and water quality, and could contribute to the direction of future research and investment into water technologies to align with the public's priorities. © 2015 Henrich et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Johnston L.M.,Simon Fraser University |
Finegood D.T.,Simon Fraser University |
Finegood D.T.,Michael Smith Foundation for Health Research
Annual Review of Public Health | Year: 2015
Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges - including goal alignment and conflict of interest - and consider how changes to partnership practice might address these. Copyright © 2015 by Annual Reviews. All rights reserved.
Holmes B.,Michael Smith Foundation for Health Research |
Scarrow G.,Michael Smith Foundation for Health Research |
Schellenberg M.,Michael Smith Foundation for Health Research
Implementation Science | Year: 2012
Background: A growing body of work on knowledge translation (KT) reveals significant gaps between what is known to improve health, and what is done to improve health. The literature and practice also suggest that KT has the potential to narrow those gaps, leading to more evidence-informed healthcare. In response, Canadian health research funders and agencies have made KT a priority. This article describes how one funding agency determined its KT role and in the process developed a model that other agencies could use when considering KT programs.Discussion: While 'excellence' is an important criterion by which to evaluate and fund health research, it alone does not ensure relevance to societal health priorities. There is increased demand for return on investments in health research in the form of societal and health system benefits. Canadian health research funding agencies are responding to these demands by emphasizing relevance as a funding criterion and supporting researchers and research users to use the evidence generated.Based on recommendations from the literature, an environmental scan, broad circulation of an iterative discussion paper, and an expert working group process, our agency developed a plan to maximize our role in KT. Key to the process was development of a model comprising five key functional areas that together create the conditions for effective KT: advancing KT science; building KT capacity; managing KT projects; funding KT activities; and advocating for KT. Observations made during the planning process of relevance to the KT enterprise are: the importance of delineating KT and communications, and information and knowledge; determining responsibility for KT; supporting implementation and evaluation; and promoting the message that both research and KT take time to realize results.Summary: Challenges exist in fulfilling expectations that research evidence results in beneficial impacts for society. However, health agencies are well placed to help maximize the use of evidence in health practice and policy. We propose five key functional areas of KT for health agencies, and encourage partnerships and discussion to advance the field. © 2012 Holmes et al.; licensee BioMed Central Ltd.