Featured Ontario researchers - May and June, 2008

May 2008

Dr. Steve Manske

As any parent or teacher can tell you, a “one size fits all” approach rarely works when it comes to kids and teenagers.

That's why Ontario cancer prevention researcher Dr. Steve Manske developed SHAPES - the School Health Action, Planning and Evaluation System - an innovative research program aimed at reducing smoking and other harmful lifestyle habits in Canadian youth.

“SHAPES can collect information on students' health behaviours, including their smoking, exercise and eating habits as well as the related school health environments. Based on this information, we create an overall health profile of that school,” explains Dr. Manske, a scientist at the Centre for Behavioural Research and Program Evaluation. Funded by the Canadian Cancer Society and located at the University of Waterloo, the Centre bridges the worlds of science and practice through research and evaluation to inform decision-makers in the areas of cancer prevention in youth, tobacco control and quality of life.

“When enough schools participate from a district or region, the information can then be pooled to identify local, provincial and even national trends in youth health behaviour and attitudes.”

SHAPES has already been used successfully in more than 1,000 schools in Ontario and 2,000 schools nation-wide in studies supported by school boards, community public health departments and provincial and municipal governments. Health Canada uses SHAPES to collect data for its national Youth Smoking Survey of Canadian students in grades 5 to 12.

With so much rich data collected every year, researchers can now also use SHAPES to help evaluate the success of youth health programs and interventions.

“The information we collect with SHAPES helps identify the most effective mix of school policy, programs and neighbourhood and community factors that can reduce risky behaviour - like smoking - amongst kids and teens,” says Dr. Manske. “Healthy behaviours developed at a young age tend to be carried over to adulthood, which reduces population health costs.”

World No Tobacco Day

May 31 marks World No Tobacco Day, and here in Ontario, the final phase of the Smoke Free Ontario Act will culminate with the complete ban of tobacco product displays in convenience stores. The work of Dr Manske and other researchers at the Centre played a crucial role in informing legislators contemplating this change.

“Tobacco use is the number one cause of preventable disease, disability and death in Canada - smoking alone is responsible for about 85% of lung cancers,” says Dr. Manske. “That's why making research relevant to decision-makers, to trigger action that improves the health of Canadians, underlies all the work we do here at the Centre.”

Q&A With Dr. Manske

Your work is designed to help shape health policy. Why is this important to you to do this work?

A: We recognized that behaviour influences heath. Thirty years ago, we emphasised individual behaviour change. After seeing little progress in many areas, we have come to realize the critical role that environment, including health policy, plays in an individual’s healthy decision-making. Our goal should be to make the healthy decision the easy decision. I’m concerned that if we don’t find ways to prevent disease and promote health effectively, our economy will be eaten up (pun intended) by health care costs. So, in some ways it is self-preservation that drives my interest in understanding the structures and processes that can lead to healthier Canadians.

How do you think we can improve the connections between policy and research?

A: Our centre’s mission is to create knowledge, relationships and resources that contribute to continuous improvements in the health of our population. Researchers and policy makers need ongoing, intensive relationships so that each understands the other. This knowledge helps align researchers’ questions to the needs of the policy makers. Finally, we need appropriate funding, efficient tools and adequate human capacities to understand how policies affect people.

What is the best part of your job?

A: Seeing the “aha” moments among people who participate in the research process. It doesn’t have to be a stretch to learn new information – but rather to make the connection between what we already know, and some new piece that allows us to move forward, in understanding, in action, in enthusiasm. These processes are what will change the world for the better.

Have you seen your work change policy?

A: While it’s difficult to establish direct cause-and-effect links between a particular piece of research and policy change, we do feel we have contributed to understanding. For example, we implemented the Youth Smoking Survey on behalf of Health Canada. The content of that survey is deliberately selected to provide policy makers with knowledge about current topics. In 2008-09 the survey will track young people’s use of flavoured “little cigars” and gather more information around exposure to smoke in vehicles. On both these topics, there is, or is likely to be, legislation coming forward.

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June 2008

Dr. Douglas Gray

How does cancer develop in the lungs? Can we find a way to stop it in its tracks?

“In lung cancer, mutations in the cells accumulate over time leading to cancer,” says Dr. Douglas Gray. “That is why we usually see lung cancer in older patients and almost never in children.” Dr. Gray is a Society-funded researcher at the Ottawa Health Research Institute, where he holds the University of Ottawa Joan Sealy Chairin Lung Cancer Research.

About 85% of lung cancer is attributable to tobacco use, but even in non-smokers lung cancer is a major cause of cancer death in older adults. Dr. Gray says that progress in treating and preventing the disease depends on understanding how DNA errors (or mutations) build up in the cancer cells and why they are not repaired correctly.

Dr. Gray is already one of Canada’s leading experts on ubiquitin, a molecule that has many functions within cells. He has received five previous funding awards from the Canadian Cancer Society totalling nearly $2 million. Early in his career, he discovered one of the first genes in the human ubiquitin pathway and became interested in ubiquitin’s role in DNA repair. More recently he has studied how manipulating ubiquitin levels affects the formation and growth of cancer cells.

“High levels of ubiquitin appear to encourage a form of DNA repair that is error-prone, and we are interesting in knowing how dependent cancer cells are on ubiquitin,” says Dr. Gray. “If we could target this pathway with treatments, we might be able to stop the cancer’s growth.”

Dr. Gray has recently received new funding from the Canadian Cancer Society as part of an initiative to boost lung cancer research in Canada. “Lung cancer is the leading cause of cancer death, but the funding doesn’t reflect its severity,” says Dr. Gray. “New scientific knowledge means that new areas of research are now possible in lung cancer. I am tremendously grateful to the Canadian Cancer Society for recognizing and responding to this gap.”

One promising area of discovery is a newly-identified group of cells know as BASC or bronchioalveolar stem cells. “These cells are really a blank slate,” observes Dr. Gray, describing why his new project will focus on these cells. “BASC were first described in a paper written only three years ago. These cells are an important new focal point for research, because we think that they are where most lung cancers begin.”

Applying Dr Gray’s previous work on ubiquitin to these cells might one day lead to a way to stop lung cancer at the very earliest stages.

Q&A with Dr. Gray

Lung cancer is a very deadly disease, how do you stay hopeful?

Progress towards effective lung cancer treatments has been frustratingly slow, but by working on unexplored aspects of lung cancer it is easy to remain hopeful that a breakthrough is still possible. It is highly motivating to work on a disease so in need of breakthroughs.

Why did you choose this field of study?

My initial interest in lung cancer was purely scientific, but it became personal with the death of my mother from the disease in 2006. My endowed chair is named in honour of a woman who, like my mother, lived an active and healthy lifestyle but succumbed to the disease nonetheless. Before we can prevent lung cancer or give hope to lung cancer patients we must understand the course of events that gives rise to the disease.

What is the best part of your job?

I am the furthest thing from gregarious, but the best part of my job is the people. Every day I am in the company of extremely clever people: scientists, clinicians, trainees and staff. It is impossible to be bored in the company of such people.

Where do you hope we will see new advances in lung cancer research in the next 10 years?

Our understanding of stem cell relationships in the lung is still at a primitive stage, and my hope is that we will become more enlightened. We need to know which cells have the capacity to divide and repair the lung, what happens to these cells as we age, and whether there is anything that can be done to reduce their propensity to become cancer cells. In 10 years I hope we have this knowledge and are exploiting it.

Last modified on: 04 February 2011