There are disproportionately high rates of poor health among First Nations populations in comparison to the general Canadian population. A contributing factor is the limited access many geographically-isolated rural and remote First Nations communities have to health information. Dr. Sandra Jarvis-Selinger is focusing on a new and innovative approach supporting community access to health information. This approach involves the formation of Community Learning Centres (CLCs) in four communities located in the Ktunaxa Nation in southeastern BC. A CLC is both a physical and a virtual space for community members to access Internet-linked computers and web-based resources developed according to community-defined health priorities. Health information is created by and for community members and is both accessed at and disseminated via CLCs through information and communication technologies. Community engagement is the cornerstone of this project, with due emphasis placed on community input and governance, local health priorities and inclusion of traditional medicine, language and knowledge. Dr. Jarvis-Selinger is conducting a program evaluation to determine the effectiveness and sustainability of the CLC design and implementation. The evaluation is being co-developed with each community in order to match the communities’ needs, workflow, schedule and style of participation. This research will increase our understanding of how to successfully and sustainably: 1) support community-university partnerships; 2) improve community wellness; 3) expand access to and awareness of community health resources; and 4) increase employment opportunities through technical, research and interpersonal skills training. Overall, this research promises to make a meaningful contribution to the domain of First Nations community health through the use of technology.
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Regulation of T Cell Development, Function and Transformation by Interleukin-7.
Immune disorders – such as immunodeficiencies, leukemia and lymphoma, autoimmunity, and allergy – are significant health problems. For example, every year 5,600 Canadians people die of cancers of the immune system, such as leukemia and lymphoma, and these cancers account for 42% of all cancers in children. Current treatments for these cancers, such as chemotherapy and radiation therapy, have significant shortcomings. To improve recovery rates and reduce unwanted side effects, researchers need to develop new, specifically targeted treatment approaches. Treating diseases with few side effects requires knowing the signals involved in disease development. Dr. Ninan Abraham is focusing his research on understanding how a cytokine called interleukin-7 (IL-7) regulates immune cells by interacting with proteins to trigger biochemical pathways that control normal cell development and function. IL-7 is an essential growth factor that promotes the development of T cells and memory T cells, which are both essential for the body’s response to pathogens that lead to disease or infection. Being able to enhance development or survival of T cells by manipulating IL-7 could lead to the creation of more effective vaccines to boost the body’s immune response to disease. Conversely, since over-expression of IL-7 is associated with several forms of human T cell lymphoma, being able to limit this cytokine’s activity could also be important. By identifying how IL-7 promotes the development or survival of T cells and memory T cells, Abraham hopes for new strategies for treating these cancers and enhancing vaccines for long-term immunity.
Pharmaceutical sales representatives, patient safety and cost-effectiveness of care: comparative cross-sectional survey
Prescription medicines are a common and important form of treatment offered by family doctors. The information that doctors receive about the effectiveness and safety of medicines helps to determine their prescribing choices. Most doctors in Canada see pharmaceutical sales representatives regularly. Previous research has demonstrated that sales representatives influence prescribing choices and that doctors often underestimate the extent to which they are influenced. A recent example of this influence emerged in the US with the arthritis drug Vioxx. Despite a 2001 Food and Drug Administration advisory committee recommendation that doctors be warned of heart attack risks associated with the drug, sales staff were advised not to inform doctors of. By the time Vioxx was withdrawn from the market in 2004, it had been linked to between 88,000 and 140,000 heart attacks. Dr. Barbara Mintzes is investigating whether information critical to safe prescribing is provided to doctors by sales representatives. She is gathering data from three countries: Canada (British Columbia and Quebec), the US, and France. She aims to identify best practices in regulation of drug promotion, and to understand how the messages doctors receive from sales representatives can be incorporated into education to improve prescribing. Ultimately, her goal is to improve prescribing safety and appropriateness. A key component of the research will be discussions of the implications of the results with policy-makers, physicians, medical educators and industry.
From Efficacy to Community Effectiveness. The proposed program of research, mentoring and knowledge translation will addresses the more effective, scalable, population-based, chronic disease and that …
The unprecedented investment in biomedical research during the past 50 years has resulted in many important advances in health care knowledge. However, the successful and timely integration of these advances into clinical practice remains a major challenge, especially in primary care and community settings. There is growing recognition that one of the obstacles to translating knowledge into clinical practice may be the knowledge itself, and how, where and by whom it was generated. Often, research knowledge is created in academic settings with little opportunity for involvement or input from primary care providers, community partners or patients. Dr. Janusz Kaczorowski aims to generate more high quality research evidence by end-users themselves, and under clinical conditions that closely resemble real life primary care and community settings. He believes that such an approach will help develop evidence that is more relevant to healthcare professionals working in these setting, which will speed up the knowledge transfer process. Building on his previous work across North America, Kaczorowski’s research focuses on the development of innovative primary care and community-based strategies for chronic disease prevention and management that will have a positive impact on the lives of British Columbians and Canadians. Strategies include collaborative ways to involve, in addition to family physicians, community caregivers (such as pharmacists), volunteer peer health educators, community-based organizations and patients in the research process.
Development of an Integrated Risk Assessment and Risk Management Tool for Health Care in BC, Phase 1 – assessment of chemical exposure hazards encountered by health care workers in BC
There are more than 80,000 health care providers working in BC. They work in complex and demanding environments where they may be exposed to numerous potential health hazards, including those that are chemical (e.g. drugs or cleaning agents), biological (e.g. bacteria or viruses) and physical (e.g. noise or radiation) in nature. Dr. George Astrakianakis focuses on understanding the many factors that determine the potential for exposure to health hazards among health care workers, and how to best mitigate their associated risks. In the initial phase of his research, he is identifying the specific chemical exposures commonly encountered in the healthcare workplace, assessing the risk to health for healthcare providers, and defining appropriate exposure control measures. In subsequent phases, he will assess biological and physical hazards, and implement and evaluate control strategies. Much of Astrakianakis’ data will be drawn from surveillance information collected by the Occupational Health and Safety Agency for Healthcare, which supports BC’s health care industry in part by monitoring information on occupations, exposure incidents and injuries among the Province’s health care professionals This information will form the basis for creating a job exposure matrix (JEM), which will be used to map exposure levels to occupations and eventually to provide risk estimates. The ultimate goal of this project is to design and implement appropriate exposure control strategies — such as technology, policy and training — in health care settings and to evaluate their effectiveness in mitigating risk to health care providers.
Mechanisms of topical calcipotriol mediated tolerance induction
Autoimmune diseases such as type 1 diabetes, lupus, and multiple sclerosis are a serious health issue in North America, affecting more than 22 million people in the US alone. Unfortunately, current treatment options for individuals suffering from autoimmunity are limited, and patients are often faced with the prospect of life-long drug regimens designed to suppress their immune systems. While effectively managing autoimmune diseases, these drugs can also hamper the body’s ability to defend itself against infection and cancer, substantially reducing a patient’s quality of life. T regulatory cells (Tregs) are a class of immune cell that prevent the immune system from attacking the body. Because Tregs can prevent autoimmune disease, many attempts have been made at designing methods to generate them. As of yet, no practical and reliable means of producing Tregs has been achieved. Previous research demonstrates that Vitamin D may play a role in the Treg production process. Paxton Bach is investigating whether applying Vitamin D to the skin can be used to generate Tregs, and early results are promising. Ultimately, this research could lead to more effective, less invasive treatments for individuals living with autoimmune diseases around the world.
Testing the neural mechanisms of face processing in individuals with Autism: An MEG study
Autism is one of the most common neurological disorder affecting children, boys more commonly than girls, and usually appears in the first three years of life. It is thought that this disorder changes the way the brain processes information, causing cognitive impairments, deficits in communication and social understanding, and unusual behaviours. As a result, individuals with autism have difficulty paying attention to, and making sense of, social situations. Faces communicate a lot of social and emotional information, and are important to everyday interactions. As children develop, they typically orient to others’ faces from birth, becoming experts at recognizing faces. Conversely, children with autism are impaired at recognizing faces and facial expressions. Jennifer Barrie is using magnetoencephalography (MEG) — a non-invasive type of brain imaging that measures magnetic energy in the brain during cognition — to determine how neural processing differs in people with autism from those without the disorder. Barrie is examining when and where brain activation occurs when both groups look at faces. She anticipates that people with autism see only elements of faces, while others see the entire face, making faces easier to recognize. Using MEG, Barrie will assess whether these developmental differences can be changed with training. If so, these findings could shape future training programs that would enable people with autism to learn how to better perceive faces, improving their social and emotional functioning and quality of life.
Determination of cleavage site specificity of matrix metalloproteases by assay of a peptide library generated by enzymatic digest of a complete or partial proteome
Mass spectrometry is a technique for separating and identifying molecules based on mass. It’s an important tool in proteomic investigations, the analysis of the whole set of proteins expressed in a cell. Recent advances in mass spectrometry have enabled the identification of thousands of unknown nd uncharacterized proteins. Many of these proteins are proteases, enzymes responsible for splitting specific peptide bonds (primary links of protein structures). Patrick Beaudette is studying a protease family known as matrix metalloproteases (MMPs). MMPs regulate a variety of cell processes, from the degradation of structural proteins to the activation and inactivation of cell signaling pathways. Proteins proteolytically processed under these circumstances can have implications in a variety of disease symptoms, ranging from inflammation to tumor growth. Beaudette’s research focuses on identifying the substrates (molecules upon which enzymes act) that a particular MMP protein splits, and the mechanism by which it locates these substrates within the cell. The research may lead to a fuller understanding of the function of the MMP family of enzyes and the role it plays within a cell. The findings could contribute to the design of inhibitors for MMPs for use in therapy of cancer and other conditions.
Genetic approaches to characterize mammary stem and progenitor cells
A stem cell can both self-renew and divide to form differentiated daughter cells. In adult tissues, stem cells have the ability to generate mature cells of a particular tissue through differentiation, and to do so multiple times. Such cells were recently identified in a mammary gland, and demonstrated their capacity to regenerate their structures in other breast tissues. This was an important discovery, as it is speculated that these stem cells are central to the development of breast cancer. Because stem cells are relatively long-lived compared to other cells, they have a greater opportunity to accumulate mutations leading to cancer. Also, these cells have a pre-existing capacity for self-renewal and unlimited replication. The idea that stem cells are inherent to malignant transformation has wide-stretching implications for therapeutics, particularly with regards to drug resistance. Angela Beckett is studying the growth and differentiation of normal breast stem cells, which will provide knowledge about what drives malignant transformation and how to prevent cancer initiation. By obtaining basic information on stem cell regulation, this research is taking an important step in designing novel therapeutic approaches to their malignant counterparts, cancer stem cells.
Characterizing the role of granzyme B in atherosclerosis and hair loss in apolipoprotein E knockout mice
Cardiovascular disease is the leading cause of death in Canada. Atherosclerosis is a cardiovascular disease, in which the inside of blood vessels contain fatty growths known as plaques. Over time, these plaques become unstable and can break, resulting in blockage of blood vessels. This can lead to heart attacks, strokes and limb loss. Wendy Boivin’s research explores what makes a plaque develop, grow, and become less stable. She is focusing on a protein called Granzyme B, which is known to cause plaques. What is unknown is which of two possible approaches Granzyme B uses to induce plaque formation and atherosclerosis: either by entering blood vessel cells and killing them, or by breaking down structural proteins in the blood vessel. Wendy Boivin is studying the role of perforin, a protein that is required for Granzyme B to enter into blood vessel cells. By conducting a study that observes what happens when perforin is removed from blood vessels, she can pinpoint the pathway Granzyme B uses to cause atherosclerosis. Ultimately, this study may contribute to new therapeutic targets for combating this disease.