Everyone is exposed to stressors in their personal and work lives. How people evaluate and deal with these stressors determines how well they cope, which has implications for their immediate and long term health. Stress can also be less direct, the result of witnessing severe trauma suffered by others, such as the 9/11 attacks on the World Trade Center in New York and London subway attacks in 2005. Research has shown this “vicarious trauma” can also have a substantial impact on health, from post-traumatic stress disorder to depression and persistent worry. Rajiv Jhangiani is studying how individuals react when exposed to trauma indirectly. He is examining how people process information, react emotionally, and make decisions during their exposure to vicarious trauma. Jhangiani is assessing how certain factors influence this reaction and ability to cope, such as identifying with victims, the degree of uncertainty about the situation, information overload, and resilience. This information will help identify how individuals and health and social service providers can support healthy ways of coping with vicarious trauma.
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Female sexual arousal disorder subtypes: Conceptualization, diagnosis and treatment
Sexual dysfunctions play a significant role in depression, anxiety, stress, and marital/relationship satisfaction. Female Sexual Arousal Disorder (FSAD) affects approximately 1/4 of women aged 18-59. However, there are no established treatments for this disorder, with drug therapy trials yielding inconclusive and contradictory results. Recently, researchers and clinicians have disputed the current classification of FSAD as it only involves impairments in physiological sexual arousal and ignores the subjective aspect that the majority of women report. As a result, experts in the field have proposed a new classification involving three specific FSAD subtypes. Building on her research as a MSFHR-funded Master’s student, Carolin Klein is conducting a series of three experiments using alternative modes of activating the sympathetic nervous system to extend and replicate previous findings on these subtypes of FSAD. Carolin aims to better understand sexual functioning and the relationship between physiological and subjective sexual arousal in women in order to improve treatments. If further research continues to support the delineation of FSAD into separate subtypes , it may explain why treatments that increase physiological arousal appear to have no, or only a minimal effect on subjective arousal, and vice versa. Accordingly, separate treatments will be needed depending on the FSAD subtype.
Understanding the Day-to-Day Process of Stress and Coping Among Both Individuals with Spinal Cord Injury and Their Primary Emotional Support Providers: Effects on Health, Mood, Functional Ability, and …
Approximately 4 percent of Canadian children are diagnosed with Attention–Deficit/Hyperactivity Disorder. Their symptoms pose significant coping challenges for the child as well as for the parents and are often comorbid with other mental health problems. Indeed, the greatest impairment appears to occur in families of children who have not only ADHD, but also comorbid disorders. However, family factors associated with disorders comorbid with ADHD have received relatively little attention in past studies, with most studies focusing on comorbid oppositional or conduct problems, and few studies examining comorbid anxiety disorders in children with ADHD. Sharon Lee is studying parenting practices associated with childhood ADHD and co-occuring anxiety disorders, She will be comparing parent-child interactions in children with ADHD and comorbid anxiety, children with each disorder alone, and a control group. Analyses will examine how parental responsiveness relates to child comorbid anxiety over and above parental levels of anxiety. This research will help us to understand how parenting style may be related to comorbid anxiety in children with ADHD and such knowledge will be useful in tailoring the empirically-supported parenting interventions used for childhood ADHD to more fully account for the presence of comorbid anxiety.
Exposure to Residential Air Pollution and Diagnosis of Acute Otitis Media During the First Two Years of Life in British Columbia, Canada
Middle ear infection, or otitis media, affects up to 80 per cent of children in North America and is the leading reason children under three visit the doctor, take antibiotics, or have surgery. The costs associated with doctors’ visits, prescriptions and parental work leave are considerable. Elaina MacIntyre is continuing her earlier MSFHR-funded research investigating whether exposure to air pollution increases the risk of middle ear infection in children. The condition is a common complication of upper respiratory tract infections. Since air pollutants irritate the upper respiratory tract, it’s plausible they could play a role in middle ear infections. Recent studies in Europe have found an association between living in areas with high air pollution and the incidence of middle ear infection, but this relationship has not been previously examined in North America. MacIntyre is conducting the first North American study to analyze whether this type of infection is linked to exposure to air pollution from industry, traffic and wood burning sources. Results of her study could be useful in assessing the public health impact and health care costs of middle ear infections, and in helping reduce the incidence through strategies to prevent or limit environmental exposure of young children to environmental conditions that contribute to the development of these infections.
Wheelchair use by nursing home residents: An exploration of the relationship between wheelchair use, activity participation and quality of life
It’s been estimated that more than half of nursing home residents use wheelchairs as their primary means of mobility. But little research has examined wheelchair use within facility settings. A few studies have shown that nursing home residents experience a variety of wheelchair-related problems, such as wheelchair discomfort, immobility, poor posture, and dysfunctional wheelchairs. As well, rather than facilitating independence, wheelchairs may be used as restraints. William Mortenson is conducting a two-phase study on wheelchair use in nursing homes. In the first phase, Mortenson will explore the overall impact of wheelchairs and wheelchair seating on nursing home residents through interviews and observations. In the second phase, he will identify factors that predict wheelchair mobility and investigate the relationship between wheelchair use, activity participation and quality of life amongst nursing home residents. He has three goals for the study: to improve understanding of how the nursing home setting influences the availability of wheelchair equipment and impacts the use of wheelchairs; to improve opportunities for residents to access wheelchairs; to support lobbying for better funding for wheelchairs and wheelchair services. He also hopes his research will ultimately contribute to the health and quality of life of facility residents through the development of an intervention program, which could improve wheelchair-related institutional policies and practices for this increasing segment of the population.
Adjusting for missing information in multilevel models with a non-binary response: identifying socioeconomic, cultural, demographic and clinical predictors of end-of-life health care service …
Many Canadians believe that equal access to health care is a fundamental right; however, evidence suggests that people experience unequal access to end-of-life care. For example, approximately 70 per cent of cancer patients die in hospital. Although little is known about Canadian preferences, international studies suggest people prefer to die at their home. Socioeconomic status is known to play a role in explaining health inequities. Michael Regier is examining whether the impact of the Canadian cultural mosaic (ethnic groups, languages and cultures that interact within Canadian society) on the use of health services is more complex than socioeconomic status alone. Each culture has its own expectations for health services, so the health system must be flexible enough to integrate various cultural understandings of health, but uniform enough to reach everyone. Regier is studying how additional “ecosocial” factors like ethnicity, language, family structure, religious beliefs and acculturation contribute to the way individuals and communities understand and use health care. He is investigating the place of death for cancer patients in BC from this perspective to determine differences in health determinants for end-of-life care. Health planners can use this information to improve access to end-of-life care across cultures, geographic areas and socioeconomic differences.
Early diagnosis of compartment syndrome following tibial fractures using Intra-Compartmental Pressure Monitoring, near infra-red spectroscopy and plasma ischemic markers
Fractures of the main bone in the lower leg, known as the tibia, cause local bleeding, and tissue swelling within the compartments of the leg. In some patients, pressure within the compartments rises sufficiently high to prevent blood flow and cuts of the oxygen supply to intracompartmental muscles, nerves and other tissues. This condition is known as acute compartment syndrome. It is a surgical emergency and requires immediate identification and surgical treatment to save the function and viability of the lower leg. Delay in diagnosing this condition exposes the patient to increased risk of local muscle loss and a wide range of severe complications which requires multiple surgical procedures, prolonged hospitalization and even amputation of the affected limb. At the present time, diagnosis of acute compartment syndrome is mainly based on the clinical observation which is not always reliable and early. Measurement of intra-compartmental pressure can help to confirm the diagnosis but requires an invasive procedure which has some drawbacks. It is believed that direct monitoring of muscle oxygenation may provide early and precise diagnosis of this condition. Near infrared spectroscopy (NIRS) is a noninvasive and continuous method for monitoring tissue oxygenation. Babak Shadgan, a sport medicine researcher, is studying whether careful monitoring of lower leg muscle oxygenation in fractured leg patients who are in a higher risk of acute compartment syndrome may allow for an early diagnosis of this critical condition. If effective, this new method would improve speed and accuracy of diagnosis, leading to improved care for patients and substantial health care cost-savings.
Mechanism of androgen regulated expression of SESN1, a potential tumor suppressor
Male sex hormones (androgens) regulate tumour growth in prostate cancer. The only effective treatment for advanced prostate cancer is the removal of androgens using medication, or the surgical removal of the testes — treatments that cause impotence and a decreased sex drive. The results are usually temporary since some tumour cells survive, become independent of androgens, and continue to grow. Prostate cancer cells depend primarily on the androgen receptor, which encodes genetic information, for growth and survival. Gang Wang is studying how the androgen receptor decreases the expression of the SESN1 gene — a gene that may inhibit the growth of prostate tumour cells. Wang believes the SESN1 gene is no longer repressed when patients receive hormone therapy. This would explain the initial suppression of prostate cancer cells seen in these patients and the subsequent reappearance of cancer cells which later follows. Wang will confirm if the androgen receptor begins lowering the gene following therapy, allowing the cancer cells to grow. If so, the SESN1 gene could be a promising therapeutic target for treating prostate cancer.
The Genetics of Asthma, Atopy and Allergic Diseases
My research focuses on trying to identify why some children get asthma and others do not. By identifing specific environmental and genetic risk factors and determining how they work together to predispose children to developing asthma and other allergic diseases we can design better treatments. Studies have found a 1-in-5 risk of developing asthma if one parent has asthma. The odds rise to 2 out of 3 if both parents have asthma. However, in itself, a genetic predisposition does not ensure that asthma will develop. Asthma and allergic disease are the result of both genetics and the environment. The interaction between a genetic disposition and environmental factors is key in the development of – or in protecting against- asthma. I will use information from 250 French Canadian Asthma Families and two additional birth cohorts, and information from the town of Busselton Australia in my research. Home visits were conducted for all the families and children to collect information on environmental factors such as family history, number of children, parental occupations, daycare, pets, dust samples, infections, hospitalizations and medication usage. After reviewing the literature we have found 162 genes which may predispose children to developing asthma and we will be looking at these genes in conjuction with other environmental factors to try and better understand why some children develop asthma and others do not. Using statistical models we will look at what genetic and environment factors best explain why some children develop asthma and others do not. We will then do further laboratory experiments to try and identify these factors work together.
Optimal, evidence-based use of vaccines
Immunization is one of the most powerful tools available in medicine. The number of available vaccines expands each year, reducing infection and disease. Optimal use of these new products can be hampered by gaps in understanding the disease epidemiology, vaccine effectiveness or longevity of protection provided. These gaps also affect decision-making related to resource allocation and prioritization of immunization programs. Dr. Jan Ochnio is working to close these gaps by gathering missing evidence to facilitate vaccine use in several viral and bacterial infections. As a MSFHR Scholar, Ochnio investigated the risk of hepatitis A for children in specific areas of the province. Now, his research is focusing on two areas: investigations of hepatitis A virus infections using population-based assays and saliva/mail-based surveys, and optimizing prevention of meningococcal infections by measuring the levels and duration of protection offered by the various meningococcal immunization schedules in Canada. A better understanding of the most efficient strategies for using vaccines could lead to substantial savings in health care by omitting unnecessary doses and the related costs of providing these doses. Ochnio’s findings will be shared with public health policy experts to be used in finely-tuned vaccination programs and policies that will provide optimal protection for Canadians.