Spinal cord injury (SCI) interrupts the flow of information between the brain and spinal cord. As a result, people with SCI experience muscle paralysis. They also experience changes in sensation, ranging from a complete loss of sensation to chronic pain. Dr. Matt Ramer’s research focuses on the sensory nervous system and how its changes due to trauma related to sensory dysfunction. In particular, he is interested in the balance between factors that promote or inhibit the growth of nerve fibres (axons). Dr. Ramer is investigating the effects of growth-promoting and growth-inhibiting molecules on the anatomy of spinal sensory axons, on their connectivity within and outside the spinal cord, and on behavioural outcomes resulting from spinal cord injury. This work will increase our understanding of sensory dysfunction and may identify new therapies for SCI.
Program: Scholar
The effect of resistance training on cognitive performance, cortical plasticity, and fall risk in women aged 65 to 75 years old: A 12-month randomized controlled trial
Falling and fall-related injuries among the elderly is a significant health issue for seniors in Canada. Older adults with cognitive impairment are at particular risk; 60 per cent fall annually, a rate that is twice that of their peers with normal cognition. Previous research has demonstrated that current falls prevention programs, such as multifactorial interventions, are ineffective in people with cognitive impairment. This suggests the need for an innovative approach to falls prevention in this group, such as targeting cognitive function itself to reduce falls. As a two-time MSFHR Trainee, Dr. Teresa Liu-Ambrose researched the effectiveness of exercise and rehabilitation programs for preventing falls in women at risk, and the specific dimensions of cognition associated with falls risk in older women. Building on this research, Dr. Liu-Ambrose is now investigating whether resistance training — a mode of exercise proven to reduce the physiological risk of falls in older adults — also benefits cognition. In her study of cognitively-intact women aged 65 to 75, Dr. Liu-Ambrose is determining whether a 12-month resistance training program improves high-level cognitive function. Using standard neuropsychological tests and brain imaging techniques, she will measure changes in cognitive performance and cortical function. She will also evaluate changes in physiological falls risk. Results from this novel study will provide valuable insight into the development of falls prevention programs that specifically focus on cognitive function in older adults.
Pre-eclampsia: Immunology, innovation and improvement
Pre-eclampsia is the most common dangerous complication of pregnancy, affecting the health of both mother and fetus. While high blood pressure in the mother and the loss of protein in her urine are the most visible symptoms of the disease, pre-eclampsia also causes inflammation and organ damage. The disease is a form of systemic inflammation, and is particularly dangerous when it occurs early in pregnancy. Dr. Peter von Dadelszen’s program of research covers a broad range of laboratory, clinical and health services research related to pre-eclampsia. He is studying the role of the immune system in the development and progression of the disease, as well as potential targets for the prevention of pre-eclampsia, and new screening techniques and predictive models. He is also researching new methods to modify pregnancy outcomes, including a novel disease-modifying therapy and development of a province-wide, structured approach to monitoring and managing pre-eclampsia. Through a greater understanding of the various facets of pre-eclampsia, Dr. von Dadelszen hopes to spur improvements in clinical care and health outcomes.
Using linked administrative data to understand the interacting effects of school readiness, family, neighbourhood and school characteristics on children's early academic achievement – enhancing the to …
There is a strong relationship between education and health. People with lower levels of education demonstrate poorer health, higher rates of health risk behaviours, lower rates of preventive health care use, and higher rates of early mortality. Thus, one important approach for reducing disparities in health is to enhance children’s opportunities for academic success. School readiness is the term used to describe a child’s preparedness at age five or six to take advantage of the learning opportunities offered in school. Encompassing physical well-being, motor development, emotional health, social competence, language skills, general knowledge, and cognitive skills, readiness to learn at school entry has shown a strong association with later academic performance. Dr. Susan Dahinten is determining the extent to which children’s academic success in Grade Four can be predicted by their school readiness in kindergarten, before and after accounting for other individual, family, neighbourhood, and school characteristics that may influence their development. The sample for this study includes BC children for whom school readiness was measured at kindergarten between 2000 and 2002. By anonymously linking this data with data from BC’s education database, and with census data describing the children’s neighbourhoods, she is investigating whether, and why, some schools may be more or less successful at reducing inequalities among students of different backgrounds.
Treatment readiness and motivation research: improving quality of care and health outcomes
Treatment refusal, dropout, and relapse are common in individuals with eating disorders, resulting in physical and emotional costs to the patient, societal costs to the community, and economic costs to the health care system. Dr. Josie Geller’s previous research has shown that a patient’s readiness to change is the best predictor of clinical outcomes in the eating disorders. However, there remains a need for validated assessment tools and guidelines to determine which patients are ready for what type of treatment; development and evaluation of interventions that enhance readiness for treatment; and dissemination of findings from this research to clinicians and to community support providers on the benefits of matching treatment to patient readiness. The primary objective of Dr. Geller’s research is to use a patient-focused approach that draws upon applications of psychological models of readiness and motivation for change to improve health service delivery, utilization, and quality of care. Her program aims to provide a set of guiding principles for efficient, cost-effective care that has broad applications to the health care system, including eating disorders, HIV, Hepatitis C, and other emerging priority areas.
Access to kidney transplantation in British Columbia and Alberta
In Canada, there are large regional disparities in the waiting times for kidney transplantation. Previous studies show that these disparities cannot be explained by differences in the rate of organ donation or the incidence of kidney disease; instead, they may be the result of practice differences in referral or acceptance of patients for transplantation. Unlike waiting lists for most other medical services, increased waiting times for transplantation are clearly associated with loss of life. Currently, there is no formal, national system to ensure that medically eligible patients have equal access to transplantation across Canada. Very little research has been conducted regarding regional disparities in access to transplantation. To gain insight into the cause of these differences, Dr. John Gill is following a group of new dialysis patients in BC and Alberta to determine if there is a difference in referral for kidney transplantation or acceptance for transplantation within one year of starting dialysis. He will investigate the reasons why patients who are medically eligible for transplantation may not be referred for transplant, and document provincial differences in the time required to complete the transplant assessment and to activate a patient onto the transplant waiting list. Ultimately, this research will contribute to enhanced patient and physician education, better implementation of protocols to ensure that patients are appropriately referred, and new strategies to minimize regional disparities between provinces.
The control of visual attention by the demands of locomotion – implications for movement disorders and their clinical diagnosis
For sighted individuals, normal everyday activities such as walking down a busy street or through a crowded grocery store are based on using vision to identify not just where one is headed, but what obstacles and hazards need to be avoided as well. While this ability to visually guide our actions may appear effortless, the task requires a complex coupling between the visual and motor systems. When disease or brain injury compromises these links between the visual and motor systems it becomes acutely obvious how much the brain is doing behind the scenes to promote normal motor behaviour. Most research on visual attention and its role in normal cognitive function has long centered on describing how it helps to recognize and identify objects in the visual world. Dr. Todd Handy’s research examines the reverse: the effect movements and locomotion have on vision, which is a previously unexplored facet of visual-motor interactions. Using a system that provides video-simulated motion and measurements of brain activity, Dr. Handy is studying how visual attention automatically responds to the many perceptual demands of locomotion – keeping track of the direction one is heading, recognizing stationary obstacles that may be looming in the path, and noticing moving objects in the periphery that may ultimately be on a collision course without conscious attention to these elements. Dr. Handy hopes his research will contribute to a better understanding of these visual-motor interactions and may provide a promising new method of diagnosing clinical motor disorders.
Relevance of the presynaptic protein Complexin II to schizophrenia
Schizophrenia and related forms of psychosis are among the most severe, persistent and debilitating illnesses affecting young people. A key priority in the treatment of this disease is the development of novel antipsychotic drugs to address common cognitive deficits resulting from schizophrenia, which include impairment of attention, memory and executive function. These deficits are identified as being the most serious symptoms of the disease, and the degree of severity is the best predictor of how well or poorly affected individuals will fare over the long term. Dr. Alasdair Barr’s current research is focused primarily on identifying brain cell alterations associated with schizophrenia that may contribute to cognitive deficits. His team’s previous work has shown that levels of two related presynaptic proteins, complexin I (inhibitory terminals) and II (excitatory terminals) are decreased in the frontal cortex and hippocampus. They also demonstrated that lower hippocampal levels of complexin II were associated with cognitive dysfunction, representing the first description of a relationship between abnormal synaptic function and cognitive function in schizophrenia. Dr. Barr’s current work is building on these findings to further understand the role of complexins in cognition and schizophrenia.
Job tenure of people with severe mental illness registered in supported employment programs
Although many people with severe mental health problems are ready and available to integrate into the competitive workplace, more than 80 per cent of this group are unemployed. For those who obtain employment, job tenure is typically brief, lasting an average of 3 to 7 months. Supported Employment (SE) programs have been developed to help people with mental problems obtain and maintain employment. Though these SE initiatives fare better than other vocational programs, they still encounter difficulties regarding implementation issues and individual differences in job tenure. Dr. Marc Corbière is evaluating the programmatic and individual components of SE initiatives in the Greater Vancouver area. He is interviewing SE program directors and employment specialists, and asking participants (300-400 people) to fill out questionnaires and tests. From these results, Dr. Corbière will create and evaluate a novel and integrated model of job tenure for people with mental illness, including the ‘best’ program services and individual components. Results of his research will bring a new understanding to the vocational rehabilitation field by determining the key factors for maintaining employment for people with severe mental illness.
Trajectories and predictive characteristics of treatment-relevant violence risk factors among persons with psychiatric illnesses
Statistics Canada figures show more than a quarter of a million violent crimes in Canada reported in 2003, with many more violent crimes unreported. Each violent crime leaves a victim potentially traumatized and physically injured, with resulting high costs to the health system. One target group for whom violence often is studied is people with psychiatric illnesses. Study results have shown an overrepresentation of violence among certain groups of people with psychiatric illnesses, and Canadian law requires that violence risk is assessed among people considered for release from psychiatric, forensic, and correctional agencies. Most of the resulting research, however, has focused on predicting violence among persons with mental illness, rather than on ways to reduce or prevent violent behavior. Dr. Kevin Douglas’ research focuses on treatment-relevant violence risk factors. His research objective is to identify those risk factors most likely to be responsive to treatment, with the goal of informing violence-reduction efforts. Dr. Douglas is following a group of people with mental illnesses released from forensic psychiatric and correctional facilities in British Columbia. They will be administered measures of promising treatment-relevant risk factors (such as poor social support, substance use, and anger) on multiple occasions in the community. From the results of this work, Dr. Douglas will discern which risk factors are most likely both to change and to predict violence. Results from his research may reveal promising treatment targets to reduce violence among this group of people.