In 2000/01, approximately 264 000 Canadians required a wheelchair for mobility. Independence with mobility is important for day-to-day living, social activities, and overall quality of life. However, although wheelchair skills training has become much more prevalent in the past decade, more than half of Canadians using a wheelchair are not independent and require assistance with their mobility. One factor that has not yet been explored by research is the impact of confidence on a person’s mobility and independence. Confidence contributes to the acquisition of knowledge and refinement of new abilities. It also influences an individual’s choice of activities, motivational level, effort, resilience, life choices, and perseverance in the face of difficulties. Preliminary research suggests that confidence may affect wheelchair mobility, but there is currently no tool to assess or address this important factor. Paula Rushton is developing and validating an assessment tool to measure wheelchair skills confidence. The creation of this tool involves input from occupational therapists, physical therapists and physicians, as well as wheelchair users in the community. The second phase of her project will involve testing the tool with one hundred community dwelling wheelchair users. The creation and validation of this tool is an important first step in developing treatment strategies that could address low confidence with wheelchair mobility. Ultimately, this work could result in better mobility and independence for people who use wheelchairs, and a decreased burden on the health care system and on caregivers.
Program: Trainee
Motion perception deficits in children with amblyopia: a functional MRI investigation
Amblyopia – commonly known as “”lazy eye”” – is a developmental disorder that causes poor vision in one eye compared to the other eye. Amblyopia can arise from an inward or outward turn of the weaker eye. This prevents both eyes from working together to form one image and results in double vision. It can also arise when one eye has much better focus than the other eye. In both cases, as the brain matures it will begin to ignore the image coming from the weaker eye, eventually causing vision in that eye to deteriorate. Regardless of how amblyopia arises, the most common treatment is to place an eye patch over the good eye. This forces the maturing brain to start using the weaker eye, so that vision in this eye will “”catch up”” to the vision of the good eye. This form of treatment has been very effective in treating some cases of amblyopia, but not other cases. Currently, eye care professionals primarily use letter charts to assess how the ability to process form is affected in amblyopia. Research over the years has found that in addition to abnormalities in processing form, there are also abnormalities in motion processing. Typically, eye care professionals do not assessmotion perception, so any abnormalities in motion processing that may develop currently do not get treated. Using functional magnetic resonance imaging (fMRI), John Secen is looking at differences in brain activity between children with and without amblyopia as they perform a motion processing task. This research will improve upon the current understanding of the neural basis behind motion-processing deficits in amblyopia, and hopefully, this knowledge could lead to the development of new screening techniques so that these abnormalities in motion processing can be detected and treated.
Examining the link between cognitive deficits in the elderly and suboptimal activity of the locus coeruleus-norepinephrine system
A working brain produces electrical activity that can be recorded at the scalp. An event-related potential (ERP) is a characteristic electrophysiological response to any specific category of stimulus or event. The P300 is an ERP associated with stimuli that must be attended. It has been suggested that the P300 may be a manifestation of functioning in the locus coeruleus – norepinephrine system (LC-NE system), a neuromodulatory system that is associated with arousal , vigilance and attention. A link has been suggested between cognitive deficits in the elderly and suboptimal activity in the LC-NE system. Christopher Warren is attempting to demonstrate the link between the P300 and the LC-NE system, and describe the related changes in the brain that occur with age. He is assessing the performance of elderly participants on a specific attentional task, while simultaneously recording the electrophysiological activity of their brain using electroencephalograph recording equipment. The data will be compared with a control group of younger participants. Chris is looking for specific, key differences in electrophysiological activity and behavioural performance between elderly participants and controls, which will support the link between the LC-NE system and the P300, and will allow inference as to how the LC-NE system is behaving in the elderly participants.. Chris’s results will describe, and possibly implicate suboptimal function of the LC-NE system in cognitive decline with age. This research has direct implications for understanding the cognitive decline associated with healthy aging, potentially describing the function and malfunction of the LC-NE system in aging populations. It could also generate a model that could be applied to understanding LC-NE function in people with attention deficit/hyperactivity disorder, dementia, schizophrenia, or traumatic brain injury. A comprehensive theory of the LC-NE system could inform the development of clinical strategies and tools to help elderly citizens effectively work around attention-related cognitive deficits that occur with age
Stress-hormone production and health: the importance of forgiveness
When they are functioning well, intimate relationships contribute to better health and increased longevity. A cornerstone of well-functioning relationships is the ability to forgive a partner for relationship transgressions, such as telling lies, flirting with another person, or saying hurtful things. Repairing a relationship following the hurtful actions of one partner has consequences, not only for relationship quality, but also for physical health. One way that the act of forgiveness may be associated with health relates to cortisol production. Cortisol is a hormone released by the adrenal gland during times of stress. Chronic elevations of cortisol have negative effects on cardiovascular, immune, and brain systems and potentially increase the risk for diabetes, hypertension, immune system deficiency, and other illnesses. Being unforgiving has been shown to produce cortisol in a similar pattern to that which is experienced during other stress responses. Kim Watt is examining whether cortisol production is a mechanism for the link between forgiveness and general physical health. She is conducting her study with 200 newlywed couples, recording their physical health and measuring their cortisol levels at baseline and following a set of emotionally stressful marital discussions. Results from this study will contribute to a clearer understanding of the risk pathways by which negative relationship processes may lead to poor physical health. This may suggest that a focus on strengthening close relationships by improving couples’ skills when discussing relationship issues is a way of ultimately reducing health problems.
Modeling Dynamical Neural Activity of Magnetoencephalography Measurements using a Real Time Hardware Phantom
The acts of perceiving, thinking, doing or feeling are marked by complex patterns of electrical activity in the brain. Dysfunction in neuronal activity is observed in many diseases and conditions, including epilepsy, dyslexia and Down syndrome. Magnetoencephalography (MEG) is a leading edge technology that images functional brain activity in the human cerebral cortex. The MEG installed in the Vancouver/Burnaby (V/B) MEG laboratory contains an array of 151 sensors configured to record minute magnetic fields that are generated when neurons depolarize in the brain. MEG is used to study neural patterns and pathways using human subjects. However, creating a phantom model to artificially activate sequences of simulated neurons in realistic patterns could help researchers explore dynamic neural networks in more detail. Using a phantom model would allow for more complex studies of brain activity and would also allow researchers to test what happens when pathways are “virtually” altered or severed. Using neuroscience, physics and engineering, Teresa Cheung is developing a phantom model of the cerebral cortex. She will use a series of magnetic dipoles to simulate the brain’s magnetic fields and write the software to control the activation of these fields. By creating a model that accurately simulates brain activity in healthy and dysfunctional states, Cheung’s research will help researchers better understand the complex workings of the brain.
The impact of therapeutic design on social engagement among residents with dementia during programmed activities in dementia care units
Dementia special care units (SCU) and freestanding special care facilities (SCF) for people with dementia are built using design principles that have been shown to enhance quality of life and reduce responsive behaviours that often occur when residents are disoriented or overstimulated by their surroundings. More supportive environments in these facilities are created through smaller unit sizes, homelike ambience, increased wayfinding, smaller activity spaces, and access to safe and secure wandering paths. Architectural planning and design features can improve the physical context where programmed activities such as music therapy, exercise sessions, creative arts, and therapy gardening occur. However, these specially designed spaces offer few therapeutic benefits without appropriate staff resources and family involvement to make the programs succeed, and consideration must be given to the combined effects of physical design, programs and policies, and staffing issues. Few studies have systematically assessed how modifications to the physical environment work in concert with social and organizational factors to enhance opportunities for residents to engage in positive social interactions through meaningful programmed activities. Krista Frazee is exploring the impact of the physical and social environments of care settings on residents’ social engagement during programmed activities in SCUs and SCFs, versus traditional integrated care facilities. She will also assess staff and family caregiver perceptions of activity spaces in helping them provide meaningful planned activities for residents. The findings from this study will be used to inform architects, interior designers, facility administrators and staff in various ways they can support the care and quality of life of residents with dementia through the integration of physical design and programmed activities.
CD-based ELISA for point-of-care diagnostics
Current methods of medical diagnostics, such as imaging and laboratory tests, tend to be time-consuming, labour intensive, and often limited to biomedical laboratories or hospital settings that have specialized equipment. In contrast, point-of-care diagnostic tools allow testing and diagnosis to be performed in a doctor’s office, at a significantly reduced cost and in a shorter time to obtain test results. This contributes to faster treatment decisions and better follow-up post treatment. The enzyme-linked immunosorbent assay (ELISA) is a popular tool for analyzing environmental or biomedical samples. The ELISA method uses a number of biochemical steps to detect the presence of a specific protein (such as an antigen or antibody) in a sample on a microscope slide, which is read by a robotic spotter or microplate reader. Preliminary research has suggested that these bioassays could be prepared on the surface of a compact disc (CD), and the results could be read by a standard computer drive equipped with special software. With commercialization, this method would undoubtedly reduce the cost of biomedical screening. Miao-Ling Ou is developing a diagnostic assay for detecting thrombin using this CD technology. Thrombin is a blood clotting factor that is the focus of many research studies on anticoagulation and cardiovascular disease therapy. Once fully developed, this CD-based ELISA method could be extended to other types of biomolecular interactions, such as those used in the screening of gene mutations or antibody-antigen interactions.
An examination of internet use for health information among Canadian baby boomers using the 2000 general social survey
The internet is a powerful health promotion tool, and it’s predicted that this technology has the potential to influence the way health information and services are distributed and accessed. Baby boomers (those born 1946-1965) are a prime target for this type of health promotion technology, since they have been exposed to the growth and widespread use of the Internet. Additionally, baby boomers are more concerned about healthy lifestyles and healthy aging than previous generations, are more interested in self-help resources, and are more demanding of good service. While previous research has found a high percentage of internet access and use among older Americans, no surveys have been carried out in the Canadian context. With the proper education and tools, baby boomers can not only delay functional loss, but improve their current health status and prevent the onset of several chronic illnesses and disabilities that begin to appear in mid-life. Providing them with appropriate, targeted resources requires knowledge about current utilization trends, needs, barriers and other concerns that could be hindering them from seeking online information regarding their health. Danielle Sinden is using national data gathered as part of the 2000 General Social Survey to examine trends, types, and levels of access to the Internet. She is also exploring predictors of health information-seeking behaviour, including sex, socioeconomic status, living arrangement/marital status, foreign-born status, region of residence, and perceived barriers and usefulness. Sinden’s research will lay a foundation of knowledge for developing online health promotion strategies targeting modifiable risk factors for baby boomers. Ultimately, this could lead to more favourable long term health outcomes that contribute to healthy aging.
Polysubstance use: psychosocial functions of combined use of alcohol and psychostimulants
Much of the research that informs current understandings of drug and alcohol use and addictive behaviour is based on studies that concentrate on a single substance type. This narrow focus is in distinct contrast to actual patterns of use and related harms: most Canadians with substance use problems use more than one substance (polysubstance use), often on the same occasion, and their behaviours and health outcomes may be strongly shaped by this combination. Health policies and programs are usually developed, implemented and evaluated one substance or behaviour at a time, without consideration of possible consequences for other substance use and addiction outcomes. In the current research literature there is a lack of information regarding polysubstance use. This includes when, in what order, and in what quantities people use substances, why they choose to use simultaneously, and the risk behaviours (e.g. sexual behaviour, spending behaviours) associated with simultaneous polysubstance use. Kristina Brache is exploring the patterns of use, the settings and the motivations associated with combined use of alcohol and psychostimulants (cocaine, amphetamines). She is conducting a series of in-depth interviews and self-administered surveys of 150-200 substance-using individuals in a treatment setting. Understanding the use of multiple substances can inform prevention and intervention strategies to reduce harm or risk to individuals using multiple substances. Ultimately, this research could improve health and health delivery systems by informing policy, programs and treatment about combined drug use in this population of interest.
Exposure to asbestos in the slums of a sub-population of migrant ship dismantlers in Bangladesh
“Shipbreaking” is the dismantling and recycling of obsolete vessels, their hulls and superstructures. In Bangladesh, this work is carried out on beaches. Salvaged items are resold in local markets and workers and their families live in adjacent slums. Ships often contain hazardous substances such as polychlorinated biphenyls, heavy metals and asbestos, which are all recognized carcinogens. Most work is done without adequate training or protection, and there is high potential for exposures to toxic materials in the shipyards, shops and the community itself. According to the International Labour Organization, shipbreaking is one of the world’s most dangerous occupations. On average, one worker dies every week; the long-term consequences of mortality due to cancer and other chronic illnesses are unknown. Few studies have been performed in Bangladesh on the environmental impact of dismantling ships, the health of shipbreakers, or the impact on the surrounding community and maritime environment. Working in collaboration with local university and non-governmental organization researchers, Midori Courtice is measuring the concentration of asbestos in workers’ living quarters, in shops selling salvaged items, and in areas downwind of ship-dismantling operations. She will interview people about their knowledge, attitudes and practices with respect to their handling of, and hazards associated with, asbestos. Courtice’s findings will be made available to the participants and the local community, and her recommendations could inform local workshops on hazards and reducing risk. Her work will also provide the basis to approach policy makers and strengthen the link between research and policy, to raise awareness of personal health and safety among workers, and to build local capacity for future research on sustainable solutions related to the shipbreaking industry.