Approximately 4 percent of Canadian children are diagnosed with AttentionâDeficit/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.
Program: Trainee
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 doctorsâ 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, itâs 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
Itâs 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 âŠ
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 âecosocialâ 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 â 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 â 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.
Genetic Factors in Premature Ovarian Failure
Although the average age of menopause is 51 years, approximately one per cent of women will experience menopause before the age of 40, a condition known as premature ovarian failure. Working on the hypothesis that multiple genetic factors may combine and interact in a single individual to determine the rate of reproductive aging, Karla Bretherick is examining the molecular genetic differences between women with normal reproductive function and women with premature ovarian failure. She hopes her work identifying specific genetic factors that contribute to early menopause may lead to the development of both treatment options for affected individuals and predictive testing for those at risk.
Molecular Basis of Cancer Cell Invasion
Tumour invasion is the cellular process that initiates the spread of cancer cells from the primary tumour to new sites in a patientâs body (metastasis). Inhibiting this process is important, as solid tumours are much more readily surgically removed if metastasis hasnât yet occurred. Researchers have identified Dihydromotuporamine C (dhMotC) as a novel tumour invasion inhibitor that may have therapeutic potential. Lianne McHardy is investigating the molecular mechanisms of this compound, focusing specifically on how the protein SNF7 is involved in these mechanisms. SNF7 is normally required for the sorting of intracellular vesicles, which are a basic tool of the cell for organizing metabolism, transport, enzyme storage, as well as being chemical reaction chambers. Lianne will investigate a potential link between the mechanisms controlling vesicle sorting and the invasion abilities of a tumour cell. By pinpointing the mechanisms that allow for metastasis, her studies may aid in the development of dhMotC as a potential drug candidate for metastatic cancers.
Genetic determinants of the host response to infection in critically ill adults with systemic inflammatory response syndrome
Each year in Canada about 100,000 people develop sepsisâa severe illness caused by the presence of bacteria in the bloodstream. The condition causes blood pressure to drop, resulting in shock and may lead to multiple organ dysfunction and eventually death. With a mortality rate of 30 and 65 per cent respectively, sepsis and septic shock cause more deaths annually than heart attacks. Inflammation and immune response to infection varies greatly between patients. Some inflammation is a normal defense against infection. However, if inflammation is excessive, white blood cells and other cells can spill into the circulatory system and damage healthy organs. Continuing her previous MSFHR-funded research, Ainsley Sutherland is studying whether the genes that recognize bacteria and viruses play a role in determining which patients will develop the excessive inflammation that can lead to sepsis. This understanding could lead to the development of drug therapies for patients at higher risk of sepsis, and the avoidance of unnecessary drug side effects in patients who are not at risk.
Step towards the prevention of gastric cancer and ulcers: understanding the role of water in Helicobacter pylori transmission
Peptic ulcers affect approximately 3 to 5 per cent of the Canadian population. Helicobacter pylori (H. pylori)âa bacterium that causes chronic inflammation of the inner lining of the stomachâplays a key role in the development of peptic ulcers, chronic gastritis and gastric cancer. As H. pylori has been detected in water, drinking water may play a direct role in transmission of the bacterium. To date, minimal research has been conducted regarding the potential association between H. pylori infection and detailed water system characteristics, such as water source, treatment, well depth and aquifer. Neil Bellack is now conducting the first population-based research project that will examine the association between H. pylori infection and exposures to different water system characteristics, as well as other factors that may affect transmission of H. pylori such as sewage disposal methods and land use. Results from this study will identify the role that water systems and water quality play in the transmission of H. pylori, and point to potential mechanisms for blocking transmission of the bacterium and preventing infection.