Falls among older people are a major health problem. In Canada, hospital emergency departments report that 86 per cent of seniors’ injury-related admissions are due to falls, and individuals who present to an emergency department after one fall are at particularly high risk of falling again and incurring significant injuries. Current practice guidelines encourage a sophisticated and costly program to prevent subsequent (secondary) falls, including referrals to physiotherapy, ophthalmology, family practice and occupational therapy. However, despite the proven effectiveness of this approach, current “real life” practices throughout BC do not generally follow these guidelines, and the outcomes – both physical and economic – have not been studied in a Canadian context. Working within VGH’s Falls Prevention Clinic, Jennifer Davis is conducting the first Canadian randomized controlled trial to compare secondary falls and fall rate between seniors receiving “gold standard” care at the Clinic versus those receiving the standard of care with their GP. She will also detail health resource utilization for all study participants in order to analyze the cost-effectiveness of the Clinic intervention versus the standard of care.
Program: Trainee
Characterization of the function of the nuclear matrix protein Lamin A in the organization of telomeres and chromosomes to determine the role in the pathology of Hutchinson-Gilford Progeria Syndrome
Hutchison-Gilford progeria syndrome (HGPS) is a rare, fatal disease that affects children and causes accelerated aging. Symptoms include dwarfism, loss of body fat and hair, aged-looking skin, stiff joints and hip dislocation. Children with this disease usually die of a heart attack or stroke at an average age of 13. HGPS is caused by a mutation in the LMNA gene which encodes a protein called Lamin A. The mutation causes instability in the cell nucleus, which is believed to lead to the premature aging in HGPS. Michelle Decker is looking for differences in the way normal and mutant versions of the Lamin A protein interact with chromosomes in the cell nucleus. Research has shown that cells from patients with HGPS have shorter than usual chromosome ends (called telomeres) than are usually found in cells of other children. Telomeres normally protect chromosomes from degradation and instability. By improving the understanding of the role that Lamin A and telomeres have in Hutchison-Gilford progeria syndrome, Michelle’s research may contribute to new understandings and therapies for the disease.
Role of Myosin Va in trafficking of neuronal vesicles
Neurons (brain cells) are separated by gaps called synapses and communicate via mechanisms which enable them to send and receive signals across these gaps. Inadequate development and maintenance of synapses is associated with a number of neurological and psychiatric conditions, from epilepsy to anxiety disorders, autism and mental retardation. Neurons use axons and dendrites to communicate across synapses. Axons are long fibers that transmit impulses to other neurons. Dendrites form a network of branches that receive signals from other nerve cells. Newly-made proteins within neurons must be transported to appropriate sites in axons or dendrites for proper communication to occur. However, little is known about how these proteins are accurately relocated. Frederick Dobie is studying one of the molecules thought to be involved in protein transport (Myosin Va), which is widespread in the brain, to clarify its role in pre and post-synaptic communication. Research has shown that a mutation in Myosin Va leads to Griscelli Syndrome, a disorder which causes severe motor and neurological impairment in humans. Other CNS disorders may also result from malfunctions in intracellular transportation of the proteins that facilitate communication between neurons. A better understanding of the action of transport molecules may lead to better methods of treatment for neurological disorders.
Meiotic errors in spermatogenesis: the role of recombination and synapsis in male-infertility and the production of aneuploid sperm
About two per cent of men are infertile due to defects in sperm production. In most cases, the underlying cause is unknown. During sperm production, two similar chromosomes – microscopic bodies that carry heredity DNA – pair up and exchange genetic material in a process called meiotic recombination. Recent studies have shown that recombination rates are significantly reduced in infertile men. Infertile men are also more likely to produce sperm with extra or missing chromosomes (called aneuploid sperm). This aneuploid abnormality is the most frequent cause of miscarriage, and among live births, the most common cause of congenital malformations. Kyle Ferguson is using leading edge technology to determine if and how aberrant recombination causes infertility. He is also investigating the recombination patterns that lead to production of aneuploid sperm. This information will help identify genetic mutations that contribute to male infertility, and may lead to new therapies for the condition.
The relationship between emotion processes and health in children at-risk for the development of anxiety disorders
While feeling shy, uncertain, or apprehensive with strangers or in new situations is common in young children, an excessive display of these behaviours can negatively affect day-to-day functioning. Disruptions in friendships and social activities, decreased school attendance and performance, and increased family conflict are all common consequences of extreme shyness. Research shows that children who consistently respond in these ways are more likely to develop anxiety disorders later in childhood and adolescence. Furthermore, older children and adults who display this pattern of behaviour have more general health complaints and problems. Sherri Frohlick is conducting a study aimed at understanding the development of these general health complaints by examining the ability of preschool-aged shy children to understand and express different emotions, and determining the effect of this on their health status. Just as being able to identify and communicate different emotions is an important part of healthy psychological growth, not having these skills is linked to emotional and behavioral problems such as depression, anxiety, aggression or other serious forms of psychological dysfunction. By examining emotion identification and communication as processes underlying health complaints and problems in young children, Sherri is working to develop prevention and intervention programs that identify their needs more directly and lessen health concerns. A reduction in health complaints would lessen the burden on a health care system faced with the challenge of diagnosing and treating these problems.
The role of dopamine in learning and memory in Caenorhabditis elegans
Dopamine is a chemical (neurotransmitter) that transmits signals between brain cells. Dopamine is involved in motor control, emotion, motivation, cognition, learning and memory. Fluctuations in the level of dopamine in the brain is associated with many conditions that involve deficits in learning and memory, including schizophrenia, Parkinson’s disease, attention deficit-hyperactivity disorder (ADHD) and drug addiction. Andrew Giles is studying how dopamine acts to produce learning and memory in C.elegans, a microscopic worm with a nervous system similar to that of humans. Andrew is examining how changes in the levels of dopamine affect the completion of learning and memory tasks. This information will help explain how dopamine functions in human learning and memory, and its role in normal and abnormal behaviours. The results could support the development of new treatments for disorders involving memory and learning deficits.
Investigating Socio-Cultural and Structural Forces Affecting Sexually Transmitted Infection Testing and Treatment Among Youth in Northeastern BC
Despite public health efforts, sexually transmitted infection (STI) rates among young people are high and rising, with some groups of youth disproportionately affected. In particular, STI’s are a growing concern for youth living in northeastern BC’s oil, gas, and mining communities. These communities are experiencing rapid growth and social change, largely associated with an influx of young people attracted by the current economic ‘boom’ in the oil, gas and mining industries. Shira Goldenberg is investigating young people’s experiences accessing STI testing and treatment services in Fort St. John, British Columbia. She is examining how socio-cultural factors, such as social norms, gender, ethnicity, religion and structural forces, such as geography, economic restructuring, and public health service delivery mechanisms, affect young people’s experiences with STI testing and treatment. Shira will use this information to recommend ways public health planners can tailor STI interventions to improve the sexual health of youth in northeastern BC and other remote, resource-based communities.
Regulation of antibiotic resistance and virulence by two-component response regulators in Pseudomonas aeruginosa
The bacterium Pseudomonas aeruginosa is a major cause of hospital-acquired infections and chronic cystic fibrosis lung infections. This pathogen is difficult to treat because it has the ability to sense and appropriately respond to changing environmental conditions. For example, it can sense and respond to the presence of antibiotics by becoming resistant, making the eradication of established infections extremely difficult. P. aeruginosa infections in cystic fibrosis patients are almost always deadly. An underlying mechanism for antibiotic resistance involves two-component regulatory systems – containing a sensor kinase and a response regulator – that enable bacteria to sense and respond to environmental signals. Two of these regulatory systems within P. aeruginosa have previously been shown to be involved in antibiotic resistance. Jamie Gooderham is determining whether other closely-related P. aeruginosa two-component regulatory systems are also involved in virulence and antibiotic resistance. To do so, he is generating bacteria defective in these systems and studying their virulence, gene expression, and responsiveness to antibiotics. These studies will increase understanding of how this pathogen adapts to environmental signals to develop antibiotic resistance. Ultimately, this will lead to more effective P. aeruginosa therapies, improving treatment outcomes for infected patients.
Respiratory system limitations during exercise in women undergoing healthy aging
There is evidence to suggest that healthy men and women experience respiratory system limitations during exercise, such as respiratory muscle fatigue, a limited ability to exhale, and an abnormal exchange of oxygen and carbon dioxide in the lungs. Young active women may be particularly susceptible to these limitations due to their inherently smaller lungs and airways compared to men of equal stature. Unfortunately, there have been few studies aimed at understanding how the female respiratory system responds during exercise. Since healthy young women are predisposed to these limitations during exercise, then healthy elderly women may be particularly vulnerable due to the decline in lung function that occurs as a result of the normal aging process. This decline occurs because of a reduction in “elastic recoil,” which is the ability of the lungs to stretch and inflate. Jordan Guenette is studying the relationships between the respiratory system, exercise, gender, and healthy aging. His goal is to identify the respiratory limitations women face as they age. This information could be used to design exercise rehabilitation programs tailored to meet the needs of different patient populations.
SHIP Down-Modulation as a Potential Approach to Protect Hematopoietic Cells During Chemotherapy or Radiotherapy
Chemotherapy and radiotherapy are currently used to treat many types of cancer. However, these treatments are not ideal because they target all dividing cells, including both cancerous and healthy cells. Blood cells, for example, have a finite lifespan and new cells are continuously being generated in the bone marrow. Unfortunately, the high doses of chemotherapy or radiation necessary to destroy malignant cells also kill these bone marrow cells. This reduces the body’s ability to replenish healthy blood cells, leading to life-threatening side effects such as anemia, infections, and uncontrolled bleeding. In such cases, the chemotherapy or radiation dose must be reduced, which, in turn, reduces the likelihood that cancerous cells will be eradicated. Melisa Hamilton is studying ways to protect blood cells during cancer treatment, with a particular interest in understanding how the SHIP protein inhibits blood cell survival. Melisa wants to determine whether reducing the level of this protein can increase cell survival during treatment. This would enable patients to withstand higher doses of chemotherapy or radiation with fewer side effects and increase the likelihood of killing the cancer cells.