Since the emergence of the population health field in the early 1990s, evidence has mounted demonstrating that health is more than simply a product of health care, biology and lifestyle. Indeed, population health outcomes are influenced by a multitude of factors, including employment, income, education, social supports, physical environment and early childhood development. Taken together, the social determinants of health (SDOH) provide a useful model for understanding the complexity underlying population health inequalities, and for formulating policy responses to address such inequalities. Despite relatively widespread acceptance of this model within academic and health policy circles, there are tremendous barriers to developing public policies and services designed to address health inequalities. These barriers include resistance to inter-sectoral collaboration within federal and provincial governments, as well as inadequate resources for inter-agency collaboration between community-based service providers. Patricia Collins is exploring awareness and application of the SDOH model among municipal politicians and community-based service providers, to determine if awareness translates into action to improve health outcomes. She is also exploring how print media present broader notions of health and well being, such as the social determinants of health, to the public. Patricia’s research will identify where more information on the SDOH model is needed, and how the model can be used to alleviate health inequalities in the GVRD.
Research Location: Simon Fraser University
P21-activated kinases role in epithelial morphogenesis and cytoskeletal polarity
Cell shape and cell movement play vital roles in organ formation and the sculpting of body shape in the development of multicellular organisms. The Rho family of small GTPases are key regulators of cell shape and cell movement through their participation in signaling pathways involved in a variety of cell processes. These proteins function as “molecular switches”, with the ability to alternate between active and inactive states. Malfunction of these switching mechanisms has been implicated in a variety of disorders including cancer, and a number of inherited conditions such as X-linked mental retardation and faciogenital dysplasia (Aarskog syndrome). These proteins have also been shown to be key regulators in wound healing. The p21-activated kinases (Paks) are proteins that have been shown to alter activity of the Rho GTPases Cdc42 and Rac, and are linked to the regulation of the actin cytoskeleton. Previous studies have demonstrated Pak’s function in the establishment of cell shape and movement via regulation of the actin cytoskeleton. However, the exact nature of Pak within the signaling cascade remains unclear. Ryan Conder’s recent studies have suggested a role for Pak in either the establishment or maintenance of specific membrane surfaces of a cell that are required for tumor suppressor proteins to position themselves properly. Using Drosophila (fruit fly) developmental processes as a model system, Ryan is studying the proteins involved in these signaling networks and establishing the mechanisms by which these developmental processes are regulated. He hopes that what he learns about these signaling pathways in Drosophila will shed light on their roles in human development and disease.
Neuromuscular versus behavioral influences in control of postural stability in elderly women
Falls are the leading cause of injury and injury-related deaths in elderly people. Impaired muscle strength, joint movement, balance, gait, vision, hearing and cognition predispose people to fall. But efforts to predict and prevent falls based on these risk factors have met with limited success. Fabio Feldman is comparing how people with a history of falling and non-fallers control their movements. Motor and cognitive functions may decline as people age. Fabio is investigating whether a tendency to attempt movements that exceed motor capacities, due to an exaggerated perception of physical abilities, is an important cause of falls in the elderly. He is measuring motor capacity for balance, reaction time, flexibility and strength in fallers and non-fallers. The research could lead to better tools for predicting and reducing risk in elderly individuals at high risk for falls. The results could also be applied in other areas, such as assessing driving abilities of the elderly and physical rehabilitation following a stroke or injury.
Role of sodium permeability and pore structure in determining differences in the rates of voltage dependent opening and closing in hyperpolarization-activated Cyclic Nucleotide-gated (HCN) channels
The pacemaker cells of the heart are a small group of cells that beat spontaneously and set the beating frequency. On the surface of these cells are “pacemaker channels”, which open and close to allow potassium and sodium ions into the cells. The flow of these ions into the cell generates the spontaneous beating in the heart. The speed at which ions flow through the channels regulates how fast the pacemaker channel opens and closes, which in turn can affect heart rate. During exercise and stress, the amounts of these ions in the blood change and may affect the rate at which these channels open and close, leading to irregular heart beat. For a small group of people with heart disease, an irregular heart beat can be dangerous and potentially fatal. Vincenzo Macri is working to determine how the function of pacemaker channels are affected by the flow of sodium and potassium ions. He is using several molecular and cellular experimental approaches, such as patch clamp electrophysiology, DNA mutagenesis, cell culture and cellular imaging to learn about the structure and function of this important protein. By understanding how this process works, he hopes his research may lead to therapies that target these channels to control the onset of irregular heart beats.
Molecular characterization of a phosducin-like protein and its co-operation with the protein folding machine CCT
Each year millions of people worldwide are diagnosed with diseases related to disordered protein folding. Normally, protein chains fold into a defined shape in order to function properly and when this process is disrupted, diseases such as Huntington’s, Alzheimer’s, cystic fibrosis and some forms of diabetes occur. The regulators of protein folding are called molecular chaperones, and as the name implies they have an important, but not well understood, assistive role in the process. Many molecular chaperones are essential for a cell’s survival. Some chaperones have been directly linked to the causes of genetic disorders involving misfolded proteins but others have been shown to be involved in slowing and preventing neurological diseases like Alzheimer’s. Peter Stirling’s research focuses on a protein called phosducin-like protein 3 (PhLP3), shown to be involved in facilitating protein folding as it interacts with an essential chaperone called CCT. Peter aims to understand how PhLP3 affects protein folding and what functional consequences the PhLP3-CCT interaction has. Peter’s research will help answer fundamental questions about how cells efficiently generate and maintain properly folded proteins, which will ultimately help to better understand what is happening in a cell when protein folding is disordered. His results may eventually lead to better treatment for diseases associated with protein misfolding.
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.
Investigating the molecular basis of collagen's finely tuned stability with single-molecule manipulation techniques
Collagen is the fundamental structural protein in our bodies, which means changes in its chemical composition can have profound, widespread effects on health. For example, connective tissue diseases, the leading cause of disability and absence from work in Canada, can be caused by a change affecting only one position out of 1000 in the DNA sequence that codes for collagen. As we age, collagens in our body tissues become chemically modified, leading to structural changes that result in weakening of bone structure and the deterioration of joints, arteries and the retina, a situation that is exacerbated by diabetes. The controlled production and degradation of collagen is important for normal embryo development; a breakdown in this controlled pathway is also associated with the spread of cancerous tumors in the body. All of these health-related problems are related to chemical changes in collagen, which lead to changes in its structural and elastic properties at the tissue level. Dr. Nancy Forde is studying the elastic properties and stability of single collagen molecules, to identify the relationship between chemical changes and changes in the structure and function of collagen. Her team is employing the world’s smallest tweezers, optical and magnetic tweezers, to grab, stretch and twist single collagen proteins. This special equipment is currently applied to protein study at only a handful of labs worldwide. Dr. Forde and her team are directing their efforts to better understand how changes in collagen at the molecular level affect the elastic and structural properties of tissues. This research could help explain how tissues deteriorate with age, as well as the impact of these changes on the development and severity of diseases such as cancer and diabetes.
Understanding community capacity in mental health reform through an examination of the gendered dimensions of the Riverview redevelopment process in British Columbia
Recent mental health reforms in British Columbia have resulted in a shift in the way services are delivered to people with serious and chronic mental health problems. Specifically, the main source of care for people has shifted from the provincial psychiatric hospital (Riverview Hospital) to smaller care facilities located in various regions throughout the province. Dr. Marina Morrow is studying the impact of these service changes on various groups affected by deinstitutionalization by examining the experiences and needs of recipients of mental health services, family members of people with mental illness, mental health care providers, administrators, advocates, and community members. Dr. Morrow is particularly focussing on issues relating to gender, and how the needs of women and men leaving Riverview Hospital might differ. Dr. Morrow is also examining the capacity of the current mental health system to respond to individuals, that have been newly discharged from Riverview, to ensure their successful integration into communities, and how the system can provide community-based support to individuals who become ill in the future. Dr. Morrow hopes the results from her research will contribute to improving the mental health care system’s response to people with serious and chronic mental health problems so that they can live full and productive lives in their communities.
Understanding the role of cryptochromes in human circadian phototransduction
The human eye is much more than the organ of vision. In addition to the machinery of the eye that allows us to see, the retina also houses photoresponsive molecules (photoreceptors) that mediate non-visual, light-driven signaling pathways. Our biological clock is regulated by the input of these light signals, including the circadian (24-hour) oscillation of our biochemistry, physiology, and behaviour. Many human functions rely on circadian rhythm and its accurate synchronization with the outside world by light (circadian phototransduction), including sleep, hormone regulation and brain function. Despite its central role in human health, however, virtually nothing is known about circadian phototransduction, including the light-driven events in a key photoreceptor called cryptochrome. Dr. Melanie O’Neill aims to uncover these events and to describe the mechanism of action of cryptochromes as circadian photoreceptors at the molecular and cellular level. Her research will provide a critical link between light input and biological response, and offer the basis for a description of circadian phototransduction that rivals our detailed description of vision. This research will enable an understanding and potential manipulation of biological timing that may transform our view of human health and our treatment of a host of human diseases including sleeping disorders, depression, and cancer.
BC Alliance on Telehealth Research and Policy to Enhance Home and Community Care and Chronic Disease Management
To provide evidence and capacity building to support the integration of sustainable telehealth care services to support patient-focused homecare initiatives in the management of chronic disease.