In spite of prevention programs that target risky sexual behaviours in youth, many BC teens continue to experience serious health and social problems related to sexually transmitted diseases (STDs) and unplanned pregnancies. However, there are significant variations in the incidence of teen pregnancy and STDs among rural and remote BC communities. Terrace, for example, has relatively high rates, while 100 Mile House has lower rates than the provincial norm. Dr. Jean Shoveller is studying the factors that contribute to this variation in sexual health outcomes among youth. In addition to personal behaviours among teens, she is investigating how other factors – such as relationships with family and peers, community social norms and the influence of institutions including education, health and religion – may contribute to decisions they make around their sexual health. Through her five-year study of three rural/remote BC communities, Dr. Shoveller hopes to provide significant insight into how communities can help prevent adverse sexual health outcomes among their youth.
Research Location: University of British Columbia
Community partnership research in population health promotion: The development of tools and measures for planning and evaluation
Strong evidence suggests that the health system is not the primary factor determining the health of Canadians. Non-medical factors – such as income, social support, education, employment, housing, health practices, child development, gender and culture – are crucial determinants of health and quality of life. Regional health authorities across BC are increasingly taking a population health approach, which addresses these non-medical factors, in community-based initiatives. However, these efforts are often complex and involve diverse participants from within and outside the health system, making it difficult to evaluate their effectiveness. Dr. James Frankish is studying how health authorities are addressing non-medical determinants of health. He is developing and testing tools to provide evidence-based evaluation of community-level effects resulting from population health initiatives. A particular focus is inclusion of vulnerable populations in these initiatives and related policy and practice implications. Dr. Frankish is also the leader of the MSFHR/CIHR program for Transdisciplinary Training in Community Partnership Research: Bridging Research to Practice, which is co-funded by the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research.
Evaluation of efficacy of borate-based fungistatic treatments on building materials and growth, pro-inflammatory and toxic products of secondary metabolism by selected micro-organisms
With the prevalence of “”leaky”” buildings in BC, there is increasing awareness of the potential health risks associated with damp building products fostering the growth of fungal organisms. These organisms grow from spores, which are naturally abundant in outdoor air. Although spores cannot grow on dry building materials, they can readily form colonies and grow on building materials that have sufficient moisture (e.g. resulting from water leaks, flooding or condensation). These fungi are thought to contribute to respiratory and inflammatory health problems in people. Dr. Karen Bartlett is studying the effects of a class of anti-fungal preservative containing borate. This preservative, used to inhibit fungal growth on wood products, is not yet approved for use in Canada. Dr. Bartlett is monitoring whether borate leaches out building materials when they are wet and becomes ineffective. She is also investigating whether the fungi produce any harmful byproducts in response to these preservatives that might create further health problems.
Investigating the link between symptom expression, medicalization and acculturation: The case of Portuguese immigrants
Dr. James has conducted groundbreaking research into the experiences of Portuguese immigrants with agonias, a commonly-expressed disorder that is literally translated as “the agonies.” While North American clinicians often diagnose agonias as anxiety and/or depression, and treat it with medication and psychotherapy, these approaches are often unsuccessful. Dr. James’ previous research indicates that the meaning, symptoms and treatment of agonias do not match the standard psychiatric disorders of anxiety or depression. Dr. James is investigating the differences in the way clinicians and members of Portuguese communities understand agonias; whether it is related to anxiety or depression; and whether assimilation into North American society changes community members’ understanding and experience of agonias. This research will further inform her work teaching therapists throughout Canada and the US how to conduct psychotherapy with ethnic minority patients.
Becoming a Nurse: The Micro and Macro Construction of First Nations Nursing Students' Experience in a Western Canadian School of Nursing
Canada’s First Nations communities are experiencing their worst nursing shortage in 30 years. First Nations health care professionals are the most effective nursing personnel in their own communities, yet efforts to recruit and retain them in nursing schools have been largely unsuccessful. The little research done on this issue indicates there are barriers to be bridged, including a feeling among First Nations nurses that they must compromise their traditional beliefs and culture to succeed in nursing education. In her doctoral research, Donna Martin is developing a clearer picture of these barriers. Her research involves interviews with students, faculty, health care professionals, First Nations elders and others, along with classroom observation and analysis of course materials, textbooks and university policies. Martin hopes the research will ultimately help nursing schools develop more effective recruitment and retention strategies for First Nations nurses.
Domestic violence victims’ appraisals of future risk: The Impact of trauma symptoms on the accuracy of risk appraisals and safety planning
Research suggests spouse abuse victims, particularly those experiencing severe psychological trauma, may underestimate their risk for future violence from their partners and, therefore, be less likely to engage in safety planning. Dr. Tonia Nicholls is advancing that research by examining how psychological, social and environmental factors impact women's appraisals of risk of future abuse and ultimately, their willingness to seek help. Nicholls will contrast the subjective risk appraisals of battered women with objective risk appraisals made with structured risk assessment measures. The goal is to increase awareness among service providers about the factors related to victims' minimization of risk and improve risk management with former batterers at risk for relapsing into abusive behaviour. She also hopes the research will result in effective methods for educating women about their partners' level of risk and encourage victims to engage in safety planning and/or treatment.
Brain and behaviour: mechanisms of human attention in patient and healthy populations
Attention problems are a major source of disability associated with a wide range of disorders, including autism, stroke and schizophrenia. In British Columbia alone, hundreds of millions of dollars are spent each year by the health system for the treatment and rehabilitation of people with disorders of attention. And this does not take into account the additional costs for the education system or the toll on patients and families. I am studying the brain mechanisms underlying our attention processes and comparing how these processes affect perception and action in healthy children and adults, and those who have attention disorders. My research team is using behavioural and neuropsychological assessments, combined with advanced imaging technologies, to reveal brain processes involved in different attention tasks and behaviours. New knowledge about how the brain works in these activities will help in understanding and possibly developing better treatment and rehabilitation options for people with attention disorders.
Suicide and self-injury as a response to radical developmental and cultural change in First Nations youth
Young people kill themselves in heartbreaking numbers, and intended and unintended self-injuries are the leading causes of death among our youth. However tragic this is when viewed in the large, the rates of suicide in certain First Nations communities are even higher – in some cases hundreds of times higher – and arguably the highest in the world. I am working to identify both individual and cultural factors that might help reduce the horrendous toll. Previous research has shown a strong link between suicidal behaviours and disruptions in the usual process by which adolescents develop their self-identity. It has also revealed that among First Nations communities, the risk youth run for suicide turns very much on the extent to which different bands have succeeded in reconnecting to their own cultural pasts. My research is directed at understanding the ways cultural differences during the course of identity development help or hinder young people’s ability to insulate themselves from such risks. By understanding the implications of these differences and working out ways of sharing them with various First Nations Communities, it may be possible to assist these communities in reconstructing cultural practices that, once recovered, may serve to better insulate their youth from self-injury and suicide.
Role for postsynaptic protein complex assembly in synapse development
Neurons (nerve cells) in the brain and central nervous system transmit signals to each other across connections called synapses. Glutamate is the primary neurotransmitter (messenger) that nerve cells use to send signals across these synapses to induce action in the brain. Glutamate enables the brain to develop and language to be learned. Without synapses that allow the chemical signal’s transmission from one nerve cell to the next, nerve cells will not be able to communicate with each other. Other neurotransmitters carry inhibitory signals to reduce activity in the brain. My research has shown that the post-synaptic density protein (PSD-95) stimulates the formation and maturing of the synapses that release glutamate, and increases the release of this neurotransmitter. Members of the PSD-95 family are involved in the development and organization of receptors that are clustered on the receiving side of the synapse. I am investigating how PSD-95 proteins regulate receptor clustering at synapses. This research is important because the number of receptors regulates the strength of the message: the more receptors, the stronger the message. We want to gain a better understanding of how receptors accumulate at synapses, and how changes in this process may underlie long-term changes in synapse structure and function associated with learning and memory. If we can determine how to change the number of receptors, we can permanently enhance the signals received in the brain, which could improve learning and memory function. Also, by understanding how synapses are formed and how neurotransmitter receptor clustering is regulated, we may figure out how to rescue abnormalities in synapse formation and function associated with several neurological diseases such as Alzheimer’s, mental retardation, schizophrenia and epilepsy.
Neurobiological and treatment studies in mood disorders
The treatments currently available for bipolar disorder and major depression are effective in relieving symptoms in only about 70 per cent of the patients. Furthermore, some patients have difficulty tolerating the side effects of these medications. In my lab, we are using Positron Emission Tomography (PET) scans to examine the levels of brain chemicals serotonin and dopamine in people with these mood disorders. Serotonin and dopamine control our emotions, sleep, appetite and energy, all of which are altered in patients with mood disorders. We are studying how these brain chemicals are altered and where changes in the brain occur, so we can develop new treatments that target these areas. Our research to date suggests that one type of serotonin receptor may be important in treating depression. In addition, I have set up a Canadian consortium on bipolar disorder (also known as manic depressive illness), which includes experts on bipolar disorder from all major Canadian universities. The consortium has recently received more than $2 million of funding from the Canadian Institutes of Health Research to examine the optimal length of therapy with novel antipsychotics and the effectiveness of psychotherapy and psychoeducation. We will also be pooling resources to examine how people with bipolar disorder respond to existing treatments compared to their outcomes with new treatments. We will be able to gather extensive data from all the sites to assess the effectiveness of different therapies. Given that many patients with bipolar disorder have problems with memory and concentration, we will study whether these symptoms are part of the illness and if early treatment can diminish them. My goal is to discover what brings on these symptoms and develop new treatments that improve patient outcomes and quality of life.