Research Location: University of Victoria

Developmental Neuroscience Research Team for Behavioural Self Regulation

This award supports the development of a team of clinicians and researchers addressing gaps of understanding about the causes of developmental disorders including Fetal Alcohol Spectrum Disorder, Attention Deficit Hyperactive Disorder and Conduct Disorder. These gaps include the electrophysiological processes underlying problems in social development, such as self-regulation, that affect children diagnosed with these disorders.

Developing a Research Program on the Process and Impact of Implementing Core Public Health Functions in BC

To contribute to public health system renewal, the BC Ministry of Health has developed a Framework for Core Functions in Public Health. The Core Functions identify the key public heath services that health authorities will provide and that will strengthen the link between public health, primary health care and chronic disease management in BC. This award supports the creation of a multidisciplinary team to establish research priorities for public health in BC as they relate to the framework, and to develop a research program on the implementation and outcomes of the core functions.

The effect of a province wide, school-based physical activity initiative on the behavioral symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) in children

Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed psychiatric disorders of childhood. Children with ADHD have a high rate of disciplinary problems in school, experience social and academic difficulties, and encompass 30 to 40 per cent of referrals to child guidance clinics. Given the frequent occurrence of ADHD and the issues associated with it, effective and appropriate treatment has become a critical issue. With the desire to provide a healthy and effective solution in treating the symptoms of ADHD, Nicole Smith’s study is exploring the effects that repeated physical activity may have on the symptoms of ADHD in a practical setting. Using a standardized ADHD questionnaire, parents and teachers will indicate the degree of influence a long-term, province-wide, school-based physical activity initiative has on the behavioural symptoms of children with ADHD while in their classroom and home environments. The primary goal of Nicole’s research is to evaluate the effect of school-based physical activity intervention on ADHD symptoms and classroom disruption among children ages 9 to 12 with ADHD. Since little research exists on the impact of exercise on the behavioural symptoms of ADHD in children, there is potential for this research to make a significant contribution in the areas of child mental health, ADHD health promotion and intervention.

Exploring a community approach to enhance the healthy development of youth

Youth across BC are exposed to a variety of risk factors that can inhibit their ability to develop into healthy adults. Some of these risks include alcohol and drug use, gambling, physical and sexual abuse, harassment and discrimination, obesity, and feeling unsafe at school. Most funding agencies support one-time projects to improve health and social outcomes among youth. Although these interventions are intended to target needs identified by the community, many are unable to generate long-term change toward healthy youth development, because of short-term grants, competing goals, a lack of trust in the community and uneven volunteer support. Carol Sparks is studying how an alternative approach—community action projects—creates sustainable change. Community action shifts the focus from one-off projects to a community-centred approach, based on the belief that families provide the primary support for children and youth, and vulnerable youth need community support to meet their health and social needs. Carol is working in collaboration with the communities of Courtenay and Campbell River on Vancouver Island to determine the processes used by local community action projects to address the social and economic determinants of youth health. This research will identify both barriers to sustainability and strategies that support sustainability.

Assessing the impact of an engaged lifestyle in preventing Alzheimer’s Disease

Genetics, education and lifestyle can all influence the aging process, and as a result there is significant variation in older adults’ cognitive function. Although some risk factors for cognitive decline are fixed – such as genetic make up – people do have control over their own involvement in physical, social and intellectual activities. However, the relationship between activity and age-related cognitive decline is unclear. While some research has found that older adults leading active lifestyles obtained higher scores on memory tests, were less likely to show memory decline, and had a lower risk of developing dementia, other research has not shown any clear association. To shed more light on the relationship between activity and cognitive decline, Allison Bielak is using a technique that assesses the consistency over time with which people perform cognitive tests. Her work is based on the observation that fluctuations in how well people perform cognitive tests at different times – rather than how well people actually score on the tests – may be a useful early indicator of long-term neurological decline. Because this tool may detect subtle changes in function, Allison hopes to determine more concretely whether activity plays a beneficial role to maintain cognitive health. Ultimately, she would like to use this information to determine the best activities and activity level to maintain cognitive ability and slow the progression of neurological diseases such as Alzheimer’s disease.

The effect of load and velocity on muscle activation and cutaneous reflexes during rhythmic human arm cycling

Stroke is one of the leading causes of disability in older adults. After stroke there may be deficits to movement control which typically are expressed as either too much activity in a muscle (spasticity) or too little activity in a muscle (low tone). These impairments interfere with normal movements involved in daily physical activities such as walking or reaching. Present rehabilitation programs include treadmill training with body weight support, with the focus mainly on the leg muscles. The speed and amount of body weight support required to maximize the rehabilitative benefits of treadmill training is not fully understood. It has been shown that the movement of the arms during walking can influence the walking pattern. Research has also shown that rhythmic movement such as walking is to a large degree controlled by neural circuits in the spinal cord called central pattern generators (CPG). More recently, it has been suggested that benefits to leg motor function result from retraining the CPG for the arms as well as the legs. This suggests that recovery of arm muscle activity may be important for the recovery of a normal walking pattern, and of leg muscle function as well as arm function. Sandra Hundza is exploring the most effective levels of speed and load to be used in an arm training protocol. By using harmless electrical stimulation of a nerve in the hand, she is evaluating muscle activity and reflexes elicited during rhythmic arm cycling movement. Results from Sandra’s research will determine what speed and load will best stimulate the spinal circuitry, thereby offering the best training protocol for arm cycling therapy. Her results will also have application to speed and weight bearing support for treadmill training protocols in general and help to better understand how rhythmic movement of the limbs are controlled.

Herbal medicine use and older adults: A social network analysis of information exchange

National surveys indicate that seniors account for a growing number of new herbal users, with the majority reporting use of at least one herbal within the last year. A growing number of older adults are seeking treatments outside of conventional medicine, and in many cases, are not informing their primary physician of this use. Lack of communication with medical doctors, coupled with the fact that information sources about herbal medicines are not always credible, creates the potential for drug-herb interactions, poor or delayed treatment and misconceptions about the efficacy of herbals for health. Doctors tend not to refer their patients to herbal practitioners or prescribe herbal medicines. Consequently, seniors rely on other sources to get this information. Kristine Votova is investigating how older adults obtain information about herbal medicines from their social networks. Kristine is assessing how these connections influence a senior’s decision to use herbal medicines. For example, are seniors more likely to act on information from people they have strong or weak ties with? And what impact does the age, sex and health status of those providing information have on the prevalence, frequency and duration of herbal use? This research will explain how seniors exchange information about alternative treatments, and can be used to target public health messages about the safety of these products.

An interdisciplinary research program for evidence-based public health interventions and policy for illicit drugs in BC and Canada

The use of illicit drugs in Canada is associated with substantial, widespread consequences, including high rates of death and health complications among users, and significant social and economic costs to society. Canada has traditionally addressed illicit drug use with law enforcement measures, with prevention and treatment measures playing a secondary role. Recent efforts to reform Canadian drug policy go hand-in-hand with a strong need for expanded research to support the development of effective and evidence-based intervention programs and public health policies. Dr. Benedikt Fischer is examining how to develop more effective public health-oriented prevention, treatment and policy options to reduce the harms of illicit drug use. His research focuses on five main areas: street drug use monitoring; opioid treatment programs; prevention and treatment for hepatitis C among illicit drug users; cannabis control reform; and criminal justice interventions for drug offenders. Dr. Fischer is integrating basic, clinical and social health research and working in collaboration with researchers from across Canada, with an emphasis on issues of national relevance as well as those specific to British Columbia.

Access to care at the end of life: encounters between home care nurses and family caregivers

An important social change of the last quarter century has been a shift in the setting for health care delivery away from institutions — the move from facility-based care to home-based care. In particular, access to palliative home care services has become a major health policy issue in Canada. With an aging population, a growing number of Canadians diagnosed with terminal illness, and almost 90 per cent of Canadians reporting a preference to spend their final days at home, current government policy is pressing for more and better care of the terminally ill in the community. While several conditions are needed to effectively support palliative care at home, two of the most important are the availability of family caregivers (FCGs) and access to services by home care nurses (HCNs). Dr. Kelli Stajduhar is studying the decision-making factors that HCNs take into account when providing specific levels and types of palliative home care nursing services and exploring how the relationships between HCNs and FCGs shape access to care for dying patients. She is interviewing FCGs providing palliative care at home, HCNs and expert clinicians and administrators. Dr. Stajduhar is also observing relationships between HCNs and FCGs to better understand how these interactions affect access to care. Ultimately, results from this research will inform the development of health services, policies and HCNs’ decision making in order to improve access to care for families in palliative care.