While the brain is the body’s command centre, connections within the spinal cord control rhythmic activities like walking. The brain contributes to such movements, but spinal cord circuits can coordinate muscle activity on their own, relying on feedback from moving limbs to regulate the pattern. When these connections are lost or altered due to injury to the brain or spinal cord, movement in the arms and legs may be greatly reduced depending on the location and severity of the injury. Dr. Paul Zehr’s research focuses on improving understanding of how coordinated muscle activity in arms and legs can be improved after neurotrauma. He is working with individuals who have had strokes or spinal cord injuries to determine the extent to which enhanced sensory feedback techniques can retrain spinal cord circuits and improve limb coordination. New knowledge gained from this research may lead to more effective methods of improving motor coordination following brain or spinal cord injury.
Research Location: University of Victoria
Development of a leisure time walking program based on the theory of planned behaviour stage 1: belief elicitation and evaluation
Substantial evidence associates physical inactivity with the development of several chronic diseases and premature mortality. Conversely, extensive research indicates physical activity helps prevent cardiovascular disease, obesity, stroke, diabetes, cancer, osteoporosis and other conditions. Despite this information, about 57% of adult Canadians do not meet the minimal requirements for physical activity, and half of those who begin a regular physical regimen drop the activity within six months. The overwhelming majority of Canadians — more than 70% — choose walking as their preferred physical activity during leisure time. Dr. Ryan Rhodes is studying beliefs about leisure time walking. The research includes an initial study assessing physical activity beliefs and a second survey assessing actual time spent walking. Results from the research will be used to develop a provincial leisure time walking campaign for adults. Dr. Rhodes’ ultimate goal: developing effective campaigns for promoting physical activity in specific populations, such as middle-aged adults and older adults.
Who “crashes” onto dialysis? Impact of social determinants of health on renal patients’ access to dialysis treatment
Despite the fact that chronic kidney disease almost always presents warning signs, 30-50 percent of new renal patients in BC “crash” onto dialysis or are referred late for assessment of kidney disease. Both scenarios are associated with increased morbidity (severity of symptoms), increased hospital stays, reduced opportunities for more ambulatory modes of care, such as peritoneal dialysis or early kidney transplant, and increased mortality (incidence of death). There is much to be learned about the range of possible determinants that may influence renal patients’ ability to access treatment. Nancy Blythe will investigate the social determinants of health of 1300 renal patients who initiated dialysis in BC in 2001-2002. Her aim is to determine whether certain social structural barriers in society (availability of social support, adequate income, etc.) constrains patients from seeking treatment before their chronic illness advances to an acute stage, resulting in late referral to the health system or the onset of dialysis under emergency conditions. Subsequently she will study whether those same social barriers and suboptimal initial access negatively influence ongoing access to dialysis as well as morbidity and mortality. It is anticipated that the research results will contribute to better ways of assisting renal patients to obtain optimal access to this life support treatment.
The role of the tumor suppressor ING in cell growth and death in a frog model system
Mary Wagner is interested in the fundamental mechanisms that govern a cell’s decision to divide, mature or die. Armed with this information, she says, we can gain greater insight into many different diseases where these basic functions are altered. For example, cancer is characterized by uncontrolled cell division, and inappropriate cell death is the hallmark of degenerative diseases such as Alzheimer’s and muscular dystrophy. Mary is studying the role of ING (INhibitor of Growth), a protein that helps regulate these basic cell functions. While ING is also found in the cells of humans, mice, rats and yeast, Mary is studying the protein’s role in the metamorphosis of tadpoles into frogs—a drastic and rapid transformation involving tail death, leg growth and brain remodeling. She is also investigating how environmental pollutants can act as hormones to disrupt normal cell development and function.
Psychosocial predicators of success following memory intervention in older adults
Memory difficulties accompany the aging process. Two common examples include reduced ability to recall recent information or events and problems remembering to do something in the future. Programs have been developed to help older adults, including people with Alzheimer’s and their caregivers, deal with age-related memory changes. Although most benefit from these programs, not everyone responds equally and some do not seem to benefit at all. Little research has been done to investigate how psychosocial factors, such as personality characteristics, coping abilities and emotional status, affect the success of memory intervention programs. In her doctoral research, Patricia Lynn Ebert is assessing the impact of psychosocial factors on adults 70 and older who are in memory programs. Patricia hopes the results will lead to greater understanding of memory function in older adults, improved memory intervention programs, and better outcomes for program participants.
Decision support systems for health care governance
Carolyn Green is studying the use of information by regional health authorities in public health policy decisions. Health authorities need high quality information to assess the health care needs of communities and appraise the performance of health care systems. But while health authorities make system-wide decisions that can affect whole populations, authority board members do not rate the information they receive as being adequate or timely. Carolyn is investigating what kinds of information are needed and which technologies can best deliver the information to authorities. Her research will help improve the quality of information available to health authorities for evaluating and making decisions about the health care system.
Gathering strengths: Contexts that reduce aboriginal children's risk for mental health problems
Research indicates peer victimization among children occurs every seven minutes on the playground, and every 25 minutes in the classroom. Wendy Hoglund is investigating the effects of rumour spreading, hitting, and other types of victimization on First Nations children’s healthy development in elementary school. She is examining how peer victimization affects areas such as mental health and academic competence. She is also assessing whether First Nations children in schools with more First Nations children and First Nations Programs, for example, experience less peer victimization and have better mental health, social, and academic outcomes than First Nations children in other school contexts. Wendy hopes this information will the development of preventative policies and programs to promote the health of First Nations children in Canada.
An evaluation of the full circle project: The effects of a theatre-based HIV prevention intervention on audience and actor/educator learning
What are the best ways to ensure young people listen to and act upon information about avoiding high risk sexual behaviours? This is the research focus for Josephine MacIntosh, who is delving into the individual, social and cultural factors that may perpetuate the epidemics of HIV and sexually transmitted diseases, especially among young women. Josephine is studying the effectiveness of using a theatre-based intervention program among youth aged 13 to 15. The theatre productions will consist of a series of original dramatic productions researched, scripted, produced and presented by youth volunteers. She hopes to develop an educational approach that can engage the audience and actors as they learn about issues such as abstinence, treatment of HIV and sexually transmitted disease, pregnancy prevention, decision-making, peer-pressure, negotiation for safer sex and alternative safer sexual behaviours.
Improving patient safety: Costs and effects count
Health economist Dr. Rebecca Warburton is analyzing the costs and effects of interventions to reduce the accidental harm caused by health care. Her research aims to provide a rational basis for establishing priorities among policies and programs for reducing errors. The US Institute of Medicine’s estimate that 44,000 to 98,000 Americans die every year as a result of preventable hospital mistakes has raised public awareness of errors in health care and focused attention on reducing risks and harm to patients. However, most Canadian hospitals are overwhelmed by the number of safety improvements suggested by experts or demanded by regulatory bodies. Limited resources, and lack of information about the likely costs and benefits of proposed changes, means that few safety strategies are actually implemented, and most changes are not well evaluated. Dr. Warburton’s research, conducted in partnership with the Vancouver Island Health Authority, compares the costs of patient safety improvements with the outcomes in terms of standard units such as life-years or quality-adjusted life years gained. Before joining the University of Victoria in 1999, Dr. Warburton spent 11 years in policy and research positions with the BC Ministry of Health. She is currently assessing the effectiveness of BC’s Premium Assistance Program, which subsidizes medical premiums for low-income residents, and assisting in the evaluation of BC’s Clinical Practice Guidelines and Protocols.
Literacy and health research
Low levels of literacy have been associated with poor health, poor understanding of treatment, greater use of health services, low adherence to treatment regimens, and poverty and unemployment. Considering that more than 40 per cent of Canadians fell into the two lowest categories of literacy in the 1994 International Literacy Survey, this is cause for concern. Recruited to BC from the University of Toronto, Dr. Irving Rootman is developing and implementing a research program on literacy and health in British Columbia. While the Canadian public health community has developed initiatives aimed at improving understanding of health information, there has been little research to measure the outcomes of these efforts. Dr. Rootman’s studies will assess the effectiveness of various approaches to improving health literacy in Canada and BC. His program will also provide training opportunities for graduate students, establish links between researchers across the country, and develop collaboration between researchers, health providers, policy makers and community members concerned about literacy and health.