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.
Research Location: University of Victoria
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.
In vivo trafficking of mutant and wild-type glucocerebrosidase-GFP chimerae
Tessa Campbell’s research has a clear purpose: improving treatment options for Gaucher disease. People with this genetic disorder lack sufficient amounts of glucocerebrosidase, an enzyme the body needs to help recycle old membrane fat. The fat accumulates in certain body tissues such as the spleen, liver, and bone marrow, resulting in problems ranging from anemia to neurological impairment. Enzyme replacement therapy helps to alleviate symptoms for one type of Gaucher disease, but the therapy’s exorbitant cost prevents many from receiving the treatment. Tessa created specially-marked versions of the gene for this enzyme, introduced them into cells, and studied the resulting protein synthesis and trafficking. Tessa also employed cutting edge RNA interference technology to further examine regulation of glucocerebrosidase protein production. Results from the research provide insights about maximizing efficiency of enzyme production and secretion, which could reduce enzyme replacement therapy costs. Results also offer further clues to glucocerebrosidase translational control and shed light upon possible involvement of inhibitory proteins in other cellular pathways.
The hierarchical structure and function of social support as a quality of life determinant among community dwelling older adults with chronic lung disease
The number of older adults with chronic lung diseases, such as asthma and bronchitis, is steadily growing in BC. Spouses are often the only source of support for people living with these diseases, yet little research has been done on their supportive role or on alternative forms of support. Gail Low hopes to address these gaps by researching support systems that promote well-being and help older adults cope with lung disease. Her research involves asking older adults to identify how and why their support systems work to help provide direction for new lung health services. She is also developing a map of meaningful support systems as a model to guide existing community health programs.
Developing an effective and efficient health care delivery system for Canadians at the end-of-life
In the mid-eighties, while working as a palliative care nurse, Dr. Kelli Stajduhar cared for a young man dying from AIDS. A few years later, her mother was diagnosed with lung cancer and died. Both received less than optimal care at the end of their lives. Stajduhar was profoundly affected by those experiences, which gave her a strong desire to examine ways to improve care and support for people at the end-of-life. Stajduhar’s PhD research focused on the provision of home-based care for people who are dying, and its impact on family caregivers. Her postdoctoral work aims to identify the elements needed for an effective, efficient, comprehensive and coordinated system of health care for Canadians who have come to that point in their lives. Ultimately, Stajduhar would like to advance health policy on end-of-life care.
Comparative and functional genomic analysis of a gene dense, GC rich region at chromosome 7q22 associated with myeloid leukemias and male infertility
Michael Wilson’s doctoral research focuses on a fragile region of the human genome, 7q22, which has been linked to leukemias, hemochromatosis (a genetic disease that causes excessive build-up of iron in body tissues), male infertility and schizophrenia. Besides preparing a detailed map of all 7q22 genes and elements that regulate their expression, Wilson is also working with a bioinformatics group at Penn State to design a web-based program that interactively displays the gene sequence data. He is also investigating the function of two specific genes, including one that plays a role in fertility. Wilson hopes the research will provide essential information for narrowing in on cancer and schizophrenia-related genes, and also provide insight into male infertility.