More than 1.4 million Canadians have osteoporosis, a chronic condition that causes bones to become fragile and fracture easily. Clinical trials have shown that lifestyle changes and early medical management can reduce osteoporotic fractures in high-risk people. Past studies suggest that many people over 50 years of age who suffer a minor fracture are at risk for osteoporosis. This is an ideal time for osteoporosis investigation. Yet these patients are most often treated for the fracture alone and not investigated for osteoporosis. The aim of Maureen Ashe’s research is to investigate whether educating patients and raising physician awareness about osteoporosis after a low-trauma fracture could improve the investigation rate and if necessary, enable more patients to receive preventative therapy. Preliminary results from the study indicate that after providing education to patients and physicians at hospital fracture clinics, a substantially higher number of patients were assessed for osteoporosis.
Research Location: Vancouver Hospital & Health Sciences Centre
Treatment adherence in first episode psychosis with a history of violence: understanding correlates and improving adherence
Research shows that if people who have experienced a first psychotic episode adhere to treatment, they are less prone to relapse and have improved overall well-being. However, studies also indicate that less than 50 percent of these individuals take their medication as prescribed, and less than one-third participate in relapse prevention treatments. It’s known that people with schizophrenia and a history of violence, substance use, or antisocial personality disorder are less likely to adhere to medication regimens and psychosocial treatments. Alicia Spidel is looking at the relationship between treatment adherence and a history of violence in people experiencing a first psychotic episode, and whether first episodes are related to higher rates of personality disorders and substance use. She is also assessing whether motivational interviewing, a client-centred therapeutic approach, motivates participants to manage their symptoms and prevent relapse. The results could be used to refine treatment programs for people with schizophrenia and reduce criminal behaviour.
The effect of surgical technique on morphology and biomechanical behavior of allograft bone-cement in hip reconstruction with impaction allografting
Of the approximately 18,000 hip replacements performed annually in Canada, 10 to 20 percent fail after 10 years. Failure and removal of an implant cause extensive bone loss to the femur (thigh bone). This bone deficiency makes it difficult to fix a new implant in place. Impaction allografting involves impacting and cementing morsels of bone in the femur to set a new implant in place. The appeal of this technique is its documented potential to restore bone. The procedure, however, has had mixed clinical results. Carolyne Albert is exploring ways to improve the surgical tools and techniques for impaction allografting. She is comparing the current technique with alternative surgical techniques. The research could lead to a technique that will provide implant stability while improving the potential for bone restoration.
Exploring and mapping illness self-management in people recently diagnosed with Psychotic Illness
Research has identified certain core abilities that enable people with mental illness to self-manage their condition. This includes the ability of individuals to understand information about their health condition. Studies have shown that providing illness-related information is a fundamental starting point for developing other self-management abilities; but little research has been done on the needs of people in the early stages of illness who are entering the mental health system for the first time. Eric Macnaughton is studying how people newly diagnosed with serious forms of mental illness can learn to successfully live with their conditions. Given the traumatic and confusing nature of a first experience with mental illness, Eric is investigating the idea that stories about people who have successfully coped with their mental illness could help motivate newly diagnosed people to self-manage their condition. The research could contribute to design of programs and tools that help build or strengthen self-management skills.
Associations among decreased planum temporale asymmetry, functional laterality during semantic processing, and severity of thought disorder in Schizophrenia
Most language processing occurs in the left hemisphere of the brain. In schizophrenia, language is disturbed on several levels: from abnormal anatomy in essential regions of the left hemisphere to deficits in comprehension and expression. Studies suggest genetic and environmental factors interact to cause abnormal anatomical development in the left hemisphere, resulting in abnormal functions that lead to schizophrenia symptoms. Sara Weinstein is investigating how abnormal brain structure and brain functions relate to a deviation in linguistic processing and expression that results in thought disorder, which is a primary symptom of schizophrenia. The research could help explain what causes schizophrenia symptoms — the first step toward developing more effective treatments.
Computer-assisted femoral head resurfacing
Every year more than 20,000 Canadians with advanced osteoarthritis receive hip replacements. A new surgical technique resurfaces the head of the femur (the long thigh bone between the hip and knee) with a metal cap, removing far less bone than the traditional method, which involves removing a large portion of the upper femur. Hip replacements for active patients under the age of 55 have significantly increased and many of these patients will likely outlive their first hip implants. This new technique will help ensure they have enough bone to support a second surgery. Surgeons use a cumbersome alignment guide to insert a wire in the top of the femur and position the implant, which leads to variations in alignment that can loosen the implant or cause the femur to fracture. Jill Brimacombe is designing a computer-assisted surgical technique to help surgeons position the implants more accurately. The computer-assisted tool could reduce surgery time, be easier for surgeons to use, and improve accuracy, which would lengthen the life span of patients’ implants.
Modelling and simulating intra-cellular signalling systems in response to pathogen invasions by semantic networks
Organisms that cause disease use various strategies to create infection. Bacteria such as Mycobacterium tuberculosis invade cells in the human immune system. These bacteria manipulate the internal machinery of a host cell to enter and survive inside the cell. A cell contains many different types of molecules that interact in complex ways to control cell behaviours. Michael Hsing is studying these interactions to understand how bacterial invasions occur. He is using a computer method, called the semantic network, to simulate molecular interactions and cellular behaviours during bacterial invasions. The research could enable researchers to predict how cells respond in different situations, potentially leading to development of drugs to prevent and treat bacterial infections.
Enhancement of melanoma chemosensitivity by adenoviral delivery of PUMA
Melanoma is an aggressive and lethal form of skin cancer that is increasingly prevalent among Caucasians. Although often curable if diagnosed early and surgically removed, melanoma tumors can rapidly metastasize (spread) to other parts of the body. Patients diagnosed with melanoma at later stages face a poor prognosis and survival rates averaging only six to ten months. Once it has spread, melanoma is extremely difficult to treat because it does not respond well to conventional cancer treatments such as radiation and chemotherapy. But the reason for this resistance is unknown. Most anti-cancer drugs induce apoptosis (programmed cell death) in tumor cells. Melanoma may have abnormally high levels of cell survival genes, making them difficult to kill with such drugs. Alison Karst is investigating whether introduction of the PUMA cell death gene into malignant tumors could overcome this problem and sensitize malignant cells to chemotherapy.
Assessing the utility of novel technologies to better characterize structure and strength in growing bone: an MRI and pQCT study
Each year in Canada more than 24,000 people will fracture hips due to weakened bones caused by osteoporosis. Current ability to predict risk of hip fracture is limited. Dual-energy x-ray absorptiometry (DXA) is used to assess bone density, but it shows a two-dimensional representation of bone, which is a three-dimensional structure. DXA is also unable to assess the structural properties of bone, which are a major factor in bone strength. Sarah Manske is evaluating whether two emerging technologies can accurately measure bone structure and strength. Magnetic Resonance Imaging (MRI) can measure cross-sections of bones to evaluate strength, without radiation exposure. Quantitative computed tomography (QCT) can assess bone in three dimensions. Sarah aims to develop a model integrating different imaging technologies to provide a more comprehensive picture of fracture risk. The information could be used to target preventative health strategies to help those at greatest risk of hip fracture.
Impact of labour market change on community and workplace health in health services
A growing body of evidence indicates that a lack of control over working conditions contributes significantly to poor health and that social networks have a positive impact on health. Amber Louie is building on that research by analyzing the impact of organizational restructuring and changing work conditions on health care workers. Amber is examining the barriers to workers’ control in the health care sector, and the factors that facilitate or serve as incentives for workers’ control. She is also investigating the relative effectiveness of the various forms that workers’ control may take. The research involves interviewing community health workers to assess individual perceptions about social support, participation in decision-making and other factors that affect their working conditions. The study could provide important information for health care practitioners, human resource managers and community developers to use in the design, implementation and evaluation of workplace and community health promotion programs.