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.
The role of the stem cell antigen, CD34, on mature murine mast cells
In earlier research supported by a MSFHR Masters Trainee Award, Erin Drew disproved theories that CD34, a cell surface protein, was specific to immature blood cells. She found CD34 on immature blood cells, but also on cells lining the blood vessels and on mast cells. Mast cells are known to play a pivotal role in allergic and asthmatic responses. Erin’s work now focuses on CD34’s function in mast cells and how the protein prevents inappropriate adhesion to other cells and tissues. These enquiries will increase new knowledge on how blood cells move around the body and how mast cells can invade tissues and respond to allergens. Ultimately, Erin hopes her work will lead to the identification of targets for the treatment of allergies and asthma.
Development of a direct computer interface using descending motor potentials recorded from the spinal cord
A variety of devices are available for individuals with motor impairments, such as electrical stimulation systems for locomotion. But people with severe disabilities are often unable to control these devices effectively. Dr. Jaimie Borisoff, who has published research papers on neural regeneration in the journals Experimental Neurology and Molecular and Cellular Neuroscience, is researching assistive technologies to enhance quality of life for people with severe disabilities. Jaimie is investigating whether motor control information can be recorded directly from the spinal cord, since much of the intentional and logistical processing has already been performed in the brain before the signal pathway terminates at the spinal lesion. If so, this information could be used to create a control system that uses signals from the spinal cord.
Bi-specific antisense and RNAi targeting of IGFBP-2 and IGFBP-5 as a novel treatment strategy for delaying progression and bony metastasis of prostate cancer
Prostate Cancer is the most common cause of cancer and the second leading cause of cancer death in men in North America. But removing the androgens (male sex hormones) that regulate tumour growth — the only existing therapy shown to prolong survival — only produces temporary remission. Surviving tumour cells usually recur, becoming androgen independent. To improve survival, new therapeutic strategies must be developed. Dr. Alan So is exploring a novel way to treat prostate cancer at the molecular level. He is observing how prostate cancer is affected by shutting down two common genes in prostate cancer cells: IGFBP-2 and IGFBP-5 (insulin-like growth factor binding proteins). These genes are essential for prostate cancer to grow and spread to the bones. His research is also examining the effect of combining this treatment with chemotherapy on prostate cancer cells. The ultimate goal is to develop a more effective treatment for prostate cancer that can be tested in clinical trials.
The effects of a community-based exercise program on cognitive function and falls in older women with a history of falls: a 12-month randomized controlled trial
Falls are the most frequent cause of injuries and injury-related death in older people. Recent guidelines on preventing falls recognize cognitive impairment as a leading risk factor. People with cognitive impairment have 2.2 times greater risk for falls causing injuries and 1.7 times the mortality rate of older adults with regular cognitive function. Research on falls has not determined which domains of cognition — including attention, memory and perception — figure most significantly in this increased risk. Dr. Teresa Liu-Ambrose is investigating the specific dimensions of cognition most strongly associated with falls in older women. She is also examining the impact of a 12-month exercise program on these dimensions, and the relationship between changes in cognitive function and incidence of falls. Results from the study could contribute to the design of exercise programs to help prevent falls in older people.
Spine biomechanics in osteoporotic thoracic vertebrae: investigating the safety of manual therapy
People with spinal osteoporosis often suffer back pain that cannot be relieved by exercise or medication. Physiotherapists with advanced training can use manual spinal joint mobilization techniques, also called manual therapy, to relieve the pain. However, there are questions about how safe the therapy is and whether the techniques pose a risk of causing fractures. Meena Sran is using bioengineering techniques to determine if manual therapy creates a risk of fracture in people with spinal osteoporosis. Besides assessing the spine’s ability to resist fracture during manual therapy by determining the pressure required to fracture vertebrae, she is also examining whether or not x-rays and CT scans can detect these fractures. The study will provide insights into the safety of manual therapy and ultimately help improve treatment of back pain in older adults with spinal osteoporosis.
The effect of early controlled mobilization interventions on early fracture healing in a simulated hand fracture-healing model
Each year, about 11,500 people in BC fracture bones in the hand, usually from an accidental fall, a blow or compression between objects. Treatment typically involves immobilizing the fractured hand in a cast or splint for up to four weeks, which is necessary to allow bones to heal, but can also lead to loss of function and the need for further interventions or rehabilitation. Some studies have shown that earlier controlled mobilization of the hand following a fracture could reduce the negative consequences associated with immobilization. But studies haven’t addressed whether this earlier intervention is safe or will improve function. Lynne Feehan is examining the safety of two methods for early mobilization to lay the foundation for future research into this potentially useful approach for reducing side effects and improving fracture healing.