Based on her previous research on pediatric bone health, Dr. Kerry MacKelvie believes that perhaps the greatest hope for preventing osteoporosis in later life is to intervene during childhood. Kerry has studied how high impact exercise affects bone mass and structural changes during growth, and she has investigated the effects of ethnic background on bone health. Now Kerry is bringing together in one study an investigation of all the factors that may contribute to bone strength during childhood: exercise, hormones, body mass and composition, and ethnicity. She will study Asian and Caucasian boys who have not yet reached puberty, focusing on bone mass changes over time for both overweight boys and inactive boys. The study is particularly relevant to Vancouver’s population, as it will examine and compare ethnic-specific hormonal, body composition and bone mass changes during growth in both Asian and Caucasian children.
Research Pillar: Clinical
The influence of alcohol on mood and cognition
Treatment of alcoholism is complicated by the fact that many alcoholics also suffer from depression. Ekin Blackwell wants to contribute to more effective prevention and treatment of alcoholism by studying alcohol’s mood-enhancing properties, and identifying individuals who are especially sensitive to these properties. In her Master’s research, Ekin focused on clinically defining the characteristics of these sensitive individuals to gain insights into factors that influence the development of problematic drinking. Results from her study showed that these individuals have a higher level of negative thoughts about themselves, more negative general mood states and a more restricted emotional range that is less responsive to change. Ekin plans to continue her research on depression and has changed her focus to the link between depression and the stress hormone cortisol. She is specifically interested in understanding how individuals at risk for depression react to stressful interpersonal encounters, and whether their thoughts and emotions in response to these stressors are related to their daily patterns of cortisol output. The results will contribute to better understanding of the pathways between psychological stress and physiological illness.
The involvement of phosphatidylcholine in the development of hepatic steatosis in children with cystic fibrosis
Alice Chen hopes to achieve a better understanding of what causes liver disease in people with cystic fibrosis (CF). Liver disease – the second most common cause of death for people with CF – may result from depletion of choline (a water soluble B vitamin) in CF patients. An inability to properly absorb phosphatidylcholine (PC), which is found in food such as organ meats and egg yolks, may cause choline depletion and may ultimately lead to accumulation of fat in the liver. To test this hypothesis, Chen is studying a group of 50 children with CF, along with 10 healthy children. She will collect and analyse data from these children to determine if there is a link between difficulty in absorbing PC and liver disease. Chen, whose goal is pursing a career in nutrition research, believes that a better understanding of the causes of liver disease in people with CF is critical for the development of nutrition interventions that could prevent this serious complication.
Pain communication during infancy and early childhood: When cry becomes a speech act
Elizabeth Stanford (Job) has focused her research on understanding and improving assessment of children’s pain, by learning more about how children express pain, and how pain expression changes from infancy to early childhood. In her Master’s research she pursued three major projects that provided insights into the nature of children’s pain experience and how to improve measurement strategies. Two of her studies examined the language children use when experiencing painful events. The first involved the analysis of recordings of children’s spontaneous use of speech during immunization injections. Results from the study improve understanding of the meaning of these experiences for children and the type of language parents and practitioners can expect from children when they are in pain. The second study examined a large database providing transcriptions of children’s use of pain language during a range of structured and unstructured activities. The results provide important information about children’s spontaneous use of pain language, and could help clinicians and researchers better understand and assess pain in young children. Elizabeth’s final study examined young children’s use of self-report pain scales and described the role of developmental factors in predicting use of these scales. Child age was found to be the best predictor of children’s abilities to use the self-report pain scale. The results also highlight the tendency for over-estimation of young children’s abilities to use self-report scales and the need for tools and training tasks to be developed for use with the scales.
Issues in the diagnosis and treatment of viral co-infection by the human immunodeficiency virus (HIV) and Hepatitis C (HCV)
While an estimated 30 per cent of British Columbians living with HIV are also infected with Hepatitis C, which is becoming a leading cause of death among HIV-positive people, the issue of co-infection has received relatively little attention. Paula Braitstein hopes to change that by focusing her research on how to most effectively treat people who are co-infected with the diseases. By analysing data from the Vancouver Injection Drug Users Study and Drug Treatment Program of the BC Centre for Excellence in HIV/AIDS, she hopes to answer outstanding questions, such as whether patients fare better when treated for Hepatitis C before beginning HIV treatment. Braitstein believes that finding these answers will have a profound and timely impact on treatment of co-infected individuals. This project builds on a significant body of HIV work that Braitstein has already accumulated. Her goal is to make a substantial contribution to the health of Canadians through a research career in epidemiology.
Impact of a Targeted Intervention on Parental Administration of Post-operative Analgesia
In her Masters research, Rebecca Pillai Riddell identified significant factors that predict parental attitudes toward administering pain medication to children after surgery. Now she’s taking this work one step further by recruiting parents of children undergoing day care surgery at B.C.’s Children’s Hospital for a project assessing the effectiveness of a targeted intervention designed to dispel common parental myths and misconceptions about proper pain management. Given that parents play a key role in post-operative pain management, Rebecca is testing the effectiveness of this intervention on parents identified as more likely to under-medicate, and parents identified as less likely to under-medicate. She hopes the study will help bridge the gap between laboratory research and the everyday experience of children with post-operative pain.
Estimation Of Cochlear Thresholds Using Multiple Auditory Steady-State Responses In Infant and Adult Subjects
Susan Small’s research examines an advanced method to test hearing in infants, young children and others who cannot be assessed through traditional testing techniques. The method focuses on Auditory Steady State Responses (ASSRs), objective measures of response to sound stimuli in the areas of the brain involved in hearing. Past research on ASSRs, which test multiple frequencies in both ears simultaneously, has shown their reliability in measuring air-conducted sounds. Small is assessing the method’s reliability in estimating bone-conducted sounds. Reliable measurements of bone-conduction thresholds help determine whether surgery, hearing aids or other rehabilitation strategies are most appropriate for an individual. Small, whose experience includes nine years of clinical practice in audiology, intends to devote her research career to gaining a better understanding of the human auditory system. Ultimately, she hopes this research will lead to more effective early intervention for patients with hearing impairment.
Development and testing of a client specific wheelchair mobility outcome measure
Wheelchairs that don’t fit properly can cause discomfort, medical complications and limit people from getting around. Despite the fact that more than 150,000 Canadians rely on wheelchairs as their primary means of mobility, research in this area is often overlooked. While working as an occupational therapist in a long-term care facility, Dr. Bill Miller recognized the lack of tools for assessing and measuring people’s ability to function in wheelchairs, and is now developing a specific tool for this purpose. He hopes the tool will ultimately improve quality of life for wheelchair users. In the longer term his goal is to be a leader in mobility disability research, with a special focus on issues pertaining to older adults who use wheelchairs.
Domestic violence victims’ appraisals of future risk: The Impact of trauma symptoms on the accuracy of risk appraisals and safety planning
Research suggests spouse abuse victims, particularly those experiencing severe psychological trauma, may underestimate their risk for future violence from their partners and, therefore, be less likely to engage in safety planning. Dr. Tonia Nicholls is advancing that research by examining how psychological, social and environmental factors impact women's appraisals of risk of future abuse and ultimately, their willingness to seek help. Nicholls will contrast the subjective risk appraisals of battered women with objective risk appraisals made with structured risk assessment measures. The goal is to increase awareness among service providers about the factors related to victims' minimization of risk and improve risk management with former batterers at risk for relapsing into abusive behaviour. She also hopes the research will result in effective methods for educating women about their partners' level of risk and encourage victims to engage in safety planning and/or treatment.
Brain and behaviour: mechanisms of human attention in patient and healthy populations
Attention problems are a major source of disability associated with a wide range of disorders, including autism, stroke and schizophrenia. In British Columbia alone, hundreds of millions of dollars are spent each year by the health system for the treatment and rehabilitation of people with disorders of attention. And this does not take into account the additional costs for the education system or the toll on patients and families. I am studying the brain mechanisms underlying our attention processes and comparing how these processes affect perception and action in healthy children and adults, and those who have attention disorders. My research team is using behavioural and neuropsychological assessments, combined with advanced imaging technologies, to reveal brain processes involved in different attention tasks and behaviours. New knowledge about how the brain works in these activities will help in understanding and possibly developing better treatment and rehabilitation options for people with attention disorders.