Spinal cord injuries lead to a variety of outcomes because of the unique nature of such injuries. Although the level of injury accounts for many of the differences in recovery among people with spinal cord injuries, it doesnât fully explain differences in functional ability and adaptation to life after an injury. Evidence suggests the way people cope with a life-altering spinal injury may be as important to their recovery and health status as the extent of their injury or the care received. Sharon Lee is studying the impact of different coping behaviours on rates and extent of physical and mental recovery from spinal injury. Through face-to-face and telephone interviews, Sharon is investigating the relationship between stress, coping strategies and social support in people with spinal cord injuries. Results from the research could be used to develop therapies that help newly injured individuals cope and readjust to life with the best possible health status.
Research Pillar: Population Health
Cognitive, emotional and social aspects of work goals as determinants of employee health
Numerous studies show stress can play a significant role in physical and mental health. Workplace stress has been linked to psychological distress, cardiovascular disease, musculoskeletal disorders, workplace injuries and reduced immune function. Yet workplace stress is preventable, and stress in the workplace does not inevitably lead to illness. Evidence suggests that attaining personally meaningful goals at work may help prevent illness. Dr. Georgia Pomaki is researching how the pursuit of personal goals can decrease workplace stress and improve physical and emotional health. She is examining the relationship between goal pursuit and stress at work and also as it applies to the home environment. The findings could help identify people who have difficulty achieving goals and are at increased risk for physical illness and emotional distress. The research could also suggest strategies to help employees attain work goals and positively impact their health.
Social determinants of health and their impact on post partum morbidity among midwifery, physician and obstetrician clients in British Columbia
After giving birth, some women have difficulty adjusting to their new role as a mother. Some problems can be attributed to injuries from childbirth, while others, such as depression, fatigue and long-term pain, are not as easily understood. Using questionnaires and face-to-face interviews, Dr. Rachel Westfall is investigating how womenâs income, education and support networks affect their recovery from pregnancy and childbirth and the adjustment to being a parent. Dr. Westfall is also looking at the different types of post-partum care available in BC â including midwifery, general physician care and obstetrician care â to assess how some approaches may meet womenâs needs better than others. Results from the research could be used to improve post-partum care and the transition to motherhood for BC women.
Beyond PTSD: the influence of culture, community, and socio-economic factors in the health and recovery of three communities affected by the 2003 BC wildfires
Firestorms devastated the BC communities of Kelowna, Barriere and Louis Creek in 2003. The exact impact of the psychological, economic and social disruption of the fires on the health and well-being of these communities is unknown. But research on the health consequences of natural disasters has shown that such events are associated with a variety of adverse health outcomes, including posttraumatic stress disorder and depression, and also with experiences of social and personal transformation and growth. Robin Cox is studying the disaster recovery processes in these three communities. Her goal is to develop a model of the processes that reflects the complexity of the event, taking into account the influence of public policy, economics, community cohesiveness and community identity on the physical, emotional and social well-being of people affected by natural disasters. The study will address gaps in existing disaster research by exploring the reciprocal relationships between community-level coping, individual coping and health, and by identifying individual and collective responses that foster resiliency and the adaptive capacities of people responding to trauma and stress. The results may also provide valuable information for governments, communities and disaster response agencies attempting to develop relevant and effective policies and services to support individuals and communities recovering from natural disasters.
HIV, STDs and drug use: an examination of the interplay between these factors and their influence on treatment seeking delays
Drug use, poverty, homelessness and sexually transmitted diseases (STDs) such as HIV are endemic in Vancouverâs Downtown Eastside. Melanie Rusch believes that improving the sexual health of marginalized populations is important for curbing the spread of STDs. She is studying a large sample of people who live in the Downtown Eastside to determine how behaviour patterns among these vulnerable populations affect sexual health. Her first aim is to study how different drugs and combinations of drugs affect sexual behaviours and STD rates. This includes estimating the impact of needle use, as opposed to sexual contact, on STD rates. Melanieâs second goal is to estimate STD rates of a group of women living in the Downtown Eastside. Melanie is investigating how their knowledge of STDs, exposure to outreach programs, and feelings of stigma affect use of health care services. Results of this research could be used to better define high-risk groups, identify barriers to accessing care, and tailor interventions to improve health of vulnerable populations.
HIV, STIs and massage parlour workers: application of social network analysis and mathematical modeling to assess the potential for disease propagation
Studies on the spread of sexually transmitted infections (STIs) and HIV usually focus on individual risk factors such as the number of partners and condom use. But these factors do not fully explain epidemics. Social Network Analysis, a new approach, looks at how relationships between people in defined groups affect risk of disease spread. Valencia Remple is using this approach to conduct a sexual health survey of women who work in massage parlours. As part of the study, trained peer outreach workers are conducting in-depth interviews with workers to obtain information about their sexual behaviour, histories of STIs and the characteristics of their sexual partners. She is also measuring factors known to influence the spread of STIs, such as bridging. Bridging occurs when people in one defined group have sexual contact with members of different groups, which could introduce infections into previously uninfected populations. The results of this research could be used to develop targeted health services for this vulnerable and hidden population.
Stigma, risk and protective factors among vulnerable youth
Adolescence is a time of promise, when major physical, cognitive and relational transitions launch the development to adulthood. But stigmatization in communities and schools can derail this process for certain teens. Teens who are more likely to be stigmatized include youth on the streets; those in foster care or custody; sexually abused youth; gay, lesbian, bisexual and transgendered youth; and indigenous and ethnic minority adolescents. As a result of being stigmatized, these youth are at greater risk for health problems such as drug abuse, HIV infection and teen pregnancy. As part of an international study taking place in Canada, New Zealand and the US, Dr. Elizabeth Saewyc is examining behaviours and environments that stigmatize youth in schools. Dr. Saewyc is studying the links between stigma and risk behaviours, and exploring protective factors that can reduce these risks and build resilience among youth. The findings will be shared with groups of teens and youth workers in the three countries to gather their ideas for reducing stigma, creating safer schools, and preventing substance use and risky sexual behaviours in culturally meaningful ways. The research could lead to interventions to reduce or prevent stigma, to help youth cope with stigma, and to foster healthy development among vulnerable young people.
Community, culture and health
Dr. Cindy Patton has conducted a series of studies on knowledge transfer from medical experts to clinicians, media, policymakers and the public. In dramatic and exceptional cases, this exchange happens almost directly. The mediaâs extensive reporting on health emergencies involving SARS (Severe Acute Respiratory Syndrome) and BSE (Bovine Spongiform Encephalopathy or Mad Cow Disease) created demand from health consumers for more medical research, changes in public health policy, and reassurance about their risk for these conditions. But more often medical research filters down through clinicians and advocacy groups, who translate complex information for consumers and advocate for their medical needs. In addition, government policy makers must sort through information from researchers and citizens to adapt health policies and resources to changing medical needs. Dr. Patton is examining existing methods and systems for exchanging information in various settingsâclinics, research centres and global information networks. The research could be used to create better channels for transferring specialized medical information. Dr. Patton is also developing training programs for researchers and the public to help improve their understanding of how to efficiently transfer knowledge from medical experts to people affected by health issues.
Behaviour of the newborn infant in response to pain, distress and caregiving influences
Recent evidence suggests newborn infants are more sensitive to pain and stress than older children and adults. The level of sensitivity may be especially acute for newborns who are at-risk for developmental problems due to prenatal exposure to pain, antidepressants or illicit drugs. Studies suggest that early exposure to pain and stress leads to changes in the newbornâs brain circuitry, and may increase vulnerability to abnormal behaviour and development. This has led to a search for better ways to understand and recognize infant pain and measure the effects of pain treatment. Dr. Fay Warnock is investigating the actions and interactions of healthy and at-risk infants. The research involves confirming a comprehensive list of behaviour associated with newborn distress, and comparing the actions of healthy and at-risk newborns during and after routine diaper change and heel lancing, a common procedure for obtaining a blood sample to screen infants for metabolic errors. She is also linking newborn behaviour with changes in facial action and heart rate. The research will further develop measures of newborn pain, improve understanding of how caregivers can help alleviate pain, and lead to protocols for preventing, assessing and treating newborn pain.
Game on: diminishing risks for depressive symptoms in early adolescence through positive involvement in team sports
In early adolescence, both girls and boys report increases in levels of depression. However, by late adolescence the rates of depression among girls are double those found among boys. Research shows that boys and girlsâ perceptions about athletic competence (how good they are at sports), social acceptance (how popular they are among peers), and body dissatisfaction (negative feelings about their bodies) are strong predictors of depression. Since girls tend to report lower levels of athletic competence, participate in sports at lower rates, and report higher levels of body dissatisfaction than boys, they may be at greater risk for depression. Erin Boone is examining whether positive involvement in team sports increases perceptions of athletic competence and social acceptance, and helps to diminish body dissatisfaction among both girls and boys. The study will be among the first to assess the mechanisms that link positive team sports involvement to diminished risks for depression in adolescence. Findings will outline the mental health benefits associated with team sports involvement and highlight the need to sustain adolescentsâ interest and participation in sports.