The development of children’s thinking and successful participation in healthy social interaction depends on their ability to share attention with others. Called joint attention, this ability begins to emerge by a child’s first birthday and enables them to learn about people, language and ways of thinking. Infants in whom this developmental milestone is delayed are often from at-risk groups, such as low birth weight children. The delay is also associated with autism, Attention Deficit Hyperactivity Disorder and language impairment. By studying observable aspects of joint attention, Timothy Racine is testing whether the parent-child relationship affects its development. In particular, he aims to identify the age at which infants begin to direct others’ attention with pointing gestures, and whether parents with a supportive style of interacting have infants who point meaningfully at an earlier age. Results from the study could help in the education and training of parents on appropriate ways of establishing joint attention in both normally developing and at-risk infants.
Research Pillar: Population Health
Examining physical perceptions of the body and physical characteristics as predictors of physical activity during adolescence
Research shows that a growing number of Canadian adolescents are becoming less active, threatening their physical and mental health by increasing their risk of being overweight. While there has been substantial research on physical activity, the primary factors that influence levels of activity have not been identified. Catherine Sabiston’s past research has focused on ways adolescents and young adults deal with feelings and emotions related to their body. In this research, she has found initial links between body image and physical activity. She is now looking at whether body image (perceptions and attitudes about one’s body and physical appearance) and actual body characteristics related to shape and weight contribute to decreasing physical activity levels among adolescents. Catherine is also interested in how these factors affect boys and girls differently. Her goal is to come up with realistic recommendations that will lead Canadian adolescents toward increased activity levels and eventually healthier lifestyles.
Mycoplasma genitalium infection among men who have sex with men
Most HIV-1 infections worldwide are acquired sexually after exposure to semen. Research shows that co-infection with ulcer-causing sexually transmitted diseases, such as syphilis and herpes, increases the chance of HIV-1 transmission between sexual partners. Studies have also associated urethritis (inflammation of the urethra) with high levels of HIV in semen. Gonorrhea or chlamydia frequently cause urethritis in men, but recent studies suggest another sexually transmitted infection, Mycoplasma genitalium, is a cause of urethritis. Dr. Thomas Lampinen is investigating the association of Mycoplasma genitalium with urethritis and accumulation of HIV-1 in semen of young gay and bisexual men in BC. The study could identify Mycoplasma genitalium as a potentially treatable co-infection linked to the spread of HIV-1. The research has special urgency given recent recommendations to delay antiretroviral therapy, which will likely cause an increase in infectiousness among men with HIV-1.
What makes women healthy? Examining social inequalities and women's health
In her PhD research Dr. Colleen Reid examined how poverty and exclusion influence the health of marginalized women. Her interdisciplinary PhD bridged social epidemiology, health promotion, feminist theory, and participatory action research. Colleen developed a theory of cultural, institutional, and material exclusion and engaged in a feminist action research project to better understand the relationship between poverty and women’s health. As a postdoctoral fellow, Dr. Reid is now developing and testing conceptualizations and measures of health inequalities with a specific focus on Canadian women. The research involves conducting an extensive literature review, integrating qualitative and quantitative measures, and working collaboratively with health researchers to move theories and methodologies toward practical and policy applications. This research will address major gaps in health inequalities research, a critical step for enabling health researchers to address root causes of social inequalities.
Pain reactivity in children as an indicator of somatization and health care utilization
Research has substantially increased understanding of pain in children, revealing for example that patterns of response to pain and other illness symptoms develop during childhood and continue into adult years. A number of studies have also shown that some children tend to react more than others to bodily symptoms and pain. Dr. Elizabete Rocha is investigating whether or not children who react more intensely to pain are more likely to visit their doctors and have repeated health problems. Her research involves collecting data on the pain response of kindergarten-aged children during immunization. This includes examining the children’s behavioural and physical responses to the needle, and giving parents a questionnaire aimed at getting their insight into how intensely their children react to pain. She will then follow the children over a number of years to document their use of the health system. Through this long term follow-up, Dr. Rocha hopes to develop methods of helping to identify children who may be at risk for low pain tolerance and of helping to prevent or better manage their pain.
Obesity in the community: a comparison of the differential distribution of body fat in four distinct populations
Being overweight or obese, especially around the stomach, dramatically increases one’s risk for health problems such as diabetes and heart disease. This is of great concern as the prevalence of obesity in Canada has steadily increased during the past 15 years. However, most of the research on obesity is based on populations with European origins; very little is known about the effects of being overweight in Aboriginal, Chinese and South Asian populations yet the rates of obesity in these populations are also increasing. Preliminary evidence suggests that at the same weight and stomach size, people of Aboriginal, Chinese or South Asian descent have a higher amount of body fat and greater risk for diabetes and heart disease compared to men and women of European descent. Therefore, using clinical targets for obesity developed from European populations may result in inappropriate screening for prevention of these diseases. Dr. Scott Lear’s research involves recruiting 200 people from each of the Aboriginal, Chinese, South Asian and European communities to study the relationship between cultural background, body fat distribution and risk for diabetes and heart disease. Each participant will undergo a scan for stomach fat, overall body fat and risk factors. By improving understanding about the implications of excess body fat in these under-studied populations, the research could lead to guidelines for identifying people at risk for chronic disease, and contribute to prevention strategies targeted to these populations.
Modeling musculoskeletal diseases: from epidemiology to quality of life
Osteoarthritis (OA), which results in the breakdown of joint cartilage, is the most common form of arthritis. Despite much research on the condition, there is no primary prevention strategy for the disease. Macro-level studies evaluating different prevention and treatment strategies are also needed. In collaboration with colleagues in Canada, the US and Europe, Dr. Jacek Kopec is conducting three osteoarthritis studies. The first involves the development of a computer simulation model of OA. The model will synthesize data from different sources, creating the world’s largest database simulating the nature history of OA. Results from this study will be used to assess prevention strategies and develop optimal treatments for the disease. The second study investigates whether or not moderate physical activity can cause OA. The third study focuses on patients’ preferences about different treatment options for OA of the hip and knee. As part of the study Dr. Kopec is developing a questionnaire that can be adapted to individual respondents, making the assessment more precise and efficient than previous questionnaires. The studies as a whole could advance knowledge of osteoarthritis and improve treatment of the condition.
Psychological pathways for the relationship between socioeconomic status and asthma in children
Research has shown a strong association between low socioeconomic status and poorer heath. Asthma, the most common chronic childhood condition, is more prevalent and more severe among children low in socioeconomic status. Although many factors have been proposed to explain the SES-asthma relationship (e.g. exposure to environmental allergens and irritants, gene by environment interactions, quality of medical care, etc.), these variables do not fully account for this relationship. Dr. Edith Chen is studying the role of psychological factors, such as stress, in explaining the SES and asthma relationship. She is testing whether children with asthma who have low socioeconomic status experience more stressful events and/or whether they have a tendency to interpret life events in a more threatening fashion than children from higher socioeconomic status, and ultimately whether stress helps to explain the connection between low socioeconomic status and poorer asthma outcomes. Some children with low socioeconomic status maintain good health despite adverse life circumstances. Dr. Chen is also examining whether children’s beliefs and supportive family and social networks can buffer children with asthma from the typical effects of low socioeconomic status on health. Results from this research may help improve the health of children with asthma.
A prospective transdisciplinary study of the impact of housing improvements on health: promoting global health equity through innovation and collaboration
Under the leadership of Dr. Jerry Spiegel, BC health researchers are playing an active role in addressing global health research priorities – issues that increasingly affect British Columbians as global citizens as well as individuals subject to increasingly global pressures. With a interdisciplinary team of researchers at the University of British Columbia, linked to colleagues at the universities of Victoria, Simon Fraser, Saskatchewan and Manitoba, with counterparts from Mexico, Cuba and other Latin American countries, Dr. Spiegel has developed a program of research which aims to improve world understanding of “upstream factors”, i.e. pathways whereby global forces affect health. For example, rapid urbanization is a growing global phenomenon that underscores the ongoing need for attention to the basic need for appropriate shelter. While there is a clear relationship between poor housing and poor health, little research has been done not only on the reasons behind rapid urbanization and deteriorating housing, but on the health gains that result from housing improvements. In a unique collaboration with world-class specialists in housing and health research, Dr. Jerry Spiegel is investigating the impact of housing on health. Dr. Spiegel and a multi-national, multi-disciplinary team are studying two groups in Cuba: one living in poor housing conditions that will receive state funded improvements to address hygiene, ventilation, illumination and overcrowding; and another group living in comparably poor housing that is not receiving improvements. The team is using a variety of methods — including ethnographic studies, surveys, environmental monitoring of homes and measurement of biological factors associated with health — to measure the effects of housing on health. Results from the study could be used to develop policies that will improve the health of vulnerable populations in Canada and throughout the Americas. Other international studies being conducted by Dr. Spiegel and his team address other social and ecosystem determinants of health, needed to provide valuable information to promote health in British Columbia and worldwide.
Development of a leisure time walking program based on the theory of planned behaviour stage 1: belief elicitation and evaluation
Substantial evidence associates physical inactivity with the development of several chronic diseases and premature mortality. Conversely, extensive research indicates physical activity helps prevent cardiovascular disease, obesity, stroke, diabetes, cancer, osteoporosis and other conditions. Despite this information, about 57% of adult Canadians do not meet the minimal requirements for physical activity, and half of those who begin a regular physical regimen drop the activity within six months. The overwhelming majority of Canadians — more than 70% — choose walking as their preferred physical activity during leisure time. Dr. Ryan Rhodes is studying beliefs about leisure time walking. The research includes an initial study assessing physical activity beliefs and a second survey assessing actual time spent walking. Results from the research will be used to develop a provincial leisure time walking campaign for adults. Dr. Rhodes’ ultimate goal: developing effective campaigns for promoting physical activity in specific populations, such as middle-aged adults and older adults.