Dr. Karen Kobayashi has long been interested in how ethnicity affects aging and health. In her current research, Karen is comparing the health of Chinese and South Asian adults—the fastest growing ethnic groups in the Lower Mainland—with Canadians of British origin. She is examining differences in health status and use of health services among middle age Canadians to determine the factors that may promote or impede healthy aging. The research involves interviewing participants to determine how differences in such variables as education, income, time since immigration, English language ability, religious affiliation, and adherence to traditional values affect their health status and the way they use health services. She anticipates the research will reveal differences between and within cultural groups. For example, the way foreign-born and Canadian-born adults access health services may vary within each population group. The way new immigrants use health services may also vary from people who have lived in Canada for 10 years or more. This information could be used to predict health care needs among the groups and improve access to health services for these populations as they age.
Research Pillar: Population Health
Evaluation of efficacy of borate-based fungistatic treatments on building materials and growth, pro-inflammatory and toxic products of secondary metabolism by selected micro-organisms
With the prevalence of “”leaky”” buildings in BC, there is increasing awareness of the potential health risks associated with damp building products fostering the growth of fungal organisms. These organisms grow from spores, which are naturally abundant in outdoor air. Although spores cannot grow on dry building materials, they can readily form colonies and grow on building materials that have sufficient moisture (e.g. resulting from water leaks, flooding or condensation). These fungi are thought to contribute to respiratory and inflammatory health problems in people. Dr. Karen Bartlett is studying the effects of a class of anti-fungal preservative containing borate. This preservative, used to inhibit fungal growth on wood products, is not yet approved for use in Canada. Dr. Bartlett is monitoring whether borate leaches out building materials when they are wet and becomes ineffective. She is also investigating whether the fungi produce any harmful byproducts in response to these preservatives that might create further health problems.
Investigating the link between symptom expression, medicalization and acculturation: The case of Portuguese immigrants
Dr. James has conducted groundbreaking research into the experiences of Portuguese immigrants with agonias, a commonly-expressed disorder that is literally translated as “the agonies.” While North American clinicians often diagnose agonias as anxiety and/or depression, and treat it with medication and psychotherapy, these approaches are often unsuccessful. Dr. James’ previous research indicates that the meaning, symptoms and treatment of agonias do not match the standard psychiatric disorders of anxiety or depression. Dr. James is investigating the differences in the way clinicians and members of Portuguese communities understand agonias; whether it is related to anxiety or depression; and whether assimilation into North American society changes community members’ understanding and experience of agonias. This research will further inform her work teaching therapists throughout Canada and the US how to conduct psychotherapy with ethnic minority patients.
Social Support Among Patients with Rheumatoid Arthritis: A Daily Progress Study
Because there is no cure for Rheumatoid Arthritis (RA), treatment focuses on alleviating pain symptoms and maintaining function. With that in mind, Susan Holtzman studied the links between pain levels, stress, ways of coping and social supports in patients with RA. The few existing studies in this area indicated that patients with strong social supports experience less pain and disability, but Susan wanted to examine this more closely. In her study she used daily monitoring techniques and collected detailed data from patients and their spouses. Susan used an advanced modelling technique to analyse the findings and concluded that social support decreased pain levels by encouraging and improving coping strategies. Findings from this study highlight the importance of social support. The research may ultimately lead to the development of psychologically-based treatment and individually-tailored pain management for patients with RA.
Investigations into Risk Factors and Determinants of HIV and Hepatitis C Incidence and Prevalence among High Risk Youth
Researchers have conducted extensive studies of injection drug use in Vancouver, but few have focused specifically on high-risk youth. Enter Cari Miller. Her Masters research — a sub-study of the Vancouver Injection Drug Users Study (VIDUS) — examined prevalence and incidence of HIV and hepatitis C among more than 200 injection drug users aged 13 to 24. Cari has first-hand experience to draw from. She put in 24-hour shifts as a part-time youth worker with the Vancouver Native Health Underage Safe House. Working with youth — most of whom were drug dependent, female and Aboriginal — has fuelled her passion for research and the urgency for new health policies to support them. Results from the research show high prevalence and exceedingly high incidence rates for HIV and hepatitis C among young injection drug users. Her findings indicate that those at highest risk are female and Aboriginal youth engaged in both drug and sexual related risk, and half of young injectors acquire hepatitis C infection during their first two years of injection drug use. Cari hopes that developing a better understanding of the risk behaviours among these young people will lead to more effective prevention and intervention programs. Ultimately, she would like to see more treatment opportunities for high-risk youth.
The Perception and Utilization of Herbals and Complementary and Alternative Medicine (CAMs) Among Older Adults with Arthritis
Research has shown that a growing number of older adults with chronic illness are turning to complementary and alternative medicine (CAM) to manage their pain and chronic illness. But little is known about why people choose these approaches, or how use of complementary and alternative medicine is associated with changes in health status over time. Kristine Votova will address these questions by using powerful and cutting edge statistical tools to analyze data from the Longitudinal Panel of the National Population Health Survey. Her research also involves recruiting older adults to participate in focus groups, aimed at illuminating the perceived effectiveness of CAMs. Votova anticipates that this research – combining quantitative and qualitative techniques – will contribute to a better understanding of the use of complementary and alternative medicine and herbals, particularly by older adults.
Moment-to-Moment: Narratives of Mindfully Living-and-Dying
Anne Bruce’s research focused on the potential for mindfulness meditation to promote a better quality of living and dying by reducing stress and anxiety. Mindfulness meditation, which involves nonjudgmental and moment-to-moment awareness of change within a person’s mind and body, has been researched extensively for the last decade. But little research has been done on the experience of people with life-threatening illness and hospice caregivers who practice this form of meditation. At the Zen Hospice Project in San Francisco, where care is based on mindfulness meditation, Anne conducted extensive fieldwork while working as a volunteer caregiver. Through in-depth unstructured conversations, she gained insights about new ways of understanding death and dying, and their meaning for those holding non-theistic, non-Western perspectives. Anne hopes findings from this research will help enhance understanding of mindfulness meditation as a self-care practice for people with life-threatening illness. Ultimately, she hopes her work will help program planners develop new models of hospice care and support services that address psychological and spiritual needs of people with life-threatening illness and their caregivers.
Menstrual pain and discomfort in adolescence: Socialization influences
Tina Wang’s interests in health psychology and peer influences prompted her to examine a problem that is a major cause of missed school days among adolescent girls – menstrual pain and discomfort. Most adolescents fail to manage their pain effectively. But virtually no research has been done on how adolescent girls influence each other’s attitudes towards pain. Wang’s study will focus on similarities and differences in the attitudes and coping behaviours of adolescent girls related to menstrual pain. Identifying peer influences could lead to the development of school programs that help adolescent girls manage menstrual pain more effectively, resulting in better health and fewer missed school days. Wang’s long-term goal is to contribute to women’s health by developing a better understanding of the social factors that influence health.
Development and pilot testing of a novel intervention to ensure optimal support for arthritis patients
While family and friends of people living with arthritis have been identified as key sources of support, little research has been done on the specific role and impact of their support. Research suggests the well-being of patients with arthritis suffers when their spouses don’t understand what support they need. Through interviews and focus groups, Allen Lehman is identifying the types of support that arthritis patients want and need from family and friends. He is also identifying ways to increase positive support and assessing how support improves health and reduces health care costs. Lehman will use the results to develop a health education program for arthritis patients and their family and friends. Ultimately, Lehman hopes this research will provide a model for identifying support needs in people with other chronic illness.
The Early Identification and Intervention for Children At-risk for Developing Dyslexia
Dyslexia affects a person’s ability to process language in order to learn to read. If undetected and untreated, the neurological disorder can lead to antisocial behaviour, depression, suicide and other consequences. Nonie Lesaux’s initial research on dyslexia revealed the persistent nature of literacy problems in adults, convincing her of the critical need to identify children at-risk of developing the disorder and intervene at an early stage. Now Lesaux is researching the effectiveness of a kindergarten intervention program for at-risk students, with a particular interest in the social and environmental factors that compound this disorder. Because dyslexia often goes undetected among low-income groups and those who speak English as a second language (ESL), Lesaux is specifically focusing on the effectiveness of the intervention program for children from low-income and ESL families. She hopes that a key result of the research will be a kindergarten screening tool to easily and accurately identify dyslexia in children.