Jan Ehses is conducting research that may contribute to improved treatment of type 2 diabetes, a form of the disease that occurs most frequently in adults and obese individuals. Ehses has a particular focus on glucose-dependent insulinotropic polypeptide (GIP), a potent hormone that accounts for at least 50 per cent of the insulin secreted from the pancreas following a meal. Studies have consistently shown that GIP’s ability to cause insulin secretion is compromised in type 2 diabetes. Using state-of-the-art technology, Ehses is investigating the hypothesis that GIP affects tissues through complex intracellular networks, and that the imbalances in metabolism associated with diabetes may affect this transfer of genetic material important for regulation of insulin production. Ultimately, the goal is to provide a map of the numerous ways GIP affects the whole body, leading to information that can be applied to treatment of type 2 diabetes.
The hierarchical structure and function of social support as a quality of life determinant among community dwelling older adults with chronic lung disease
The number of older adults with chronic lung diseases, such as asthma and bronchitis, is steadily growing in BC. Spouses are often the only source of support for people living with these diseases, yet little research has been done on their supportive role or on alternative forms of support. Gail Low hopes to address these gaps by researching support systems that promote well-being and help older adults cope with lung disease. Her research involves asking older adults to identify how and why their support systems work to help provide direction for new lung health services. She is also developing a map of meaningful support systems as a model to guide existing community health programs.
Epidemiological and population-based investigations of persons infected with HIV
I am a demographer who is currently involved in observational research into the impact of antiretroviral therapy on quality of life and life expectancy of persons with HIV disease in British Columbia. I am also interested in issues regarding access to antiretroviral therapy in developing nations. My most significant contributions to HIV research include: Studies monitoring seroincidence and determinants of HIV infection and risk behaviour among gay and bisexual men In a natural history study of HIV-positive gay and bisexual men, we demonstrated that lower socioeconomic status decreases the length of survival. Low income was significantly associated with shorter survival from HIV infection to death, even after adjustment for CD4 count (which measures immune suppression in persons with HIV), age at infection, year of infection and use of HIV therapies and prophylaxis. Studies measuring the impact of HIV infection on population health My primary goal in the area of population health research has been examining the impact of HIV on patterns of mortality, migration and hospitalization in Canada. One study I conducted showed that although there are barriers to widespread HIV treatment, limited used of antiretroviral therapy could have an immediate impact on South Africa’s AIDS epidemic. A second study demonstrated that the cost of making combination antiretroviral therapy available worldwide would be exceedingly high, especially in countries with limited financial resources. Studies evaluating the impact of antiretroviral therapy on the health and well-being of persons with HIV disease One of my studies demonstrated a significant reduction in mortality and AIDS-free survival for HIV infected individuals who initiated therapy with regimens including stavudine or lamivudine compared to those who initiated therapy with regimes limited to zidovudine, didanosine and zalcitabine.
The role of SHIP in normal and aberrant macrophage and osteoclast development and function
Michael Rauh believes the best approach to health research is to acquire insights from patients, and then to explore those insights in the laboratory. That’s why he’s enrolled in a combined MD/PhD program at UBC to become a clinician-scientist. Rauh’s research focuses on the molecular pathways that lead to the development of cancer cells. His particular interest involves the SHIP gene and its possible use as a therapeutic target in the treatment and prevention of leukemia and other diseases such as osteoporosis. Rauh is investigating whether SHIP can inhibit development of the diseases by preventing inappropriate cell growth. The research will contribute to his ultimate goal of learning how to identify cancer at its earliest, most treatable stages to enable more effective preventative strategies.
Developing an effective and efficient health care delivery system for Canadians at the end-of-life
In the mid-eighties, while working as a palliative care nurse, Dr. Kelli Stajduhar cared for a young man dying from AIDS. A few years later, her mother was diagnosed with lung cancer and died. Both received less than optimal care at the end of their lives. Stajduhar was profoundly affected by those experiences, which gave her a strong desire to examine ways to improve care and support for people at the end-of-life. Stajduhar’s PhD research focused on the provision of home-based care for people who are dying, and its impact on family caregivers. Her postdoctoral work aims to identify the elements needed for an effective, efficient, comprehensive and coordinated system of health care for Canadians who have come to that point in their lives. Ultimately, Stajduhar would like to advance health policy on end-of-life care.
The role of BDNF in progesterone and estradiol effects on cell proliferation, survival and cell fate in the dentate gyrus of adult female rats following contusion
Research has revealed that adult humans and all other mammals are unique in their ability to generate new brain cells as part of a process called neurogenesis. After a traumatic injury, estrogen and progesterone (female steroid hormones) and the Brain Derived Neurotrophic Factor (BDNF) protein help the brain recover. Jennifer Wide’s Masters research focused on the interaction between estrogen and neurogenesis, and in particular, the effects of chronic estradiol treatment on neurogenesis. Based on previous research, she hypothesized that changes in neural structure affect cognition, such as through working memory (also known as short-term memory). She studied, therefore, the effects of estradiol treatment on acquisition and reacquisition of working memory. The research demonstrated that chronic estradiol treatment has a significant differential effect on working memory, especially in low doses. Increasing understanding of neurogenesis will bring researchers closer to the goal of replacing lost cells throughout the brain and have a major impact on neurotrama and neurophsychiatric disorders.
Regulation of Bcl-2 family members involved in macrophage cell survival
Shih Wei Wang is examining the role of a family of proteins implicated in atherosclerosis (hardening of the arteries), a condition that puts people at risk of heart attacks and stroke. In the early stage of atherosclerosis, plaque forms along the inner lining of arteries. This occurs at sites where altered LDL blood proteins enable blood cells known as macrophages to survive. While macrophages act as scavengers to remove foreign substances from the body, macrophages also turn into foam cells that contribute to plaque build-up. Wang’s research focuses on the Bcl-2 family of proteins, including proteins that regulate cell death and others that contribute to cell survival. In experiments incorporating techniques from biochemistry, cell biology and molecular biology, Wang is analyzing proteins that influence macrophage survival and death. The research could lead to improved therapy for people with atherosclerosis, involving selective drugs that block specific proteins or enzymes.
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.
Hepatitis A virus infections among children in British Columbia: Is routine vaccination needed?
Hepatitis A is a viral disease that causes inflammation of the liver. Once contracted, there is no treatment. Adults and older children with the disease usually suffer for four to ten weeks, and the symptoms include jaundice, fatigue, abdominal pain and fever. Young children usually have mild, symptom-free cases that go unrecognized, but can transmit the virus to people of all ages. The BC infection rates for hepatitis A virus have exceeded the national average for more than a decade. Yet a safe, effective vaccine has been available since 1994. The vaccine is currently only given to high-risk groups, and most cases reported by physicians come from these groups. I am investigating the risk of hepatitis A for children in two areas of BC that consistently report high infection rates. The study will determine whether universal childhood immunization is warranted. We can gauge risk for hepatitis A by testing saliva for antibodies to the virus, which would indicate a past infection. Our research team has tested about 800 randomly selected grade nine students. Students also filled out a questionnaire on potential risk factors. We are analyzing this data to identify why the hepatitis A rates may be higher in these areas and whether the scope of the disease is broader than reported cases indicate. If we find high rates of past infection, routine vaccination may be warranted. If low rates are found, the results will provide reassurance that existing sanitary measures are adequate to protect local children.
Quality improvement of stroke surveillance, prevention and care in a sentinel health region
Stroke is the third leading cause of death in BC and the leading cause of brain disability. Stroke is also estimated to be the most expensive disease in Canada that, until recently, was considered untreatable. My research team is evaluating a three-step stroke program in the Vancouver Island Health Region to improve prevention and treatment options. The first step will be developing a surveillance system to collect information on all strokes in the region and to find people who are at high risk. Next, the project team will work on providing new tools to help patients and their doctors plan ahead and implement life style changes that will reduce stroke risk. The third component will use Stroke Victoria’s computer system as a tool for quality improvement initiatives in stroke care. The team will evaluate every stage of the project to assess the effectiveness of this approach for saving lives, improving care and reducing the costs of health care delivery. Stroke is so debilitating, complex and costly that it is worth investing in innovative approaches to prevention. We believe relevant, rapid and rigorous epidemiology is key.