The discovery of penicillin in the early 1900s offered the possibility of a “magic bullet” for the treatment of bacterial infection. Bacteria have proven incredibly versatile, however, as new strains have evolved that can overcome the newest and most sophisticated antibiotics. Superbugs are strains of bacteria that are resistant to all available antibiotics. Staphylococcus aureus, also known as Staph, is a normally harmless skin-borne bacterium that can be lethal in patients with weakened immune systems. Strains of Staph function as superbugs that can tolerate all but the newest experimental drugs. As fast as new antibiotics are developed, Staph appears able to evolve resistance to them. Mark Wilke is researching the molecular mechanisms that regulate resistance to a class of antibiotics called beta-lactams. The findings could help explain how Staph bacteria switch their antibiotic resistance on and off, as well as lead to new strategies for combating Staph infections.
Year: 2004
Effects of changes in joint alignment and loading on cartilage in humans
One in ten Canadians suffers from osteoarthritis, a debilitating and painful disease caused by cartilage degeneration in joints. Abnormal load on the cartilage or some part of it caused by poor joint alignment or obesity can lead to loss of cartilage, which does not usually regenerate on its own. However, it has been shown that cartilage can repair itself following surgery, although the conditions to ensure re-growth are unknown and the reasons for success or failure over the long-term are poorly understood. Using non-invasive magnetic resonance imaging (MRI) scans, Agnes d’Entremont is assessing cartilage health and knee movement in bow-legged patients before and after they have high tibial osteotomy, a surgery to correct their joint misalignment. Agnes aims to define the best conditions for protecting cartilage and promoting repair. The research could increase understanding of osteoarthritis, improve surgical outcomes, and lead to better treatments.
Clinical outcomes of cardiac surgery are influenced by genetics of inflammatory mediators
Open heart surgery usually requires a cardiopulmonary bypass (CPB) pump to manage blood circulation while the heart is stopped for repair. Use of the pump and the surgery itself can cause inflammation and, although some inflammation is needed for the wound to heal, too much can prolong organ dysfunction and recovery time in hospital. The intensity of inflammation after surgery varies substantially among individuals. Age of the patient, pre-surgery health and the amount of time on the pump are factors, but they do not fully account for the differences. There is evidence indicating that genetic factors may contribute to a greater susceptibility to infection and inflammation following cardiac surgery. David Shaw is researching whether two types of cytokines (hormone-like proteins) affect the severity of inflammation following cardiac surgery. These proteins, interleukin 18 and interleukin 10, have been implicated in complications from cardiac surgery. Identifying the genes involved in inflammation may lead to the development of new therapies to improve prognosis and treatment of inflammation.
Bathing without a battle: organizational and physical environmental features associated with resident agitation during bathing on dementia special care units
Agitation in cognitively impaired individuals is one of the most difficult behaviours for nursing home staff to manage. Research indicates that between 40 percent and 73 percent of long-term care residents with dementia display disruptive behaviour during bathing. This behaviour, which causes distress and sometimes injury for both residents and staff, ranges from verbal and physical resistance, to hostile language, punches, hits and slaps. Both the organizational and physical environments of a long-term care facility are believed to influence resident agitation levels. However, most research on the bathing of individuals with dementia has focused on only one of these environments. Heather Cooke is examining the bathing policies, training of bath staff, staff assignment and physical features of bathing areas in all Dementia Special Care Units in B.C., to explore the role of such features in the occurrence of resident agitation during bathing. Findings from the study will be used to develop standards and best practices designed to reduce resident agitation and to guide health care planners in the appropriate distribution of funds for improving the care facility.
Assessing sensitivity to unobserved confounders in observational studies: a Bayesian approach
Hospitals and other health care organizations collect data in areas including admissions, diagnostic tests, and hospital discharges. Health services researchers use this information because it is abundant, readily available and inexpensive to access. However, this type of data differs from experimental data, which is collected for the purpose of research. With experimental data, half of participants receive a treatment and the other half receives a placebo based on random allocation, which allows researchers to measure the impact of the treatment in a manner which is unbiased. Results may be less reliable for non-experimental data when comparing groups of patients because uncontrolled circumstances can influence the outcomes in a process known as confounding. Lawrence McCandless is examining whether a new approach to using health care databases, Bayesian sensitivity analysis, can improve the accuracy and reliability of statistical studies. Lawrence is investigating the effectiveness of the approach in studying waitlists for coronary artery bypass surgery in BC. The research could suggest ways to more broadly use health care databases to study and improve the health system.
The nature and extent of genetic discrimination for presymptomatic individuals identified with an increased risk for Huntington's disease
A genetic test predicting onset of Huntington’s Disease (HD) has been available since 1986. Reports of discrimination resulting from genetic test results have been documented in the US and Great Britain and, while there are no published reports of such discrimination in Canada, research suggests that it occurs here as well. Yvonne Bombard is investigating discrimination faced by Canadians who test positive for genetic risk of HD, but have not yet developed outward symptoms. She is assessing the degree of discrimination they experience when trying to obtain extended health coverage, life and disability insurance, and employment, and comparing these findings to discrimination levels in the US and Australia. Results from the research could be used to inform social, legal and health policy related to predictive genetic testing.
Alternative methods for assessing exposure to occupational risk factors for back injury
Back strain is the leading cause of injury among Canadian workers. From 1997 to 2001, the Workers’ Compensation Board of BC received more than 90,000 back strain claims and paid out more than $661 million in compensation. Major occupational risks for back injury include heavy lifting and awkward postures. Rahul Chhokar is comparing different methods for assessing exposure to these risks in five BC industries that account for more than 25 per cent of back claims: forestry, wood and paper products, construction, transportation and warehousing. Direct measurement systems are costly and not always practical to use, but are generally considered the most precise. Rahul is studying whether other, less expensive approaches also provide reliable data on exposure to occupational risks. These include interviewing workers, asking them to fill out questionnaires, and observing workers at job sites. If accurate, these methods could provide a more cost-effective way of identifying potentially harmful work environments and reducing the risk of injury.
Does a counselor's occupational stress impact client outcome in addiction treatment?
Continuous demand for addiction services, ongoing reorganization, staff shortages and gaps in service have created a stressful work environment for B.C.’s addiction service providers over many years. Little research has been conducted on the work environment of addiction counsellors and on the impact that environment has on client outcomes. Annemarie Gockel is studying the level and impact of the occupational stress experienced by addiction counselors in BC. She is investigating whether stress affects counselors’ ability to form effective working relationships with clients, and whether service provider stress affects client outcomes. Results from the research could be used to enhance the effectiveness of addiction treatment and improve workplace quality for addiction service providers.
A place to grow old: past experience and present circumstance as motivation for seniors to migrate or to age-in-place
Nearly 25 percent of Canadians will be 65 or older by 2036. With increasing age, most seniors face the difficult decision of where to live. Jennifer Harvey is studying how seniors’ sense of place, emotional ties and experiences in a community influence their decision to move to a new location or to stay in the same place. She is also studying how support networks differ for seniors who stay in place and those who move. Jennifer is examining the experiences of seniors in two small B.C. communities: Parksville, where almost 31 percent of the population were seniors in 2001, and Qualicum Beach, where 38 percent were seniors. These figures are significantly higher than the provincial average of approximately 13 percent. Results from the research could be used to forecast migration patterns among seniors and improve housing, health and social service policies in communities with aging populations.
Punjabi immigrant women’s experiences of breast cancer
Breast cancer affects one in nine Canadian women. In BC’s South Asian community, while the majority of immigrants are Punjabi, little is known about the experiences of Punjabi immigrant women with breast cancer. Fuchsia Howard is studying how cultural, social and life contexts influence Punjabi women’s experiences with breast cancer. She is assessing whether these factors affect accessibility of health services and social supports, and how Punjabi women think about, adjust to and cope with breast cancer. Results from the research could enable health care providers to better understand Punjabi women’s health needs, and provide more culturally appropriate, respectful care. The findings could also be used to develop policies and programs that ensure women of all ethnicities receive optimal cancer care.