More than 1.4 million Canadians have osteoporosis, a chronic condition that causes bones to become fragile and fracture easily. Clinical trials have shown that lifestyle changes and early medical management can reduce osteoporotic fractures in high-risk people. Past studies suggest that many people over 50 years of age who suffer a minor fracture are at risk for osteoporosis. This is an ideal time for osteoporosis investigation. Yet these patients are most often treated for the fracture alone and not investigated for osteoporosis. The aim of Maureen Ashe’s research is to investigate whether educating patients and raising physician awareness about osteoporosis after a low-trauma fracture could improve the investigation rate and if necessary, enable more patients to receive preventative therapy. Preliminary results from the study indicate that after providing education to patients and physicians at hospital fracture clinics, a substantially higher number of patients were assessed for osteoporosis.
Year: 2004
Treatment adherence in first episode psychosis with a history of violence: understanding correlates and improving adherence
Research shows that if people who have experienced a first psychotic episode adhere to treatment, they are less prone to relapse and have improved overall well-being. However, studies also indicate that less than 50 percent of these individuals take their medication as prescribed, and less than one-third participate in relapse prevention treatments. It’s known that people with schizophrenia and a history of violence, substance use, or antisocial personality disorder are less likely to adhere to medication regimens and psychosocial treatments. Alicia Spidel is looking at the relationship between treatment adherence and a history of violence in people experiencing a first psychotic episode, and whether first episodes are related to higher rates of personality disorders and substance use. She is also assessing whether motivational interviewing, a client-centred therapeutic approach, motivates participants to manage their symptoms and prevent relapse. The results could be used to refine treatment programs for people with schizophrenia and reduce criminal behaviour.
The effect of surgical technique on morphology and biomechanical behavior of allograft bone-cement in hip reconstruction with impaction allografting
Of the approximately 18,000 hip replacements performed annually in Canada, 10 to 20 percent fail after 10 years. Failure and removal of an implant cause extensive bone loss to the femur (thigh bone). This bone deficiency makes it difficult to fix a new implant in place. Impaction allografting involves impacting and cementing morsels of bone in the femur to set a new implant in place. The appeal of this technique is its documented potential to restore bone. The procedure, however, has had mixed clinical results. Carolyne Albert is exploring ways to improve the surgical tools and techniques for impaction allografting. She is comparing the current technique with alternative surgical techniques. The research could lead to a technique that will provide implant stability while improving the potential for bone restoration.
The effects of inconsistency on everyday activities of Alzheimer’s disease
Studies have shown that people with Alzheimer’s disease are more inconsistent, compared to healthy older adults, on cognitive tasks (e.g., memory, reaction time). Research in this area has measured fluctuations in performance on multiple occasions over short periods of time. What is not clear is how these inconsistencies affect people’s daily lives. Various factors — including cognitive, visual and perceptual abilities, language and speed of processing — influence functional abilities. Catherine Burton is studying the impact of inconsistent cognitive performance on ability to perform everyday activities, such as managing finances and taking medications. Her research could help characterize the neural systems required for particular cognitive processes, which would assist in identifying people most at risk and in need of support.
A randomised controlled trial of a home based strength and balance retraining program in older persons presenting to the emergency department with a fall or related injury
In BC, falls are the most common cause of injury leading to hospitalization of people over 65. Older people with fall-related injuries severe enough to require a visit to an emergency department are at particularly high risk of falling again and incurring further injuries. Current treatment guidelines encourage an extensive and costly course of care for these individuals, including physiotherapy, ophthalmology, family physician support and occupational therapy. Meghan Donaldson’s research has shown that many at-risk patients do not receive this course of care. Meghan is investigating whether a home-based strength and balance retraining program can prevent subsequent falls in people who have already been treated in an emergency department for a fall. The research could provide evidence that a simple and cost-effective exercise program, involving fewer referrals than what current guidelines call for, could successfully reduce falls in older adults at risk of injury due to falls.
Bone-conduction auditory steady-state response thresholds: Effects of maturation and hearing loss
Tests to detect hearing loss measure the ability of sound vibrations at different frequencies to reach the brain. Hearing tests measure the ability to hear either air-conducted sounds (sounds that reach the inner ear through the ear canal) or bone-conducted sounds (sounds transmitted through bones in the ear and skull). Susan Small received a 2001 MSFHR Trainee Award to study an emerging method for testing hearing focused on auditory steady-state responses (ASSRs), which objectively measure response to sound stimuli. Studies show that ASSRs can accurately estimate hearing levels for air-conducted sounds. However, there is no data on the effectiveness of ASSRs in measuring hearing levels in infants for bone-conducted sounds. Susan is building on her earlier research by estimating bone-conduction hearing thresholds for infants when using ASSRs. Results from this research could improve hearing assessments and early diagnosis of hearing loss in infants.
Exploring and mapping illness self-management in people recently diagnosed with Psychotic Illness
Research has identified certain core abilities that enable people with mental illness to self-manage their condition. This includes the ability of individuals to understand information about their health condition. Studies have shown that providing illness-related information is a fundamental starting point for developing other self-management abilities; but little research has been done on the needs of people in the early stages of illness who are entering the mental health system for the first time. Eric Macnaughton is studying how people newly diagnosed with serious forms of mental illness can learn to successfully live with their conditions. Given the traumatic and confusing nature of a first experience with mental illness, Eric is investigating the idea that stories about people who have successfully coped with their mental illness could help motivate newly diagnosed people to self-manage their condition. The research could contribute to design of programs and tools that help build or strengthen self-management skills.
Family environment and mental health of youth from biological and adoptive families
Research suggests the family environment plays an important role in youth health and development. For example, youth exposed to more coercive forms of discipline, higher family stress, and less parental care seem to be at higher risk of developing alcohol problems. However, other research suggests genetic factors may influence both risk behaviours and family factors, such as parenting. Ming Ao is studying both biological and adoptive families to determine if the family environment influences mental health and risk behaviours in youth. Ming is assessing how family environment affects young people’s emotional well-being, social skills and competence. The findings from this study could improve understanding of family influence on youth mental health and be used to develop youth health services for biological and adoptive families.
Patterns of social anxiety in Chinese and European Canadian populations
Many people experience the social anxiety of being uncomfortable in certain social situations. But social anxiety can develop into social phobia, a clinical condition characterized by excessive fear related to attention and scrutiny by others that can significantly impair quality of life. Surveys in Asia have shown Asians experience considerably less social phobia than Western populations. But North American studies show Asians report higher levels of social anxiety than Caucasians. Lorena Hsu is examining two possible explanations for this discrepancy: Asians are less impaired by social anxiety and therefore less likely to develop social phobia, or Asians are less likely to openly admit to symptoms of social phobia. Using data collected from questionnaires and interviews of Chinese and European Canadians, Lorena will determine which explanation provides a better account of the discrepancy. This study could help explain how people in different cultures experience and express social anxiety, and contribute to development of culturally appropriate mental health services.
Assessing the role of neighbourhoods in the school readiness of kindergarten children in British Columbia
Research has documented that a child’s immediate surroundings affect early development. Neighborhood variables such as socioeconomic status, cohesion, safety, and access to community resources (e.g. childcare, libraries) are amongst those factors that can affect child health and development. However, there is little Canadian research that addresses this connection. Vanessa Lapointe wants to fill that gap by studying how neighbourhood conditions affect the developmental health of British Columbian kindergarten children across five developmental categories: physical health and well-being; social competence; emotional maturity; language and cognitive development; and communication skills and general knowledge. This research will be helpful in designing early intervention programs to assist children who may otherwise lack the developmental foundation needed to be successful as they begin school.