Does cognitive behavioural therapy normalize androgen and estrogen levels in a clinically-depressed sample?

Depression is a widespread mental illness, affecting one in ten people. Twice as many women as men suffer major depression. Hormonal changes brought on by puberty, menstruation, menopause, and pregnancy may contribute to the higher risk, as these periods in a woman’s reproductive cycle have been associated with depression. Hormone replacement therapy has been prescribed to treat changing sex hormone levels, but a study found the health risks exceeded the benefits. Carolin Klein is investigating the impact of an alternative approach, cognitive-behavioural therapy (CBT), on hormone levels. CBT has been as effective as medication in treating depression, with no side effects. If depression and sex hormone levels are related, cognitive-behavioural therapy could also normalize hormone levels. Carolin is measuring hormones in depressed men and women before, during, and after CBT. The results could clarify if changing hormone levels cause depression, and lead to greater use of cognitive-behavioural therapy to treat abnormal hormone levels, without the side effects associated with some medications.

Mending and maintaining the quality of lives: Evaluating the treatment programs provided for mentally disordered offenders in British Columbia

The Forensic Psychiatric Hospital in British Columbia is currently evaluating approximately 30 rehabilitation programs offered to psychiatric patients who are found not criminally responsible for offenses because of severe mental illnesses, such as major mood disorders, schizophrenia and other psychotic disorders. While standard outcome indicators are needed to evaluate the effectiveness of these programs, these are difficult to develop because each patient experiences different symptoms and disabilities. Carol Wong is assessing a patient-centered evaluation tool (called Goal Attainment Scaling) for measuring patient improvement. Using this approach, the treatment team identifies and evaluates the most important goals and outcomes for each patient to achieve in a particular timeframe. Carol is also examining whether a patient’s readiness for treatment has an impact on outcomes, as this factor has consistently been overlooked in practice. The results of this research should help improve the effectiveness of rehabilitation programs, therefore reducing the likelihood of repeat offenses and improving mental health and quality of life for forensic psychiatric patients and their families.

The relationship between attachment and empathy in the development of psychopathic traits among aggressive adolescents: Theoretical considerations and implications for intervention

Violent crime is a devastating social problem that affects the physical and mental health of victims, and has significant economic costs. Aggressive and violent behaviour among adolescents is particularly disturbing. Although adolescents who commit violent crimes are often incarcerated, placement in an institution does not reduce violent acts committed after release. A subset of aggressive adolescents demonstrates antisocial traits such as callousness, a lack of empathy, and a propensity for engaging in diverse, and at times severe, violent acts. These traits have been called “”psychopathic,”” because they appear to be an early version of adult psychopathy. These adolescents are at higher risk for continuing violent behaviour well into adulthood. While some research has examined biological causes, the family environment has been ignored, even though the family plays an important role in children’s development of empathy and social behaviour. Rosalind Catchpole is studying aggressive adolescents’ styles of relating to their caregivers and empathy levels. Her research will identify the risks and protective factors related to adolescent violence, and help improve intervention programs for aggressive adolescents.

Biochemical and structural characterization of bacterial type III secretion system components

Harmful bacteria are becoming much more resistant to the currently available antibiotics, a situation that poses a serious threat to public health. The development of new and more effective ways of protecting against these increasingly dangerous (and antibiotic resistant) microbes requires a thorough understanding of the molecular mechanisms through which they cause disease. The bacterial type III secretion system (TTSS) is a complex mechanism that controls how bacterial proteins are transfered into human cells, a process that is essential to the disease-causing capabilities of a large number of pathogens, including Salmonella and pathogenic E.coli. Although many components of the TTSS have been identified, exactly how this secretion system is assembled and how virulence proteins (toxins) are delivered into target cells remains poorly understood. With support from a 2002 MSFHR Trainee Award, Calvin Yip successfully described the first high resolution structure of an extracellular component of the TTSS. Now funded for a second time, he is working to further characterize its structure and function. This work will help answer fundamental questions about the biochemical and structural characterization of TTSS, and may facilitate the design of new classes of drugs to combat a broad range of infectious agents.

Nurse Staffing, Interruptions in Practice, and Patient Safety Outcomes: Exploring the Systems Issues

Changes to health care in Canada over the latter part of the 1990s have resulted in a number of new challenges for hospital nurse executives and health care leaders. In response to fiscal constraints and funding reductions, many health care settings restructured and downsized in an effort to reduce costs and improve the efficiency of services provided. These changes, coupled with the nursing shortage, have prompted concern in the nursing community regarding the work environment of nurses, and how this may influence nurse and patient safety outcomes.

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Injection site infections of injection drug users in Vancouver's downtown eastside

In addition to other serious health risks experienced by Canada’s estimated 125,000 injection drug users, individuals who inject drugs commonly develop infections at the site of injection, such as abscesses and cellulitis (infection of the skin’s deeper layers). Previous studies have shown these injection site infections account for the majority of admissions to emergency departments and hospital beds in Vancouver. Treatment is inefficient and costly, and these infections can lead to more severe complications, including bone infection, amputation and death. Surprisingly, there has been little research on preventive measures. Now, Elisa Lloyd-Smith is studying which individuals are at increased risk for injection site infections, and what preventive measures and treatments are most effective. She is also assessing whether the supervised injection facility in Vancouver’s Downtown Eastside community, the first in North America, reduces hospitalizations due to injection site infections. This is the first study anywhere in the world to evaluate the impact of a safe injection site on infection rates. Elisa’s research will identify preventive measures to reduce the incidence of injection site infections, improve health outcomes among injection drug users, and reduce health care costs.

A subunit-specific role for NMDA receptor antagonism in neonatal seizures: in vivo and in vitro characterization

Seizures are more common during an infant’s first month than at any other time during their development. They are caused by temporary abnormal electrical activity in the brain and can have long-lasting consequences such as memory impairments and an increased risk for epilepsy. Unfortunately, anticonvulsant treatments are ineffective for at least 35% of babies who have seizures as newborns. Currently, the mechanisms underlying the onset of these seizures are unclear. While research indicates that increased transmission of glutamate (a neurotransmitter) may result in seizures in the adult brain, there have been indications that seizures in newborns may be triggered by a reduction in glutamate transmission. These and other findings suggest that certain glutamate receptors may have different roles in causing seizures over the course of neurological development. Dr. John Howland is investigating the role of glutamatergic transmission levels and seizures during the neonatal period. He is analyzing two highly specific glutamate receptor antagonists (blockers) to determine the specific receptor subtypes involved in triggering seizures. Results from his research may have significant implications for the understanding of neonatal seizures and the development of novel drug targets for their prevention and treatment.

Identification of sialyltransferase inhibitors and their use in the development of a chemical genetics tool for the study of normal and pathological cell surface carbohydrate modification

The complex arrangement of carbohydrates that cover the surfaces of cells is known to play a key role in biological processes ranging from cellular recognition to gene regulation. Changes in the composition of these carbohydrate structures are linked to the onset of many diseases, including the proliferation of cancer cells and compromised immune function. Research suggests that these changes are often associated with elevated activities of the enzymes responsible for sugar placement. As such, these enzymes (glycosyltransferases) represent an attractive drug target for the treatment of many human diseases. Unfortunately, multiple enzyme forms for a given sugar transfer are encoded by the human genome and the role that individual genes play in both normal and pathological cell surface modification remains largely unknown. Luke Lairson’s goal is to identify the small molecules that inhibit the activity of a class of glycosyltransferases known as sialyltransferases. These enzymes are responsible for adding a particular type of sugar known as sialic acid (known to play a key role in many types of cancer) to cell surfaces. Luke hopes that identifying these small molecules will serve as a potential starting point for the development of a new class of anti-cancer drug. His results may also be used to develop a technology for the identification of individual gene products responsible for the placement of particular sugars in both normal and diseased cells at a given point during development.

A molecular picture of the innate immune response to Salmonella: quantitative proteomic and cell biological analysis of Salmonella vacuole development

Salmonella bacteria reside in the intestines of animals and can be transmitted to humans via contaminated food or water. These bacteria cause diseases such as typhoid fever and acute gastroenteritis, posing major health problems throughout the world. The body normally produces an immune response to these invading microorganisms. In a process known as phagocytosis, the blood’s immune cells engulf the bacteria, enclose them in specialized internal compartments, and then release destructive enzymes that kill them. However, Salmonella and several other intracellular parasites have evolved methods to subvert this process. By blocking the delivery of the destructive enzymes, these parasites avoid extermination and are able to survive and multiply inside the immune cells. Ultimately, bacteria escape from the cell and spread throughout the body to cause disease. Dr. Leonard Foster is employing advanced proteomic methods and instrumentation to explore and describe what occurs at the molecular level during phagocytosis. This research will lead to a better understanding of the basic operation of this important aspect of immune function. It will also advance knowledge of the molecular mechanisms employed by Salmonella bacteria to prevent the immune cells from delivering the destructive enzymes, potentially leading to better methods of protecting against Salmonella infection.