Chronic pain is a relatively common phenomenon that typically results in considerable health services use as well as significant hardship for the sufferer. Experts generally agree that chronic pain is often poorly managed leading to poor quality of life for the sufferer. Additionally, most experts suggest that access to appropriate chronic pain expertise is a major contributor to poor outcomes in the sufferer despite the existence of a variety of pain management programs/services. Because poorly managed chronic pain is so common, a critical look at chronic pain management services is warranted. Canadian health services must meet the needs of diverse Canadian populations and specialized services have been developed for some ethno-cultural groups. While all Canadian people may experience difficulties accessing health services, some are at a special disadvantage due to unfamiliarity or lack of comfort with our current system. Aboriginal-Canadians, who have historically had difficulties with access to the health care system, have been identified as a population at a special disadvantage. In this study I will speak with Aboriginal and Anglo-Canadian chronic pain sufferers and their health care providers. In addition I will observe how patients and the health professionals who look after them interact with one another. I will also examine materials that are written about current pain management programs and services. This study will lead to recommendations for improvements in the health services for chronic pain for these two populations.
Year: 2005
Role of integrin-linked kinase in human melanoma invasion
Cutaneous melanoma is a highly aggressive skin cancer. The highly malignant nature of melanoma is characterized by the capability of the melanoma cells to invade tissue below the epidermis and spread (metastasize) to almost any organ. Melanoma cells acquire distinct characteristics that enable them to break loose from surrounding tissue and migrate to remote sites. Cell migration is a complex process involving a variety of signaling proteins. Many studies have suggested that integrin-linked kinase (ILK), which provides a link across the cell membrane between integrins in extracellular matrix and actin filaments within the cell, is able to regulate the activity of various components of cell movement. Most strikingly, ILK is highly expressed (active) in melanoma compared to normal epidermal cells, and its expression is significantly correlated with melanoma progression. Philip Ng is studying the role of ILK in melanoma invasion. By investigating the molecular mechanisms on melanoma cell migration promoted by ILK, he hopes to assess the feasibility of blocking melanoma cell migration by interfering with the action of ILK.
Role of notch signaling during endothelial to mesenchymal transformation
During heart development a subset of cells that line the inside of the heart, called endocardial cells, undergo a transformation termed endothelial-to-mesenchymal transformation (EMT). This transformation is critical for normal development as it generates the cells that form the walls which divide the adult heart into chambers and the heart valves which regulate blood flow. It has been shown that Notch proteins (signaling molecules highly localized within the endocardial cells of the developing heart) play an important role in EMT as the activation of Notch signaling induces the EMT process. In about 1% of newborns, anomalies in this process are associated with congenital heart defects. Kyle Niessen is investigating a key transcription protein, called Slug, shown to be involved in the initiation of EMT. The Slug protein binds to DNA and affects the cellular composition of a cell. Kyle is examining the importance and the role of Slug during EMT and from this hopes to define the key regulatory steps required for heart development. Kyle’s research will contribute to a better understanding of the molecular mechanisms of normal heart development, and provide insights into correcting and preventing congenital heart defects.
Manipulating spinal plasticity to improve bladder function following spinal cord injury
While most people understand paralysis due to spinal cord injuries, they are less aware of the other consequences of these injuries. Damage to the spinal cord can also result in chronic pain, loss of sexual function, and loss of control of bodily functions, including control of the bladder and bowels. Loss of bladder control is particularly problematic because it frequently results in bladder infections requiring medication, and sometimes hospitalization. Because most spinal cord injuries (SCIs) do not involve a complete disconnection of the brain from the spinal cord, there is potential to make new connections in the spinal cord by stimulating neurons that survive the injury. Leanne Ramer is researching the potential for growth of uninjured neurons in the spinal cord to improve bladder function after SCI. She will examine bladder function in rats with SCI, with and without treatments to enhance growth of neurons in the spinal cord. The outcome of these studies may provide new avenues for exploring ways of improving bladder control and quality of life following spinal cord injury.
Spinal cord regeneration following cellular transplantation: actions and mechanisms of olfactory ensheathing glia
Spinal cord injury results in devastating, permanent consequences for the injured individual when the nerve cells that form the spinal cord and connect the brain to the muscles of the body fail to regenerate. One of the most promising therapies for nerve cell regeneration is transplantation of olfactory ensheathing cells, which are involved in our ability to smell and help nerve cells in the olfactory system to continually regenerate. Research has focused on the transplantation potential of olfactory ensheathing cells, which form a protective layer around nerve cells and also play a role in regulating their function. Restoration of some motor functions has been reported following transplantation of these cells, but the mechanisms by which this occurs is not understood. Further, only some spinal cord injuries respond to this treatment and the reason for that is also unknown. Miranda Richter is studying nerve cell growth in vivo and in vitro to determine the intrinsic differences between different tracts of the spinal cord in their responsiveness to ensheathing cells. This will enable her to understand what mechanisms are used by ensheathing cells to promote nerve cell growth. By dissecting the mechanisms of this action, her research may contribute to the development of a more effective treatment for spinal cord injury.
Maternal decision making regarding initiating stimulant treatment for child ADHD
About three to five percent of school aged children have Attention-Deficit/Hyperactivity Disorder (ADHD). Children with ADHD have difficulty sustaining attention, uncontrollable hyperactivity and impulsive behaviour. They account for a significant number of referrals to children’s mental health services. Stimulant drugs, such as methylphenidate (Ritalin) and dextroamphetamine, generally reduce ADHD symptoms. However, 22 to 26 percent of parents who have children with ADHD decide against treatment using these medications. Research shows children with ADHD who are never medicated are at greater risk for substance abuse than those treated with medication. While some parents reject stimulant drugs in favour of behavioural therapy, which has also been demonstrated to be effective, other parents reject drug therapy in favour of less effective and possibly harmful treatments such as diet or vitamin therapies, or no treatment at all. Carla Seipp is studying how beliefs held by parents, teachers and friends about ADHD and information provided by physicians influence a mother’s decision about initiating stimulant drug treatment. The findings could help physicians and families address barriers to using these medications.
Characterization of novel isoforms of tapasin and their function in immune modulation
A healthy immune system constantly monitors the body, helping to detect and eliminate infected cells and those that become cancerous. This system is mediated by a group of molecules called MHC Class 1, which adhere to and present a sample of the contents of a cell for scanning by T cells. T cells are specialized immune cells that are programmed to recognize and destroy abnormal or infected cells. In auto immune disease, such as Crohn’s disease, Lupus and Rheumatoid arthritis, this system breaks down and the T cells kill both abnormal cells as well as healthy ones. Robyn Seipp is researching the role of a specific molecule within the MHC Class 1 assembly pathway called tapasin. This molecule assists in the assembly and determination of which proteins are presented to the T cells on the cell surface. Her research is examining two newly discovered variants of the tapasin molecule that appear to function differently. She is studying these variants of tapasin to determine their effect on how, when and where immune responses to various pathogens or tumours are made. Results from her research will help better understand how tapasin contributes to the body’s ability to mount immune responses to pathogens and cancers while avoiding autoimmune diseases. A better understanding of their function could have important implications for vaccine design and may lead to better application of generalized tumour therapy.
The search for novel regulatory elements in C.elegans
Gene expression is the process by which a gene’s information is interpreted via RNA messengers to regulate all aspects of cell growth and function. Errors in this complex process can cause birth defects and diseases such as cancer. Although the mapping of the human genome was a major breakthrough in gene research, much remains to be learned about the molecular mechanisms which determine when a gene will be turned on and off (i.e. signaled to start or stop the production of messengers to co-ordinate specific types of cellular activity). Monica Sleumer is studying how genes are controlled at the molecular level. She is using the nematode (roundworm) C. elegans as a model organism because its genome has been fully sequenced (its genes are known) and it has been shown to share basic regulatory elements with humans. Using sophisticated bioinformatic methods for sorting and analyzing genetic data, Monica is investigating what turns genes on and off under different conditions and in different tissues. Ultimately, results from Monica’s research on the C. elegans will lead to new understanding of the much more complex human genome and the consequences for health when regulation errors occur.
Attention and optic flow in dynamics scenes
The ease with which most people navigate their surroundings conceals an important fact: the brain works very hard to take in as much information as possible about the environment to plan and coordinate actions needed to get around. But how this occurs is not well understood. Vision is one of the most important sources of information for navigation. As people move, visual information continually changes in a process known as optic flow. This process helps inform the brain of actions needed to get to a certain destination, and how to avoid any obstacles along the way. Alzheimer’s disease is often associated with difficulties perceiving optic flow. As a result, people with Alzheimer’s are at significantly greater risk of injury from falls and car accidents. Christine Tipper aims to understand how optic flow is used for navigation by examining how we attend to the dynamic visual information encountered as we move through the environment. Her research goal is to gain insight into how the brain processes this visual information and uses it to coordinate effective actions. This understanding could help explain problems with navigation seen in people with Alzheimer’s, and may be an important step towards developing useful remediation or coping techniques.
Women with chest pain: Negotiating experiences of emergency department care
Cardiac disease is the number one killer of Canadian women. Research has shown that women and men have different experiences in the health-care system. Although emergency departments (ED) are often the first point of contact for women with cardiac symptoms, this setting has seldom been studied. Yet what happens during a visit to the ED may set the stage for later events. Treating heart attacks is highly time-dependent. If women get to an ED for treatment within four hours of the onset of symptoms, health professionals have a good chance of salvaging heart muscle that would otherwise be destroyed. Sheila Turris is investigating how experiences of emergency department care shape women’s decisions about seeking care in future situations. Specifically, she is examining how women arrive at the decision to seek treatment, and how they negotiate emergency care. This research may improve the quality of care women receive in emergency departments, helping to ensure women seek and get early, more effective treatment for signs of cardiac illness.