Renal artery stenosis is the narrowing of the arteries that supply blood to the kidneys. Research on the progression of kidney and cardiovascular disease in patients with this condition is limited. Dr. Nadia Zalunardo is examining whether kidney disease progresses more quickly in people with renal artery stenosis. Nadia is also studying whether people with the condition have higher rates of mortality, cardiovascular events such as stroke, heart attack and heart failure, and vascular procedures such as amputations and bypass surgery. The research could increase understanding about whether treating cardiovascular risk factors, such as diabetes, high blood pressure and elevated cholesterol, slows the progression of kidney disease and improves outcomes in patients with renal artery stenosis. The findings could also enable nephrologists (physicians specializing in treating kidney disease) to better project the need for dialysis and improve care for patients with kidney disease.
Year: 2005
Structural and biochemical analysis of the essential type III secretion system ATPase from Gram-negative pathogenic bacteria
Infection by gram-negative bacteria is a growing threat to humans, animals and plants. The severity of disease and death rate associated with these infections continues to grow because of the increase in antibiotic-resistant strains of these bacteria, including strains of Yersinia, Shigella, Salmonella, Pseudomonas, Chlamydia and enteropathogenic Escherichia coli (EPEC). In several of these organisms, disease-causing properties are dependent upon a type III secretion system (T3SS). The T3SS is a complex of more than 20 unique protein components structured into a syringe-like apparatus, which delivers the virulence factors (toxins) from the bacteria directly into the host cells. A key component for toxin insertion is the activity of a type III ATPase, an enzyme that provides the energy for this process and acts as a gatekeeper on the bacterial inner membrane. Dr. Raz Zarivach’s goal is to determine the first three-dimensional molecular structure of this type III ATPase and further understand its mechanisms and role in virulence. He hopes his work will lead to the design of new drugs that will inhibit this secretion system and protect against these common disease-causing bacteria.
The relationship between access to health care services and relocation for rural older adults: Is the decision to move one of choice or necessity?
Previous research comparing how older adults use health services in urban and rural areas of Canada is inconclusive and sometimes contradictory. Some research found no differences between urban and rural residents; other studies found that people living in rural areas tend to use fewer services than those in urban centres. Diane Allan is comparing health care use and the mobility patterns of urban and rural residents. She is tracking health service records for people 55 and older on Vancouver Island to determine health service use before and after a move, including physician and hospital visits, home support and long-term residential care. Diane is assessing whether the current health care system is able to accommodate people in rural areas who require more specialized and intensive services, and if a lack of services forces people to relocate closer to the health care they require. One challenge is developing an appropriate measure of rural and urban residence. Diane is comparing traditional measures developed by Statistics Canada, with measures based on geographic information systems (GIS) technology, such as distance to a hospital. From a policy perspective this research may help to clarify why some findings report few differences in health service utilization among rural and urban older adults. If only healthy older adults remain living in rural areas while those with poorer health are forced to relocate to more resource rich environments, similar health utilization does not necessarily suggest an adequate health care system. Diane hopes her research will contribute to determining if and why rural older adults move in order to place these utilization patterns into context.
Assessing the impact of an engaged lifestyle in preventing Alzheimer’s Disease
Genetics, education and lifestyle can all influence the aging process, and as a result there is significant variation in older adults’ cognitive function. Although some risk factors for cognitive decline are fixed – such as genetic make up – people do have control over their own involvement in physical, social and intellectual activities. However, the relationship between activity and age-related cognitive decline is unclear. While some research has found that older adults leading active lifestyles obtained higher scores on memory tests, were less likely to show memory decline, and had a lower risk of developing dementia, other research has not shown any clear association. To shed more light on the relationship between activity and cognitive decline, Allison Bielak is using a technique that assesses the consistency over time with which people perform cognitive tests. Her work is based on the observation that fluctuations in how well people perform cognitive tests at different times – rather than how well people actually score on the tests – may be a useful early indicator of long-term neurological decline. Because this tool may detect subtle changes in function, Allison hopes to determine more concretely whether activity plays a beneficial role to maintain cognitive health. Ultimately, she would like to use this information to determine the best activities and activity level to maintain cognitive ability and slow the progression of neurological diseases such as Alzheimer’s disease.
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.
The role of specific genomic alterations in the aggressive nature of small cell lung cancer
Lung cancer remains the leading cause of cancer death for both men and women in Canada and Small Cell Lung Cancer (SCLC) accounts for about 25% of all cases annually. Patients diagnosed with SCLC have a very poor prognosis, with statistics indicating that only 10% of patients will survive past 5 years. This survival rate has seen little improvement over the past several decades and new targets for therapy and diagnosis of SCLC are desperately needed. SCLC is particularly challenging for researchers because samples are relatively difficult to obtain. Because the type of cell from which SCLC develops is not known, it is also difficult to define normal gene expression (RNA) levels for comparison. Bradley Coe is investigating SCLC gene expression levels by focussing on changes found in the DNA rather than in the RNA. Analysis of DNA has a significant advantage in that the source cell is not needed for establishing a baseline. Bradley is comparing the DNA profiles of SCLC cells with profiles generated from similar types of lung cancer which are less aggressive – an approach that has been made possible because of new genome comparison technology. The results of his research will include a list of genes which may contribute to the aggressiveness of SCLC. His research will also contribute to increased knowledge of the biology of SCLC, which will assist in the classification and diagnosis of this disease and in the identification of potential new targets for drug therapy.
Exploring the impacts of municipal government and local stakeholders groups' interpretations of the social determinants of health model on alleviating local health inequalities
Since the emergence of the population health field in the early 1990s, evidence has mounted demonstrating that health is more than simply a product of health care, biology and lifestyle. Indeed, population health outcomes are influenced by a multitude of factors, including employment, income, education, social supports, physical environment and early childhood development. Taken together, the social determinants of health (SDOH) provide a useful model for understanding the complexity underlying population health inequalities, and for formulating policy responses to address such inequalities. Despite relatively widespread acceptance of this model within academic and health policy circles, there are tremendous barriers to developing public policies and services designed to address health inequalities. These barriers include resistance to inter-sectoral collaboration within federal and provincial governments, as well as inadequate resources for inter-agency collaboration between community-based service providers. Patricia Collins is exploring awareness and application of the SDOH model among municipal politicians and community-based service providers, to determine if awareness translates into action to improve health outcomes. She is also exploring how print media present broader notions of health and well being, such as the social determinants of health, to the public. Patricia’s research will identify where more information on the SDOH model is needed, and how the model can be used to alleviate health inequalities in the GVRD.
P21-activated kinases role in epithelial morphogenesis and cytoskeletal polarity
Cell shape and cell movement play vital roles in organ formation and the sculpting of body shape in the development of multicellular organisms. The Rho family of small GTPases are key regulators of cell shape and cell movement through their participation in signaling pathways involved in a variety of cell processes. These proteins function as “molecular switches”, with the ability to alternate between active and inactive states. Malfunction of these switching mechanisms has been implicated in a variety of disorders including cancer, and a number of inherited conditions such as X-linked mental retardation and faciogenital dysplasia (Aarskog syndrome). These proteins have also been shown to be key regulators in wound healing. The p21-activated kinases (Paks) are proteins that have been shown to alter activity of the Rho GTPases Cdc42 and Rac, and are linked to the regulation of the actin cytoskeleton. Previous studies have demonstrated Pak’s function in the establishment of cell shape and movement via regulation of the actin cytoskeleton. However, the exact nature of Pak within the signaling cascade remains unclear. Ryan Conder’s recent studies have suggested a role for Pak in either the establishment or maintenance of specific membrane surfaces of a cell that are required for tumor suppressor proteins to position themselves properly. Using Drosophila (fruit fly) developmental processes as a model system, Ryan is studying the proteins involved in these signaling networks and establishing the mechanisms by which these developmental processes are regulated. He hopes that what he learns about these signaling pathways in Drosophila will shed light on their roles in human development and disease.
Neuromuscular versus behavioral influences in control of postural stability in elderly women
Falls are the leading cause of injury and injury-related deaths in elderly people. Impaired muscle strength, joint movement, balance, gait, vision, hearing and cognition predispose people to fall. But efforts to predict and prevent falls based on these risk factors have met with limited success. Fabio Feldman is comparing how people with a history of falling and non-fallers control their movements. Motor and cognitive functions may decline as people age. Fabio is investigating whether a tendency to attempt movements that exceed motor capacities, due to an exaggerated perception of physical abilities, is an important cause of falls in the elderly. He is measuring motor capacity for balance, reaction time, flexibility and strength in fallers and non-fallers. The research could lead to better tools for predicting and reducing risk in elderly individuals at high risk for falls. The results could also be applied in other areas, such as assessing driving abilities of the elderly and physical rehabilitation following a stroke or injury.
Exploring and addressing dimensions of health in older children with perinatally-acquired HIV-1 in British Columbia in partnership with communities
Effective antiretroviral therapies are enabling children born with HIV in developed nations to mature into adolescence and young adulthood. These children represent a unique group in the global HIV epidemic, because they have developed throughout their lives with access to antiretroviral drugs. Few Canadian studies to date have examined the lives of these children. As HIV-positive children mature, they face new medical and social challenges, and additional age-appropriate services are needed to support their development. For her MSFHR-funded Master’s work, Sarah Fielden explored the needs of older BC children born with HIV, in collaboration with the children, their family members, and their health care and community service providers. Now, Sarah’s goal is to develop health promotion programs to promote healthy development among these children. Sarah brings previous experience working with young people living with HIV in Zimbabwe, Africa, to this community-based study. She will also assess mortality, drug treatment trends and demographic profiles of BC children with HIV. The lessons learned from this research may be of interest to those working with children with other chronic diseases and the international HIV community at large.