Examining the complex role of social, environmental and structural factors as barriers and facilitators for HIV risk and prevention among substance-using women in survival sex work.

Women engaged in survival sex work in Vancouver’s Downtown Eastside (DTES) face multiple vulnerabilities that directly enhance their risk of HIV transmission, including entrenched poverty, homelessness, repeated episodes of violence and assault, substance abuse, and social marginalization. In addition, the illegal, clandestine and largely unregulated nature of sex trade work in Canadian cities increasingly pushes street-entrenched women to the outskirts of society, limiting their means to protect themselves and access to supportive health services. Despite increasing evidence of gender differentials in new HIV infections facing women – particularly youth and women of Aboriginal ancestry – and extensive harm reduction and public health efforts focusing on illicit drug use in this community, little information exists about the complex social, environmental and structural factors that facilitate prevention, harm reduction practices, and access to care. Kate Shannon’s research will use participatory-action research methodologies to explore the social and environmental barriers and facilitators to HIV prevention among survival sex workers. While several individual factors have been shown to elevate HIV and STI (sexually transmitted infection) risk among female substance users in this setting, far less attention has been paid to the role of social and structural violence and power relations in facilitating HIV risk through both sexual and drug use pathways. Using social mapping, focus group discussions and interview-questionnaires, Kate’s research will aim to demonstrate the social and environmental factors that mitigate the HIV risk environment of survival sex workers, and in particular, the role of violence and power relations in the negotiation of HIV prevention behaviours among drug-addicted women and their intimate and working partners This research will provide valuable information about a population that has remained largely on the periphery of public health and harm reduction strategies and services. It is anticipated that the research will also foster capacity building among survival sex workers and help inform evidence-based policy and practice tailored to this population.

Roles of the cilium, a sensory organelle, in health and disease

Cilia are slender appendages that protrude from most cells and tissues in humans. The motile forms produce whip-like motions, while the non-motile (known as “primary”) forms act as antennae, detecting chemical and physical changes in their environment. Both forms of cilia are critical to human health. For example, motile cilia propel sperm in males, and move debris in respiratory airways. Primary cilia are implicated in sensory processes such as vision, sense of smell and hearing. Defects in the forms or functions of cilia can cause a wide range of human ailments, including kidney and heart disease, obesity and diabetes, and sensory impairments such as blindness. Using bioinformatics, genetics, cell biology, biochemistry and genomics approaches, Dr. Michel Leroux is studying previously unknown components of cilia and characterizing them in the nematode C. Elegans and in human tissue culture cells. He is also working to identifying genes associated with the many ciliary disorders in humans, including some associated with obesity and cystic kidney disorders. By providing fundamental insights into the form and functions of cilia, Dr. Leroux’s studies may uncover new potential targets for therapy in a wide range of human diseases.

Sensory function and dysfunction in neurotrauma: models, molecules and mechanisms

Spinal cord injury (SCI) interrupts the flow of information between the brain and spinal cord. As a result, people with SCI experience muscle paralysis. They also experience changes in sensation, ranging from a complete loss of sensation to chronic pain. Dr. Matt Ramer’s research focuses on the sensory nervous system and how its changes due to trauma related to sensory dysfunction. In particular, he is interested in the balance between factors that promote or inhibit the growth of nerve fibres (axons). Dr. Ramer is investigating the effects of growth-promoting and growth-inhibiting molecules on the anatomy of spinal sensory axons, on their connectivity within and outside the spinal cord, and on behavioural outcomes resulting from spinal cord injury. This work will increase our understanding of sensory dysfunction and may identify new therapies for SCI.

The effect of resistance training on cognitive performance, cortical plasticity, and fall risk in women aged 65 to 75 years old: A 12-month randomized controlled trial

Falling and fall-related injuries among the elderly is a significant health issue for seniors in Canada. Older adults with cognitive impairment are at particular risk; 60 per cent fall annually, a rate that is twice that of their peers with normal cognition. Previous research has demonstrated that current falls prevention programs, such as multifactorial interventions, are ineffective in people with cognitive impairment. This suggests the need for an innovative approach to falls prevention in this group, such as targeting cognitive function itself to reduce falls. As a two-time MSFHR Trainee, Dr. Teresa Liu-Ambrose researched the effectiveness of exercise and rehabilitation programs for preventing falls in women at risk, and the specific dimensions of cognition associated with falls risk in older women. Building on this research, Dr. Liu-Ambrose is now investigating whether resistance training — a mode of exercise proven to reduce the physiological risk of falls in older adults — also benefits cognition. In her study of cognitively-intact women aged 65 to 75, Dr. Liu-Ambrose is determining whether a 12-month resistance training program improves high-level cognitive function. Using standard neuropsychological tests and brain imaging techniques, she will measure changes in cognitive performance and cortical function. She will also evaluate changes in physiological falls risk. Results from this novel study will provide valuable insight into the development of falls prevention programs that specifically focus on cognitive function in older adults.

Pre-eclampsia: Immunology, innovation and improvement

Pre-eclampsia is the most common dangerous complication of pregnancy, affecting the health of both mother and fetus. While high blood pressure in the mother and the loss of protein in her urine are the most visible symptoms of the disease, pre-eclampsia also causes inflammation and organ damage. The disease is a form of systemic inflammation, and is particularly dangerous when it occurs early in pregnancy. Dr. Peter von Dadelszen’s program of research covers a broad range of laboratory, clinical and health services research related to pre-eclampsia. He is studying the role of the immune system in the development and progression of the disease, as well as potential targets for the prevention of pre-eclampsia, and new screening techniques and predictive models. He is also researching new methods to modify pregnancy outcomes, including a novel disease-modifying therapy and development of a province-wide, structured approach to monitoring and managing pre-eclampsia. Through a greater understanding of the various facets of pre-eclampsia, Dr. von Dadelszen hopes to spur improvements in clinical care and health outcomes.

Using linked administrative data to understand the interacting effects of school readiness, family, neighbourhood and school characteristics on children's early academic achievement – enhancing the to …

There is a strong relationship between education and health. People with lower levels of education demonstrate poorer health, higher rates of health risk behaviours, lower rates of preventive health care use, and higher rates of early mortality. Thus, one important approach for reducing disparities in health is to enhance children’s opportunities for academic success. School readiness is the term used to describe a child’s preparedness at age five or six to take advantage of the learning opportunities offered in school. Encompassing physical well-being, motor development, emotional health, social competence, language skills, general knowledge, and cognitive skills, readiness to learn at school entry has shown a strong association with later academic performance. Dr. Susan Dahinten is determining the extent to which children’s academic success in Grade Four can be predicted by their school readiness in kindergarten, before and after accounting for other individual, family, neighbourhood, and school characteristics that may influence their development. The sample for this study includes BC children for whom school readiness was measured at kindergarten between 2000 and 2002. By anonymously linking this data with data from BC’s education database, and with census data describing the children’s neighbourhoods, she is investigating whether, and why, some schools may be more or less successful at reducing inequalities among students of different backgrounds.

Assessment of Pain, Psychosocial Variables, Cognitive Variables, and Work Outcomes in Healthcare Workers Registered in PEARS Programs – A Longitudinal Study

To explore the relationship between depression, pain, and specific cognitive factors in healthcare workers who have had a work-related injury, and how these factors influence their ability and the time it will take for them to recover from injury and return safely to work.

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Priority Setting, Health Care Utilisation and Outcomes Evaluation in Seniors’ Care in Interior Health

With about 20% of the region’s population being 65 years and older, the proportion of seniors in the Central Interior region is high compared with provincial and national averages (13%). Projections over the next ten years suggest that the seniors’ population in this region will continue to exceed that of other regions and provinces. As a result, health care for seniors has been identified by Interior Health as one of its key areas of strategic interest.

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