Numerous studies on the relationship between spirituality and mental and physical health have demonstrated that spiritual coping is an effective way of dealing with stress. Most research in this area has been conducted with members of ethnic and religious majorities. But little is known about how ethnic and religious minorities employ faith in coping with stress. Derrick Klaassen is examining the spiritual coping practices of Portuguese immigrants to British Columbia. Susan James and her colleagues at the University of British Columbia demonstrated that many of these immigrants suffer from a culture specific disorder termed agonias, translated as “”the agonies””. North American health care providers have generally misdiagnosed this problem as indigestion rather than anxiety or stress, and as a result the treatments have remained ineffective. Klassen has two goals for his research. The first is to add to the understanding of effective intervention for agonias by exploring the various healing systems that Portuguese immigrants employ (e.g. mental/health systems, spiritual, community, and cultural resources). The second goal is to examine the ways in which Portuguese immigrants use spiritual strategies to cope with agonias. Klaassen’s research involves conducting focus groups and revising an existing assessment tool for this community. The resulting questionnaire will serve both practitioners and scholars in their investigations of the role of spirituality in coping with stress in Portuguese immigrants. This project is part of a multi-stage program of research that will formulate a culturally sensitive treatment manual for health providers.
Year: 2007
Knowledge translation of health outcome measurement research into clinical practice to improve health care effectiveness and efficiency in a Prevention and Early ACtive Return-to-work Safely (PEARS) …
With population growth, an aging population, and an aging and supply-limited workforce of health professionals, British Columbia is challenged to sustain its current levels of health services in the face of unprecedented demand. In this context, the use of valid health outcome measures (OMs) is important to evaluate and improve the results of various interventions for health professionals with musculoskeletal injury (MSI)-related disabilities. Prevention and Early Active Return-to-work Safely (PEARS) is a primary (injury prevention) and secondary (physiotherapy for MSIs) program designed to reduce disability in healthcare workers who have sustained a workplace injury. Outcome measures used in the program pilot included Activity-level self-report disability questionnaires. With expansion of PEARS across BC, only Participation-level outcomes like time-loss duration and level of return-to-work were retained. Currently, few physiotherapists in PEARS are using disability measures, limiting ability to measure effectiveness of the secondary prevention component of the program. This further limits ability to improve outcomes through predictive modeling and examining effectiveness of the variety of available treatments. Allan Kozlowski is evaluating a training program intended to promote the adoption of self-report outcome measures by PEARS program physiotherapists. In addition to information about how to use the OMs, individual- and organizational-level barriers will be identified and addressed. The objective is to demonstrate that physiotherapists can measure disability outcomes as part of their practice without diminishing patient service. Implications of this work include enhanced decision-making for individual patients, identifying ‘best-practice’ treatments, managing distribution of resources within health authorities, and development of enhanced predictive modeling of outcomes, all of which would contribute to a viable and sustainable health care system.
Characterizing the role of palmitoylation in the trafficking of multispanning membrane proteins to the cell surface
Molecules are transported to various parts inside the cell to maintain vital functions, such as cell growth and communication. For example, many proteins regulate the intake of nutrients or detect external signals — it’s crucial to cell survival that these proteins are transported to the cell surface so the cells can recognize and respond appropriately to the different stimuli they encounter. However, there is much to be learned about the way these proteins are transported. This is the focus of Karen Lam’s research, in particular, understanding the mechanisms by which the saturated fatty acid palmitate attaches to proteins (I do not work with brain cells, but with yeast cells, which serve as a model) and affects their transport to the cell surface. For example, palmitate attaches to various proteins found in brain cells. Many of these proteins help chemicals called neurotransmitters send signals in the brain, a process that’s essential for learning and memory. Defects in this communication can result in neurological diseases like Alzheimer, Huntington and Parkinson’s. Lam wants to determine what causes defective function and transport in these proteins by modeling the processes in yeast cells. Understanding the fundamental mechanisms of palmitate attachment may lead to the development of molecular-based therapies to treat a variety of neurological disorders.
Assessing reward-entrainment as a means to activating and identifying the food-entrainable pacemaker
Optimal functioning requires organisms to anticipate and adapt to daily environmental changes driven by the cycle of the sun. Entrainment is the process by which daily rhythms of behaviour and physiology are synchronized to the environment. Shift-workers and air travelers are often out of sync with their environment due to a mismatch between their internal clock and the external environment. This dyssynchrony leads to general discomfort and reduced performance known as shift-work malaise or jet-lag. This has a detrimental effect on health, performance, levels of productivity and quality of life. Glenn Landry aims to achieve a better understanding of the mechanisms of entrainment. In mammals, an area of the brain called the suprachiasmatic nucleus acts as a master pacemaker. In animal models that have access to food and water without restriction, damage to this area of the brain eliminates all daily rhythms. However, if food is restricted to one to two meals at a fixed time each day, these animal models are still capable of anticipating the feeding time. This shows that a separate pacemaker exists for anticipating food. But identifying this food-entrainable pacemaker has been a challenge since many brain structures are activated during food restriction, making it difficult to isolate the pacemaker from background activity. Landry is testing a recently developed strategy to filter out this background activity. By using a number of different stimuli capable of activating the food-entrainable pacemaker, he aims to isolate this pacemaker by identifying brain areas activated in common across these stimuli. Landry hopes identifying the food-entrainable pacemaker could ultimately lead to new approaches to re-setting the clocks of shift-workers and air travelers, improving health and productivity.
The effect of reward expectation and dopamine release on the mechanism of the placebo effect in Parkinson's disease
Parkinson’s disease (PD) is the second most common neurodegenerative disorder and affects about 100,000 Canadians. It occurs when cells that produce dopamine in the brain die. Without enough dopamine to send signals to the striatum, an area of the brain that controls movement, people with Parkinson’s develop tremors, stiffness and balance problems. Patients take medication to replace the missing dopamine, but this often produces troubling side effects. Interestingly, a significant placebo effect can occur in patients with Parkinson’s, with patents showing an improvement in symptoms due to their belief that a particular treatment will be beneficial. Sarah Lidstone is expanding on her earlier MSFHR-funded research to study how patients’ expectations for an improvement in symptoms actually produce measurable improvement. Using positron emission tomography (PET), a powerful brain scanning technique, Sarah has shown that patients with Parkinson’s disease release dopamine in the brain when given a placebo they thought was medication. Dopamine is also released in the same brain areas when people anticipate receiving a reward such as money or food, a response also generated in drug addiction. Sarah is examining whether the placebo mechanism in Parkinson’s taps into the same process as reward anticipation. If so, this research could lead to better treatments for the disorder. It could also inform treatment for drug addiction and other conditions influenced by a placebo effect or dopamine, including pain management, depression and obsessive-compulsive disorder.
Investigating the Role of the O-GlcNAc Post-Translational Modification in the Development of Type II Diabetes and Alzheimer's Disease
There is a growing prevalence of type 2 diabetes. It has been estimated that more than 20 million people have the disease in the United States alone. Type 2 diabetes is a disease characterized by resistance of our bodies to insulin, a hormone needed for normal metabolism of carbohydrates, fats, and proteins. This resistance leads to prolonged elevation of blood sugar levels, eventually giving rise to the diseased state. Understanding what events lead to insulin resistance is an intense topic of research. Nevertheless, the precise molecular mechanisms by which insulin resistance arises still require delineation in order to fully understand the disease Building on his MSFHR-funded Master’s research, Matthew Macauley is investigating what the role of proteins modified by a sugar known as GIcNAc have in causing insulin resistance. One hypothesis is that high levels of glucose over a long time period may increase GlcNAc modification and that this in turn results in insulin resistance. Macauley is using an enzyme inhibitor of O-GlcNAcase to artificially create elevated levels of GlcNAc in animal models to determine if insulin resistance and type 2 diabetes ensue. Using this same enzyme inhibitor, Macauley is also conducting a separate study to increase GIcNAc attached to tau, a key protein involved in the development of Alzheimer’s disease. The goal of this study is to determine if the inhibitor can prevent or delay the onset of Alzheimer’s in an animal model.
Goal adjustment processes and caregiver health: Can giving up be a good thing?
Mounting evidence indicates that caring for a family member with a chronic illness not only reduces the quality of life for the caregiver, it also increases the caregiver’s risk of becoming ill. Little is known about the specific mechanisms by which caregiving impacts health and well-being. One important factor may be the caregiver’s ability to adjust personal family and career goals to meet the demands of the difficult situation. If a caregiver is able to let go of goals set before the diagnosis, such as getting a promotion at work or building a vacation home, he or she may have an easier time adjusting to this new role, and in turn, experience reduced distress and better physical health. Teresa Marin is examining the impact of tendencies to adjust goals on both psychological and physical well-being. Once she has determined the relationship between goal adjustment and health in the context of caregiving stress, it will be possible to apply this knowledge to clinical interventions designed to foster better coping skills among caregivers. This research follows Marin’s MSFHR-funded Master’s work, in which she analyzed the mental and physical health of spouses caring for cancer patients to determine the daily impact of expressing or suppressing their emotions.
Links between Patellofemoral Biomechanics and Osteoarthritis
One in ten Canadians suffers from osteoarthritis, an incurable disease that causes pain and limits motion in joints. It occurs most often in the knee joint; the patellofemoral joint, which is located at the juncture of the kneecap and thigh bone, is involved in half of these cases. Emily McWalter’s research is focused on improving the diagnosis and treatment of patellofemoral osteoarthritis. It is widely believed that biomechanical factors, such as abnormal joint motion and excessive force exerted on bone and cartilage are related to the onset and progression of osteoarthritis. While treatment focuses on correcting abnormal joints through surgery or physiotherapy, these treatments do little to slow progression of the disease. That’s likely because the procedures do not correct all of the biomechanical factors contributing to the damage. With recent advances in MRI imaging, it’s now possible to study biomechanical factors and cartilage degeneration simultaneously. Emily McWalter’s research is focused on developing better methods of detecting and identifying the causes of cartilage degeneration earlier. She is currently working to develop and validate a tool that can estimate the pressure that develops on the surface of cartilage, with a view to using this information to determine if areas under abnormal levels of pressure are at greater risk for degeneration. If successful, this tool will be a valuable asset in understanding the onset and development of patellofemoral osteoarthritis and in assessing the effectiveness of surgeries and other biomechanics-based treatment strategies.
Action Schools! BC: The effect of a school based physical activity model on risk factors for cardiovascular disease in Aboriginal children
Cardiovascular disease (CVD) is a chronic condition that can lead to heart attack and stroke. CVD costs the BC health care system approximately $2.5 billion a year. Sadly, the onset of cardiovascular disease often starts in childhood. About 50 per cent of North American children exhibit one or more risk factors for CVD and many children and adolescents exhibit multiple risk factors. These statistics are worrisome because the severity of CVD increases with the number of risk factors, and risks during childhood tend to track into adulthood. As a result, these children are susceptible to developing cardiovascular disease as adults. Previous research has linked higher levels of physical activity during childhood to a lower risk for CVD as adults. Lindsay Nettlefold is examining the prevalence of CVD risk factors in children and whether differences exist between girls and boys and between children of different ethnicity. She is also studying whether a school-based physical activity program can reduce the level of risk factors for cardiovascular disease in children. The goal to develop an effective program that could be used to improve cardiovascular health in children will prove beneficial in helping to prevent the development of disease later in life.
The characterization of KiSS1 and GPR54 in breast cancer and other hormonally responsive cancers
Cancers whose growth is influenced by sex hormones, such as estrogen and testosterone, form the largest group of cancers that affect Canadian men and women. Breast cancer remains the second most common cause of cancer death among women in North America, and prostate cancer rates third for men. While there have been advances in treatment, many of these patients will succumb to their disease when tumors metastasize (spread to other organs or tissues in the body). The KiSS1 and GPR54 genes have demonstrated the ability to prevent metastases from developing. While the importance of KiSS1 and GPR54 are being studied in other cancers, little has been done to investigate the involvement of these two genes in clinical breast and ovarian cancers, and no studies have been conducted in prostate cancer. Building on her MSFHR-funded Master’s research, Leah Prentice is investigating whether KiSS1 and GPR54 have dual roles as both tumor promoters, via their involvement in hormonal processes, and also as suppressors of metastasis. By understanding the anti-metastatic mechanism of these two genes, Prentice hopes to contribute to the development of more targeted therapies and diagnostic tests that would allow for earlier detection of these potentially life-threatening cancers.