Resistance to insulin — the hormone that converts sugar into energy — leads to diabetes and high blood pressure (hypertension). Chronic hypertension can lead to cardiovascular complications like heart disease and stroke — two leading causes of death. This is a cause for concern since two million Canadians have diabetes, and this number is expected to rise to three million by the end of the decade. Consuming a diet high in fructose, a sugar used to sweeten soft drinks and other foods, causes insulin resistance and increases blood pressure. Harish Vasudevan has found that differences in gender and sex hormones play a role in the development of high blood pressure. For example, pre-menopausal women are less likely to develop hypertension than men or post-menopausal women. The female sex hormone, estrogen, protects these women against developing insulin resistance and high blood pressure. But the male sex hormone, testosterone, is required for blood pressure to elevate following insulin resistance. Fructose also disturbs the normal relaxation in blood vessels, but requires testosterone to do so. Vasudevan is examining how changes in the blood vessels depend on testosterone and estrogen. This research will further clarify the role of sex hormones in the development of insulin resistance and hypertension, which should, in turn, lead to new treatments for these chronic diseases.
Year: 2007
Volume and Shape of the Caudate Nucleus and Putamen as Biomarkers for Parkinson's Disease Progression
Parkinson’s disease is a degenerative disorder of the central nervous system. Symptoms include shaking, muscle stiffness, speech problems, memory loss and vision problems. The disease involves the inactivation of dopamine-producing cells in a part of the brain called the substantia nigra. There is no definitive test to diagnose Parkinson’s disease, making it difficult to diagnose in its early stages. By the time a patient is diagnosed, up to 80 per cent of the dopamine-producing cells may have already stopped working. There is therefore a need for a more reliable test for diagnosis of Parkinson’s disease. There is reason to believe that Parkinson’s disease can be detected by measuring the size and shape of two anatomic structures within the brain that are both connected to the substantia nigra: the caudate nuclei and the putamen. When the cells in the substantia nigra become inactive, less dopamine is sent to the caudate nuclei and putamen. Aaron Ward is studying whether a decrease in dopamine results in changes to the size or shape of the caudate nuclei or putamen. Using magnetic resonance imaging, Ward is computing a 3-D representation for each patient’s caudate nuclei and putamen. The ultimate goal is to discover aspects of the shape of these structures that could serve as indicators of Parkinson’s disease. This would allow earlier and more reliable diagnosis, and facilitate the tracking of patient response to therapy.
How the eating disorder therapist's personal experience of an eating disorder influences the therapeutic relationship with clients who have eating disorders: A grounded theory
The demand for eating disorders treatment in BC typically exceeds what is available in existing specialty programs. This service gap is often filled by community psychotherapists. Research indicates that eating disorders among eating disorder treatment professionals far exceeds prevalence rates in the general public. This suggests that there are likely to be therapists working in the field of eating disorders treatment who have recovered from, or who many currently struggle with, an eating disorder. Recovered/recovering eating disorder therapists are ethically obliged to evaluate how their personal experience may influence the therapeutic relationship with the eating disordered patient in helpful or harmful ways. Meris Williams’ research aims to enlarge our understanding of the recovered/recovering eating disorder therapist, especially how the personal history of an eating disorder influences the therapeutic relationship with eating disordered patients. She will conduct extensive interviews with 20 psychotherapists who provide services to patients with an eating disorder, and who themselves have received a diagnosis of an eating disorder. The study’s results can enhance the effectiveness of recovered/recovering eating disorder therapists by helping them assess their readiness to work with eating disordered patients. It can also help ensure that therapists’ personal experience is influencing the therapeutic relationship in a manner that benefits patients. The results could also be used to inform the education, training, and supervision of eating disorder therapists-in-training in BC. Ultimately, this research will help people seeking treatment for an eating disorder.
Improving public health through active transportation: Understanding the influence of urban infrastructure on decisions to travel by bicycle
Cycling offers great benefits as an urban transportation option in terms of public health. It’s free of air and noise pollution, and it incorporates physical activity into people’s daily routines, therefore contributing to increases in fitness, decreases in obesity, and potential declines in heart disease, cancer and diabetes. Cycling rates in Canadian cities are very low compared to those in European centres. Despite the room for growth, Canadian municipalities are struggling to accomplish even modest changes in cycling rates. Some cities have sponsored research to understand how to encourage their residents to cycle more, but none have investigated how neighbourhood characteristics and transportation networks are related to cycling rates. Meghan Winters is researching which characteristics influence cycling rates in MetroVancouver. Information about factors such as population density, hills, distances to shops and workplaces, street types and bike routes will be linked to information from more than 2,000 Vancouver area residents about whether they drive, cycle, walk or use transit for their most common weekly trips. She will measure the effect of neighbourhood characteristics and transportation networks on the likelihood of a trip being made by bicycle. By providing evidence on how to build neighbourhoods that are favourable for active transportation, this study will help make the healthy transportation choice an easier choice, thus improving the fitness and health status of the community.
The role of the DOG-1 helicase in repair of DNA interstrand cross-links in the model organism Caenorhabditis elegans
DNA damage repair pathways prevent cancer by recognizing and repairing DNA damage. If DNA damage is not constantly and consistently repaired in this way, it can lead to mutations in the DNA, which accumulate over time. Without normal DNA repair pathways in action, cancer will eventually develop. Jillian Youds’ research focuses on the DNA repair pathway involved in the hereditary cancer susceptibility syndrome Fanconi anemia. Patients with Fanconi anemia have unstable chromosomes and commonly develop cancer at a young age. It is thought that these patients are unable to repair cross-links in their DNA, which can prevent essential cell processes from occurring. As these DNA repair pathways are common to many organisms, Youds is using the nematode C. elegans to conduct her studies. Using molecular biology, genetic and biochemistry techniques, Youds will study how DNA cross-links are repaired by the cell under normal circumstances. This research is relevant to patients with Fanconi anemia, and it will contribute to the development of the best possible chemotherapeutics to optimize cancer treatments. Since the loss of functional repair pathways is a contributing cause of cancer and also a means to target cancer cells for elimination during treatment, an understanding of how the DNA cross-link repair pathway works will bring us closer to the ultimate goals of prevention and successful treatment of cancer.
Signaling Pathways Underlying Spreading Depression and Ischemic Depolarization
The visual aura some people experience with migraine headaches is caused by “spreading depression,” a wave that begins in the outer portion of the brain and spreads throughout the gray matter. During the wave, nerve cell activity lessens and brain tissue swells. A similar wave, called ischemic depolarization (ID), occurs during a stroke. Ischemic strokes cause the sudden death of brain cells when blood flow to the brain is blocked. Although spreading depression was first reported more than 60 years ago, researchers are still unclear about how the wave is generated. Ning Zhou is using a new imaging technique, called two-photon laser scanning microscopy, to examine detailed changes in individual cells when brain tissue suffers from spreading depression or ischemia (insufficient blood supply). Although these two events are similar, brain cells do not die during the wave of spreading depression. Zhou will examine the differences to discover why nerve cells undergo unusual swelling during spreading depression, and how this contributes to cell death during stroke. This research could provide insight into how to prevent tissue damage induced by strokes.
eVENT: An expert system for detecting ventilatory events during anesthesia
Despite the best intentions of clinicians many patients suffer adverse events during their medical care. As technology becomes more sophisticated and the amount of information generated increases, the risk that something goes wrong or is missed increases. The technology, work environment and clinical work flow needs to be designed to mitigate these risks. Technology has the potential to help clinician’s with tasks that humans do not perform well, such as vigilance, and reduce risk to patients.
Dr. J Mark Ansermino is a pediatric anesthesiologist with a background in health informatics and a particular interest in patient safety. He and his team are developing an expert system that automatically detects important changes in a patient’s status in the operating room. The clinician must divide his or her time between keeping an eye on the monitors, attending to the patient, and other tasks such as teaching students and giving drugs. Important events or evolving conditions can be missed. The technology will assist the busy clinician with attending to the huge amount of information generated by the monitors and bringing the important changes to the attention of the clinician. The system can also offer advice on what should be done about these changes and information on current treatment guidelines, providing the clinician with a recommended course of action in real time.
The current emphasis is on developing rules for a few dangerous events that affect breathing. This will be expanded to address other anesthesia-related events in the operating room. In this research, the system will be evaluated in both simulated and real clinical settings to determine if it is possible for clinicians to identify and respond to critical events more rapidly and reliably. This expert system will lend itself to promoting better decision making by both less skilled or experienced anesthesiologists during training or in situations where advanced training is not available.
The MTHFR C677T polymorphism and postpartum mental illness in at-risk women
Psychotic disorders (which include schizophrenia, schizoaffective and bipolar disorders) are common mental illnesses, affecting about 3 per cent of the population. Women face a number of challenges when dealing with these disorders, especially when it comes to pregnancy, childbirth and parenting. Women with a history of a psychotic disorder have substantial risks for a postpartum episode of mental illness like depression or psychosis. Postpartum mental illness carries risks for suicide and infanticide, as well as other less dramatic but still significant problems like difficulties with parenting skills and problems with mother-child bonding and attachment. Research has shown that, in general, psychotic disorders stem from interactions between genetic and environmental influences. The specific genetic variations that increase risk for postpartum episodes of mental illness are largely unknown. Dr. Jehannine Austin will use a new approach to investigate whether a variation to one particular gene contributes to risk for postpartum episodes of mental illness in women with a history of mental illness. This gene is known to encode a protein whose function is dependant on the B vitamin, folate. Dr. Austin will not only look at genetic variations, but will also measure folate levels in pregnant women at high risk of postpartum mental illness. If her work shows that the genetic variation plays a role in risk for postpartum mental illness, it may be possible to decrease risk for postpartum episodes of mental illness by providing folate supplements for these women.
Predicting the outcomes of cancer care services
With an aging population, rising costs and an increasing number of cancer cases, predicting the outcome of cancer care services is important for health care planning. Predictions can be based on computer models that take information from simple processes into larger systems. A model’s accuracy can be determined by comparing its predictions with real-world data and activity. As an MSFHR scholar, Dr. Chris Bajdik created a model to predict demand for hereditary cancer services in BC. He is now working to further develop prediction models for cancer care services. These new models will predict outcomes associated with cancer screening, treatment, supportive and palliative care. The predictions described through modeling will be compared with observed outcomes from provincial, national and international cancer care services. Dr. Bajdik’s approach provides a cost-effective way to predict outcomes – using the experience reflected in previously-collected data. Most importantly, these models will provide healthcare planners with a tool to predict the outcomes associated with new cancer care services and health policies. If the predictions are considered accurate, health care agencies can better plan and evaluate their services to care for those with cancer. The methods can be generalized to develop models for other forms of health care and other diseases.
Health Innovation Design and Evaluation (HeIDE)
In the last decade, the Canadian government has invested billions of dollars in development of a Canadian health information infrastructure. Health information technology goals are varied but they usually include faster, more efficient delivery of care based on shared information through electronic health records. However, despite the investment to develop an information technology infrastructure, the potential gains for the health system have been slow to materialize. Dr. Ellen Balka’s research focuses on the challenges associated with realizing Canada’s vision of an information technology-rich health care sector. She is working with stakeholders in actual health care settings, including technology developers, health system decision makers and health care providers, to assess design shortcomings, usability, implementation challenges, and issues related to governance of information technology within organizations. Dr. Balka’s studies will contribute to a more comprehensive understanding of how complex it is to introduce new information-based technologies into the health sector, and will lead to development of strategies that improve the rate of success for these initiatives within the health system. This will ensure that the potential benefits of these systems and technologies (administrative efficiencies, improved patient care and development of health data for research purposes) can be achieved.