Illicit drug use is a major public health concern in British Columbia, most notably the high rates of HIV and Hepatitis C transmission among injection drug users. Additionally, in Vancouver and elsewhere in British Columbia, there is concern regarding escalating rates of crystal methamphetamine (CM) use. The prevalence of CM use is rising internationally, and has been associated with unsafe sexual and injecting practices among specific subpopulations at risk for HIV. However, the potential associations between CM use and sexual and injection-related risk behaviour among marginalized populations in Vancouver have not been thoroughly investigated. Brandon Marshall was previously funded by MSFHR for his Masterâs work studying the interactions between drug use and sexual risk behaviour among street youth in Vancouver. He is now continuing his examination of a number of social, environmental, and structural factors that predict frequent CM use and subsequent health-related harms among young injection drug users. He hypothesizes that social disadvantage, impoverished living conditions, frequent exposure to law enforcement, and poor access to health and harm reduction services will be associated with higher frequency and intensity of CM use. This research will help inform evidence-based public health policy and interventions for marginalized populations. Marshallâs findings may be used to develop strategies that seek to reduce the harms associated with CM use, prevent further transmission of HIV and Hepatitis C, and provide better support for youth and injection drug users who are already infected.
Year: 2008
Early mother-infant interaction and infant mental health
The quality of the mother-infant relationship early in infancy forms a foundation for infantsâ subsequent social and emotional development. In particular, mothersâ sensitive responses to behavioural and emotional cues help their infants develop a sense of self and help them regulate their emotions. Attachment â or the bond between infants and their caregivers â is a developmental achievement in the first year of life that is essential for healthy physical and psychological growth. Studies have shown that insecurely-attached infants are at risk for a range of negative developmental outcomes. Nancy Mcquaid was funded by MSFHR for her early PhD work into the relationship between attachment and infant mental health. She is continuing this longitudinal investigation among a community sample of mothers and their infants. Mcquaidâs research is now evaluating whether maternal responsiveness and infant social expectations observed at four months are related to subsequent infant mental health at 12 and 30 months of age. She is also assessing the impact of mother and infant temperament to healthy developmental outcomes. Mcquaidâs research will contribute to our understanding of healthy infant development and will help develop means of intervention for infants who are at risk for developmental emotional and interactive disturbances, such as infants of mothers with postpartum depression and low birth weight infants.
Social support groups as a means to enhance the health literacy status of ESL-speaking immigrant women
Health literacy is defined as the ability to read and comprehend prescription bottles, appointment slips, and other essential health-related materials, or the capacity to obtain, interpret and understand basic health information and services needed to make appropriate health decisions. Inadequate health literacy increases a personâs risk of dying of chronic and communicable diseases, and directly affects the ability to follow physician instructions, to understand disease-related information, and to understand health care rights. In particular, immigrant women may struggle to understand health information. On average, they have lower literacy rates than immigrant men and they also have significantly lower literacy levels than the Canadian-born population. There is a social dimension to health literacy, but no study to date has investigated whether or how social support can moderate the effects of health literacy on individual health and health service use. Laura Nimmon is partnering with an immigrant society in BC to implement a community health education program that fosters social relationships for ESL-speaking immigrant women and builds on their health literacy levels. She is creating a pilot program that will educate research participants about health information and guide them to act as community health advisors to their peers, mentoring other immigrant women to participate in healthy choices and activities. Nimmonâs research aims to improve understanding about how peer-based social support groups might enhance the health literacy status of immigrant women and alleviate the adverse health consequences of low health literacy.
Rehabilitation Aimed at Muscle Performance
Research indicates that sustained physical inactivity leads to chronic degenerative conditions and premature death. Currently, approximately 75% of Canadians aged 50-75 years and 84% of those over 75 are physically inactive. The associated health and economic burdens will continue to escalate as the proportion of elderly British Columbians increases to 20% of the population by 2026. Physical activity can slow the progression of certain diseases; however, questions regarding cause-and-effect remain unanswered and specific exercise prescriptions for middle-aged and older people with acute, complex, and/or chronic health conditions are not clearly defined. RAMP comprises researchers from physiotherapy, kinesiology, sports medicine, orthopedics, respiratory medicine, engineering, geriatrics, and computer science disciplines. Using basic science, clinical, and translational approaches, the team is studying muscle deficits (atrophy, injury, and failure to train) at the cell, tissue, and whole body level among middle-aged and elderly people. From these investigations, the researchers will develop rehabilitation protocols to improve muscle performance and mobility. This team received an MSFHR Team Planning Award in 2006.
Public Health Services Renewal in BC
Canada’s public health system faces serious systemic challenges for adequately meeting the health needs of the population. To help guide a plan for improvement and renewal of public health services in BC, the BC Ministry of Health has developed a Framework for Core Functions in Public Health. This framework defines the core activities of a comprehensive public health system, and serves as the roadmap by which the province is planning and investing in public health services. By studying the implementation and outcomes of the Core Functions Framework, this team will contribute new knowledge for BC and Canada regarding ways for public health system renewal to improve population health, reduce health inequities, and better integrate with health services. This team received an MSFHR Team Planning Award in 2006. MSFHR’s Team Start Up grant will now support the team — which comprises academic researchers and key decision-makers at the provincial, regional, and national levels — to further develop its productivity and competitiveness.
Optimization of Trauma systems
Every year approximately 400,000 British Columbians suffer a traumatic injury — the leading cause of mortality and morbidity in Canada. The development of trauma systems to improve the access of injured patients to timely, and often life saving care is a health care priority. Unfortunately, access to timely and appropriate trauma care is not universal in BC. For example, injured patients in rural communities typically face economic, social and geographical barriers to care. In contrast, injured patients in urban communities are typically in close proximity to several hospitals; however, the trauma capabilities within in each hospital are highly variable, so choice of hospital may impact survival. This team of trauma surgeons, trauma care providers, geographers and epidemiologists is building a comprehensive dataset to investigate the performance of, and identify gaps within, the delivery of trauma care in rural and urban communities. The team’s goals will be to create evidence-based solutions where population vulnerabilities exist, and increase the reach and capability of the BC’s trauma system to address disparities in trauma outcomes across the province.
Health Innovation Design and Evaluation Research Team
In their ongoing efforts to improve health outcomes, decrease health care costs, and increase administrative efficiency, health care agencies are increasingly investing in information-based technologies (IT). Recently, the Canadian government highlighted the need for developing new methods for evaluating new health sector technologies in order to provide insight into the challenges associated with increased use of IT in health care settings. This award supports the development of a team that is researching the use of IT for epidemiological data collection (EDC), also known as e-epidemiology. The team’s goals include: identifying technological, organizational, governance and implementation challenges associated with the increased use of IT for EDC; addressing data quality issues arising from increased use of IT for EDC; and improving collaborations among researchers, decision makers and technology developers across disciplines who share an interest in e-epidemiology. The team hopes to improve the quality of evidence used in decision making about information technologies used for collecting epidemiological data in BC.
Neuroethics for British Columbia
Neuroethics is a relatively new field of study that focuses on the ethical, legal, social and policy implications emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience). This award supports the creation of a team focused on working with practicing neuroscientists, physicians and clinical researchers, ethicists, and health policy-makers in BC to ensure that advances in neuroscience are aligned with societal and individual human values. The team will work towards identifying educational, research and clinical needs in neuroethics in BC, and encouraging collaboration between additional teams involved in complementary research activities.
Functional Lung Imaging for Radiation Therapy
Lung cancer is the leading cause of cancer death in Canada. Patients who undergo radiation therapy (RT) for lung cancer face only a 14% chance of surviving for five years. In addition, they are likely to experience significant radiation-related health effects, such as impaired lung function. While current therapy attempts to reduce injury by limiting the amount of lung tissue treated, it is difficult to predict how much function will be lost. Researchers believe radiation therapy could be given at higher, more effective doses if accurate ways were identified to measure lung function within the affected area prior to treatment, and to predict how the region will be affected by radiation. Currently, as functional imaging methods such as perfusion SPECT and hyperpolarized 3He MRI (He-MRI) are being developed, predictors of radiation lung damage are emerging. FLIRT — a multidisciplinary team of radiation oncologists, and radiotherapy and imaging physicists — is researching the potential to combine these two diagnostic techniques to improve the planning, delivery and outcome of RT for lung cancer patients.
VITALiTY Team
Catastrophic disability is the rapid onset of disability and loss of independence in three or more basic activities of daily living. The six leading causes are stroke, congestive heart failure, pneumonia and influenza, ischemic heart disease, cancer, and hip fracture. Within the next 25 years, the number of people aged 65 years and older in British Columbia will double, resulting in a significant burden on the health care system. Novel strategies are needed to reduce both the risk of catastrophic disability, and the related increased care needs. This award funds the creation of a research team focused on developing interventions that identify and minimize risk for catastrophic disability and promote healthy aging in older adults. The team’s objectives are to determine which inflammatory markers predict catastrophic disability, relate these markers to other identified risk factors, and develop targeted, effective interventions.