The safety of home birth for women at no identifiable risk is a controversial issue. Approximately 40 per cent of women accessing midwives in BC choose to give birth at home. If there is an emergency related to birth, access to definitive care can be delayed by geography, weather and timing of labour. Severe hemorrhage (bleeding) during childbirth is a clinical emergency that requires immediate invasive interventions by specialized health professionals. It is one of the top three leading causes of death among mothers. Survivors are at risk of developing kidney damage, surgical removal of the uterus and adverse events associated with blood transfusions. But little is known about the consequences of hemorrhage in home birth. Eman Hassan is researching the risk of developing serious consequences following hemorrhage in the home birth setting. She is comparing rates of unfavourable events that occurred due to hemorrhage among planned home births and planned hospital births in the period 2002-2004. The study will provide important information to practicing midwives and childbearing women about what may contribute to hemorrhage, who is at greater risk of developing these events, and the factors that may affect timely access to specialized care. This information will help prevent serious health problems among women considering home birth in BC, and will also be applicable to other provinces in Canada.
Research Location: Child & Family Research Institute
Molecular mechanisms of retrograde transport
A single human cell is made up of many small organelles (compartments). Through a process known as vesicle transport, proteins and lipids move from one compartment to another to support and maintain cell function. Motor nerve cell diseases are progressive disorders involving the nerve cells responsible for carrying impulses that instruct the muscles in the upper and lower body to move. Abnormal vesicle transport causes a family of these devastating diseases, including Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis or ALS). Abnormal vesicle transport has also been found in Alzheimerās, Down syndrome, and Neimann-Pick C disease, suggesting that these abnormalities also play a role in the development of these diseases. To better understand these diseases and hopefully lead to improved treatments, Dr. Benjamen Montpetit is focusing his research on determining how vesicle transport works. Montpetit, who received MSFHR trainee awards in 2002 and 2006 in support of his PhD research, is studying the process in yeast with the aid of robotic-based systems. Yeast makes an excellent model for his research because the yeast genome has been fully sequenced and, therefore, its genetic code is known.
Critical protective role of Toll-like receptor 2 in bacterial induced colitis
Inflammatory bowel diseases (IBD), as well as many forms of infectious gastroenteritis, are thought to occur when the integrity of intestinal barriers is disrupted, allowing luminal bacterial products to cross into the intestinal mucosa, stimulating immune cells and triggering and unmitigated immune response. Unfortunately, there is currently no cure, no prevention and limited therapeutic options for IBD. Current evidence suggests that a genetic defect in people with IBD can affect intestinal homeostasis or the balance between an active inflammatory response to an invading pathogen and tolerance to commensal bacteria In individuals with IBD, inflammation is turned on to protect against offending agents, but it doesnāt get turned off once the pathogen has been cleared. Instead, the immune system seems to react to intestinal commensal bacteria that were once tolerated. It is suspected that the usually protective epithelial and mucosal barrier lining the intestine is impaired in patients with IBD, allowing intestinal bacteria to leak across the epithelium and activate immune cells. This prolonged exposure to intestinal bacteria and their products results in exaggerated and chronic inflammation. This causes the symptoms of IBD, which includes diarrhea, severe abdominal pain and other health problems outside the digestive system. Dr. Deanna Gibson is investigating the immune mechanisms involved in IBD by examining how the immune system recognizes and responds to bacteria within the intestine in vivo. She is studying a molecule, Toll-like receptor 2, which has been implicated in IBD and is critical for protecting the intestine from developing severe and lethal colitis. By determining how Toll-like receptor 2 controls susceptibility to bacterial induced colitis, her research could lead to an understanding in intestinal homeostasis which is required to design new therapeutics and discover targets against IBD.
Early Nutrition, Language and Cognitive Development
Large amounts of omega-3 fatty acids are essential to support fetal and infant brain development. Omega-3 fatty acids accumulate in the central nervous system in the developing infant brain during and after pregnancy, although the brain appears to be particularly sensitive to dietary deficiencies of important essential fatty acids during intrauterine development. Before birth, essential fatty acids (those fatty acids which humans cannot form and which must be obtained from the diet) are transferred through the placenta, and after birth, through breast milk. The intake of omega-3 fatty acids in western diets is low with research demonstrating that many women following typical western diets likely have lower intakes than what is required by the developing infant before birth. Current guidelines for intake of Omega-3 fatty acids are directed at reducing the risk of chronic diseases like cardiovascular disease, and do not consider the needs of pregnant and lactating women, or the important role of omega-3 fatty acids in brain development and function. Dr. Orly Lipka is investigating whether an increase in omega-3 fatty acids during pregnancy reduced the risk of poor neurodevelopmental outcome in infants. Her research involves the use of sensitive tests of early language and problem solving ability to assess subtle delays in development secondary to nutritional deficiency during prenatal development. An important part of this work is also following up to assess the later effects in early childhood. The findings should lead to better understanding of the importance of omega-3 fatty acids with respect to cognitive and behavioral development.
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 Dadelszenās 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.
Impact of nutrition and physical education school policies on childhood obesity: Understanding the implementation process and its impact on behavioural and weight outcomes
The prevalence of childhood obesity is rapidly increasing in Canada, increasing fivefold for both boys and girls from 1981-99. As the genetic characteristics of the human population have not changed in the past 30 years, childhood obesity is thought to be caused by behavioural and environmental factors that predispose children to consume more calories than they expend. Obesity is also linked to a number of diseases, including cardiovascular disease, type 2 diabetes, and some cancers. Schools provide an ideal setting to intervene on childrenās behaviours. Recently, policy strategies have been proposed to change the school environment to limit access to unhealthy food and to increase opportunities for children to be more physically active. However, these changes are taking place without the scientific evidence necessary to support these strategies. Louise MĆ¢sse is examining the impact of school-based policies on changing nutrition and physical activity behaviours among children. In addition, she is identifying the factors that prevent from implementing healthy school policies and creating healthier environments. The results of her study will provide insightful information for policy-makers to improve the health of BC children
Vaccine Evaluation Centre
The Vaccine Evaluation Centre (VEC) was originally established in 1989 at BC Children’s Hospital. Now, the Unit is expanding and evolving to better meet provincial and national needs for applied vaccinology research, with emphasis on expanded local and national collaboration and leadership, greater use of advanced technology, active translation of new products into optimal immunization practice, and excellent training in vaccinology.
The Collaborative Research Group for Designing Safety Interventions for Individuals in Violent Relationships
This award funds the development of a team focused on enhancing safety of victims of relationship abuse. The team’s goal is to bring together researchers from social work, psychology, nursing, medicine and public health with front-line service providers to develop abuse interventions for individuals in violent relationships. Through a series of meetings and workshops, the team aims to develop safety-promoting strategies that can be tested with women and men in different socio-ethnic groups. The team will include participation by community agencies and health institutions, including the Vancouver General Hospital and St. Paul’s Hospital emergency rooms.
Genetic Factors in Premature Ovarian Failure
Although the average age of menopause is 51 years, approximately one per cent of women will experience menopause before the age of 40, a condition known as premature ovarian failure. Working on the hypothesis that multiple genetic factors may combine and interact in a single individual to determine the rate of reproductive aging, Karla Bretherick is examining the molecular genetic differences between women with normal reproductive function and women with premature ovarian failure. She hopes her work identifying specific genetic factors that contribute to early menopause may lead to the development of both treatment options for affected individuals and predictive testing for those at risk.
Immunity and childhood disease
Immune white cells, such as cytotoxic T lymphocytes (CTL) and natural killer (NK) cells, protect us from infectious diseases and cancer by killing infected or unwanted cells. Defects in the function or regulation of these cells can lead to immunodeficiency or autoimmunity. Two childhood diseases resulting from autoimmune malfunction include the common disease, type 1 diabetes (T1D), and X-linked lymphoproliferative (XLP) diseaseāa rare immunodeficiency. Dr. Rusung Tan studies the role of these cells in T1D and XLP. He is working to determine how defects in the molecular and cellular function of cytotoxic immune cells lead to disorders of childhood and will translate these findings into improved diagnostic tools, preventions and therapies for disease. His personal goal is to use the successes achieved in this work as models to drive the overall development of childhood immunity research in British Columbia.