Year: 2008

“Shipbreaking” is the dismantling and recycling of obsolete vessels, their hulls and superstructures. In Bangladesh, this work is carried out on beaches. Salvaged items are resold in local markets and workers and their families live in adjacent slums. Ships often contain hazardous substances such as polychlorinated biphenyls, heavy metals and asbestos, which are all recognized carcinogens. Most work is done without adequate training or protection, and there is high potential for exposures to toxic materials in the shipyards, shops and the community itself. According to the International Labour Organization, shipbreaking is one of the world’s most dangerous occupations. On average, one worker dies every week; the long-term consequences of mortality due to cancer and other chronic illnesses are unknown. Few studies have been performed in Bangladesh on the environmental impact of dismantling ships, the health of shipbreakers, or the impact on the surrounding community and maritime environment. Working in collaboration with local university and non-governmental organization researchers, Midori Courtice is measuring the concentration of asbestos in workers’ living quarters, in shops selling salvaged items, and in areas downwind of ship-dismantling operations. She will interview people about their knowledge, attitudes and practices with respect to their handling of, and hazards associated with, asbestos. Courtice’s findings will be made available to the participants and the local community, and her recommendations could inform local workshops on hazards and reducing risk. Her work will also provide the basis to approach policy makers and strengthen the link between research and policy, to raise awareness of personal health and safety among workers, and to build local capacity for future research on sustainable solutions related to the shipbreaking industry.

Regular exercise is associated with many health-related benefits including improvement in heart and lung functioning, sleep patterns, and mood. Improving health through physical activity also decreases the demand placed on the health care system. Unfortunately, adhering to an exercise program can be very difficult, particularly for older adults. Older adults face more chronic health problems, are more susceptible to social isolation and withdrawal, and are more likely to be hindered by age-related stereotypes regarding physical activity. Given the gradual population shift of the “baby boomers” into this age group, the importance of enhancing the adherence of older adults to exercise programs becomes acutely apparent. Research has sought to examine what social and environmental factors are likely to engage and sustain the involvement of seniors in physical activity. Studies suggest that older adults prefer to exercise with others of a similar in age, and generally dislike exercising in groups composed of young and middle aged adults. Although the perceived age of others may be one important characteristic, it is likely that other perceptions of the group environment may similarly influence older adults’ motives and exercise adherence behaviours. William Dunlop is further exploring the relationship between older adults’ perceptions of group member characteristics and their subsequent motivation and adherence to group exercise programs. He will study exercise groups at community and health centres across British Columbia’s lower mainland, characterizing them by the surface-level traits of the group (age, gender, ethnicity) as well as the deep-level traits of members (e.g., attitudes, beliefs and values). By identifying how the composition of exercise groups influences the adherence behaviours of group members, Dunlop hopes his work will contribute to the development of intervention-based studies that more effectively increase the physical and psychological health of older adults.

Huntington’s disease (HD) and amyotrophic lateral sclerosis (ALS) are both progressive, fatal neurological diseases that together affect 6,000 Canadians. HD is associated with mental and physical deterioration, while ALS is associated primarily with physical deterioration. While there is a longstanding body of literature on the biomedical aspects of HD and ALS, there is little literature or knowledge regarding the experiences of people afflicted with these diseases. HD and ALS may progress in a manner that is unique compared to other non-neurological illnesses. Individuals can receive a diagnosis and then wait years or decades before the severe effects of the disease become apparent. During this time, these individuals are paradoxically ill in concept, but are still physically healthy and can lead comparably normal and productive lives. Michael Halpin is studying how these individuals experience knowing they are seriously ill prior to the development of the most severe symptoms, and how this affects they way in which they view health and their lives. Comparing and contrasting the experiences of people with HD and ALS, he will explore how this period of impending illness influences individuals’ perception of their health and how they view their lives as meaningful after diagnosis. Halpin’s research will improve our current understanding of individuals with these illnesses and give health professionals and researchers greater sensitivity to the concerns of these populations and their unique quality of life issues. Ultimately, this knowledge could help ensure that medical treatments and services are well suited to their experiences and needs.

Rheumatoid arthritis (RA) is an incurable autoimmune disease that affects approximately one in 100 Canadians. It is associated with a variety of distressing and debilitating symptoms including chronic pain, stiffness and inflammation of the joints, fatigue, and frequent mood changes. As a result of their disease and related distress, persons with RA (PWRA) typically experience a wide range of daily stressors, such as difficulties performing household chores, impaired ability to work or hold a job, difficulties engaging in leisure or social activities, and interpersonal tensions resulting from added burdens for friends and family members. Although biomedical factors prompt the initial pain symptoms, psychological and social factors appear to play a significant role in the severity and course of the disease over time. For example, social support from family and friends and effective coping strategies may help to decrease pain and increase functional ability of PWRA. A relatively unexplored component of this phenomenon is the role of the spouse, who is most often the primary caregiver for PWRA . Mark Lam is investigating the relationship between the well-being and mood of the spouse and the level of support they provide to the RA patient. He seeks to answer the impact of spousal support on the RA patient’s well-being and symptoms and course of their disease. Findings regarding the role of the spouse and the social support they provide will help inform families, friends, and health care providers as to the most beneficial ways in which to respond to patients suffering from RA, helping them cope more effectively with their pain and disability.

Hormonal emergency contraceptives (EC), commonly referred to as “”morning after pills,”” have the potential to prevent pregnancy before it starts. They can be used as a preventive measure after unprotected sex by women who do not have a routine contraceptive method in place, who experience contraceptive failure such as condom breakage, or who miss several oral contraceptive doses. With the goal of improving women’s access to ECs, pharmacists in British Columbia were granted authority by the provincial government in 2000 to prescribe ECs without a doctor’s prescription. After granting pharmacists EC prescriptive authority, the province saw a 102% increase in EC prescriptions. The most commonly used ECs are the Yuzpe regimen, containing estrogen and progestin, and the progestin-only levonorgestrel regimen. Previous research has suggested that the effectiveness of the Yuzpe and levonorgestrel regimens is 76% and 89%, respectively.. However, there is growing evidence that the effectiveness of ECs has been overestimated in clinical studies. Also, there have been no studies to date that measured the outcomes (pregnancy versus no pregnancy) among women who received ECs under conditions of routine use. Using anonymized health data from all women who sought ECs from pharmacists in British Columbia in 2001 and 2002, pharmacist and graduate student Dr. Vivian Leung is comparing pregnancy rates between the two regimens. The rates will be used to estimate the effectiveness of each regimen and evaluate whether their effectiveness differs significantly when used in the routine community care setting. Leung’s study will explore the health outcomes of ECs on a larger scale than ever before. Her work will contribute important knowledge to better inform women and clinicians of optimal EC use in the prevention of unwanted pregnancy.