UCALGARY
WINTER 2012
MEDICINE A UNIVERSITY OF CALGARY FACULTY OF MEDICINE PUBLICATION
Bridging a gap
A new program is geared towards aspiring radiation oncology physicists
Learning in strides
Research is underway that could benefit individuals with Parkinson’s disease
Meet Canada’s
Researcher of the Year
This year’s recipient of the prestigious award is one of our very own
UCALGARY
MEDICINE Vol 4 Issue 1 | WINTER 2012
UCalgary Medicine is published three times a year by the University of Calgary Faculty of Medicine, providing news and information for and about our faculty, staff, alumni, students, friends and community. For more information contact:
MANAGING EDITOR Kathryn Sloniowski T 403.220.2232 E kjslonio@ucalgary.ca
Dean
Dr. Thomas E. Feasby
Vice Dean
Dr. Jon Meddings
Senior Associate Deans
Dr. Richard Hawkes, Research Dr. Benedikt Hallgrímsson, Education Dr. Ronald Bridges, Clinical Affairs
Associate Deans
Dr. Anthony Schryvers, Undergraduate Science Education Dr. Bruce Wright, Undergraduate Medical Education Dr. Jennifer Hatfield, Global Health & International Partnerships Dr. Doug L. Myhre, Distributed Learning & Rural Initiatives Dr. Joanne M. Todesco, Postgraduate Medical Education Dr. Frans A. van der Hoorn, Graduate Science Education Dr. Jocelyn Lockyer, Continuing Medical Education Dr. John Reynolds, Basic Research Dr. Michael Hill, Clinical Research Dr. Janet de Groot, Equity & Teacher-Learner Relations Dr. Kamala Patel, Faculty Development
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PM AGREEMENT NO. 41095528 RETURN UNDELIVERABLE CANADIAN addresses TO: University of Calgary Faculty of Medicine Communications & Media Relations Health Sciences Centre 3330 Hospital Drive NW Calgary, Alberta T2N 4N1 Winter 2012
| UCALGARY MEDICINE
CONTENTS
WINTER 2012
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Building success through collaboration
Students shine at competition
MESSAGE FROM THE DEAN
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Reflecting on another successful year.
EDUCATION
Bridging a gap
A new certificate program at UCalgary is helping aspiring radiation oncology physicists reach their full potential. COVER STORY
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PHILANTHROPY
The key to an imprisoned mind Molly Visentin was given her life back when a surgery to treat her temporal lobe epilepsy was successful.
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SERVICE TO SOCIETY
RESEARCH
Meet Canada’s Researcher of the Year He’s one of our very own.
It has the potential to save lives and increase our understanding of gastrointestinal diseases.
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EDUCATION
All eyes on alumni
RESEARCH
Learning in strides New research is underway that could benefit individuals with Parkinson’s disease.
UCALGARY MEDICINE |
Scoping out a new health technology
Dr. Jaelene Mannerfeldt’s journey as a physician has taken her around the world.
http://medicine.ucalgary.ca/magazine/
EDUCATION
A group of students at UCalgary have proven that teamwork and collaboration is key to success.
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SERVICE TO SOCIETY
Combating hunger by spreading the love Making a difference in the world is possible through many forms, and for one Bachelor of Health Sciences student that form is a sandwich.
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research
Getting to the heart of the matter New research has shown that individuals are more likely to complete a cardiac rehabilitation program if they have early access to it.
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In the news
• $3.8 million to study progressive forms of multiple sclerosis. • Study finds benefits of chinook winds. • Workshop to teach sexual assault awareness.
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Message From The Dean
Building success through collaboration
A
s we move into yet another new calendar year, we can reflect on another successful year at the Faculty of Medicine. We’re very proud of all our faculty and staff for their contributions to our achievements and we look forward to the coming year with great anticipation as to what lies ahead. In November, the Faculty was very proud to learn that our own Paul Kubes, PhD, received one of Canada’s top awards for medical research–Canada’s Health Researcher of the Year from the Canadian Institutes of Health Research (CIHR). We explore some of Paul’s accomplishments at the Faculty on pages 8, 9 and 10, and we are grateful to him for his hard work and dedication to his research. Paul sets a high standard. Two of our senior scientists also won prestigious awards in November. Gerald Zamponi, PhD, won an ASTech award in the category of Outstanding Leadership in Alberta Science, and Dr. Morley Hollenberg was awarded the 2011 McLaughlin Medal from the Royal Society of Canada−an award that recognizes distinguished achievement in medical sciences in Canada. Throughout this issue of UCalgary Medicine we have many stories that reflect the importance of collaboration. We believe a teamwork approach provides a well-rounded and comprehensive education for our students and is fertile ground for research. On page 18, we are pleased to share with you the success of UCalgary’s iGem team. This group of 11 students, from the faculties of medicine, engineering and science, worked together to create a project that monitors toxins in oil sands tailings ponds. They won a major award in competition against the world’s best universities at iGem’s World Championship Jamboree, in November at MIT in Boston, showing how teamwork can achieve great things. We also catch up with alumna Dr. Jaelene Mannerfeldt, on pages 13 and 14, who shares her experiences volunteering abroad. Jaelene’s contributions to society are a solid example of how working together can make a very meaningful impact in the world. While these are only a few of the stories in this issue, I trust you will find the others just as enjoyable. We thoroughly enjoy sharing our accomplishments with you, and we can only speculate about what great stories will come out of the Faculty of Medicine as the new year is upon us. As always, I welcome your feedback.
Tom Feasby, MD Dean, Faculty of Medicine University of Calgary
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Winter 2012
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Philanthropy
The key to an
imprisoned mind Molly Visentin was given her life back when a surgery to treat her temporal lobe epilepsy was successful. And now, because of a generous donation, further research into her form of the disease will be made possible. By Alison Myers
Molly Visentin isn’t exactly sure how it all started. After all, she was just eight months old. “My skull was bumped and it bruised the inside,” she says. “It left scar tissue in my brain, above my left ear.” The attacks started not long after, lurking as possibilities every day since. It would be fair to say that epilepsy shaped who Visentin became. She grew up on a farm, befriending animals who never judged or teased her like the kids at school. As a young adult, she lied about her disease to get a summer job manning a fire tower lookout. She worked alone, in the forest, surrounded by animals and the silence of nature. Every now and then that silence was broken by what she calls her inner funny. It started with a ringing in her right ear, sig-
UCALGARY MEDICINE |
Dr. Samuel Wiebe is a professor in the Departments of Clinical Neurosciences, Community Health Sciences and Pediatrics.
naling an attack was imminent. Later, a short ring in her left ear would let her know it was over, that she was okay. Those signals were her brain’s Morse code way of telling her the disease was in control.
And so, on Jan. 28, 2011, Visentin’s life took a dramatic shift. Doctors removed a piece of her brain about the size of a peanut in its shell. When she woke up, much of her life changed.
“The brain is extremely eloquent,” explains Dr. Samuel Wiebe, a neurologist at the Faculty of Medicine and member of the Hotchkiss Brain Institute (HBI). “Whether it’s smell or taste or vision, hearing things or feeling something in your hand or foot− those are all governed by different areas of the brain. So it’s extremely important to pay attention to the symptoms of a seizure because that tells us which part of the brain is affected.”
“All of a sudden, you can figure things out,” she marvels even now, a year since her release. “All I can say is, wow!”
It’s been almost a decade since Wiebe helped change the way doctors around the world treat people with temporal lobe epilepsy, the kind that ruled Molly’s life. His successful clinical trial at the turn of the century proved that surgery can actually cure some patients, releasing them from a lifetime of drugs and treatment. “Epilepsy is produced by abnormal electrical discharges in areas of the brain,” says Wiebe, who is also the director of HBI’s Clinical Research Unit. “If we can find the area where this is occurring and safely remove it, then we cure the disease.” Doing so is an extremely sophisticated procedure. It requires doctors to extensively map the patient’s brain to find out what functions are governed by the tissue surrounding the seizure trigger. Visentin’s telltale ringing was like a yellow brick road leading Wiebe and the neurology team right to the epicentre of her disease.
http://medicine.ucalgary.ca/magazine/
Visentin’s new lease on life came as a direct result of Wiebe’s research into temporal lobe epilepsy. Research in this area is getting a welcome boost at UCalgary thanks to a generous donation from UCB, a global biopharmaceutical company that focuses on epilepsy treatments. Wiebe says the donation will be used to fund a research fellowship for a neurologist in training, whose focus is finding new ways to treat Visentin’s form of the disease. “It’s through donations exactly like the one UCB made that these new ideas about treatment and mechanisms of epilepsy can be explored and brought to trials that demonstrate new ways of treating people with this disease.” Seeing Visentin, and patients like her, go through such a radical change is an incredible motivator for Wiebe and the neurology team, especially when all other forms of treatment have failed. While Visentin still has hurdles to overcome, she is well on her way to recovery from a lifetime of disease. “It just makes my day,” he explains with a bright grin on his face. “She’s been freed from lifelong shackles into a completely new outlook on life. It’s unbelievable!” ✦
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Bridging a gap A new certificate program at UCalgary is helping aspiring radiation oncology physicists reach their full potential. By Kathryn Sloniowski
The University of Calgary is home to a new certificate program that is preparing aspiring radiation oncology physicists (ROP) for residency. The new Post-Doctoral Certificate in Radiation Oncology Physics, offered through the Faculty of Science but whose instructors are cross-appointed with the Faculty of Medicine, is one of only two accredited programs of its kind in the world. Designed to educate individuals with a PhD in physics who wish to pursue a career in radiation oncology physics, the certificate program offers students the background required to enter into an ROP residency program. Radiation oncology physicists are primarily involved with the planning and delivery of radiation treatments to cancer patients.
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Somewhat of a hidden gem in the medical world, their work is done largely behind the scenes. Their role however, is nonetheless critical to the delivery of safe, high quality health care. “A lot of patients might not know medical physicists exist,” says Wendy Smith, PhD, assistant professor in the Department of Oncology and co-director of the ROP certification program. “We’re involved in all stages of radiation therapy from site planning to designing new techniques. We ensure the radiation dose that’s prescribed by the physician is what is delivered to the patient.” The two-term program was inspired by the large volume of applicants for the Winter 2012
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Education
ROP residency program at the Tom Baker Cancer Centre who, despite having competitive educational backgrounds, lacked a background specific to radiation oncology physics. Without this background, students were ineligible for the residency program. “We saw this need, this gap, where people were interested in joining our field,” she says. “They’re smart, talented people, but we couldn’t accept them.” Smith says ROP courses have been offered to graduate physics students for several years, so they decided to repackage those courses. By making the courses accessible to individuals with a PhD in physics, the ROP certificate program provides students with that missing piece of the puzzle.
“They’re smart, talented people, but we couldn’t accept them.” “We don’t, however, guarantee they’ll get into our residency,” says Smith, adding that there are many ROP residencies at various locations students can apply for. A residency in radiation oncology physics is similar to that of a medical residency, the difference being participants haven’t gone through medical school−they’ve completed a PhD in physics. The residency gives them formal, on-the-job training, and just as in a medical residency, they are prepared by qualified mentors in each area they study. The ROP residency is generally two years in length, and after completion, graduates become clinical scientists. They are then able to work in a hospital or to choose a more academic career involving research and teaching. Smith says while a medical physicist is not a physician, the job has a distinct medical focus. “We take our scientific background and apply it to medicine,” she says, adding that they also do a lot of training with medical residents. “We have the first-year radiation oncology residents do a course in medical physics because they have to understand the principles of radiation
UCALGARY MEDICINE |
Wendy Smith, PhD, (centre) with students Doaa Ghoneim, PhD, (left), and Congwu Cui, PhD, (right) in a radiation therapy unit. Both students are enrolled in the new certificate program.
physics to plan a treatment.” Historically, medical physicists were hired based on completion of a PhD in physics and were given on-the-job training. The system was vulnerable to inconsistencies in the levels and types of training, prompting professional bodies to step in to attempt to tighten up the requirements for formal training. Residencies were also quite versatile, with no governing training standards. Smith says in the past few years, that trend has been changing as well. “Now there are new regulations coming in saying you have to have gone through an accredited residency program in order to take the exams in Canada, so now you will be required to take an accredited program.” Both the residency program and the certificate offered through UCalgary are accredited programs. While the program is still new, Smith says they have many long term goals for the program, not only to serve Calgary, but to become a leader at an international level. Ultimately, they’d like to serve as a training facility, so if clinics elsewhere need to train somebody but don’t have the resources, they could send them to the UCalgary program.
http://medicine.ucalgary.ca/magazine/
Did you know? · 39 per cent of Canadian women and 45 per cent of Canadian men will be afflicted by cancer. Approximately half of them will require radiation treatment. · There are approximately 350 radiation oncology physicists practicing in Canada.
“This could take a long time to achieve, but ultimately I think we could be a very useful international training program resource.” In the meantime, the program is open to accepting students from anywhere in the world. Smith hopes that it can provide opportunities for people who may not have been previously aware of them, and that it helps those who wish to enter the field. Currently, there are two students enrolled and she says the contributions they’ve made to the education system have been substantial. “I think they improve the quality of education. You get these older students who have seen a bit more of life and are really motivated. I think by being present, they’ve raised the bar for everyone.” ✦
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Paul Kubes, PhD, is a professor in the Departments of Physiology & Pharmacology, Medicine, and Microbiology, Immunity & Infectious Diseases.
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Winter 2012
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Research
Meet Canada’s Researcher of the Year He’s one of our very own.
I
t has been a busy year for Paul Kubes, PhD. As the director of the university’s Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, Kubes has been responsible for building relationships with stakeholders and the external community, the recruitment of both staff and students, and increasing public profile. As a researcher in the Faculty of Medicine, he has also maintained his steady research pace, publishing a number of papers including a study featured in Science−one of the world’s top science journals.
national. Despite the time commitments, Kubes is not complaining. “Absolutely it’s been busy. This is fabulous news for the University of Calgary, and it puts a spotlight on all the research happening here.” The research Kubes’ research touches on many areas of science and medicine that are not
By Marta Cyperling
always in the spotlight. He studies infection and inflammation−conditions which affect vast numbers of people but which do not receive the publicity or notoriety of other diseases. While the conditions may not come with the long lasting relationships that you have with arthritis or other autoimmune diseases, they kill a lot more people. “People don’t often think about infections,” Kubes explains. “You usually recover really quickly or you die.”
This past November, the Canadian Institutes of Health Research (CIHR) named Kubes Canada’s Health Researcher of the Year. This award honours remarkable contributions to health research and comes with a $500,000 research grant. Kubes says it will allow him to conduct research that otherwise might not have been funded. “I’m going to take some big risks. If they work, there is the potential for greater rewards scientifically.” Aside from the grant, Kubes is already noticing the effects of the acclaim. “This week alone I’ve received a huge increase in fellowship applications from all over Canada and abroad,” he says. Since the announcement, the demands on his time have been extensive. In between academic speaking engagements all over North America, he has managed to provide several local and national media interviews for outlets such as The Globe and Mail and CBC’s Radio Canada Inter-
UCALGARY MEDICINE |
Dr. Alain Beaudet, CIHR president (left) with Paul Kubes, PhD, (right).
http://medicine.ucalgary.ca/magazine/
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Research
Kubes specializes in the visualization of the immune system. Specifically, he looks at white blood cells. Occasionally the body can dispatch an excess amount to sites of infection, causing tissue damage. His real-time imaging system can visually display immune cells and the bacteria they are chasing. “Five or six years ago, we couldn’t picture what was happening in the blood. Now it’s easier to see and target the cells.” The impact Antibiotics are often cited as one of medicine’s greatest achievements, but over the last few decades there have been disturbing developments in the field. Some bacteria have begun developing a resistance to common antibiotics, triggering an arms race as scientists strive to develop new weapons to combat these increasingly common “superbugs”. In the last six
years, the medical community has seen a 30-fold increase in the prevalence of these organisms in Calgary alone. Kubes’ research will be of vital importance as the number of antibiotic resistant bacteria grows and alternatives for the treatment of infection become critically important. “We’ve got to stop using antibiotics. We need to target the immune system and not the bacteria,” says Kubes, referring to the overuse of antibiotics which can lead to resistant infections. He has another thought about the future, and it’s a chilling one. “We will reach a stage similar to the early 1900’s where people lived in a world without antibiotics. We won’t have antibiotic protection.” The connection Kubes is also the lead researcher for the Alberta Sepsis Network. Sepsis is a
potentially fatal blood disease where the blood is overwhelmed with bacteria and inflammation throughout the body. Approximately 250,000 people in North America die from sepsis each year. The most common treatment for sepsis is a combination of antibiotics and IV fluids to maintain blood pressure. However, a patient infected with antibiotic resistant bacteria will not be affected by this treatment, causing for a much more complicated treatment and recovery process. After a conversation with a doctor about the high rates of infection in stroke patients, Kubes also became interested in studying how the immune system responds post-stroke. He discovered that when an individual has a stroke, the brain tries to protect itself by blocking inflammation. This lowers the body’s immune system which could potentially lead to infection. Using a mouse model, Kubes’ team believes they may have found a drug to halt cells from suppressing the immune system, thus stopping the infection. Kubes and his colleagues are now investigating if the science can be applied to humans. The future The research done in Kubes’ lab has applications in many different areas of medicine. Kubes’ research is looking at new ways to treat infections by making the body’s own immune system more effective, as opposed to trying to keep up with the relentless evolution of resistant bacterial strains. This research is critically important to the many Canadians who must deal with any type of infection, and it will hopefully contribute to new ways to improve treatment options. ✦
Following the announcement of his award, Paul Kubes, PhD, provided several local and national media interviews.
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Scan this QR code with your smartphone to see a video about Paul Kubes, PhD, and his award. Don’t have a smartphone yet? No problem! you can check it out online at: www.youtube.com/ucalgarymedicine Winter 2012
| UCALGARY MEDICINE
Service to society
Scoping out a new health technology It has the potential to save lives and increase our understanding of gastrointestinal diseases. It’s even brought along a very talented doctor.
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ess than a year ago, Dr. Marietta Iacucci, was enjoying life as a senior gastroenterologist at the S. Camillo-Forlanini Hospital in Rome. Today, she is a clinical associate professor in the Division of Gastroenterology at UCalgary’s Faculty of Medicine, and is introducing a novel endoscopic technology to her colleagues. Confocal laser endomicroscopy in vivo (CLE) is intended to advance surveillance of gastrointestinal conditions, diagnose cancers earlier and more efficiently, and finely-tune therapeutic treatments. Iacucci, a medical doctor since she was 23-years-old, studied this technology in Italy, Britain and Germany. Calgary is the first Canadian community to embrace the tool to better understand the pathogenesis of gastro-type diseases. There are many conditions which use scoping for tracking and diagnosis. Iacucci’s particular interest is inflammatory bowel disease (IBD)−patients with this condition are at high risk of developing cancer after a 10 year period. With CLE, Iacucci also hopes to learn more about mucosal healing−a key component of remission. And she, along with her colleagues, will work with the technology to learn more
UCALGARY MEDICINE |
By Colleen Biondi
about the genetic makeup of individuals at risk for gastrointestinal issues. At first glance, the CLE machine–manufactured by Pentax−uses what looks like a normal endoscope. But the high-resolution scope has a laser on its tip and two buttons that allow for examination of the mucosal (surface) layer and the subcellular (nuclei and cytoplasm) layers. Typical or “white light” technology looks at surface tissue only. A huge advantage of this technology is that histology is possible during the scoping process itself (a good endoscopist also has knowledge of pathology and can interpret images) so cancerous cells can be excised in the moment. “You can more efficiently understand the situation,” says Iacucci. ”You can target biopsies and diagnose early cancer.” Because of the depth of the technology’s range it can even detect hyperplastic or “flat” lesions. This is significant because, contrary to earlier research, it is now known that these lesions can be cancerous. Traditional scoping technologies can miss up to 30 per cent of such lesions. This tool can also distinguish low-grade
http://medicine.ucalgary.ca/magazine/
Dr. Marietta Iacucci is working with the CLE machine. It has a laser on its tip and two buttons that allow for detailed examination.
from high-grade intraepithelial neoplasia (abnormal cell growth) with up to 95 per cent accuracy. While the technology does render great potential, there are however a few downsides. It takes time to train professionals to use the technology and because of the detailed work of the scope, the process can take additional time. When in the office, Iacucci’s priority is clear−to contribute to the lives of patients. When she’s not peering down a scope or consulting with patients however, Iacucci takes time to relax. Going to the mountains, biking and practising yoga are all on the agenda as is an upcoming trip to Mexico. “It is important to be balanced, to enjoy life,” she says. ✦
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research
Learning in strides A device is being researched at the Faculty of Medicine to see if it can help individuals with Parkinson’s disease walk properly long term. By Kathryn Sloniowski
Do you need to find the best restaurant in town? There’s an app for that. What about the latest snow report? There’s an app for that. What about if you have Parkinson’s disease and you’re working on improving your walking abilities? Guess what? Yes, there’s an app for that too. The Faculty of Medicine’s Dr. Bin Hu, who is also a member of the Hotchkiss Brain Institute (HBI), has created what is called the Gait Reminder−a device designed to help Parkinson’s patients walk with the help of music. Using the movement sensing technology of the 4th generation iPod touch, the device incorporates the use of a specially designed app that computes leg movement signals, triggering music to positively reinforce proper walking. In an ongoing trial, Hu is trying to determine if the Gait Reminder can help patients walk properly, long term. Our gait is our stride (the length of steps we take). When we walk, large steps provide us with stability while smaller steps can lead to instability. Individuals with Parkinson’s have a motor disorder which makes it difficult for them to control their motor skills. Their steps, consequently, get smaller as they walk making the task very difficult. “Difficulties in walking are disabling symptoms for Parkinson’s patients and they respond poorly to medications,” says Hu. This walking difficulty can lead to what is called a vicious cycle. The lack of mobility can lead to additional health problems such as muscular atrophy and bone loss, making it even more of a challenge for patients to be active. The concept of the Gait Reminder is to positively reinforce proper walking with music. The device is strapped to the knee of the patient and music can be heard through wireless headphones. As they walk, music plays when their steps are large enough. If their steps begin getting too small, the music will turn off–reminding them to increase their step size. Hu says Parkinson’s patients are able to increase their stride if they’re constantly reminded to do so, so music in this context serves as that reminder. It’s also more likely a patient will enjoy walking when the music serves as a contingent reward.
Dr. Bin Hu, who is a professor in the Departments of Clinical Neurosciences and Cell Biology & Anatomy, observes study participant Thomas Vladut as he uses the Gait Reminder. He is funded by Alberta Innovates — Health Solutions.
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“Difficulties in walking are disabling symptoms for Parkinson’s patients and they respond poorly to medications.” Each patient taking part in the study undergoes a base-line test on campus to determine their suitability. They undergo a walking and balance test, and their step size and other variables are measured. Hu then teaches each patient, along with their caregiver, how to use the device, which is very user friendly− those who wouldn’t consider themselves technologically savvy, who have never used an iPod, or who are even upwards of 75 will be able to use it. The device contains three distinct playlists of music: a playlist of self-selected music the patient chooses, a playlist of neurology based music (music that is chosen based on human brain scans of music-elicited responses), and music that the patient has been exposed to in a group-learning environment such as choir. The patient is then able to take the Gait Reminder home to use at their convenience, with no limitations. When in use, information regarding how far the patient has walked and what music they listened to is stored, giving an objective report of patient progress. “Some people may ask why we don’t put patients on treadmills,” says Hu. “With this kind of exercise, they can walk with another person or as part of a group, so they can really do this anywhere they want and when they want.” While the study is still ongoing, Hu says that from the preliminary data collected they’ve seen promising results. He says some patients have entered the study struggling to walk without a walker, and are now able to walk regular distances of over one kilometre. As well, patients are reporting that they’re enjoying using the Gait Reminder. “We’re optimistic. I think this device has lots of benefits. I don’t know how long they’ll last and how long treatment will have to be−this is something we’ll have to figure out. Just like a drug we need to find the dosage for an optimal outcome.” ✦
Dr. Bin Hu shows Ritta Vladut, Thomas’s wife, how to use the Gait Reminder.
UCALGARY MEDICINE |
http://medicine.ucalgary.ca/magazine/
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All eyes on alumni Dr. Jaelene Mannerfeldt’s journey as a physician has taken her around the world. Involved in several team-oriented volunteer projects in developing countries, she is dedicated to working with and educating physicians world-wide, to enhance their knowledge and skills in obstetrics and gynecology. Mannerfeldt sits down to discuss her medical journey, since graduating from the Faculty of Medicine in 1989–the year of the flamingo.
What was your first job as a doctor? My first job was as a family physician in the town of Rimbey, Alberta. What is your current position as a doctor? I’m the site leader of obstetrics and gynecology at the Rockyview General Hospital. I also work as the director of medical education at the Rockyview. And in that capacity, I monitor and work with the curriculum development and program administration for nine different specialty programs that have their first year of residency training at the hospital. Why did you choose to make the change from family medicine to obstetrics and gynecology? I had done a third year after family medicine and focused on obstetrics and surgery and had the skill set to do caesarean sections. So, I was doing more advanced obstetrical care as a family doctor. Then, the opportunity came up to do a residency in obstetrics and gynecology and my family and colleagues all said ‘this is a passion of yours, you need to be there.’ They were very supportive so I went back and did it. I think I’ve still practiced a lot from
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a family medicine perspective in that I really think about an individual within their family context as well as think about other issues that can affect health, as opposed to just focusing on my one area. You’ve been involved with a volunteer project in Laos for quite some time now. Will you talk a little bit about the project? The project in Laos is a partnership with UCalgary’s Faculty of Medicine and the University of Health Sciences in Laos− there are about 20 to 30 people from the Faculty of Medicine involved. The formal project started in 2005 and that’s when I got involved. Preliminary work, done by Dr. Guenter, found that a lot of people in Laos said their medical education wasn’t meeting the needs of the people. So the project aims to help the univeristy in Laos restructure their curriculum to meet the needs of the Laotian people. We’ve been working with the medical school as well as working with groups of physicians who have been accepted into the family medicine program and we basically help them teach. We work with their teachers on giving or teaching medical education as well as carrying out clinical experiences with the residents and helping them develop
their skills−as far as patient presentation and how to define and develop a differential diagnoses. In addition to that, the program wants to develop family medicine as a specialty with the aim of having family physicians in the rural district hospitals and health centres throughout Laos. Eighty per cent of the population of Laos lives in rural communities. So now, where there were no family doctors seven years ago, we now have approximately 150 family doctors and a lot of them are working in rural communities throughout Laos. So it’s been a wonderful project. How has volunteering impacted your life? I think it’s changed my life in so many ways it’s hard to count. In developing countries in particular, there’s no way that they could pay for the medical expertise and the assistance they need, and you realize that we have so much in Canada and we want for nothing. I learn as much from them as I hope that I leave with them and I think if we all contribute a little bit to our world and take the focus off of what’s in it for me, but what’s in it for us−this relationship building−there’s real personal satisfaction and a real sense of fulfillWinter 2012
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Education
ment. I also think that you know, there’s huge disparity in the world and we need to ensure that those born in countries less advantaged than those of us in Canada will still have the same opportunities. Really, depending on where you’re born has a huge impact on what your health outcomes will be, what your whole life experience will be. And I think about, why was I so lucky to be born in Canada? Your volunteer work is heavily based on teaching, and you are also an assistant clinical professor at the Faculty of Medicine. How has teaching impacted your life? I really believe that education is kind of my life’s purpose−it’s to help people to live better lives through education. That means my colleagues, students, patients and everyone else. The students are there and they need to learn. I had people that gave of themselves and their time to teach me and I need to pay back.
UCALGARY MEDICINE |
Another area I feel passionate about is the Faculty Advisor System at the Faculty of Medicine. I think it’s a wonderful opportunity to work with our students, be there for them, encourage them–just really be a real mentor in their lives. My first student was assigned to me in 2000 and she still sends me updates–tells me what’s going on in her world and, you know, those are relationships that change from student to mentor, to the ability to mentor them in their careers−and they become colleagues. I think it’s a fabulous program−I really have enjoyed it. What has your proudest moment as a doctor been thus far? There have been a few. Last spring my daughter said she’d decided she wanted to apply for medical school. So that makes me feel pretty proud because you kind of go, ‘wow’. You know, she lived through this with me–because she was three-years-old when I started medical school.
http://medicine.ucalgary.ca/magazine/
There was also an experience I had in Tanzania with the Advances in Labour and Risk Management (ALARM) program. It’s about taking emergency obstetrical skills to low and medium resource countries and I’ve been working with them since 2003. I was there teaching an emergency obstetrics course. At the end of the course one of the things I asked the participants to do was to identify one thing they were going to do differently in their world and to share it with the group. This very tall, Tanzanian man stood up when it was his turn and he said he worked as a medical assistant in the hospital. When women would come in and he knew they were having a miscarriage−because they had taken medication to induce the miscarriage−he said he had, in the past, told the nurses to put them in the corner to wait. He said that when he had time he would go care for them because they brought it on themselves. And he said, after being involved in the course, he realized that that’s wrong and everybody who came to him needed care. So he said from then on, those women would get the care they needed when they came to the hospital. I was dumbfounded because you always kind of wonder, does anybody listen, does anybody hear you−and he had heard it. And all I can hope is that when he went back, the women in his community−I hope they’re experiencing better care today because of the change he saw. So that was powerful. You have to start the conversation. People really want to do what’s right but they’re often held back by their own experiences and cultures and if you’re not willing to put yourself out there then we will never change. What advice would you like to offer to aspiring doctors and/or medical students? I would encourage them to hold on to their humanitarian reasons for wanting to be there for other people. I hear it from the students–they’re in medicine because they really do want to make a difference in other people’s lives. I would encourage them to keep the heart in medicine both for themselves and for their patients. We as physicians, we’re in an incredibly privileged position−people share with us the most intimate things of their lives. We’re here to make that difference for those people who entrust their lives to us. ✦
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Education
From left to right: iGem team members Robert Mayall, Felix Young and Emily Hicks.
Students shine at competition
A group of students at UCalgary have proven that teamwork and collaboration is key to success. By Marta Cyperling
Students from UCalgary’s International Genetically Engineered Machines (iGEM) team won the “Best Environment Project” at the iGEM World Championship Jamboree at the Massachusetts Institute of Technology (MIT). The UCalgary team was the only Canadian team to win an award and competed against 64 other teams from across the world including Harvard, Yale and universities in Asia and Europe. “We beat some really good teams” says
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Mayi Arcellana-Panlilio, PhD, one of the faculty advisors to the iGEM team. “This is the best showing UCalgary has ever had in the competition.” UCalgary’s iGem team is made up of 11 students from the faculties of medicine, science and engineering, and relies on the expertise from all the disciplines. Their winning project genetically modified bacteria and used it to develop a biosensor to monitor toxins in oil sands tailings ponds. They believe their project could make it faster and cheaper to test for contamination than current methods. “We are very proud to have represented our university and shown all of the world what we can do,” says Robert Mayall a student in the Bachelor of Health Sciences program. He says the team took a few days off and has already started planning for next year’s competition.
So what is the plan for next year? Mayall says they may focus on optimizing the biosensor and exploring how to harness bacteria to transform the toxins so that they become less harmful. ✦
What is iGem? The International Genetically Engineered Machine competition (iGEM) is an undergraduate synthetic biology competition. Student teams are given a kit of biological parts at the beginning of the summer from the Registry of Standard Biological Parts. Working at their own schools over the summer, they use these parts and new parts of their own design to build biological systems and operate them in living cells.
Winter 2012
| UCALGARY MEDICINE
Service to society
Combating
Hunger by spreading the love
Making a difference in the world is possible through many forms, and for one Bachelor of Health Sciences student that form is a sandwich.
“We combat hunger through the simple power of the sandwich.” This is what Miles Robert Aronson, a Bachelor of Health Sciences student in his final year, says about Spread the Love–a non-profit organization he founded in 2002 when he was only 15-years-old. The organization makes sandwiches for individuals struggling with food insecurity−those who live not knowing when or where they’ll have their next meal. With locations in Alberta, British Columbia, Ontario and Quebec, at high schools and on post-secondary campuses, Spread the Love has made over 70,000 sandwiches that have been distributed to the hungry. The classics, cold cut and lettuce and cheese, are the sandwiches of choice–the simplest way to cover all the food groups in a manageable way. Aronson says Spread the Love is essentially a volunteer franchise so opening up new locations is a matter of encouraging young people to set up their own chapter. At universities they’re called clubs. UCalgary has a Spread the Love Club with over 500 volunteers and an office at MacEwan Hall. Each individual chapter is responsible for the recruitment of its own volunteers, fundraising and giving the sandwiches to front-line organizations for distribution. In Calgary, the Mustard Seed and the Alex Centre are just a few of the locations they have supported. There is no set guideline as to how often fundraising and sandwich making events must take place–it’s all up to each individual chapter.
UCALGARY MEDICINE |
By Kathryn Sloniowski
“One of our strongest high schools in Calgary runs one sandwich making event practically every month throughout the year. UCalgary’s club usually holds one massive event every semester so there’s a lot of variance between chapters which is great.”
“We combat hunger through the simple power of the sandwich.” While volunteers not only get to be a part of a respectable humanitarian effort that makes a difference in the lives of others, the organization also provides tremendous learning opportunities for those involved. Aronson and other key members of Spread the Love provide new chapters with some start up ideas and offer basic mentorship; however, fundraising, volunteer recruiting, administration and all other aspects of managing a charity is their own responsibility. “Young people have to learn to fundraise–that’s a key aspect to any social or humanitarian effort,” says Aronson. “They’re learning to mobilize community support to be self-sustainable.” Aronson says fundraising is essentially what keeps the charity alive, but sponsorship has also had a huge impact. “We have a variety of sponsors and past donors that provide a central aspect of support−every organization needs that,” he says, mentioning that donations have
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Miles Robert Aronson.
come in the forms of both cash and sandwich supplies. As for future plans for the organization, Aronson is looking ahead to the day when they’re no longer needed. “We want to run ourselves out of operation one day like responsible charities do−or eventually have to decrease our output in the future. In the interim, we’re trying to grow as much as possible to meet the current demand.” ✦
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Research
Getting to the heart of the matter
Did you know? Most major cities in Canada offer cardiac rehabilitation programs. Calgary’s cardiac rehabilitation program, located at the Talisman Sports Centre, is one of the few programs of its kind in Canada that has a minimal wait for enrollment.
Cardiac rehabilitation is a series of educational and exercise components aimed at teaching participants how to live a healthy lifestyle. By learning about topics such as nutrition, physical fitness and mental wellness, participants learn to reduce their factors for future heart related illness. A new study from the Faculty of Medicine has found that individuals who have experienced a heart attacked are more likely to complete a cardiac rehabilitation program when they have access to it within 14 days of hospital discharge. “The proven benefits of participation in cardiac rehabilitation are multi-faceted,” says Dr. James Stone, co-author of the study and member of the Libin Cardiovascular Institute of Alberta. “They include living longer, less-frequent hospital admissions, requiring fewer heart procedures and having better control of the risk factors that cause coronary artery disease.” The study involved 469 patients who were admitted to the Foothills Medical Centre after experiencing a heart attack, between January 2007 and July 2009. Half of the participants had traditional cardiac rehabilitation access (weeks to months), while half received early access to the program. Those who had early access to the program had a cardiac rehabilitation consultation scheduled for them within 4-14 days of discharge. The results of the study showed that participants who had early access were twice as likely to finish the program compared to those who had to wait longer.
Brian Gibbs (left) with Dr. James Stone. Stone is a clinical professor in the Departments of Cardiac Sciences and Medicine.
New research has shown that individuals are more likely to complete a cardiac rehabilitation program if they have early access to it. By Kathryn Sloniowski
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pproximately 70,000 Canadians will experience a heart attack each year, and in 2010, Brian Gibbs was one of them. The Calgary resident, grateful for his second chance, was determined to take control of his health so he enrolled in a cardiac rehabilitation program.
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Dr. Sandeep Aggarwal, co-author of the study and clinical assistant professor in the Departments of Cardiac Science and Medicine, says it’s possible that patients who have to wait for the program are less likely to participate because they may want to move on with their lives after a heart attack. “When patients get a call two or three months after a heart attack they may think the program won’t be beneficial to them so far away from the event. They may also have to go back to work or they may just get tired of waiting,” says Aggarwal, who is also a member of the Libin Institute. Gibbs, having experienced the benefits of the program firsthand, says he can’t speak highly enough about the program and says anybody who has the opportunity to participate, should do so. “Without having participated in the program, I think I would still be wallowing in ignorance on how best to be responsible for my own health,” he says. “Education is a key ingredient in improving our health.” ✦ Winter 2012
| UCALGARY MEDICINE
In the news $3.8 million to study progressive forms of multiple sclerosis The Multiple Sclerosis Society of Canada and the Multiple Sclerosis Scientific Research Foundation announced a $3.8 million grant to investigate the complex interplay between degeneration and inflammation in multiple sclerosis (MS). The grant will fund a study led by Dr. Peter Stys which will investigate damage that occurs in MS prior to inflammation. This research may have special relevance for those with progressive forms of MS. “This study hypothesizes that the inflammatory response in MS is the result of an underlying degenerative process rather than the primary cause of injury,” says Dr. Peter Stys who is a professor in the Department of Clinical Neurosciences and a member of the Hotchkiss Brain Institute (HBI). In general, progressive disease is characterized by a non-inflammatory neurodegenerative process. Approximately 10 per cent of people with MS are diagnosed with primary progressive MS. A more common type of progressive MS is secondary progressive MS– which begins as relapsing remitting MS, but then transitions to a progressive course. Fifty per cent of those with an initial diagnosis of relapsing MS eventually develop secondary progressive MS within ten years of diagnosis. “The important roles of autoimmunity and the damage of inflammation are undeniable. But this doesn’t mean that this is the starting point. If we can understand more about the earliest triggers in the disease processes in MS, we might learn how to intervene and prevent the damage that occurs prior to an inflammatory response,” Stys says. “This research could provide information that benefits both relapsing remitting and progressive forms of MS.”
Workshop to teach sexual assault awareness Wilfreda Thurston, PhD, a Faculty of Medicine researcher, is involved in a new study taking place on campus to determine if a specially designed workshop is effective in helping women resist sexual assault by male acquaintances. The study, which is in partnership with the University of Windsor and the University of Guelph, is studying the effectiveness of Sexual Assault Resistance Education–a workshop designed to teach women to assess their risk of sexual assault in certain situations, to assess men’s behavior, and to take action to resist coercive sex. In a randomized control trial, the study will focus on university women ages 18-24 who are in their first year of a degree program−including medicine and veterinarian medicine. Participants volunteer to take part in the trial and will be randomly assigned to either partake in the workshop, or to receive educational materials and instruction currently available to students. Each participant will then complete follow up surveys at six month intervals for two years. “If the sexual assault resistance education is as effective in the trial as it was in the pilot, this will be a cost-effective population health intervention that all universities could use,” says Thurston. “There are many social and health consequences of sexual assault and experiencing it has a long term effect.” Thurston says the workshop was developed based on the principle that, “everybody has the right to choose what type of sexual practice they want to participate in and that coercion is never right.”
UCALGARY MEDICINE |
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News
Study finds benefits of chinook winds A new study that looked at the relationship between chinooks and neuropathic pain found some participants’ perceptions of the effects of Chinooks on their neuropathic pain (such as sciatica, pinched nerves, or nerve pain associated with diabetes) differed from recorded data. Dr. Cory Toth, an assistant professor in the Department of Clinical Neurosciences and a member of the Hotchkiss Brain Institute (HBI), tracked close to 100 pain sufferers over four years. Participants were told researchers were investigating different factors that might affect their pain such as: exercise, diet, mood, anxiety levels and weather conditions. Participants regularly recorded their assessments of their pain levels, noting precise times. This allowed researchers to compare those levels with hourly weather data from Environment Canada. At the end of the study, when asked what the impact of a chinook was on their pain, 63 per cent thought chinooks had worsened their pain. However, when the meteorological data was compared to the pain diaries, it was discovered that participants were 1.8 times as likely to have had relief from neuropathic pain on a chinook day as compared to any nonchinook day. Previous studies in migraines suggested lower barometric pressures and higher temperatures during chinooks may increase the risk of triggering a migraine. “I think both these studies show that we don’t yet fully understand the effects of weather on pain,” Toth says, who is also an Alberta Innovates – Health Solutions Clinical Investigator Sybil Ngan, from the University of Calgary’s Department of Clinical Neurosciences, is a co-author on the study.
Did you know? Southern Alberta and a region of Turkey are the only areas in the world that experience chinooks.
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