UCalgary Medicine | Fall 2017 by Cumming School of Medicine

CELEBRATING 50 YEARS OF CHANGING LIVES

UCalgary Medicine is published by the Cumming School of Medicine at the University of Calgary, and provides news and information about our students, faculty, staff, alumni, friends and community. Editorial Team Communications and Media Relations

On the Cover Celebrating 50 years of changing lives

Jordanna Heller, Director Kelly Johnston, Senior Communications Specialist Genevieve Juillet, Communications Advisor

Contributors

Melanie Tibbetts, Senior Communications Specialist

Julia Dick, Aisling Gamble, Laura Herperger, Leigh Hurst,

Pauline Zulueta, Communications Coordinator

Kelly Johnston, Genevieve Juillet, Caitlyn MacDonald, Steve Macfarlane, Jenny McLean, Dawn Smith, Melanie

Marketing

Tibbetts, Nancy Whelan, Pauline Zulueta

Natasha Chalmers, Manager Aisling Gamble, Communications Advisor

Photography and Illustrations

Amanda Fisher, Graphic Designer

Riley Brandt, Amanda Fisher, Trudie Lee, Kevin Pee-ace,

Samara McBain, Digital Producer

Adrian Shellard, Kim Smith, Pauline Zulueta

Dean

Managing Editor

Jon Meddings

Melanie Tibbetts T 403.210.6577

Vice Dean

E melanie.tibbetts@ucalgary.ca

Glenda MacQueen Senior Associate Deans

Interested in receiving a copy of UCalgary Medicine

Ron Bridges, Faculty Affairs

in your inbox or by mail?

Maureen Topps, Education Marcello Tonelli, Health Research Gerald Zamponi, Research

Visit cumming.ucalgary.ca/ucalgarymed to sign up for our distribution list.

Associate Deans Beverly Adams, Professionalism, Equity and Diversity Tara Beattie, Graduate Science Education Kelly Burak, Continuing Medical Education Sylvain Coderre, Undergraduate Medical Education Derek Exner, Clinical Trials Jennifer Hatfield, Strategic Partnerships and Community Engagement David Keegan, Faculty Development Ebba Kurz, Undergraduate Health and Science Education Doug Myhre, Distributed Learning and Rural Initiatives Paul Schnetkamp, Research Infrastructure Ray Turner, Research Grants Lisa Welikovitch, Postgraduate Medical Education Samuel Wiebe, Clinical Research

PM Agreement No. 41095528 Return undeliverable Canadian addresses to: University of Calgary Cumming School of Medicine Communications and Media Relations 7th Floor, TRW Building, 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6

UCALGARY MEDICINE FALL 2017

Contents

In this issue:

Features:

Building a foundation

Message from Dr. Jon Meddings Looking forward to another 50 years

RESEARCH

A look at the beginning of our medical school

Making informed decisions Cumming School experts help develop Alberta’s approach to cannabis legalization

Microbiome

New facility at the Cumming School drives discoveries in microbiome research

Celebrating 50 years of changing lives

An illustrated timeline of our achievements

Power of the platform

Health and medicine in the digital age

Minocycline as a treatment for MS

20 years from lab to proven therapy

SPECIAL SECTION: Care in the community

Arthritis care in Indigenous communities

Helping patients adapt to chronic conditions

Indigenous health initiatives Pathways to medicine

UCLIC program inspires young doctors

Harnessing the power of big data How patient data influences better health outcomes

The future of cardiac imaging New imaging techniques help develop precise treatment plans

Participate in research You can help shape the future of medicine

COMMUNITY ENGAGEMENT

Inflammatory bowel disease A modern disease of modern times

Together, we’re creating the future of health Highlights from our 50th Anniversary Celebration

Just call me Susa Practicing precision medicine with Dr. Susanne Benseler

EDUCATION

Awards and recognition See how we’re making an impact

Supporting the enrolment and success of under-represented medical students

Falling in love with rural medicine

Machine learning medicine Tapping into artificial intelligence to imrove patient care

Creating health equity and providing access to quality care

A full-circle moment Mother and daughter CSM graduates share their story

PHILANTHROPY

Saving lives with the best EFW Radiology Fellowship elevates training standards

ALUMNI

Alumni of Distinction Award Learn how one of our alumna is changing lives

CUMMING.UCALGARY.CA/UCALGARYMED

Celebrating 50 years of changing lives During the past 30 plus years, medicine has done a decent job of diagnosing and treating the average illness in the average human being. But what’s “average”? We understand that one plan doesn’t fit all. We want the right treatment, for the right individual, at the right time. Precision medicine and precision public health offer an individualized approach to patient diagnosis, treatment and disease prevention.

his is a very special year for us as it marks the 50th anniversary of our medical school. What a perfect time to reflect on all that we’ve accomplished and look ahead at what’s yet to come. Since opening our doors in 1967, our medical school has grown and evolved into an internationally recognized leader in education and research. We’ve seen immense growth, life-changing research advancements and innovative shifts in health care that are improving lives every day. I’m extremely proud of what we’ve achieved throughout the years — it’s because of our rich history that we look at the future with such optimism. Our school has grown from one single building, the Health Sciences Centre, to a campus with world-class facilities such as the Advanced Technical Skills Simulation Laboratory (ATSSL), the Ward of the 21st Century, and the microbiome centre. The number of students enrolled in our Undergraduate Medical Education (UME) program has increased from 33 in 1970 to 155 in 2017. The number of programs we offer has also risen. In addition to our UME program, which is one of only two threeyear medical programs in Canada, we also offer a Bachelor of Health Sciences program, graduate and post-graduate medical education programs, and a highly

regarded Leaders in Medicine program, which provides motivated students with the opportunity to complete both a medical degree and a graduate degree.

We’re focused on diversity and collaboration. When it comes to creating equity in health care, we want to be a leader. In addition to our education programs, the Cumming School of Medicine is home to seven research institutes and three research centres that are working to better the lives of people in southern Alberta and beyond. We’ve seen great developments — from the creation of the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) database, to identifying the gene responsible for Nager Syndrome, to discovering that a common acne medication can slow the progress of multiple sclerosis (MS). This type of research is possible because of our willingness to take risks and try new things — qualities that have come to define us. We strive to create the future of health, and have adapted both our research and education programs to achieve this goal. For us, the future of health is something called precision medicine.

We’re also very focused on diversity and collaboration. When it comes to creating equity in health care, we want to be a leader. We’ve designed a Pathways to Medicine Scholarship program to support the enrolment and success of future medical students from traditionally under-represented groups throughout Alberta. We also want to show others how to close the gaps that exist when it comes to the health of Indigenous people and their communities. All of these qualities combined is what attracts the best and brightest minds to our school. The people who work and study here, and those who support us from the community, are the key drivers of our success. This began with our founding dean, Dr. Bill Cochrane, who passed away in October at the age of 91. It’s because of his original vision that Calgary has a medical school, and I’m delighted that we’ve been able to honour him in different ways throughout the year. This edition of UCalgary Medicine celebrates just how far we’ve come on our journey in the evolution of medicine, and the impact of our school. We’re seen as a young medical school, and you’ll see how our youthful spirit sets us in good stead to look ahead and be innovative. Here’s to 50 years of changing lives, and to a future that’s even brighter than our past. Jon Meddings, MD Dean, Cumming School of Medicine University of Calgary

By A

Ga sling

m bl

Fifty years ago, the challenge of building a medical school in Calgary began. The founding faculty of whatâ&#x20AC;&#x2122;s known today as the Cumming School of Medicine, and those who later joined them as students and teachers, created revolutionary programs and tools for Calgaryâ&#x20AC;&#x2122;s future physicians. Their vision, commitment and determination resulted in a medical school that works every day to improve the quality of life for patients, and benefits people in southern Alberta and beyond.

nspired by his family doctor and driven by a strong work ethic, Dr. Bill Cochrane decided to pursue a career in medicine. Recognized early on as a leader in pediatrics, Bill’s career evolved through medical research and education, biotechnology, and business. He completed his residency in 1958, beginning his career in Toronto, and later making a move to Halifax where he became a professor of pediatrics at Dalhousie University. While there, he initiated the first cystic fibrosis clinic in the Maritimes, formed the Atlantic Research Centre for Mental Retardation, and secured support and funding for the Isaac Walton Killam Hospital for Children. In 1967, Bill used his natural talent as a leader when he became the founding dean of the University of Calgary’s Faculty of Medicine. It would be a challenge to build a medical school from the ground up, but Bill stuck to what he believed in and focused on the future. His integrated and interdisciplinary approach to medical education has since become the Canadian standard. Over the next several years, Bill continued to serve as dean of the medical school and began teaching in the Department of Paediatrics. He established a satellite health clinic at the Stoney Indian Reserve in Morley and was named honorary medicine chief, a very rare accolade. Bill also saw the first class of medical students graduate in the top half of the licentiates of the Medical Council of Canada (1973).

CUMMING.UCALGARY.CA/UCALGARYMED

His time at the university was briefly interrupted in 1973 when he was seconded to the Alberta government where he served as deputy minister of health. Upon his return to the university, Bill held the role of president and vice-chancellor, and was instrumental in the creation of the faculties of Law and Humanities. After leaving the university in 1978, Bill continued to be a leading force in the Canadian biotechnology and research communities. He received several honours for his leadership, including the Order of Canada (1989), the Queen’s Golden Jubilee Award (2002), the Alberta Order of Excellence (2007), and he was elected to the Biotechnology Hall of Fame by the BioAlberta Association (2009). He was named one of 100 Alberta Physicians of the Century (2005) and has received four honorary doctorates. Bill’s role in the successes of Canada’s medical, educational and biomedical communities is evident across the country — in schools, labs and businesses that have benefited from his vision and leadership. During the Cumming School’s 50th Anniversary Celebration in April, the school recognized Bill’s contributions with the unveiling of a special portrait, commissioned for his induction into the Canadian Medical Hall of Fame (2010). In October, Bill passed away at the age of 91. We’re thankful to Dr. Cochrane for bringing our medical school to life and for the impact he has had on medicine and health care in Canada.

r. Bob Church is often described as an outstanding scientist, administrator, teacher and friend. An internationally known leader and expert in transferring the technologies of genetics, reproductive physiology and molecular biology to the agricultural and biotechnology industries, Bob is a founding member of what was formerly known as the Faculty of Medicine at the University of Calgary. Working alongside founding dean, Dr. Bill Cochrane, and others, Bob was instrumental in the building of the medical school and the creation of its curriculum. He arrived at the university following the completion of a post-doctorate at the University of Washington’s medical school where he focused on cuttingedge molecular genetics. Bob began his time with the university’s Department of Biology before relocating his lab to the newly established medical school. Working alongside founding dean, Dr. Bill Cochrane, and others, Bob was instrumental in the building of the medical school and the creation of its curriculum. He led many of the school’s successes, including the recruitment of people from around the world who believed in Dr. Cochrane’s vision of a three-year multidisciplinary educational program. Bob established the Department of Biochemistry and Molecular Biology, and was its first department head, a

UCALGARY MEDICINE FALL 2017

position he held for 14 years. During its early years, Bob was instrumental in hiring leaders in molecular genetics, molecular and developmental biology, and cellular signaling research, which laid the department’s foundation for decades to come.

hen she arrived at the University of Calgary for her first day as a member of the medical school’s faculty, Dr. Bernadette Curry found herself surrounded by a number of tall men wearing jeans, untidy shirts, boots and wide brim hats.

In 1992, an endowed lectureship in biotechnology, which allows students and faculty to participate in a global network of leading biotechnologies, was created to honour Bob’s contributions to the medical school.

Originally from Scotland, Bernadette had never imagined working in another country. Her plan was to stay in Calgary for three months. She arrived in the summer of 1972 and, with an avid curiosity for what a Canadian winter would be like, had accepted a full-time position in the Department of Pathology with clinical service responsibilities at what’s now known as the Foothills Medical Centre.

Bob’s presence in the local community includes more than two decades as director of the Calgary Exhibition and Stampede. He was also a founding member of the Natural Sciences and Engineering Research Council, and a board member for the Alberta Research Council and the Medical Research Council of Canada. Bob has earned many high honours throughout his career, including the Outstanding Contribution to Alberta Science and Technology Community Award from the ASTech Foundation (1992), the Alberta Order of Excellence (1993) and induction to the Order of Canada (2000). Reflecting on his career at UCalgary, Bob is most proud of the people who were involved with bringing a medical school to Calgary and the positive legacy they were able to leave to the next generation.

A few years later, the Department of Clinical Neurosciences conducted a cross-country search for a neuropathologist. With no formalized neuropathology service — the study of disease of nervous system tissue — in southern Alberta, Bernadette was approached and agreed to pursue additional training to apply for the role. She began her journey at the University of Toronto, only to return to Calgary within two years to establish the first neuropathology lab in southern Alberta in 1980. In addition to university and hospital commitments, Bernadette was generous with her volunteer time. She participated on numerous committees including those of the Royal College of Physicians and Surgeons of Canada, and the Alberta Royal College of Physicians and Surgeons Advisory Committee on Laboratory Accreditation and Quality Control. She was also a member

of the Alberta Society of Laboratory Physicians executive for several years, including a five-year term as president. In addition to her neuropathology career, Bernadette would go on to be appointed the director of the Anatomic Pathology Residency Training Program. While in this role, she was key in the development of UCalgary’s Neuropathology Training Program. Bernadette was the program’s director from 1990 to 2004, and remained head of neuropathology until her retirement in June 2007. W hen she arrived at the University of Calgary for her first day as a member of the medical school’s faculty, Dr. Bernadette Curry found herself surrounded by a number of tall men wearing jeans, untidy shirts, boots and wide brim hats. In her retirement, Bernadette is active with her volunteer activities both in the medical field and in a non-professional capacity. She has a keen interest in the vision and mission of the Calgary Centre for Global Community, which provides education, engagement and research opportunities to enhance and expand Calgarians’ capacity for responsible, wellinformed and effective global citizenship.

CUMMING.UCALGARY.CA/UCALGARYMED

itting outside the Tom Baker Cancer Centre on a spring morning in 2013, 28-yearold PhD student Lauren Capozzi (MD/PhD’18) received an email that would change her life forever. “Congratulations!” it said, “We are pleased to inform you that you have been accepted to the University of Calgary’s Faculty of Medicine.” Overwhelmed with excitement, Lauren immediately called her closest confidante and mentor — her mother, Dr. Barbara Gail Plecash (MD’75), who graduated from the same Undergraduate Medical Education (UME) program nearly 40 years earlier. “I think we both cried for 10 minutes,” says Lauren. “Acceptance was huge for me because I had applied to medical school before and didn’t get in. It was crushing. Mom had always been so supportive of me, so it was a really big deal and a very exciting moment.”

A full-circle moment Forty-two years after Gail Plecash graduated from the University of Calgary’s medical school, she gets to watch her daughter enjoy the same experience. By Pauline Zulueta

Inspired by her mother’s passion for medicine, Lauren always knew she wanted to pursue a career as a doctor. As a young child, she often saw how her mother, who ran an active family practice in Kelowna, made a difference in the lives of patients.

UCALGARY MEDICINE FALL 2017

“We would be in the grocery store and patients would come up to my mom with gratitude in their hearts,” says Lauren. “They would share with us how much they valued her role in their lives. I just thought, ‘How lucky, to have a job where you have that honour and feel so rewarded.’” Although Lauren and her mom always had a close relationship, having this shared experience of attending the same medical school deepened their relationship even more. On difficult days, Lauren calls her mom to share her experiences and ask for advice. On rewarding days, she can hardly contain her excitement, telling her mom about her successes and breakthroughs. “It’s a very enriching experience to have these wonderful calls,” says Lauren’s mother Gail. “She’ll say, ‘Mom guess what?!’ and I’ll have to hold the phone three inches away from my ear. We’ve always had this mature mother-daughter relationship, but now we have a whole new language.” For Gail, hearing stories of her daughter’s medical school experience often brings back a lot of her own memories. Some of her cherished memories include the camaraderie she developed with fellow classmates as the pressure and demands of school grew, and having a glass of sherry on Friday afternoons with her teachers and peers as they discussed their cases that week. In 2015, Gail returned to UCalgary for her 40-year reunion to reconnect with her classmates and recount these experiences. During the celebrations, she had the opportunity to participate in a school tour — led by her daughter. “It was so nice to take her through after all that time and have that full-

circle moment,” says Lauren. “I got to tour her around the medical school and show her how much things have changed. Many of the now interior walls were once exterior walls and I was able to show her the labs, which now have all this high-tech equipment.”

For Gail, hearing stories of her daughter’s medical school experience often brings back a lot of her own memories. Gail adds that the buildings aren’t the only things that have changed. The program itself has also evolved significantly as her class was only the third group of students to be admitted into the medical program, which started in 1970. “When we were going through the school, we felt like we were almost helping write the course,” says Gail. “Now I see a sophisticated building with a well-tried program that’s so well equipped. It has a maturity about it that’s incredible.” Both Lauren and her mother credit the UME program for giving them the tools and knowledge necessary to prepare for a lifelong career in medicine. “UCalgary’s medical school has given us the opportunity to understand all that a career in medicine has to offer,” says Lauren, who participates in the Leaders in Medicine program — a joint degree program designed to give highly motivated students the opportunity to complete a graduate degree and a medical degree.

“I really want to be a clinician-scientist and am grateful for the training we get around that in the Leaders in Medicine program,” she adds. As Lauren finishes her last year of medical school and prepares to enter residency, she says she’ll continue to carry the lessons she has learned from her mother. “Some may think that in order to prevent burnout in medicine, you shouldn’t engage and keep your distance,” says Lauren. “What my mom taught me is, to prevent burnout, you need to get engaged and learn about people. That’s what keeps you curious and feeling rewarded. Lean in.” Meanwhile, as Gail enjoys her first year of retirement, she says she’s looking forward to her daughter’s graduation day. “I’m extremely proud of this girl,” she says. “I’m so grateful to have her as my daughter. She’s going to have an MD/ PhD and graduation is going to be a fantastic experience because she has worked so hard for so long. This will be the party of the decade for me.”

CUMMING.UCALGARY.CA/UCALGARYMED

UCALGARY MEDICINE FALL 2017

Cumming School experts help develop Alberta’s approach to cannabis legalization By Melanie Tibbetts

n less than a year, recreational cannabis use will be legal in Canada.

Tasked with adapting the new legislation, which comes into effect July 1, 2018, the Government of Alberta has developed a proposed cannabis framework based on feedback from Albertans as well as stakeholders and partners such as the University of Calgary. In 2016, UCalgary’s Health Technology Assessment (HTA) Unit was asked to support the Government of Alberta’s cannabis policy development. “The government needed to respond to the federal decision to legalize cannabis and wanted to do so with the best evidence out there,” says Fiona Clement (PhD’06), director of the HTA Unit. “They came to us because of our reputation — we do good science here — and asked that we complete a systematic review to support the legislation development.”

The Health Technology Assessment Unit, within the O’Brien Institute for Public Health, supports the Government of Alberta by developing evidence-based reports that educate the government on a particular topic. These reports are used to guide the government when making decisions that involve policy.

Clement and her team, which is made up of physicians, researchers and students, compiled a wide range of evidence on five key topics: the

current Canadian context, health harms and effects, medical cannabis, advertising and communication, and experience with legalization. The final report was made public in February 2017 and has been used to develop the Alberta Cannabis Framework, a structure that sets the stage for the legal and responsible use of cannabis by Albertans. “The report is getting great traction,” boasts Clement, who’s an associate professor in the Department of Community Health Sciences and a member of the O’Brien Institute for Public Health. “For us, it’s great to publish it, but to have people read what we’ve written and say, ‘Wow, we really need to be thinking of this,’ is on another level. That’s the kind of thing a policy researcher lives for.” Clement has also been participating in the provincial government’s roundtable stakeholder series where representatives from various institutes and organizations come together to discuss topics such as the minimum age of purchasing, protecting roads and workplaces, and public consumption. “I use the evidence-based information from the HTA Unit’s report as my voice during those talks,” explains Clement. “It’s important to have that type of neutral party during these types of discussions. We’re here to support policy based on strong research.” In addition to supporting the government, the Cumming School also plays a significant role in

CUMMING.UCALGARY.CA/UCALGARYMED

educating the public. In May 2017, the O’Brien Institute, in partnership with the Canadian College of Health Leaders, hosted a forum to address the public health implications of cannabis. More than 300 policy experts, patients, leaders “With a public health approach, in substance use the focus is not so much on and public health, individual-level risks and harms, and members of but on creating population-level the general public policies and interventions to attended the prevent the potential for problems forum to discuss associated with cannabis use.” the impact of legal -Rebecca Haines-Saah, PhD cannabis use. “There’s a lot of important work being done in our province around substance use and public health, and we wanted to share some of that work with the general public and the public health community,” says Rebecca Haines-Saah, PhD, an assistant professor in the Department of Community Health Sciences and a member of the O’Brien Institute.

According to Haines-Saah, who played a large role in organizing the event, the forum aimed to set the tone for cannabis policy in Alberta. “We needed to elevate dialogue through the lens of public health, and the forum allowed us to do that,” Haines-Saah explains. “With a public health approach, the focus is not so much on individual-level risks and harms, but on creating population-level policies and interventions to prevent the potential for problems associated with cannabis use. Beyond health, there’s also an emphasis on how policies that criminalize cannabis have been harmful, discriminatory and have ultimately failed to ‘protect’ people from use.” As things move forward, Clement and HainesSaah believe that the CSM’s role will stay the same. “The government is going to have a lot of ongoing questions, and we have strong data and analytic capacity,” says Clement. “The partnership we have with Alberta Health enables us to respond quickly as issues emerge.”

Alberta Cannabis Framework at a glance • After legalization, 18 will be the proposed minimum age to purchase cannabis — the same age limit for alcohol and tobacco. • The Government of Alberta will be working with labour groups and employers to ensure worksites are kept safe. • Cannabis consumption will be allowed in homes and in some public spaces where smoking tobacco is allowed, but restricted in places where kids tend to be.

• You’ll be able to grow up to four cannabis plants in your home, but not outdoors where kids can potentially access them. • No cannabis use will be allowed in vehicles, even by passengers. Like alcohol, cannabis will need to be secured away from drivers and passengers. Additional rules will be put in place to prevent people from driving under the influence. • If you’re an adult, you’ll be able to possess up to 30 grams of dried cannabis in public.

Visit alberta.ca/cannabis for more information.

• In the beginning, there will be no online sales in Alberta. However, this is something the provincial government will look at in the near future. • Licensed growers across Canada will be required to meet federal quality and safety standards. Growers will sell cannabis to a government owned and operated distributor who will ship safe products to retail outlets. Retail stores will have to follow strict rules such as special staff training, hours of operation, and more.

UCALGARY MEDICINE FALL 2017

Machine learning in medicine Tapping into artificial intelligence to improve patient care By Kelly Johnston

n the time that it takes a doctor to review one patient’s file, a computer could have scanned thousands of patient files looking for connections to help the doctor provide the best treatment plan for their patient. This is the next step in precision medicine — doctors using artificial intelligence as a diagnostic and treatment tool just like ordering an MRI (magnetic resonance imaging) scan to view internal organs, or an X-ray to look at the bones beneath a patient’s skin.

“There’s no question that for some aspects of medicine, machines are much more precise than we are.” -Samuel Wiebe, MD “It has taken the field of medicine a long time to adopt machine learning, partly due to a lack of good digital data and partly due to a reluctance to accept the involvement of machines in our clinical activities,” says Dr. Samuel Wiebe, associate dean of clinical research at the Cumming School of Medicine (CSM) and a professor in the departments of Clinical Neurosciences, Community Health Sciences and Paediatrics. “There’s no question that for some aspects of medicine, machines are much more precise than we are.”

Wiebe uses the example of a patient suffering from a headache. There are multiple tools to help a doctor reach a diagnosis including the patient’s history, symptoms, lab tests, imaging, X-rays, statistical analysis and a doctor’s own experience. Wiebe says machine learning can be applied to determine what tests should be done. Using parameters determined by the doctor, the computer scans thousands of cases derived from clinical practice, applies complex formulas to make predictions, and trains itself over time to detect patterns and place the patient in a risk category helping to avoid unnecessary tests. “We couldn’t obtain this kind of information with simple analyses or without the aid of advanced computing. Machine learning in medicine will allow us to identify a person’s risk of disease and determine the probability of how they’ll respond to treatment, which is specifically designed for them based on their genetic and molecular make-up, their risk factors and their clinical presentation,” adds Wiebe who’s also a member of the Hotchkiss Brain Institute, the Alberta Children’s Hospital Research Institute and the O’Brien Institute for Public Health. “This is what will take us into the future; it’s important and unavoidable.” The CSM and the Department of Computer Science in the Faculty of Science are collaborating on several

machine learning initiatives that apply to medicine and health as a tool for research and patient care. “We’re connecting clinicians, researchers and mathematicians to help build a framework to provide early detection, more precise diagnosis and tailored treatments for patients,” says Dr. Marcello Tonelli, associate vice-president of health research at the University of Calgary and senior associate dean of clinical research at the CSM. “We’re turning data into usable information, seeking patterns that may be hidden and not identifiable to humans. This is not a technique that traditional clinicians use.” An example of a collaborative project could involve early detection of diabetic retinopathy that can lead to blindness. Researchers could input thousands of retinal scans, training the computer to look for subtle changes and patterns that a human may not detect that could inform ophthalmologists. “These kinds of studies could allow for earlier detection and intervention,” adds Tonelli, who’s also a member of the O’Brien Institute. “We have really outstanding health data in Alberta. There are good opportunities for us to have a huge impact on patient care.”

CUMMING.UCALGARY.CA/UCALGARYMED

Harnessing the power of big data in health care By Julia Dick

e’re living in the era of big data. Whether it’s location settings on our cellphones, cookies informing the types of digital ads that we see or activity trackers on our wrists, vast amounts of data are being generated and collected.

With more information becoming available because of digitization, the development of automated analytic methods is crucial. As the already massive amount of information collected increases, a dedicated group of researchers at the Methods Hub, within the Cumming School of Medicine’s (CSM) O’Brien Institute for Public Health, are developing new ways to analyze and use this information to support initiatives and improve patient outcomes in Canadian hospitals. While nearly all hospitals use data in some form to make decisions, the health system has a long way to go to fully realize the potential of data-driven improvement, according to Methods Hub director Maria Santana, PhD. “It’s easy to generate data, but many hospitals aren’t utilizing their data effectively,” says Santana, an assistant professor with the CSM’s departments of Community Health Sciences and Paediatrics, and a member of the O’Brien and Libin Cardiovascular Institutes. “Developing the tools to understand and

interpret this information quickly will help providers enhance the patient experience while improving care and reducing costs.” Methods Hub researchers recently worked with the Canadian Institute for Health Information (CIHI) to develop a data-driven way to identify patient safety incidents — events or occurrences that could have resulted, or did result, in unnecessary harm to the patient. By measuring this information, it’s possible to improve the resources available to heath care practitioners to support patient safety improvements. Shaping how the world shares information for better health With more information becoming available as a result of digitization, the development of automated analytic methods is crucial, says Methods Hub researcher and founding member Hude Quan (PhD’98). In order to track and monitor diseases and mortality rates, the World Health Organization (WHO) has developed an International Classification of Diseases (ICD) standard, which shapes how health professionals, scientists and policy makers communicate and share information relating to health care. Research led by Quan on improving the ability to define medical conditions in ICD administrative data has garnered international recognition. In 2015, the O’Brien Institute was officially designated a WHO Collaborating Centre for Classification,

Terminology and Standards. The centre is working closely with partners at Stanford University and the Mayo Clinic, a non-profit medical practice and medical research group based in Rochester, Minn., to standardize international practices regarding the collection and use of information. Data, however, is not always gathered with the same language. This makes it challenging to use this research as a tool to improve outcomes. “The main question is, ‘How can we know how many people die and why?’” says Quan, who’s also a member of the O’Brien and Libin Institutes, and a professor with the Department of Community Health Sciences. “We can count in Alberta or Canada, but how do we determine what that number is when the scope becomes global?”

UCALGARY MEDICINE FALL 2017

“When health researchers are able to leverage data, they’re better able to improve health, prevent and detect disease at an earlier stage, and personalize interventions.” -Hude Quan, PhD

n the end, the intent is to provide better information to policy makers on the spread, risk and prevention of disease, as well as measuring health system safety and quality. Quan says this will have a major impact both abroad and at home. “When health researchers are able to leverage data, they’re better able to improve health, prevent and detect disease at an earlier stage, and personalize interventions, says Quan. Other big data initiatives by the O’Brien Institute The University of Calgary Biostatistics Centre (UCBC): Made up of members from Alberta Health Services, the University of British Columbia, and the faculties of Veterinary Medicine, Science, Nursing, Kinesiology and the Cumming School of Medicine at the University of Calgary, the UCBC is looking at how to better mine and classify big

data to improve the health of populations. Its work has garnered the attention of the Canadian Statistical Sciences Institute and has led to the creation of the UCBC’s own Rocky Mountain Data Sciences Training Centre, which provides graduate level training on big data. International Population Data Linkages Network (IPDLN): Sharing the directorship with Ontario’s Institute for Clinical Evaluative Sciences (ICES), the O’Brien Institute is serving as half of the IPDLN’s secretariat and directorship from 2016 to 2018. The network is made up of members from North America, Europe and Australasia. It brings together data scientists and research from all over the world in an attempt to put data to work, improving the health of populations at a global scale.

Saving lives with the best EFW Radiology Fellowship elevates training standard By Steve Macfarlane

wo years ago, University of Calgary researchers announced the groundbreaking results of the ESCAPE trial, where a clot retrieval procedure could dramatically improve patient outcome after a stroke, reducing both mortality and disability rates.

While the results were being shared with the world, Zarina Assis’ plane was touching down in Calgary. She was about to meet the special stroke team she had admired from her home in India.

“All over the world, people in my field speak about the Calgary Stroke Program.” -Zarina Assis

As the inaugural EFW Radiology fellow, Assis, a radiologist specializing in diagnosis and treatment of head, neck and spine diseases, had been given the opportunity to come to North America and learn from the best in her field.

“All over the world, people in my field speak about the Calgary Stroke Program,” says Assis, who had been working at a charity hospital in Bangalore, India, prior to coming to Canada. “This was a dream for me, to be able to work with the program team.” Assis is doing that on a daily basis now, improving her skills in stroke intervention alongside her mentors. She’s also taking classes as a scholar

and doing research to help her profession progress. Under the supervision of Drs. Mayank Goyal and Michael Hill (MSc’03), Assis is involved in various stroke imaging research projects, participating in imaging analysis of trials like ESCAPE, and supporting studies of clot-busting drugs for people experiencing minor strokes. She’s also involved in her own research, focusing on the challenge of treating high-percentage blockages of blood vessels in the neck and brain. This work will help build the foundation for future clinical trials for complex cases, with the hopes of establishing standard guidelines for their treatment. The 36-year-old admits her experience still seems surreal at times. Assis completed her radiology and neuroradiology training in India but knew additional training could help elevate her skills, as well as provide a new opportunity to learn and help more people. For Assis, there’s no better place for that than the Cumming School of Medicine (CSM) and the Calgary Stroke Program, so she applied for the EFW Radiology Fellowship with the hope of coming to what she calls the “hub of stroke intervention.” Inspiring and helping doctors come to Calgary to learn and grow in the field of radiology was the intention of EFW Radiology when

UCALGARY MEDICINE FALL 2017

Zarina Assis with Drs. Michael Hill (left) and Mayank Goyal.

the company’s physician partners decided to make a generous $2 million donation to the CSM to establish the fellowship program. “It’s imperative that we continue to elevate the standard of training for radiologists,” says Dr. Houman Mahallati, managing partner at EFW Radiology. “We hope our contribution, coupled with the growing international reputation of our city and medical school, will attract the most intelligent, compassionate and dedicated young physicians from around the globe. We trust that those who later return to their places of origin will do so with the skills and memories gained in Calgary. For those who remain in Calgary, our community will be richer for their talent and continued service.” Philanthropic contributions toward education and training are key to raising the standard of health care in Canada and beyond. In Assis’ case, she’s already exploring opportunities to stay and work in Calgary, but will also attempt to pass her knowledge on to India, where stroke intervention is not part of the health care system yet — due in part to poor ambulance systems and roadways, the large population and lack of insurance coverage for patients. She has experienced the helpless feeling of being unable to save a person coming into her hospital with stroke symptoms. Assis says the

experience in Calgary has been dramatically different and has changed her life. “If you want to see the impact of technology on health, you should witness one stroke intervention here in Calgary. You see a healthy 50-year-old patient coming into the emergency room, completely paralyzed on one side, not able to speak, and the family is devastated,” she says. “We do the procedure, open up the vessel and the patient starts moving, speaking and says thank you right on the table.” Assis attests to the incredible impact for patients and as a caregiver. “I’ve been doing it day in and day out,” she says. “When I walk home, I actually feel like a superhero.”

“When I walk home,

With a year remaining in her I actually feel like a fellowship, Assis knows there’s superhero.” more to learn and improve on -Zarina Assis when it comes to her radiology skills. At the completion of her fellowship, she hopes to continue to call herself a Calgarian and make a difference in the health of the community. “I’ve gained so much from this country; I look forward to giving back.”

CUMMING.UCALGARY.CA/UCALGARYMED

Paul Kubes, PhD

Kathy McCoy, PhD

Driving discoveries New world-class centre for microbiome research opens at Cumming School of Medicine By Caitlyn MacDonald

These isolators have filtered air and positive air pressure to retain a sterile environment.

s humans, we have a collection of essential organs for survival that have been studied excessively. But what if there’s an organ that has been hiding right under our noses?

Recent research on the community of bacteria, viruses and fungi in the human digestive tract has led scientists to suggest that there’s an organ we’ve completely ignored. “The human body harbours a complex community of over 100 trillion microorganisms,” says Paul Kubes, PhD, a professor in the departments of Physiology and Pharmacology, Medicine, and Microbiology, Immunology and Infectious Diseases, and director of the Snyder Institute for Chronic Diseases. “The unique collection of cells in your mouth, skin and gut are known as the microbiota. Together, all of their genes make up your microbiome. This newly discovered organ consists of more cells than those that make up the rest of your body. Until now, we’ve completely overlooked the importance of this in our daily lives.”

UCALGARY MEDICINE FALL 2017

Powerful jets spray material in the air tunnel with high velocity filtered air to remove any particulate matter, including bacteria, from the outside of equipment before bringing it into the clean side of the centre.

The importance of this “organ” was marked on November 9, 2017, when the University of Calgary opened the microbiome centre. Funded through Western Economic Diversification, the Government of Alberta, the CSM, and supported by generous members of our community, the centre is a unique worldclass facility designed to drive discoveries in microbiome research. It’s also home to the world’s largest (10,000 sq. ft.) germ-free lab dedicated to studying the microbiome’s role in immunity and disease. “One of the least understood frontiers of medicine is the interaction between us and our microbiome,” says Kubes. “We know that the microbiome can be dramatically affected by antibiotics meant to kill specific infections or high fat diets, which provide fuel for the wrong bugs. What we now want to understand is the impact these ‘disruptions’ to the microbiome can have on the human body.” Kathy McCoy, PhD, director of the germ-free facility, explains that these disruptions may potentially play a role in everything from cancer and obesity to the growing number of children affected by allergies and asthma. “The human microbiome has been associated with a growing number of human diseases, including irritable bowel syndrome, diabetes, asthma, allergies, and cardiovascular disease,” says McCoy, a professor in the Department of Physiology and Pharmacology, and

This isolator can be easily moved between rooms while keeping contents sterile.

a member of the Snyder Institute. “These bugs release molecules that may impact distant sites thought to be sterile and unaffected by bacteria. Now we’re thinking that they contribute to Alzheimer’s disease, depression, and autism. The more we understand about the microbiome, the more chance we have to stop the development of certain diseases. The centre will provide us the cutting-edge tools to interrogate the microbiome and be leaders of medicine in this evolving field of research.” The microbiome centre hosts a powerful coalition of researchers from all areas of the university. These researchers will create applications to address global health issues and collaborate with industry partners to apply emerging microbiome discoveries to areas beyond health care. In addition to the prevention and treatment of chronic diseases, researchers will also focus on fields such as food production and the search for alternative energy sources. “Applying microbiome discoveries to broader areas of life science such as agri-food and energy management will truly be a new approach,” says McCoy. “Research at the centre has the potential to create jobs by sparking new business opportunities in Alberta, helping grow existing industries, improving therapeutic and diagnostic technologies for our health and the environment, and triggering translational discoveries that will benefit millions of people worldwide.”

Research underway at the microbiome centre: • Marie-Claire Arrieta, PhD, and Laura Sycuro, PhD, are studying the microbiome of 1,000 babies born in Alberta. They’re examining how the microbiome changes from the womb to after birth, and how the use of antibiotics throughout the children’s first five years of life impacts the microbiome. • Markus Geuking, PhD, is currently investigating how inflammatory immune responses change the function of the microbiome and how this impacts health • Paul Kubes, PhD, is studying how the microbiome helps to heal tissues to ensure its own survival. • Dr. Tom Louie is investigating how we might be able to transplant the microbiome from a healthy individual to an ill individual and improve diseases like Closteridium difficile and Alzheimer’s disease. • Dr. Pere Santamaria is studying how the microbiota contributes to the development and protection against autoimmune diseases, including inflammatory bowel disease (IBD).

CUMMING.UCALGARY.CA/UCALGARYMED

By Melanie Tibbetts

hat was once thought of as a western disease is now becoming a global health concern. Since the middle of the 20th century, researchers have watched the incidence of inflammatory bowel disease (IBD) in most western regions — including North America, Europe, Australia and New Zealand — increase and then stabilize. In contrast, newly industrialized countries in Asia, South America and the Middle East have documented a dramatic rise in the number of people affected by IBD. “IBD isn’t something that existed a few hundred years ago,” says Dr. Gilaad Kaplan (MD’00), an associate professor in the departments of Medicine and Community Health Sciences. “It’s a relatively modern disease of modern society. What’s happening in newly industrialized countries is very similar to what we saw in the western world between 50 to 70 years ago.” Kaplan’s research focuses on understanding where IBD exists in the world, and how it’s evolving and changing. In 2012, he led a team that published a paper which looked at the global epidemiology of IBD. In October, Kaplan and his colleague Siew Ng, PhD, who works

at the Chinese University of Hong Kong, published a five-year update on the paper in The Lancet and presented it at the World Congress of Gastroenterology in Orlando, Fla. “Our research brings together data from all population-based studies reporting on IBD rates since 1990,” says Kaplan. “We’ve shown that there’s a link between IBD and the types of societal changes we see in newly industrialized countries. Now we need to understand what the exact triggers are so that we can better prepare, treat and hopefully prevent IBD.” He explains that newly industrialized countries experience societal transformations that include migration from rural to urban areas, and a shift from agricultural to manufacturing industries. These changes trickle into other areas including lifestyle (poor diet and sedentary occupations) and new environmental exposures (increased pollution). Understanding the role these factors play in the onset of IBD will allow patients and medical communities to better manage the problem that’s caused by steadily climbing IBD rates.

“The biggest challenge is caring for more and more people; it’s costly and complex, and every year we’re adding more people to the base number,” says Kaplan. “IBD is a chronic, incurable disease that’s predominately diagnosed in young people, which causes us to see an annual increase in the number of people who have the disease.” Currently, the prevalence of IBD in the western world is more than 0.3 per cent of the population with over 200,000 patients afflicted in Canada alone. The direct

UCALGARY MEDICINE FALL 2017

“We need to address the fact that 10 years from now, the number of patients will be even higher than what it is today,” says Kaplan. “We’re not expanding the number of gastroenterologists or nurses, or the number of supporting programs that are in place. The disease is expanding faster than we are and one way to tackle this problem is to have fewer people diagnosed.”

and indirect health care burden of managing IBD is substantial. Most patients are treated with medications, some costing roughly $30,000 per person, per year. Patients are on these drugs indefinitely and some end up needing surgery to remove parts of their bowel. And this estimate doesn’t factor in the “real” price of IBD. The disease can impede career aspirations, instill social stigma and impair quality of life, which also takes a toll on health care and community support funding.

In order to prevent IBD, Kaplan and his team believe that a co-ordinated solution involving research into interventions that modify the environment and more innovative care methods will be required to address the evolution of IBD throughout the world. “Future research will focus on identifying environmental risk factors observed during the early stages of industrialization,” says Kaplan. “We’ll prioritize research into environmental intervention that helps prevent IBD. As the disease continues to become a global problem, we’re hopeful that a co-ordinated solution to prevent and treat IBD will be possible.”

Epidemiology is the study of how often diseases occur in different groups of people and why. Epidemiological information is used to help prevent illness and improve patient care. Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of the digestive tract. There are two distinct forms of IBD which include ulcerative colitis and Crohn’s disease. Ulcerative colitis causes long-lasting inflammation and sores (ulcers) in the innermost lining of the colon and rectum. Crohn’s disease is characterized by inflammation of the lining in the digestive tract, which often spreads deep into affected tissues.

CUMMING.UCALGARY.CA/UCALGARYMED

Jon Meddings and Frank LeBlanc applaud former dean, Bill Cochrane. (Top right) Former Cumming School of Medicine dean, Tom Feasby, posed for a picture with Dinos mascot, Rex, who wore a white lab coat over his jersey for the occasion. (Bottom right) UCalgary medical school founder and philanthropist Bob Church. (Below)

UCALGARY MEDICINE FALL 2017

On April 20, 2017, the Cumming School of Medicine hosted a celebration to mark a very special milestone — the school’s 50th anniversary. About 500 people came together in the Health Research Innovation Centre atrium to celebrate the past, present and future. (Right) Alvin Libin, Jon Meddings, Geoff Cumming and Bill Cochrane. (Below)

Guests enjoyed red macarons marked with a gold “50th” in celebration of the milestone. Since opening its doors 50 years ago, the school has grown and evolved into an internationally recognized leader in education and research with a focus on precision medicine and precision public health. (Above) The program included a panel discussion about medicine through the decades as well as a moving tribute to the school’s founding dean, Bill Cochrane, who attended with his family. (Left)

CUMMING.UCALGARY.CA/UCALGARYMED

UCALGARY MEDICINE FALL 2017

CUMMING.UCALGARY.CA/UCALGARYMED

UCALGARY MEDICINE FALL 2017

CUMMING.UCALGARY.CA/UCALGARYMED

UCALGARY MEDICINE FALL 2017

CUMMING.UCALGARY.CA/UCALGARYMED

Awards and recognition Aravind Ganesh, MD

Jocelyn Lockyer, PhD

Jocelyn Lockyer (PhD’02), received a Royal College of Physicians and Surgeons of Canada Honorary Fellowship (2017), in recognition of her stature and remarkable accomplishments in medical sciences. Lockyer’s nomination was a result of her exceptional contributions to clinical care, mentorship, teaching, and inspirational leadership — all attributes that are strongly aligned with the Royal College’s mission and mandate.

Tom Feasby, MD

William Ghali, MD

Eric Smith, MD Pere Santamaria, MD

Drs. William Ghali (MD’90) and Pere Santamaria were named fellows of the Royal Society of Canada (RSC) in 2017. The fellowship of the RSC comprises distinguished men and women from all branches of learning who’ve made remarkable contributions in the arts, the humanities and the sciences, as well as in Canadian public life. Nigel Shrive, PhD, was inducted as an RSC fellow in 2016.

Ken Lukowiak, PhD

Dr. Tom Feasby and Ken Lukowiak, PhD, were honoured in 2016 with the inaugural Rhodes Trust Inspirational Educator award. The award highlights incredible teaching around the world. Rhodes Scholars were invited to nominate exceptional mentors who influenced their lives before they received their Rhodes Scholarship.

The Canadian Medical Association (CMA) awarded Dr. Aravind Ganesh (MD’12) with the 2017 CMA Award for Young Leaders in the resident category. This award recognizes Dr. Ganesh as a role model and inspiration to his fellow physicians, as well as his desire to make a difference.

Nigel Shrive, PhD

Stephanie Borgland, PhD

Matt Hill, PhD

Dr. Eric Smith, for the 2016 cohort, along with Stephanie Borgland, PhD, and Matt Hill, PhD, for the 2017 cohort, were named to the Royal Society of Canada College of New Scholars, Artists and Scientists, Canada’s first national system of multidisciplinary recognition for the emerging generation of Canadian intellectual leadership. Those named to the College represent the emerging generation of scholarly, scientific and artistic leadership in Canada.

UCALGARY MEDICINE FALL 2017

Tom Noseworthy, MD

Braden Manns, MD V. Wee Yong, PhD

The J. Allyn Taylor International Prize in Medicine (2017) was presented to V. Wee Yong, PhD, by Western University’s Robarts Research Institute. The Taylor Prize, which recognizes the contributions of outstanding internationally recognized leaders, has been awarded annually to leading scientists since 1985. Yong is a world-leading multiple sclerosis (MS) researcher who has dedicated his career to understanding the disease and translating his findings in the lab into new treatments.

Jong Rho, MD

Christine Friedenreich, PhD

Carolyn Emery, PhD

Brenda Hemmelgarn, MD

Dr. Brenda Hemmelgarn was the 2016 recipient of the Dr. John B. Dossetor Research Award, given by the Kidney Foundation of Canada. The foundation also recognized Dr. Hemmelgarn and Dr. Braden Manns in 2017 with the Medal of Research Excellence.

Chen Fong, MD Tuan Trang, PhD

The 2017 Canadian Association for Neuroscience (CAN) Young Investigator Award was presented to Tuan Trang, PhD, an award given in recognition of outstanding research achievements by a young neuroscientist at the early stage of their career. Trang was also the recipient of the Piafsky Young Investigator Award, presented by the Canadian Society for Pharmacology and Therapeutics. This award recognizes significant contributions to the advancement and extension of knowledge in the field of basic or clinical pharmacology.

Hude Quan, PhD

The Canadian Academy of Health Sciences (CAHS) inducted Drs. Tom Noseworthy and Jong Rho as fellows in 2017, while Christine Friedenreich, PhD; Carolyn Emery, PhD; and Hude Quan (PhD’98), were inducted in 2016. Induction into the CAHS as a fellow is considered one of the highest honours within Canada’s academic community. CAHS fellows are nominated by their institutions and peers, and selected in a competitive process based on their internationally recognized leadership, academic performance, scientific creativity, and willingness to serve.

Nady El-guebaly, MD

Dr. Chen Fong was named to the Order of Canada (2016) for his influential philanthropy in the field of health care and for fostering the development of companies which produce medical devices. Dr. Nady El-Guebaly’s induction to the Order of Canada (2017) recognizes his contributions to mental health and addiction, particularly for his efforts to have addictions treated as a mental health issue.

CUMMING.UCALGARY.CA/UCALGARYMED

2017 Cumming School of Medicine Alumni of Distinction Award D By Leigh Hurst

r. Rupinder Toor Mangat (MD ’96) is the 2017 Cumming School of Medicine alumna of distinction. The award recognizes her outstanding service to our community, and her significant and ongoing contributions to immigrant women’s health in Calgary.

During medical school, Toor Mangat realized that, due to gender, language and cultural barriers, many immigrant women didn’t have a comfortable place to seek health care. In October 2007, she established the Northeast Calgary Women’s Clinic, a not-for-profit women’s clinic that provides quality health care to women who aren’t able to seek this care elsewhere. The clinic hosts a team of female physicians with language skills including

English, Punjabi, Hindi, Urdu and French, and a special interest in serving women from different cultural backgrounds. The team offers two clinical services — primary women’s health care and intra-uterine device (IUD) care — and partners with stakeholders working with similar populations to support and co-ordinate care. Since opening, the clinic has served nearly 50,000 women. Toor Mangat also organizes the annual Women’s Health in Primary Care Conference and helped establish women’s health as an area of focus within the scope of family medicine. Her contributions have been recognized with many awards, including the Global Women of Vision Award, the Queen

Elizabeth II Diamond Jubilee Medal, and the Canadian College of Family Physicians Recognition of Excellence Award. Toor Mangat was presented with the 2017 Cumming School of Medicine Alumni of Distinction Award at the UCalgary Alumni Arch Awards Ceremony held in September 2017. To learn more, visit ucalgary.ca/alumniweekend/archawards.

UCALGARY MEDICINE FALL 2017

POWER OF THE PLATFORM Health and medicine in the digital age By Genevieve Juillet

Researchers, clinicians and co-ordinators at the Cumming School of Medicine (CSM) are changing that and stepping into the digital age. Social media and new technology have made it possible to connect with patients, provide health services and conduct research in creative new ways.

THE RESEARCHER

Social media is here to stay. Sixty-four per cent of Canadians of all age groups use social media. Health topics are prevalent on Twitter and Facebook, whether through shared articles from legitimate sources or opinions expressed by friends and acquaintances. However, these health-related conversations are largely happening without the input of medical professionals. Only 8.5 per cent of physicians say they use social media as a professional tool.

hen Turin Chowdhury, PhD, began working with immigrant and refugee communities in Calgary in 2014, he struggled to keep them engaged. “I tried many different avenues to reach and engage them,” says Chowdhury. “Newcomers to Canada may be alone here, without extended family and friends, and their smartphones are what keep them connected to home. I’ve seen people cutting down on necessities in order to maintain a smartphone.” This realization led to Chowdhury’s interest in exploring social media as a health tool. “Social media was one of the ways to reach and engage immigrant and refugee communities on a regular basis.” Since this discovery, Chowdhury has focused his research on looking at how social media can best be used in the realm of health and medicine. “It’s a complicated question,” he says. “There’s a lot of junk on the internet, and it’s as equally accessible as the good stuff. How reliable and credible is the health information that’s shared on social media?” Chowdhury has studied this by tracking what information is shared on Facebook and YouTube, as well as the comments sections on online news sites and peer support web platforms. Chowdhury advises individuals to be safe online. “We talk about internet safety for children, but we need to think

about it for the general public; only use health information from credible sources. This means you’ll need to do a bit of homework to look at the source. Anybody can make a nice website, so you need to do your due diligence.” For physicians and institutions like the CSM, Chowdhury believes that knowledge providers have a responsibility. “Individual doctors who use social media may not have much impact, but as an institution we can. We need institutional processes to make sure knowledge translation for social media is built into our research. This will also benefit the individual doctors in their outreach activities.” “The potential for using social media in health promotion and prevention education is huge, but we must understand how best to navigate it in an impactful way,” says Chowdhury. “As generational changes occur, we need to be good knowledge translators and engagement entities. We need to play the game according to the rules of the current generation.”

CUMMING.UCALGARY.CA/UCALGARYMED

“T

THE INNOVATOR

he opportunities for social networking and medicine are incredible,” says Dr. Paul McBeth (MD’07), a critical care physician and trauma surgeon and a clinical assistant professor in the Department of Surgery. “We’re really just in the infancy stage at the moment.” McBeth has started to explore the possibilities of how social networks and new technology can improve medical care through his research program, teleTraumaDoc. Using remote ultrasound technology and video conferencing software like Skype, teleTraumaDoc has made it possible to conduct an ultrasound and have it interpreted by a trauma surgeon anywhere in the world.

“I think in the future we’ll see a transition from face-toface medical care to virtual care. With remote sensing technology, doctors can gather data from patients at home and make recommendations without patients having to go to the hospital or clinic.” -Paul McBeth, MD

“Basically, the portable ultrasound machine works with an interface built for the iPhone, which transports the images to a remote doctor for interpretation. Results can be communicated over video conferencing.” TeleTraumaDoc’s first partnership was with emergency medical physicians in Banff, who carry a portable ultrasound machine in the field. A computer in the Foothills Medical Centre in Calgary is designated for interpreting ultrasounds as they come in. TeleTraumaDoc has also been used in distant locations around the world, including northern parts of Canada and remote locations in Africa. Closer to home, oil and gas companies are interested in using the technology for their field operations. Another use for teleTraumaDoc is providing training for health care

providers throughout the country. “A challenge with ultrasound is beyond using the actual machine, you need to know how to interpret the images,” says McBeth. “We can educate clinicians in rural or remote locations on how to perform and read ultrasounds using this technology.” McBeth and his partners are currently conducting research on how best to create training tools for the portable ultrasound. “Taking advantage of new technologies, we can help rural and underserved communities in Canada and overseas,” says McBeth. “I think in the future we’ll see a transition from face-to-face medical care to virtual care. With remote sensing technology, doctors can gather data from patients at home and make recommendations without patients having to go to the hospital or clinic.” This would also introduce new challenges. “One concern with any kind of data transfer is confidentiality,” says McBeth. “We’re working with our partners to ensure that the data coming from the portable ultrasounds is encrypted.” Overall, McBeth is optimistic about the future of social media and medicine. “Particularly as a trauma doctor, I believe social media plays an important role in disseminating information to the general public. The ability to reach anyone, anywhere, is amazing.”

UCALGARY MEDICINE FALL 2017

Stay connected Follow us on social media to stay up-todate on the latest health research, news and opportunities to get involved.

@ucalgarymed

THE CO-ORDINATOR

ecruiting participants for research studies is hard work. “Especially for studies looking at older populations, who can be hard to reach,” says Gabrielle Heine, a research specialist in the Clinical and Translational Exercise Physiology (CTEP) Laboratory. “Social media helps us cast a wider net when we’re looking for participants.”

Features like sponsored posts on Facebook can also be a benefit for study recruitment. With the ability to target specific regions, age groups and interests, the chance of study information reaching the appropriate people increases.

Heine uses social media to promote the Brain in Motion II study, which looks at how exercise works to protect against dementia and Alzheimer’s disease. “We’re looking to recruit people who are 50 to 80 years old. Twitter has actually been helpful. Younger people who see our tweets can then talk to their parents and grandparents about the study.” Features like sponsored posts on Facebook can also be a benefit for study recruitment. With the ability to target specific regions, age groups and interests, the chance of study information reaching the appropriate people increases. While Heine doesn’t currently run a Facebook account for the Brain in Motion II study, she’s interested in starting one. “The ability to target our ideal participants would be amazing and would hopefully help us boost our numbers.” For Heine, the benefits of using social media to share information on the study goes beyond recruitment. “We use our social media account to inform the public about the work we do at the CSM,” she says. “Having a Twitter account makes our presence known and gives more visibility to our research. It’s also a

great way to send out the message that exercise is good for the mind. We’re a source of accurate and up-to-date information on exercise and cognition.” One possibility for the future is that social media activity could help in the establishment of research partnerships. “There’s a lot of research happening now looking at similar population groups. Social media helps us stay up-to-date with other projects,” says Heine. “It would be interesting to see if we could partner with another research group also looking at the elderly population in order to share recruitment resources and data. Social media is amazing for making connections.” For more information on exercise, cognition and the Brain in Motion II study, follow @BRAININMOTION on Twitter. Sources: InsightsWest (2016); National Physicians Survey (2014).

Arthritis care in Indigenous communities When a patient is diagnosed with a chronic condition like rheumatoid arthritis, health care becomes more complex. By Nancy Whelan

uddenly there are appointments with specialists and physiotherapists, lab tests, X-rays and visits to the pharmacy. Co-ordinating all these health services can be overwhelming, but add a remote location and cultural differences to the mix, and it becomes extremely difficult for patients to receive the care they need.

First Nations patients with RA and osteoarthritis were often receiving care for their condition from their family physician rather than a specialist. They were also one-third less likely than non-First Nations Albertans to get orthopedic surgeries for osteoarthritis.

This is especially evident for arthritis patients living in Indigenous communities across Alberta. “In this world, unfortunately, medicine works in silos,” says Dr. Adalberto Loyola Sanchez, a physician and postdoctoral fellow at the McCaig Institute for Bone and Joint Health. “Services are very fragmented,

even in urban settings,” he says. “Coordinating access to health services is even more challenging in Indigenous communities due to adverse socioeconomic factors.” Loyola Sanchez and his supervisor, rheumatologist Dr. Cheryl Barnabe (MSc’11), are working to improve arthritis care for those living on Alberta reserves. An inequity in care Rheumatoid arthritis (RA), an autoimmune disease that causes painful inflammation and damage to joints, is three times more common among First Nations people than other Albertans. Having access to a rheumatologist and related support services is vitally important because RA can often be treated successfully if caught early. However, after looking at provincial health information, Barnabe noticed that First Nations patients with RA and osteoarthritis were often receiving care for their condition from their family physician rather than a specialist. They were also one-third less likely than non-First Nations Albertans to get orthopedic surgeries for osteoarthritis. So she asked the question, “Why?”

Identifying the barriers Barnabe, who herself is of Métis heritage, travels monthly to the Tsuut’ina, Siksika Nation and Blood reserves to provide rheumatology care. Through her work on the Siksika Nation, and in co-ordination with Siksika Health Services, she and Loyola Sanchez embarked on a study to identify the barriers to receiving arthritis care for patients from that community. Through interviews with health care workers, patients and their families, they found that, while living in a remote location made it difficult to access specialty care, the bigger issue was

that specialist health providers were not recognizing and respecting cultural differences. “People were deciding to ‘tough out’ their arthritis because they didn’t trust the western health system,” says Barnabe. “This had to do with frank episodes of stereotyping and racism that had occurred in the health system when they came to specialty care.” “We determined that seeing a physician once a month is not enough. There needs to be someone with cultural knowledge from the community to coordinate services — medications, appointments and rehabilitation services.” -Cheryl Barnabe, MD In addition, even though specialists were visiting the community, there were still important areas of arthritis management not being met. With the help of an advisory committee comprised of community leaders, patients and health care workers, Loyola Sanchez determined four things that could improve arthritis care:

• Co-ordination of services: Even in a small centre, there are many different departments such as clinical services, community health, home care, and rehabilitation services. These departments need to enhance the development of co-ordinated care plans to meet patient needs. • Physician awareness and advocacy for needed services: As the physicians that practice at the Siksika Nation don’t live in the community, there’s a gap in understanding what’s needed for access to services and disease education. • Support for patients to explore traditional medicine options: Many patients feel threatened by western medicine; however, community knowledge of traditional medicine is dwindling. Patients feel caught in the middle of two cultures. • An arthritis patient support system within the community: Patients feel disconnected from other people with the same health issues. They would like to connect with others for support.

Implementing change With the help of the advisory committee, it was decided that a case manager with cultural knowledge was needed at the Siksika Health Centre to co-ordinate services for patients living with RA. “We determined that seeing a physician once a month is not enough. There needs to be someone with cultural knowledge from the community to co-ordinate services — medications, appointments and rehabilitation services.” They recently recruited a community member to fill the position and will do an evaluation to see if arthritis outcomes and satisfaction with care improves. Dr. Cheryl Barnabe is an associate professor in the departments of Medicine and Community Health Sciences, and a member of the McCaig Institute for Bone and Joint Health and the O’Brien Institute for Public Health. Dr. Adalberto Loyola Sanchez is a researcher with Dr. Barnabe’s team, and a physiatrist with the Mayan Municipality of Chankom in Yucatan, Mexico. He recently received the prestigious Banting Postdoctoral Fellowship.

CUMMING.UCALGARY.CA/UCALGARYMED

Working towards health equity for Indigenous people and communities By Melanie Tibbetts

hen it comes to achieving health equity and providing access to quality health care for Indigenous people and their communities, the Cumming School of Medicine (CSM) aims to be a leader. In 2015, the CSM’s work in Indigenous health, which has been ongoing for

over a decade, was formalized with the launch of its Indigenous Health Dialogue (IHD). The IHD was established to enhance existing Indigenous health initiatives, create new opportunities for programming, and purposefully respond to the Truth and Reconciliation Commission’s (TRC) Calls to Action.

The IHD is led by Blackfoot family physician and CSM professor, Dr. Lindsay Crowshoe, and Rita Henderson, PhD, a postdoctoral fellow with the O’Brien Institute for Public Health. It oversees seven service, research and educational initiatives that will help address some of the most pressing health concerns in Canada.

UCALGARY MEDICINE FALL 2017

Indigenous health in medical education The CSM’s medical education curriculum reinforces the importance of Indigenous health and illustrates the complex social, cultural and bio-medical aspects associated with Indigenous health issues. Based on innovative medical education, students are taught how to develop care approaches that take a patient’s background experiences, impacts of colonization and personal resilience into account.

Indigenous student admissions

Alberta Indigenous Mentorship in Health Innovation (AIM-HI) Network Along with investigators located throughout the province, CSM faculty members Drs. Cheryl Barnabe (MSc’11) and Lindsay Crowshoe lead this provincial network to recruit and support Indigenous trainees pursuing health research. In April 2017, the AIM-HI network secured $1 million from the Canadian Institutes of Health Research to increase the number of Indigenous scholars in health research, and provide students with enhanced research and mentorship opportunities.

The CSM has developed an admissions framework that promotes Indigenous applicant success. While admissions scoring remains the same, Indigenous applicants are assessed according to a peer-referenced standard. This strategy addresses the typical disadvantages faced by Indigenous applicants and provides a more appropriate benchmark. Group for Research with Indigenous Peoples (GRIP)

In 2016, the CSM’s Department of Family Medicine organized a multi-stakeholder meeting to discuss mobilization of Indigenous primary care while engaging the diversity of cultural, geographic, jurisdictional and Treaty contexts within Alberta. The conversation between government representatives, health care providers and First Nations leaders was guided by respect for Indigenous self-determination, including Indigenous community decisions on the leadership and service providers to act in their interests. A report from that event was released and further activities in this area are anticipated.

Established in 2008, the Aboriginal Health Program (AHP) addresses the under representation of Indigenous people in the field of medicine. The AHP supports the recruitment of Indigenous learners and provides effective Indigenous health training opportunities for all medical students. As part of the program, the CSM has created an Indigenous Learner Award to acknowledge the contributions of Indigenous students in the medical school. ucalgary.ca/mdprogram/ahp

Pathways to Medicine Scholarship

ucalgary.ca/future-students

Innovating Indigenous primary care

Aboriginal Health Program

GRIP is a research network of over 170 health researchers, students, Indigenous community members and organizations, health care providers, and government agencies that are working together to achieve positive changes in Indigenous health status. GRIP promotes research practices that are informed by the determinants of health, and that are grounded in principles of Indigenous health research ethics. GRIP has active working relationships with local, regional, national and international organizations, and hosts a Community Advisory Council, which provides liaisons to the broader community as well as guidance and oversight on research priorities and directions.

In 2016, the CSM introduced a Pathways to Medicine Scholarship, which is designed for high school students from under-represented populations (e.g. Indigenous, rural or low socio-economic backgrounds) who wish to pursue a career in medicine. The goal of this scholarship is to foster diversity within the medical profession. Every year, up to five students are provided tuition support towards an undergraduate program of their choice, a relocation allowance (if needed), a paid summer research internship, and mentorship opportunities. Once their undergraduate degree is complete, and certain criteria are met, Pathways to Medicine scholars are guaranteed admission into the CSM’s Undergraduate Medical Education program.

obrieniph.ucalgary.ca/research

cumming.ucalgary.ca/pathways

CUMMING.UCALGARY.CA/UCALGARYMED

Pathways to Medicine Scholarship Supporting the enrolment and success of under-represented medical students in Alberta

raduating high school and preparing to enter the world of post-secondary education can often be a stressful time. For students coming from low-income families, furthering their education may seem out of reach — especially for those who dream of becoming a doctor.

introduced the Pathways to Medicine Scholarship, which is designed for high school students from under-represented populations (e.g. Indigenous, rural or low socio-economic backgrounds) who wish to pursue a career in medicine. The goal of this scholarship is to foster diversity within the medical profession.

In 2016, the Cumming School of Medicine (CSM) at the University of Calgary

Every year, up to five students are provided tuition support towards a

orn in Ontario, Amber Cox, a Pathways to Medicine scholar, has moved all over the country — from Nova Scotia to Saskatchewan then British Columbia. However, she says her adolescent years spent in Cardston, Alta., has made the most impact on her outlook and future. “I saw so much addiction growing up,” says 18-year-old Amber. “It’s sad because addictions take over the people you love as well. I want to be in a position where I can give back and help.” Although she has many interests — such as photography, literature, rugby and playing the guitar — Amber says she has always dreamt of pursuing a career in medicine. She wants to study psychology and neuroscience in order to better understand addictions. Due to limited means, she was unsure how she’d be able to complete the necessary education. After her high school counsellor approached her about the CSM’s Pathways to Medicine Scholarship program, Amber immediately jumped at the chance to apply.

Pathways to Medicine Scholar Amber Cox

“Medicine was always something I thought about, but the financial side was really holding me back,” she says. “This scholarship has really opened up that door for me.”

By Pauline Zulueta

UCalgary undergraduate program of their choice, a relocation allowance (if needed), a paid summer research internship, and mentorship opportunities. Once their undergraduate degree is complete, and certain criteria are met, Pathways to Medicine scholars are guaranteed admission into the CSM’s Undergraduate Medical Education program. In total, each scholarship recipient

Amber is currently in her first year of studies at the University of Calgary. She’s enrolled in the Bachelor of Arts – English Literature program and is a member of the Arts and Science Honours Academy (ASHA), a program that gives students with high academic standing an opportunity to supplement their undergraduate degree with language studies, experiential learning and a study abroad experience. “I’m the first one in my family to be going to university,” says Amber. “This is kind of a turning point for our family as a whole, and for our future generations. This scholarship means breaking the chain in my family and that’s really the most important thing for me.” After graduating medical school, Amber hopes to be known as a physician that focuses on a one-on-one personalized approach to medicine and encourages her patients to make more conscious decisions about their life and health. “I’d love to be a doctor who inspires people to be more active and less reliant on technology and drugs,” she says. “I also want to be in a position where I’m stable enough to give back generously to those who’ve given to me.”

UCALGARY MEDICINE FALL 2017

receives up to $30,000 of funding towards their journey of becoming a doctor. Based on research published in the Canadian Medical Association Journal, medical students in Canada were found to be unrepresentative of the general Canadian population, with medical students more likely to be children of highly educated parents within highearning households in urban areas.

With the Pathways to Medicine Scholarship program, students from under-represented populations are given access to the post-secondary education and resources necessary to achieve their academic and scholarly goals — transforming Alberta’s next generation of doctors to more accurately reflect the diverse patient population.

fter playing competitive hockey throughout his childhood, Mathieu Chin saw firsthand the many injuries athletes will sustain in the name of sports. Now 19 years old, Mathieu is a learner in the Pathways to Medicine Scholarship program and is currently helping to research the effects of body checking policies in youth ice hockey players. “I’ve always had a strong passion for sports,” says Mathieu, who played ice hockey for 13 years. “What really propelled me to pursue medicine was my involvement with sports and seeing all the injuries.” During his senior year at John D. Diefenbaker High School, Mathieu stumbled upon the CSM’s website and discovered the Pathways to Medicine Scholarship. With a track record of academic excellence and community leadership, as well as a need for financial assistance, Mathieu applied for the scholarship and was accepted in June 2016.

Pathways to Medicine Scholar Mathieu Chin

“I grew up in a family where no one was in the medical field,” he says. “My mom is a cook and my dad works in a warehouse. I came from high school not knowing many people who wanted to go into medicine, and now here at the University of Calgary, there’s a lot of support.”

For more information, visit cumming.ucalgary.ca/pathways or email pathways@ucalgary.ca.

Now in his second year of the Bachelor of Science - Kinesiology program, Mathieu says he plans to continue his research and hopes to get involved with the Scholars Academy, a group of the university’s most ambitious students who are considered outstanding academics and leaders in their community. This past August, Mathieu was recognized for the Best Podium Presentation in the Healthy Outcomes category during the Alberta Children’s Hospital Research Institute’s Summer Student Research Day. He presented his research on the effects of body checking policy in youth ice hockey players. Currently majoring in biomechanics, Mathieu has high hopes of pursuing a specialty in orthopedic surgery or neurology and credits the Pathways to Medicine Scholarship for helping him take his first steps towards that goal. “Now I have an idea of what my future will look like,” he says. “If I didn’t have this scholarship, I’d be wondering every day about my career and what I’d be doing. This scholarship has given me a safety net and an opportunity to explore my areas of interest, knowing I’m encouraged and supported.”

Falling in love with

CUMMING.UCALGARY.CA/UCALGARYMED

rural medicine UCLIC program inspires young doctors to practice in rural communities By Genevieve Juillet

UCALGARY MEDICINE FALL 2017

“T

here’s no traffic in the country,” says Dr. Doug Myhre, associate dean of Distributed Learning and Rural Initiatives at the Cumming School of Medicine (CSM).

A short commute isn’t the only reason why medical students are attracted to a career as a rural doctor. Many students who participate in the University of Calgary Longitudinal Integrated Clerkship (UCLIC) program, an opportunity for medical students to spend one year working in a rural location, fall in love with rural medicine. “Rural medicine is very different in scope than urban practice,” says Myhre. “Rural doctors do everything — from psychiatry, emergency medicine, surgery, obstetrics and pediatrics — they specialize in everything for the community they’re working in. The scope of services a family doctor provides in rural communities is much wider than what’s practiced in the city.” Starting in 2008, the UCLIC program originally began with five communities and nine students. Since then, the program has expanded to 12 communities and 23 participating students. The year-long program is designed to give students a taste of life as a rural doctor, including the continuity of community and patients that urban doctors might not experience. “In my previous rural practice, I had families who came in and we could talk about their grandparents who had passed, referring back to the family tree,” says Myhre. “It’s a long-term relationship. It may not seem like you see them very often, but when you spend 15 minutes with a patient twice a year over the course of 30 years, you do develop a relationship.” Myhre explains that the program is also about social accountability. Since rural doctors perform many different functions, you don’t just lose a family physician when a doctor retires or leaves the community. You also lose an obstetrician, a surgeon and more. The realities of rural medicine appeal to many students, who often end up staying to work in the community after graduation. “We work closely with Alberta Health Services to ensure that students are being sent to areas where they’re needed,” says Myhre. “The CSM isn’t only known for our intensive three-year medical degree program, but also for being innovative in our approach to administering long-term clerkships in remote areas. We’re the only school in the world with a long-term clerkship in the third and final year. Other schools

hesitate to implement these types of programs due to concerns that students won’t be able to get their academic courses and research days done. The UCLIC program has implemented many inventive ways to make sure this happens. Students communicate with us electronically on a weekly basis. We give exams and do all sorts of things online. You don’t need to be inside the Foothills Medical Centre to learn medicine.” One student who experienced this firsthand is Dr. Nathan Zondervan (MD’13), who completed his UCLIC placement in Yellowknife, N.W.T. “Applying to the UCLIC program was an easy decision for me,” says Zondervan. “I live for the outdoors and after a few years in the city, I was ready for a new adventure. Rather than constantly switching rotations as is done in the urban environment, I thought consistent exposure would allow for greater skill development as I progressed through clerkship.” Zondervan sees his time in Yellowknife as a period of great challenges and opportunities. “I was frequently asked to take on a higher level of responsibility than I would have if I stayed in the city. I was always on the frontline of patient care. Although I always felt supported, I often had to manage acutely ill patients until the doctor arrived from home and would also frequently act as the first assistant in urgent surgical cases.” Zondervan is now a fifth-year general surgery resident and is considering the next steps in his career. “Working in Yellowknife has helped me see that I could have a very satisfying career in a rural community,” he says. “As I approach the end of my training, I’m considering community surgery as a realistic opportunity for myself and my family.” In the future, Myhre hopes to see up to 50 per cent of the medical class taking part in UCLIC. The program’s reach has continued to grow year after year and is now working with institutions such as Flinders University in Adelaide, South Australia, to help them evaluate and improve their rural medicine programs. “More and more of our specialists outside of UCLIC are beginning to go out into rural communities, too,” says Myhre. “People just fall in love with the lifestyle and the experience.”

CUMMING.UCALGARY.CA/UCALGARYMED

Susa Just call me

Practicing precision medicine with Dr. Susanne Benseler By Laura Herperger

UCALGARY MEDICINE FALL 2017

hen Dr. Susanne Benseler talks about the role she plays in treating children with unique conditions, you can hear the gratitude in her voice.

form of vasculitis which causes inflammation in the blood vessels surrounding the heart and kidneys. The condition posed a serious risk to the child’s life; according to Benseler, the child would lose kidney function in weeks. Because of Benseler’s accurate and rapid diagnosis, researchers were able to find a novel life-saving therapy in time to treat the condition and the child recovered to return home.

One of these conditions is childhood arthritis — a disease that most people don’t realize affects children as well as adults. Children with arthritis suffer from pain, joint swelling and stiffness, as well as eye inflammation, “We worked as a team, an innovative bench-to-bedside fevers and rashes. It’s not known what causes this partnership with Calgary researchers, to identify the condition in children, but the immune system, which key inflammatory pathway is supposed to protect the body, causing this child’s rare condition. is instead attacking healthy Children with arthritis suffer This clearly demonstrates tissue causing inflammation. from pain, joint swelling the benefits of individualized Kayla Baayens is one of the and stiffness, as well as medicine,” says Benseler who 20,000 children in Canada with eye inflammation, fevers works with researchers around rheumatoid arthritis. The 10-yearand rashes. It’s not known the world in a network to share old from Red Deer, Alta., has an what causes this condition knowledge on inflammation aggressive form of the disease. It in children, but the immune and search for biomarkers to progressed to the point that she system, which is supposed improve early diagnosis. could not lie down comfortably to protect the body, is Benseler was recently coin bed or even brush her own instead attacking healthy awarded a grant of $8 million teeth due to joint inflammation. tissue causing inflammation. from the Canadian Institutes Kayla was referred to the Alberta of Health Research; ZonMw Children’s Hospital. With a team (the Netherlands Organization for Health Research of clinician researchers, Kayla received a diagnostic and Development); and Reumafonds (the Dutch evaluation based on her own unique biological profile. Arthritis Foundation) to bring precision medicine to “From a blood sample, we were able to examine Kayla’s children with arthritis. The Canadian-Dutch team biomarkers to identify her specific biological subtype will study how genes, ribonucleic acid (RNA) and of disease and choose the best method of treatment,” specific inflammatory proteins characterize the says Benseler, a rheumatologist and professor in disease in each child and provide therapies that fit. the Department of Paediatrics, and a member of Benseler strongly believes that specific subtypes the Alberta Children’s Hospital Research Institute of the disease can be identified and treated with and the McCaig Institute for Bone and Joint Health. targeted therapies, ultimately improving the care Today, Kayla can run and jump like any other energetic and quality of life for these children. “We can do a lot preteen. It highlights to Benseler — who didn’t need better. We have the knowledge and the technology convincing — the power of precision medicine, a health to achieve better outcomes for children suffering model that proposes tailoring care to the individual. from arthritis in Canada and beyond,” says Benseler. This singular case dots a career of stellar achievements Drop into her clinic at the Alberta Children’s Hospital, for Benseler who is known as “Susa” to patients and and you will see families and children keen on colleagues. In addition to her work on childhood talking to their superstar Susa. She has developed a arthritis, Benseler is one of the world’s leading well-earned reputation for being the best caregiver researchers in childhood vasculitis, a condition that for her clinical patients. And nothing would make involves inflammation of the blood vessels. Two years Benseler happier than being able to do for all kids ago, Benseler saw firsthand the critical importance what she has done for individual children in her care. of precision medicine. During a young patient’s routine checkup, health workers noticed the child had The Pediatric Brain Injury Research Program funded by the unusually high blood pressure. Benseler immediately Alberta Children’s Hospital Foundation has provided initial recognized the signs of Takayasu Arteritis, a rare support for vasculitis research at the University of Calgary.

CUMMING.UCALGARY.CA/UCALGARYMED

Minocycline as a treatment for MS 20 years of patience and persistence pays off for Hotchkiss Brain Institute researchers

In researching multiple sclerosis (MS), Wee Yong, PhD, discovers the importance of a group of molecules.

They help immune cells break the blood-brain barrier to cause inﬂammation and destroy cells in the brain.

Yong searches through literature for an aﬀordable generic medication, in pill form.

A drug that could aﬀect those molecules to stop immune cells from entering the brain.

Yong determines minocycline, a well-known antibiotic, has properties that could be eﬀective in treating the immune abnormalities of MS.

Yong approaches Dr. Luanne Metz (MD’83), a neurologist and MS clinic director for collaboration and clinical expertise.

Yong successfully applies for a pilot grant from the MS Society of Canada. Money is awarded for an idea considered wild but worthy.

The Canadian Institutes of Health Research (CIHR) awards $5 million over ﬁve years to Yong and Metz.

The grant eventually helps fund the ﬁrst clinical trial by Metz to use minocycline as a treatment for multiple mclerosis.

Yong, Metz and other colleagues publish their ﬁrst paper on the eﬀectiveness of minocycline in reducing severity in an animal model of MS.

UCALGARY MEDICINE FALL 2017

Study published in the New England Journal of Medicine shows that minocycline, a common acne medication, can slow the progress of relapsing-remitting MS in people who have recently experienced their ﬁrst symptoms.

Data analyses, writing and revision of paper for publication.

Patient recruitment begins for a 12-institution cross-Canada clinical trial.

The MS Society Research Foundation awards over $4 million to fund a double-blind, randomized, placebo-controlled clinical trial of minocycline in early MS. Philanthropic support from the community continues to boost the research.

Metz, Yong and colleagues report on their promising results in the ﬁrst clinical trial of minocycline in MS.

Their group reports that minocycline improves the eﬀectiveness of approved MS therapies in an animal model of MS, providing the rationale for combination treatment.

Metz leads a four-institution clinical trial on the combination of minocycline with copaxone, funded by Teva Canada.

CUMMING.UCALGARY.CA/UCALGARYMED

The future of cardiac imaging Stephenson Cardiac Imaging Centre (SCIC) uses innovative techniques to develop individualized treatment plans By Dawn Smith

Changing the way we use cardiovascular MRI Since its introduction nearly two decades ago, cardiovascular MRI (magnetic resonance imaging) has become the most versatile imaging technique to measure heart health. According to Dr. James White, director of the SCIC at the Libin Cardiovascular Institute of Alberta, cardiac MRI can be used to create images of heart structure, function, blood flow and changes to the muscle such as inflammation or scarring. These images can then be used to predict possible outcomes for patients. “There are numerous MRI-based features that can predict things like sudden cardiac death in patients with heart disease, but it’s all in how those features are used,” says White. “The SCIC team is creating computer models to take these features into account in an effort to help physicians and their patients make the best care decisions.”

4D Cardiac Modelling tracks hundreds of individual points on the heart while it’s beating, providing more than 20,000 data points to describe each patient’s heart. According to Alessandro Satriano (PhD’13), staff at the SCIC are developing new ways to use 4D technology in the management of patients with heart disease.

For example, the SCIC team is working to prove this tool can be used to detect scar tissue in the heart. If successful, 4D Cardiac Modelling could replace the typical MRI that requires the use of intravenous contrast, which can be problematic for patients who can’t tolerate the dye. The goal is to use 4D technology on patients in an everyday clinical setting.

White, who leads the SCIC Research Group, explains that it’s possible to predict how patients will respond to specific treatments by using data that’s collected from genetic, laboratory and imaging tests. The group is currently exploring this approach using data collected from cardiovascular MRI scans. The information is stored within the Cardiovascular Imaging Registry of Calgary (CIROC), a unique database that collects and tracks clinical, patient-reported and diagnostic data from all patients who walk through the Stephenson

UCALGARY MEDICINE FALL 2017

Centre’s doors. Launched in 2015, the registry has already collected data from more than 8,000 MRI scans. “We might expect that a patient with a weak heart from heart attacks will respond very differently than a patient with a heart weakened by a recent viral infection,” says White. “So why do we manage these patients so similarly? We’re using our data to better understand which medications can make the greatest impact for patients with specific patterns of heart disease.” Historically, there has been a challenge in combining clinical and research services. The Stephenson Centre has successfully integrated the two, which allows for a highly personalized service where patients can actively contribute to advancing medical research while having multiple questions answered about their own care. According to White, the types of data collected by CIROC are key to developing precise care plans for patients with heart disease because each diseased heart is so unique. He believes that incorporating a “fingerprint” of this disease through cardiac imaging can help create treatment plans most likely to benefit each patient. “Imaging technology has vastly improved over the past few years,” White says. “The power of imaging is immense — it greatly impacts the way we diagnose and treat our patients, and we’re using it to provide a whole new level of care.”

4D Flow MRI is a cutting-edge imaging technique that allows blood flow to be visualized in real time using a display, which helps identify abnormalities of the heart and blood vessels. One practical application of this technique is the multi-site research of Dr. Paul Fedak, a professor in the Department of Cardiac Sciences and a member of the Libin Institute. This research examines patients with bicuspid aortic valve (BAV), a genetic condition in which patients are born with two flaps in their aortic valve instead of the usual three. The goal of the project is to develop a personalized approach for preventing the sometimes fatal consequences of this common congenital heart defect.

Julio Garcia, a postdoctoral fellow in the Stephenson Centre with a PhD in experimental medicine, explains that in a normal heart, blood flows relatively straight and smooth like the flow from a garden hose. In abnormal hearts, the blood flow can become erratic, much like how water diverts when you put a finger over the stream from a hose. This erratic flow may cause problems as the flow puts added strain on specific areas of blood vessels and the heart. By determining where this pressure is greatest, imaging experts and physicians may be better able to diagnose problems and treat those at risk, while avoiding costly surgeries for those that don’t need it.

CUMMING.UCALGARY.CA/UCALGARYMED

Connect with UCalgary to Participate in Research By Jenny McLean

he University of Calgary calls on volunteers from our community to make thousands of research studies possible each year, but it “Working with can be a challenge people from our for researchers communities helps and community us to stay focused members to on what we’re trying connect. to achieve — better That’s why the health for Albertans,” university has -Marcello Tonelli, MD launched the new Participate in Research website, which makes it easier to search and explore studies and trials that are seeking participants.

3754 active studies

“Working with people from our communities helps us to stay focused on what we’re trying to achieve — better health for Albertans,” says Dr. Marcello Tonelli, senior associate dean of health research. “We hear from participants that our studies are a rewarding experience; they’re an opportunity to learn about the great work going on at the university and to contribute to research advancements.” UCalgary’s Participate in Research initiative is designed to increase and streamline study recruitment by connecting potential participants with investigators and to ensure that research at the university is patient, family and community-centred to maximize benefits for Albertans.

571

active clinical trials

Conducting research that changes the world UCalgary believes in research that has a positive impact on our communities at home and around the world. Our scholars conduct research studies and clinical trials in a wide range of disciplines — from MRIs to understand childhood brain development, to online surveys that help us understand social media interactions — and we need your help to do it.

1137

principal investigators with active studies

UCALGARY MEDICINE FALL 2017

Get involved The Participate in Research website includes all types of research that need participants, including health and non-health related disciplines such as social sciences, humanities, engineering, business and medicine. Participants may be involved in a range of activities, depending on the discipline and

Who can participate? study design. In health research, participants may help researchers to understand the effects of new drugs or therapies. In other kinds of research, participation might involve completing questionnaires or interviews, behavioural tasks like physical exercises, or memory and cognitive tasks.

Two types of research you might participate in include: Qualitative studies

Clinical trials

Qualitative studies aim to understand how people think about the world and how they behave in it.*

Clinical trials evaluate the effects of health-related interventions on health outcomes.*

• Methods include interviews, focus groups and observations to collect data

• Considered the “gold standard” for assessing the effects of biomedical interventions, such as drugs, devices, cognitive-behavioural therapy, diagnostic tests, and others

• Emphasize the importance of studying a topic in a naturalistic setting, which can provide important insight into real-world context • Qualitative research can help to address the gap between evidence-based practice and decision-making by informing the context in which the knowledge would be used**

• In some cases, clinical trials may provide early access to cutting-edge treatments • Clinical trials can also be used to assess the impact of population and public health interventions that use preventive measures or target the social impacts on health**

* Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans ** Clinical, Health Services, and Population Health Research Platform Strategy

Participating in research at UCalgary is a great opportunity to learn about new technologies, therapies and ideas. While many projects call for participants who meet certain criteria such as a health condition or lifestyle, many also need healthy or control participants in order to conduct a successful study or trial. Often, friends or family members join as a control participant when a loved one is participating in a trial. Similarly, individuals who’ve been impacted by health or other challenges in their life may participate as a way to engage and contribute to research.

Visit ucalgary.ca/research/ participate to explore studies and trials that are currently recruiting participants.

Realize the possibilities with the University of Calgaryâ&#x20AC;&#x2122;s TENET i2c business pitch competition. See competitors battle it out for up to $100,000 to turn their medical research into a commercial product.

Innovation to commercialization

Tuesday, May 8, 2018 Libin Lecture Theatre Health Sciences Centre 3330 Hospital Drive NW Calgary, Alberta T2N 4N1 cumming.ucalgary.ca/teneti2c