UCalgary

MEDICINEA University of Calgary Faculty of Medicine Publication

Putting the rural in rural medicineGiving students and residents a first-hand glimpse of what rural medicine is really like

Looking back to help look forwardExploring the early detection of mood disorders in youth

Spring 2013

Profiling a pathologistWhen Dr. Jennifer Chan began medical school, she knew very little about what pathology was. What she did know came from watching television shows such as Quincy as a kid.

DePartments

MessAge FroM the DeAn 2

serviCe to soCiet y

Bridging the gap 3 In the community 22

PhilAnthroPy

The way to personalized medicine 4

reseArCh

Researching the walkability of neighbourhoods 10 What is a stem cell? 14

eDUCAtion

University of Calgary’s global health program increases research capacity in Ethiopia 16

news

In the news 23 Good reads 26 Awards and recognition 28

AlUMni

And the Alumnus of Distinction Award goes to... 29

SPRING 2013 ISSue

01UCALGARY MEDICINE SPRING 2013

Pm agreement no. 41095528

return Undeliverable Canadian addresses to:University of Calgary Faculty of Medicine, Communications and Media Relations7th Floor, TRW Building 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6

eDUCAtion

Puttingtheruralinruralmedicine6

FeatUres

reseArCh

Lookingbacktohelplookforward12 Exploringtheearlydetectionofmooddisordersinyouth

serviCe to soCiet y

Profilingapathologist18 WhenDr.JenniferChanbeganmedicalschool,sheknewverylittle

aboutwhatpathologywas.WhatshedidknowcamefromwatchingtelevisionshowssuchasQuincyasakid.

Look for this icon for more content found exclusively online at

medicine.ucalgary.ca/magazine

WANt MoRE?

UCalgary volume 5 | issue 1

MEDICINEUCalgary Medicine is published twice a year by the University of Calgary Faculty of Medicine, providing news and information for and about our faculty, staff, alumni, students, friends and community.

For more information contact:

MANAGING EDIToR

Kathryn Sloniowskit 403.220.2232e kjslonio@ucalgary.ca

EDIToRIAl TE AM

Jordanna Heller, Director, Communications and Media RelationsMarta Cyperling, Manager, Media RelationsAmy Dowd, Manager, Internal RelationsAmanda Fisher, Communications CoordinatorAisling Gamble, Communications Advisor, Events and Recognition

DE AN

Dr. Jon Meddings

VICE-DE AN

Dr. Glenda MacQueen

SENIoR ASSoCIATE DE ANS

Dr. Gerald Zamponi, ResearchDr. Jocelyn lockyer, EducationDr. Ronald Bridges, Faculty Affairs

ASSoCIATE DE ANS

Dr. Anthony Schryvers, Undergraduate Science EducationDr. Bruce Wright, Undergraduate Medical EducationDr. Jennifer Hatfield, Global Health and International PartnershipsDr. Doug l. Myhre, Distributed Learning and Rural InitiativesDr. Maureen Topps, Postgraduate Medical EducationDr. Frans A. van der Hoorn, Graduate Science EducationDr. lara Cooke, Continuing Medical Education and Professional DevelopmentDr. John Reynolds, Basic ResearchDr. Michael Hill, Clinical TrialsDr. Janet de Groot, Equity and ProfessionalismDr. Kamala Patel, Faculty DevelopmentDr. Samuel Wiebe, Clinical Research

DESIGN

CoMBINE Design & Communications

PHoToGRAPHy AND IllUSTRATIoNS

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To receive a free copy of UCalgary Medicine please call 403.220.2819 or email medcomm@ucalgary.ca

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CONTeNTS

oN THE CoVER

A slide of a tissue sample.

Message from the Dean

MessAge FroM the DeAn meDiCine.uCalgary.Ca /magazine

stemming From the countlessinterestingstorieswehavecomingfromtheFaculty,you’llnoticethatournewmagazinehasincreasedinpagecount.Welookforwardtosharingthisnewandimprovedmagazinewithyou,whichyoucannowexpecttwiceayear:onceinthespringandonceinthefall. HereattheFacultyofMedicineweareveryproudoftheachievementsofourfacultymembers,staffandstudents,andwe’reespeciallyproudwhentheseachievementsleadtoexternalrecognitionandaccolades.Thispastyear,we’vehadanumberofhigh-profileawardrecipients,including:DavidProudandHansVogel,whowereelectedasfellowsoftheRoyalSocietyofCanada,MerrilKnudtsonwhowasnamedaMemberoftheOrderofCanada,

andBrendaHemmelgarn,ToddAndersonandSubrataGhosh,whowereallinductedintotheCanadianAcademyofHealthSciences.We’rearelativelyyoungFacultysohavingthismanyrecipientsofsomeofCanada’stopawardsdemonstratesthatwearetrulycomingofage. Inlinewithourresearchpriorities,andkeytotheEyesHighstrategicdirectioninitiativesetforthbytheuniversity,theFacultyismakingprogressinthedevelopmentofournewUnitforClinicalAnalyticsandResearchSupport(UCARS).Theunit,whichweanticipatewillbeabletoofferinitialserviceslaterthisyear,willprovideresearcherswithaccesstoresearchdataacquisition,managementandanalytics,opportunitiesforcollaborationandeducationinclinicalresearch,andwillallowthemtoaccess

resourcessuchasassistancewithmethodologicalandstatisticalsupport,andstudydesign.UCARSwillalsostreamlinetheprocessofimplementingclinicalresearchprojectsofalltypes,subsequentlygivingourcommunityevenbetteraccesstothemostforwardthinking,cutting-edgehealthcare.UCARSismodeledaftertheClinicalResearchUnitattheHotchkissBrainInstitute,whichwasfoundedbySamuelWiebesixyearsago.TheClinicalResearchUnithasbeenverysuccessfulinimplementingclinicalresearchforbrainandmentalhealthissuesandweanticipatethesamesuccessesmorewidelywiththedevelopmentofUCARS. Albertaisfacingaruralphysicianshortage,aruralfamilyphysicianshortageinparticular,andit’sbeenanongoingchallengetocomeupwithasolutiontothisproblem.DougMyhre,associatedeanofDistributedLearningandRuralInitiatives,hasimplementedanumberofinitiativesattheFacultyofMedicinetoencourageourstudentstoexploreandpursueruralmedicine,andhehasthedatatoprovethattheseinitiativesareworking.Youcanreadmoreaboutourruralmedicineprograminthisissue. IwouldalsoliketoextendmycongratulationstoallofourstudentsattheFacultyofMedicinewhowillgraduatethisspring.Graduationisanadmirableaccomplishmentandweareproudofeachandeveryoneofyou.Pleasestayintouch.We’dlovetohearwhereyourjourneytakesyou.

Jon Meddings, MDDean, Faculty of medicineuniversity of Calgary

i’d like to begin by welcoming everyone to our new volume of UCalgary medicine.

03UCALGARY MEDICINE SPRING 2013

Working UnDer theumbrellaofsurvivorship,thenotionoflivingwithandbeyondcancer,CancerBridges,apartnershipbetweentheuniversitiesofCalgaryandAlberta,theAlbertaCancerFoundation,andAlbertaHealthServices,isamultidisciplinarygroupofhealth-careprofessionalswhosegoalistoresearchandbringforthevidence-basedprogramstobenefitthoselivingwithcancer.TheFacultyofMedicine’sJanineGiese-Davis,PhD,isthedirectorofthisnewprovincialinitiative. Inadditiontoaddressingpost-treatmenthealthchallengessuchasthelastingphysicaleffectsoftreatment,andtheimportanceofself-monitoringforsignsofdiseaserecurrence,CancerBridgesalsofocusesonthementalandsocialchallengesfacedbypatients,suchaspost-treatmentcarecoordination,thetransitionbacktoworkandthefosteringofrelationships. “Oncepeopleleaveactivetreatment,they’lloftengobackhomeandtrytoputtheirlivesbacktogetheronlytorealizethatnothingisquitethesame,”saysGiese-Davis,amemberoftheSouthernAlbertaCancerResearchInstitute.“Finishingtreatmentcanbeoverwhelming,andpatientsoftenhavenoideawhattoexpect.” Todate,CancerBridgeshasspearheadededucationalsessions,bi-annualsurvivorsymposiums,amonthlyspeakerseriesandawebsitethatisnotonlybeingusedtoinform,butalsoasatooltobringsurvivorstogetherinan

onlinecommunity.WhiletheeventsareprimarilyheldinCalgaryandEdmonton,theteamiscurrentlyinvestigatingwaystobringitsresourcestosmallerruralcommunitiesaswell. “We’rereallyallabouttryingtowadeintotheareasofprovidinginformationandsupport,toadvocateforprogramsthatmightbebeneficial,andtodotheresearchnecessarytohelpusunderstandthekindsofcommunicationandtransitionsupportthatpeopleneed,”saysGiese-Davis.

JanineGiese-Davis,PhD, was recruited from stanford to the University of Calgary four years ago to lead a province-wide survivorship initiative through the enbridge research Chair in Psychosocial oncology held by linda e. Carlson, PhD. she is currently an associate professor in the Faculty of Medicine’s Department of oncology.

When it comes to cancer care in Alberta, the good news is that treatment efficacy is improving and people are living longer. The bad news is that this cohort of patients now faces a new set of needs that health-care professionals are only beginning to explore.

Currently in alberta, approximately 100,000 people have, at one point, had cancer.

Since its inception, the CancerBridges website has seen visitors from over 50 communities in alberta.

What’s on the website?The CancerBridges website hosts survivor stories, educational videos, a community events calendar and a blog. Topics vary from debunking the myths of survivorship to current research and health tips from health professionals. For more information visit: cancerbridges.ca

most of the video material is created by CancerBridges coordinator and innovative young adult cancer survivor mike lang. lang is currently pursuing a master’s degree in health services research at the university of Calgary’s Faculty of medicine.

Bridging the gap By Kathryn sloniowski

Did you know?

cancerbridges.ca

05UCALGARY MEDICINE SPRING 2013 meDiCine.uCalgary.Ca /magazine

2013isabigyearfortheCanadiannowknownasCanuckOne.

not a hoCkey PLayer, comedianorteenidol,CanuckOneisthefirstCanadiantoundergogeneticsequencingaspartofanewresearchventurecalledPersonalGenomeProject–Canada. Alloftheinformationcollectedwillbemadepublicthroughadatabaseavailabletoscientistsaroundtheglobe.TheresearcherswilllearneverythingthereistoknowaboutCanuckOnesuchasheritageanddiseaseprofile,andeveninformationnotyetunderstood.ThegoalofthiscollaborationbyCanadianresearchersistoeventuallymapthegenomesof100CanadianswhohavevolunteeredtomaketheirDNApublicforthepurposeofadvancingscience. TheprojectisbeingcloselywatchedbyDr.FrancoisBernier,headoftheFacultyofMedicine’sDepartmentofMedicalGeneticsandamemberoftheUniversityofCalgary’sAlbertaChildren’sHospitalResearchInstitute(ACHRI).

Onadailybasis,BernierworkstoidentifythegenesbehindthediseasesofpatientsattheAlbertaChildren’sHospital.Heandhisteamhavealreadyfullyandpartiallysequencedatleasttwodozenindividualsinhopesofsolvingthegeneticpuzzleoftheirparticularconditions. “Sequencingissoimportantbecauseitisallowingdoctorstoenterthestageofpersonalizedmedicine,”saysBernier.Personalizedmedicineaimsspecifictreatmentstowardsspecificpatients—apossibility,hesays,oncegenesandgenevariantsbehindspecificconditionsareknown. Findingagenevariantisnoteasywork.Humanshavethreebillionnucleotides—themoleculesthatmakeupDNA.DNArepresentsthegenomeofaperson,andeveryperson’sgenomeisdifferentfromthenextatoverthreemillionpositions.Nonetheless,BernierandhisteamofgeneticresearchersatACHRIarenowbetterequippedtoperformthatsearch. Thankstonewequipmentandthecreationofanewgenomicscalesequencinglab,ledbyACHRIandfundedwiththehelpofcommunitysupportthroughtheAlbertaChildren’sHospitalFoundationandsupportfromtheFacultyofMedicineandAlbertaHealthServices,Bernierandhisteamarediscoveringtheexactgeneticcausesofdiseases,somethingunheardofeven10yearsago.Heandhisteamhavealreadyidentifiedtwonewgenevariantsandarehopingtoreportonseveralmoreverysoon. ACHRI’sfacilityisequippedwiththreeadvancedDNAsequencersknownasnext-generation.Oneofthenewestsequencersisthepersonalizedgenomemachine,acquiredlastJuly,whichallowsresearcherstoconfirmabnormalitiesinonlyfourhours.

Butnotonlyhavethedonationsprovidedfortheequipment,thefundshavealsoallowedACHRItobuildaresearchteam.WithanoperationalgrantfromtheFacultyofMedicine,ACHRIhasbeenabletorecruittworesearchersinbioinformaticsandisintheprocessofenlistingthreeadditionalgeneticists—onesupportedbyAlberta’sMinistryofEnterpriseandAdvancedEducation.Additionally,grantsfromtheMinistryhavealsoprovidedfortheestablishmentoftheTranslationalHealthChairinPersonalizedGenomicstoprovideexpertiseandcollaboration. Dr.BrentScott,directorofACHRI,isexcitedaboutthepossibilities. “Donorfundingofthiscombinationofcuttingedgegenetictechnologyalongwiththeopportunitytorecruitexcellentclinicalinvestigatorsandscientiststhatuseit,isallowingACHRI,theUniversityofCalgaryandAlbertaHealthServices,GeneticLaboratoryServicestounlockthegeneticbasisofdiseaseandimprovethehealthoutcomesofAlberta’schildren,”saysScott. OneofthenewmembersofthegeneticsteamisJasondeKoning,PhD.Anexpertinbioinformatics,afieldofhighlyspecializedstatisticalandcomputationalanalysis,deKoningisdevelopingnewwaystocombinestatisticalandcomputeranalysistobetterandmorerapidlyinterpretDNAsequencingresults.Hisworkhasreducedthecomputingtimesofgeneticdatafrommonthstominutes,withoutsacrificingaccuracy. Asaresultofthesedonations,andthevisionandleadershipputforwardbyACHRI,researcherssuchasBerniernowhavetheopportunitytodiscovergeneticvariationsinpatientsuponwhichhecanadvancethecauseoftreatmentsandcures.

“JustliketheresearchtakingplacearoundPersonalGenomeProject–Canada,sotooisACHRIworkingattheleadingedge,offeringAlbertanssomeofthebestscienceandhealthcareinCanada,”saysScott.

1Dr.FrancoisBernier

Sequencing is so important because it is allowing doctors to enter the stage of personal ized medic ine

Did you KNow?Sequencing equipment can now produce 1.2 trillion bits of data in the span of two weeks. If you tried to count to 1.2 trillion, you would probably die before finishing

PhilAnthroPy

The way to personalized medicine By laura herperger

1

Alberta Children's Hospital Foundation

The alberta Children’s Hospital Foundation has supported research at the alberta Children’s Hospital and the university of Calgary for more than 30 years. Through the alberta Children’s Hospital research institute for Child and maternal Health, the Foundation supports the efforts of approximately 200 experts working to improve health care for children and mothers in alberta. Without the Foundation’s support, much of the work at the institute could not advance. This past year alone, the Foundation provided over $10 million for child and maternal health research at the institute, including support for eight chairs, five professorships and 18 research awards. “We are so grateful to our donors for recognizing that new cures and better treatments start with research,” says Saifa Koonar, president and CeO of the alberta Children’s Hospital Foundation. “Their generous investments have and will continue to make possible important advancements in child health.”

eDUCAt ion

Ask Dr. Doug Myhre, the associate dean of Distributed Learning and Rural Initiatives at the University of Calgary,

why rural medicine isn’t at the top of the list when medical students choose their clerkship and residency programs, and he’ll say it’s probably because they don’t know what rural medicine means.

07UCALGARY MEDICINE SPring 2013meDiCine.uCalgary.Ca /magazine

Putting the rural in rural medicine By Kathryn sloniowski

sPeCiaLty Orthopedics,fifth-yearresidentrCi rotation LoCation LethbridgeWhat would you say was the

biggest difference between rural medicine and urban medicine?

Fromanorthopedicsperspective,inCalgary,we’reveryfocusedonspecificbodyparts,whereasinLethbridge,youdon’tknowwhatwillcomethroughthedoor.Itcouldbebadarthritis,post-traumaticdeformitiesinthearm,pediatriccases,etc.Youhavetowearabunchofhats.What did you notice about

the lifestyle of working in a rural location? Icouldwalktoworkorwhen

Ididdrive,Iwouldn’tgetstuckintrafficjams.It’saslowerwayoflifecomparedtotheratraceofthecity.What skills do you think you

learned working in a rural environment? I’dsaymulti-taskingina

differentway—havingtothinkmorebroadlyinscopeofhowapatientpresents.What would you say to someone

considering rural medicine? Keepanopenmindandtryit

out.It’saneyeopeningexperience.Whenyougetintomedschool,everythingisnewandbigandyouwanttobeonthewardsandintheemergencyroom.Asyouprogressthroughresidency,thethrillofthatdoestakeitstoll,andexperi-encingapracticethatisn’tasbusycanbequiterewarding—you’llstillgetthestuffthatgetsyourbloodpressureandheartrateup.Ifyougettheopportunitytodoit,youshouldjustgoforit.Youwillprobablybepleasantlysurprisedathowawesomeitis.Would you work in a rural setting

if you had the opportunity? Absolutely.Ireallyenjoyed

livinginasmallertown.

sPeCiaLty AnesthesiologyrCi rotation LoCation Lethbridge What would you say was the

biggest difference between rural medicine and urban medicine? Sometimestheperceptionisif

youchooserural,youdolessorit’slessacademic.Tomysurpriseitwasequallyasacademicandchallenging.Thedifferenceis,youmaynothavethesamelevelofsupport;soyoumayhavetomakesomejudgmentcallsthatyou’renotusedtomakinginthecitywhereyouwouldbeabletoconsultmorepeople.What did you notice about the life-

style of working in a rural location? Itonlytakesaboutfiveto10

minutestodrivehome.Yougainsomuchtimeinyourdaywhenyoudon’thavethatlongcommute.What did you notice about your

rural work environment? Workinginasmallercommu-

nitymakescommunicationandworkingaspartofahealth-careteameasierbecauseifyouknoweverybodybynameandface,it’samuchmorecomfortableworkingenvironmentanditmakespatientcaremuchmorestreamlined.Inthecity,thereissomuchstaffthatsometimesyou’llworkwithsomeoneonceandyouwon’tseethemagainforsixmonths.What would you say to someone

considering rural medicine? Anelectiveortriallocumis

definitelyworththeexperienceevenifyou’renotinterestedinpursuingacareerinruralmedicine.Theexperienceispositiveandenriching,soyoudon’treallyhaveanythingtolose.Would you work in a rural setting

if you had the opportunity? Iamnow.Whentheopportunity

cameupformetogobackaftermyrotation,IthoughtabouthowgreattheexperiencewasandbothmyhusbandandIdiscussedhowhappyIhadbeen.Itwasdefinitelyoneofthebetterrotations,sowedecidedtogoback.

MeetDr.MeLissasetiawan MeetDr.sPenCerMCLean

08 MeDIcINe.ucAlGARy.cA/MAGAzINe eDUCAt ion

“TheRCIprogramwasperceivedbytheresidentsaseducationallyvaluableanditmaybecriticalinhelpingshiftattitudestowardsruralpractice,”saysMyhre.“Thenextstepistofollowtheresidentstodetermineiftheattitudechangeissustainedandisfollowedbyabehaviouralchangeaswell.”

andeventuallymakeprogresstowardsattractingandretainingruraldoctors. “Theyneedtogoandseewhatworkinginaruralenvironmentisreallylikeinordertomakeaninformeddecision,”hesays.“Whilestudentswhogrewupinruralcommunitiesaremorelikelytochooserural,wehavetoconsiderthefactthatwehavefarmorestudentsattendingmedicalschoolwhoarefromcities.Theymaybringmisconceptionstothetableaboutwhatruraldoctorsdo,soweneedtoactuallyshowthem.” RuralinitiativesattheFacultyofMedicinecurrentlyrangefromshadowingopportunitiesinfirstyear,toclerkshiprotationsinthirdyear,andareavailableinlocationsascloseasAirdrieandasfarafieldasYellowknife. Untilrecently,theseinitiativeshavetypicallyfocusedonrecruitmenttofamilymedicine—whatMyhrecallstheworkhorseofruralAlberta.However,afewyearsago,agroupofmedicalgraduatesshowedinterestinspecializinginotherareasofmedicinebutdidn’twanttopursuethatspecialtyinCalgary.Inresponsetothis,theDistributedRoyalCollegeInitiative(RCI)wascreatedandproposedtothegovernmenttohelpfillthisgap.Sinceonly2.4percentofmedicalspecialistspracticeinruralAlberta,ruralspecialistscanbeinevenhigherdemandthanfamilydoctors.Additionally,asthepopulationsofthesenon-urbancommunitiesincrease,demandforspecialistswillundoubtedlyincreaseaswell. WithsupportfromtheRCI,residentshaveaccesstoruralopportunitiesandfinancialsupporttopursueaspecialtybothoutsideoffamilymedicine—generalistspecialtiessuchassurgeryandpediatrics;andsub-specialtiessuchasorthopedics,respiratory,oncologyanddiagnosticimaging—andoutsideofAlberta’smajorcities,CalgaryandEdmonton. AstudypublishedinOctober2012concludedthattheRCIhascontributedsignificantlytochangingperceptionssurroundingthepursuitofamedicalspecialtyinaruralcommunity.

While the minds of city-dwelling students may instantly conjure images of wheat fields, livestock and sparse populations, the actual definition of rural varies. For instanCe, theAlbertaGovernmentdefinesruralasbeinganycommunityinAlbertathatisn’teitherCalgaryorEdmontonwhileStatisticsCanadaconsidersruraltobeanycommunitywithapopulationoflessthan10,000.TheFacultyofMedicineusestheAlbertaGovernment’sdefinition,andfurtherdesignatestheprovince’slargercentres:MedicineHat,Lethbridge,GrandePrairie,FortMcMurrayandRedDeerasregionalsites.Regardlessofthedefinitionhowever,there’snoquestionthatruralphysiciansareregularlyindemandinAlberta. Aspartofaprovince-wideinitiativetorecruitmoredoctorstoruralenvironments,Myhrehasbeenspearheadingruralinitiativesatthefacultyforthelast10years.HeandhisteamattheDistributedLearningandRuralInitiativesofficehopethatbyexposingstudentsandresidentstoruralmedicine,byprovidingthemwithaccesstobothopportunitiesandfunding,theycanchangeperceptionsaboutruralmedicine

other rural medicine opportunities for students:

ShADoWING Through the rural Physician action Plan, first-and second-year students are given the opportunity to shadow a rural physician for two to three days, to see what it’s really like.MEDICINE 330 This first exposure to family medicine throughout the first-and second- year is also available in rural and regional communities.PRE-CLERkShIP ELECtIvES Second-year students have the opportunity to explore rural family medicine and/or regional specialty electives at placements throughout alberta, in a minimum two-week rotation.CLERkShIP ELECtIvES Third-year students have the opportunity to enroll in rural family medicine and regional specialty electives year round.CLERkShIP RotAtIoNS Third-year students have the opportunity to participate in six-week rural family medicine rotations. Certain specialties such as psychiatry, obstetrics and pediatrics are also available in regional communities.RURAL INtEGRAtED CoMMUNItY CLERkShIP

(RICC) Third-year students have the opportunity to complete their entire nine-month clerkship in a rural community, focusing on the model of continuous care.

While students who grew up in rural communities are more likely to choose rural, we have to consider the fact that we have far more students attend-ing medical school who are from cities.

11UCALGARY MEDICINE SPring 2013

andmixoflandusesanddestinations,supportphysicalactivitybehaviouroftheresidentsinthoseneighbourhoods. Inthefuture,thisresearchcouldbeusedtoinformdecisionsonhownewcommunitiesshouldbebuiltandhowestablishedneighbourhoodscanpotentiallyberedevelopedorretrofitted.Thesedecisionscouldhaveasignificantimpactonthehealthofourcommunities. “ModifyingasingleCalgaryneighbourhoodtomakeitmorepedestrian-friendlyhasthepotentialtoinfluencethewalkingbehaviourofalargenumberof

residentsoveralongperiodoftime,”saysMcCormack.“Itisthistypeofintervention,onethatisfarreachingwithimpactonbehaviouroveralongtimespan,thatislikelytoleadtoincreasesinphysicalactivityatthepopulationlevel. “Inthefuture,thiscouldresultinsignificantreductionsintheriskofobesity,aswellaschronicdiseasessuchascardio-vasculardisease,typeIIdiabetes,hyper-tension,depressionandsomecancers.” Decreasingtheincidenceoftheseadversehealthissuescouldalsoreducethecostburdenonourhealth-caresystem

fortreatingandmanagingtheseconditions.Creatingwalkableneighbourhoodsmightalsohaveotherpositivehealthandeconomicbenefits.Forexample,aswalkingbecomesmoreconvenient,itcouldreplaceprivatemotorvehiclesasthepreferredmodeoftransportationforlocaltrips,potentiallyleadingtoareductioninairpollutionandbetterairquality. Foracitythatstillseemsruledbytheautomobile(arecentciviccensusshowedthat70percentofpeopledrovealoneontheirlasttriptowork),thisisgoodnews.

PhD,istakingthisknowledgeonestepfurther.Heisexploringthelinksbetweenthewalkabilityoftheneighbourhoodswechoosetoliveinandouroverallhealthandlevelsofphysicalactivity. “Theevidencesuggeststhatassociationsbetweenaneighbourhood’sbuiltenvironmentandlevelsofphysicalactivityexist,butwestilldon’tknowtowhatextenttheseassociationscanbeconsideredcausal,”saysMcCormack.“Livinginneighbourhoodsthathavehighstreetorpedestrianconnectivityandalargemixoflanduses(amongotherfeatures)is

Most of us wake up knowing that we’ll be spending a good portion of our day in the dreaded commute: slow-moving traffic, construction delays and detours that can take us to unexpected places on our way to work, school or wherever we need to go.

in Light oF this,itcomesasnosurprisethatmanyCalgariansdefinetheiridealneighbourhoodasonethatwouldallowthemtowalktowork.AttheUniversityofCalgary’sInstituteforPublicHealth,AssistantProfessorGavinMcCormack,

associatedwithmorewalking,butnoteveryonewhoresidesinawalkableneighbourhoodregularlywalks,andnoteveryonewhoresidesinalesswalkableneighbourhoodisinactive.” Currently,McCormackisexploringtheinterrelationshipsbetweenthebuiltenvironmentandmotivation–ourintentions,attitudestowardsphysicalactivity,self-efficacy,andourperceptionsoftheneighbourhoodswelivein.He’sinterestedinknowingwhatfeaturesoftheneigh-bourhood’sbuiltenvironment,suchasthepresenceofsidewalksandtheproximity

meDiCine.uCalgary.Ca /magazine reseArCh

Researching the walkability of neighbourhoods

By leora rabatach

13 UCALGARY MEDICINE SPRING 2013

WhenDuffystartedherresearch(withatwo-yearclinicalresearchtrainingfellowshipinOntario),allthestudieswereofadultswithmooddisorders. “Theseareillnessesthatruninfamilies.That’sthemostreliableriskfactor,”shesays.“IthoughtifIreallywantedtounderstandthetrajectory

intoprimaryrecurrentmooddisordersthenIshouldbestudyingtheyoungergenerationofthesefamilies.” Duffy,alongwithherlongstandingcollaboratorDr.PaulGrof,co-foundedtheMoodDisordersCentreofOttawa(mdco.ca)toresearchadultpatientswithbipolaranddepressivedisorders,andtheirchildren.Twentyyearslater,it’sthelargestandlongestrunninglongitudinalfamilycohortstudyofevolvingmooddisordersintheworld. “Theideaoffollowingpeopleatriskistoidentifythemearlier,interveneeffectivelyearlierandmanagetheillnessandpreventthemorbidityandmortality,”shesays.“Thesepeopleareathighrisk,especiallyearlyinthecourse,forsuicidality. “Thesekidsarealsoathighriskforsubstanceabuse,whichreallywreakshavocontheillnesscourseandtreatmentresponse.” Duffy’sresearchisrevealingimportantbiologicalcomponentstomooddisorders,suchasabnormalitiesincortisolprofiles,ahormoneregulatedbythehypothalamic-pituitary-adrenal(HPA)axisinthebrain. “Whenthey’regoingtogetillortheyareill,thecortisollevelsincrease

substantiallyanddonotrespondtothenormalfeedbacktokeepthemincheck,”shesays. WhiletravellingbacktoOttawaregularlytocontinueherresearchthere,DuffyishelpingsetupanintegratedclinicalresearchprogramforpeoplewithmooddisordersandtheirfamiliesinCalgary. “I’dliketodomorelookingatnormalneurodevelopmentandneurodevelopmentinkidsathighrisk,”shesays.“WehaveaverystrongtraditioninneurosciencesresearchinCalgarywithpeoplewhospecializeintheHPAaxispathwaysandneurodevelopment.” Duffy,whowasborninToronto,isthrilledtobebackinCalgary,whereshecompletedherMDin1991. “It’sagreatplacetoliveandawonderfulmedicalresearchcommunity,”shesays.“It’svibrantanddynamicandthingshappenhere.” AndforDuffy,thingshappenwhensheaskstherightquestions: “Howdowehelpyouthwhoareatriskformooddisorders,orpresentingwithmooddisordersatriskforsuicideandsubstanceabuse?Howdoweallgettogethertodothat?”

2Dr. Duffy is a professor of psychiatry in the Faculty of Medicine.

The idea of following people at risk is to identify them earlier, intervene effectively earlier and manage the illness and prevent the morbidity and mortality.

she Was ComPLetinghermedicalspecialtytraininginpsychiatryattheUniversityofOttawaandspendingalotoftimeoncallinemergencyseeingadolescentpsychiatricpatients,where“everysecondone”seemedtomeetthecurrentcriteriafordepressivedisorder. “Iwasperplexed,”saystheholderoftheCAIPProfessorshipinYouthMentalHealthattheMathisonCentreforMentalHealth,HotchkissBrainInstitute(HBI). “Somekidswereclearlyinanacutecrisis,somewereanxiouskidswhobecameveryunhappyandupsetandsomeofthesekidsseemed

tohaveamajordepressiveepisodeoutofnowhere,”Duffysays.“Ithought,whyarewegivingallthesekidsthesamediagnosis?” Thatquestionhasledtoadistinguishedcareerexploringtheearlydetectionofmooddisordersinyouth. Duffy’slandmarklongitudinalstudiesofchildrenwithparentswhohavebipolardisorderallowedherto

mapouttheearlycourseofthedisorderanddevelopaclinicalstagingmodel—animportanttoolforresearcherstofindtreatmentsandbetterunderstandtheneurobiologybehindbipolardisorder.

Dr. Anne Duffy started asking a few questions during long nights in the emergency room.

meDiCine.uCalgary.Ca /magazine reseArCh

Looking back to help look forwardBy Jennifer Allford

About The Mathison Centre for Mental Health Research & education

one in Five CanaDians exPerienCes a mentaL iLLness in their LiFetime—anD most oF these iLLnesses, anD aDDiCtions, start BeFore the age oF 24, Preventing yoUng PeoPLe From getting an eDUCation, seCUring emPLoyment or maintaining FamiLy ties.

Calgary businessman ronald P. mathison was inspired to “make a real difference” in the lives of people with mental illness.

The president and CeO of matco investments ltd invested $10 million to create The mathison Centre for mental Health research & education to support research into the early identification, treatment and prevention of mental disorders, with a particular focus on children and youth populations.

The mathison Centre supports 11 researchers and clinicians with world-class expertise in brain and neuroscience research who work together to enhance mental health care in our community.it is a partnership with the university of Calgary’s Hotchkiss Brain institute, which develops and supports state-of-the-art research and education programs focusing on neurological and mental health challenges.

This is the only centre of its kind in the country and it’s leading the way to finding solutions to mental health illnesses —solutions that will help transform people’s lives in Canada and around the world. For more information, visit mathison.ucalgary.ca.

These kids are also at high risk for substance abuse, which really wreaks havoc on the illness course and treatment response.

2

What clinical conditions are

currently treated using stem cells?

CURRENtLY, adult stem cells can be used in the treatment of various blood cancers, such as leukemias and lymphomas, through bone marrow transplants. it is hoped that with further research, stem cells could one day be used to treat diseases such as diabetes and liver disease, and conditions such as spinal cord injuries and heart attacks.

How is a stem cell different from other cells in the body?

othER cells in the body such as those found in the nervous system, muscles and in various organs can have limited ability

to replicate themselves and cannot differentiate into other specialized cell types. Due to their defining properties,

stem cells play an important role in normal tissue maintenance and repair.

How do they do this?

WhEN an injury occurs, certain cells at the site will secrete chemical signals that notify the rest of the body

that there has been an injury. Stem cells have receptors on their surface that pick up on these signals, and they subsequently

migrate to the injury site to participate in repair. They will replicate themselves to increase their numbers, and will differentiate into

the specialized cell types that are needed to repair the tissue. in a bone fracture for example, the stem cells may create blood cells to help with

clotting and they may participate in new cartilage and bone formation.

reseArCh

this information was provided by Jaymi taiani, PhD, the scientific affairs manager at the University of Calgary’s McCaig institute for Bone and Joint health. taiani researched stem cell use for bone tissue engineering as part of her Msc and PhD projects, and currently focuses on public education and awareness at the McCaig institute.

illustration reprinted with permission by the national Academy of sciences, courtesy of the national Academies Press, washington, D.C., 2013.

scientists describe a stem cell as any cell in the body that can replicate itself and differentiate into specialized cell types such as heart, bone, cartilage or nerve cells. one of the richest sources of adult stem cells is the bone marrow.

What is a stem cell?

15meDiCine.uCalgary.Ca /magazine

What do stem cells do?

StEM cells help with the natural repair of injuries

and the natural turnover of tissues.

A single cell that can replicate itself, or…

…differentiate into different cell types.

For exclusive online content visit us at medicine.ucalgary.ca/magazine

How many stem cells do we have in our bodies?

DIffERENt parts of our bodies will have different numbers of stem cells at various points in our lives. For instance, a 30-year-old adult will have stem cells in the bone marrow

(known as mesenchymal stem cells or mSCs) at a frequency of one stem cell for every 250,000 cells. By the age of 80, this number drops to approximately

one stem cell for every 2,000,000 cells. This could help explain why bone fractures

in the elderly take longer to heal.

17UCALGARY MEDICINE SPRING 2013 eDUCAt ion meDiCine.uCalgary.Ca /magazine

the short CoUrse wasdesignedtohelpestablishatrainingprogramforresearchersinanefforttoincreasebiomedicalresearchcapacitythroughoutthecountry. Thisinitiative,theEthiopiancomponentoftheuniversity’sglobalhealthprogram,wasoriginallyconceivedbyGedamuthroughdiscussionswithcolleaguesintheFacultyofMedicine’sBachelorofHealthSciences(BHSc)degreeprogram. Theshort-courseprogramhassinceevolvedtoincludeeducationalvisitsfromnumerousfacultysupervisorsaswellasBHScundergraduatestudentsfromallthreesubjectstreams:biomedicalsciences,bioinformatics,andhealthandsociety. “ThepurposeoftheprogramwastobuildcapacityinglobalhealthresearchwithafocusonmolecularbiologyandinfectiousdiseasesatAHRI,aswellasotheruniversitiesandinstitutesinEthiopia,”saysGedamu. GuidovanMarle,PhD,andWendyHutchins,PhD,membersoftheUniversityofCalgary’sSnyderInstituteforChronicDiseases,havebeendevelopinganddeliveringthetrainingcoursesinEthiopiaformorethanfiveyears.vanMarlesaysthereisaneedtotrainresearchersinacross-disciplinaryfashionandtoestablishatrainingapproachthatcanbeadoptedsoastopositionthosebeingtrainedtotrainothers—atrainthetrainerapproach.Theprogramalsoprovidesnecessaryhands-onexperience. “Wefocusonateachingphilosophyofapplyingknowledgeinabroadrangeoftechniquesandareasthatdirectlytransferstotheirowntrainingenviron-ments,”saysvanMarle,alsotheBHScbiomedicalsciencesdirector.“Overtheyears,wehavefocusedonhands-ontrainingcoursestoteachmolecularbiologytechniques,andhowtomaximizetheirlimitedresourceswhenappliedtoseeminglyadvancedandexpensivetechniques,suchasthepolymerasechainreaction(PCR).

“Byincreasingtheirresearchcapacity,wehelpEthiopianresearcherstakecontroloftheirownresearchandbecomeself-sufficient.Thisincludesdrivingtheirownresearchprogramsinareassuchastuberculosis,malariaandHIV.” Theprogramalsogoesbeyondareasoflaboratoryandclinicalmedicine,andtrainsresearchersinveterinarymedicineandagriculture,increasingresearchcapacityasawhole. Asevidenceoftheprogram’ssuccess,thecourseisnowtaughtindependentlytwiceayearbystaffatAHRI,andGedamusaysthattheteachingphilosophyisdrawinginterestfromotherEthiopianinstitutesinterestedinadoptingthemodelfortheirinstructorsandresearchers

aswell.In2011,itexpandedtotheUniversityofGondar,locatedinGondar,Ethiopia. “Overthepastfiveyears,theglobalhealthprogram,incollaborationwithAHRI,hastrainedmorethan200Ethiopianscientistswithdiverseresearchinterestsfromdifferentuniversitiesandinstitutes,”saysGedamu.“TheprogramhassignificantimpactonbuildingsustainableresearchandeducationalcapacityinEthiopia,andisexpandingrapidly.”

3 Guido van Marle, PhD, giving a molecular biology laboratory training demonstration for ethiopia researchers and instructors at the University of gondar.4 Lashitew Gedamu, PhD, Stefana Pancic, erin Stebner-Degelman, Azin Rouhi and Ruble Sandu posing with a local soccer team in gondar ethiopia.

In 2003, Lashitew Gedamu, PhD, a professor in the University of Calgary’s Department of Molecular Biology and Biochemistry, delivered the first molecular biology short-course as part of the University of Calgary’s global health program at the Armauer Hansen Research Institute (AHRI) in Addis Ababa, Ethiopia.

By increasing their research

capacity, we help Ethiopian

researchers take control

of their own research and

become self-sufficient.

University of Calgary’s global health program increases research capacity in Ethiopia By todd o’Keefe

Addis Ababa

Sudan

Eritrea

Djibouti

Somaliland

Gulf of Aden

Indian Ocean

Kenya

Uganda

3

4

19UCALGARY MEDICINE SPring 201304 meDiCine.uCalgary.Ca /magazine serviCe to soCie t y

W hen Dr. Jennifer Chan first began medical school, she knew very little about what pathology was—what she

did know she picked up from watching television shows such as Quincy as a kid. After enrolling in pathology electives and recognizing that pathology played a key role in virtually every one of her medical rotations, it wasn’t long before she found herself waiting eagerly in the lab to speak to the pathologists about their findings and to peer down the microscope with them. After completing a residency in anatomic pathology at Harvard, a fellowship in neuropathology and a research fellowship at the Dana Farber Cancer Institute in Boston, Chan is now a practicing neuropathologist and researcher at the University of Calgary’s Faculty of Medicine. She examines all types of neuro-specimens, from the brain and spinal cord to the peripheral nerve, and also has a keen research interest in neuro-oncology—pediatric and adult malignant brain tumours specifically.

Profiling a pathologist

name

PrOFeSSiOn

lOCaT iOn

OTHer

“ What we do is critically important to the treatments patients receive.”

Dr. Jennifer Chan

neuropathologist

Calgary

mom of two

What was so intriguing to you about pathology?Pathologyisthebasisofdisease;pathologistsseektoanswerthewhat,whyandhowquestionswithrespecttodisease.It’salsoveryvisualandapplied.Ilovelookingatstuff.Itwasjustparticularlyfascinatingtometoseeatumoureitheronthebenchorunderthemicroscopeandtothinkaboutwhatmakesthosecellsgrow.Iamconstantlyasking,‘Whatcanwelearnfromthis.’It’ssomuchfuntolookattheslides,andtoreadaboutthediagnosesandthesciencebehindit.

COnT inue re aDing...

MisCOnCePtiOns

Pathologists only do autopsies.Chan says that in her line of work, 90 per cent or more is based on examining surgical samples while less than 10 per cent is based on autopsies. other branches of pathology, however, such as forensic pathology, will focus more intently on autopsies.

Pathologists are antisocial because they do not have patient contact.Chan admits that while there is indeed a type of geeky phenotype that gravitates toward her field, most pathologists are dynamic and social individuals. she counters that just because they don’t interact directly with patients, it does not mean they do not like people. they simply spend more of their time around other physicians rather than patients.

Pathologists sit in the lab all day, running machines that make diagnoses.while pathology is a field that focuses on diagnostics, and while machines are used in the diagnostic laboratories, pathologists are not simply technicians overseeing machines. the pathologist’s job is to make sure that the right tests are performed, to make sure that the results from those tests are accurate, and to interpret the meaning of those results. Pathologists need to have a large knowledge base about biomarkers and molecular abnormalities, and clinical correlates in order to synthesize several pieces of information to yield a diagnosis.

2120 MeDIcINe.ucAlGARy.cA/MAGAzINe serviCe to soCie t y

What is the hardest part of your job?Becausemyjobisabout75percentresearchand25percentclinical,themostdifficultthingisjuststrikingtherightbalance.It’schallengingtokeepcompetitiveinbothrealms.Iwouldsaythisisthecaseforallclinicianscientists—howtochooseyourareaofinteresttoensurethatyourresearchcareermeldswithyourclinicalcareer.Thatbeingsaid,it’salsoprobablythegreateststrength.Myresearchinformsmyclinicalpracticeandmyclinicalpracticeinformsmyresearch.

What is the hardest part of being a pathologist in general?Clinicianslooktousforthefinaldiagnosis.Itcarriesalotofresponsibilityandsometimes,inreality,wedon’tknowalltheanswers.That’sthemostuncomfortablesituationforapathologist—tosaywhenyoudon’tknow.Ithinkthesecondhardestpartisthatfewpeopleunderstandwhatwedo.Therearemanymisconceptionsaboutthefield.

What kind of interactions do you have with patients?Pathologistsinteractalotwiththehealth-careteambutwe’reonestepremovedfromthepatients,thoughImightseethemintheelevatorsandhallways.Buteventhoughwedonothavedirectpatientcontactforcare,whatwesayoftendeterminesandchangesthecourseofhowthepatientistreated.Whilewemaynotsitdownwithpatientsandexplainwhatwesawunderamicro-scope,whatwedoiscriticallyimportanttothetreatmentspatientsreceive.

Being that you’re often far removed from patients, do you ever find yourself getting emotionally connected to your cases?Yes,allthetime.Youcan’thelpbutfeelaconnectiontothatpersoneventhoughyou’venevermetthem.Whenwereceiveacase,thespecimencomeswithapieceofpaperthatdoesn’tnecessarilyhaveapictureorlifestoryofthepatient,but

genome,andmanydisease-associatedmutationsarebeingdiscovered.Nowthechallengeistofigureoutwhicharethedriversintumourgenesisandmain-tenance,andwhicharethepassengers.Tosortthesequestionsoutyouneedgoodmodelsystemsinwhichtotestthefunctionsofthesegenes. Ialsointerfacewithsomelargercollaborativeprojectsandprovidepathologyexpertisetothoseefforts.I’llhelpdesignexperimentscontributingthepathologypointofview.Also,whennewdrugsaretestedinanimalmodels,forinstance,Iwillevaluatethetissueafterwardsanddetermineifthereisaneffectornot,andifthereareanychangesinmorphologyorgrowth. Lastly,Irunatumourbankforbraintumoursandarangeofpediatrictumours.Thebankisaresourcethat’sopentootherresearchers.We’rebuildingthiscollectiontoempowertumour-relatedstudies.Patientsareaskedforconsentbeforetheirtumourtissueisplacedinthetumourbank.It’sagreatwayforpatientstobeengagedinresearchandhelpfuelfuturediscoveriesabouttheirtypeofdisease.

demographicinformationandafewwordsabouthowtheypresentedtoclinicalattention.IfIseeafrontallobetumourfroma40-year-oldfemaleitishardnottothink,oh,thatcouldbeme.Ialsohavetwokids,andIseealotofpediatricbraintumours;whenyouseethediagnoses,especiallyifit’smalignant,youthinkhowterribleitis.WealsodiscussourcasesandthepatientsintumourboardsoIhearaboutthepatient’streatmentcourse.Buttherearegoodstoriestoo.OnetimeIwaslookingatalesionthatwasthoughttobeahighlymalignantbraintumouronimaginganditturnedouttobeaparasite.Ithoughtwow,thisguyjustwentfromcertaindeathintwoyearstowe’llgiveyousomespecialantiparasiticmedicineandseeyouinfollow-up.Itmademewanttogivetheguyahigh-fiveeventhoughIdidn’tknowhim.

What kind of interactions do you have with other health-care professionals?Weinteractalotwithclinicians.Whenwemakeourdiagnoses,ifit’sunusualinanyway,we’reonthephonewiththem,lettingthemknowit’sanunusualcase,talkingaboutotherteststhatmightbeuseful,andlettingthemknowwhattowatchoutfor.Wearepresentintumourboardrounds,alongsidetheoncologist,theradio-oncologist,theradiologistetc.Wearetheretodiscussthe

as a neuropathologist, what kinds of cases do you see?EventhoughIhavemyowninterestinneuro-oncology,I’mtrainedtoexaminematerialacrossawidediseasespectrum.Forinstance,IneedtoknowaboutneurodegenerativediseasessuchasAlzheimer’sDisease,Parkinson’sandALS;cancersofthebrain,infectiousdiseasesthataffectthenervoussystem,andinflammatoryprocessessuchasmultiplesclerosis.Thoseareallintheparametersofaneuro-oncologist’spractice.

What do you like most about being a neuropathologist?Atabaseline,thebrainandthecellsthatcompriseitareinterestingthemselves.Butthereisalsoacertainactivationenergyrequiredforasurgeontobiopsythebrain.It’snottrivial.Neuropathologistsonlygetspecimensthatarereallyimportant.Toputitbluntly,there’sahighlikelihoodofhavingsomethinginterestinginyourmaterial—ahightreasure-to-trashratio.Also,neuro-pathologycasesareoftencomplex.Ireallyliketheproblemsolvinganddelvingdeepintowhatitis.

pathologyoftumoursandtomakesurethatourpathologyeithershowswhateveryoneelseisthinkingtoconfirmthatwe’retakingtherighttack,orwhetheritshowssomethingdifferentandleadstoanalternatecourse.

What would you say to anybody interested in pathology?Talktoapathologist!Icouldn’tbehappierwithwhatIchose.Itisfordifferentpersonalities,andifyouneedalotofglory,youwon’tfinditinpathology.We’reverylow-key,butit’sintellectuallychallengingandfascinatingwork.Forthosewhomightbeconsideringbasicortranslationalresearchcareers,it’salsoagreatwaytofuseclinicalworkwithresearch—youusemuchofthesameskillsetsoit’sagoodwaytoblendthetwo.Yourscheduleandtimeoncallarealsomorepredictablethanmanyotherfields,sowhetheryourinterestisresearchorsomethingelse,acareerinpathologyallowsmoreattentiontobepaidtothosepursuits.

What is your research?AlotofwhatI’minterestedindoingismakingnewandbettermodelsofbraintumoursandstudyingtheearlyeventsinthegenesisofbraintumours.I’malsoinvolvedinseverallargerprojectstosequencethegenomesofcertainbraintumourtypestolookfornewgenemutations.It’sanincrediblyexcitingtimeinscience.Wecannowsequenceeverygeneinthehuman

STOry COnT inueD

“ You can’t help but feel a connection to that person even though you’ve never met them.”

DiDyOuknOw?

PathoLogy is the study of diseases and diagnoses. anatomic pathology deals with looking at tissues that can come from anything that is removed from a patient, either surgically or from an autopsy. Other areas related to anatomic pathology that also fall under the pathology and laboratory medicine umbrella are specialties such as clinical chemistry and microbiology, among others. There are many different areas of pathology such as dermatopathology (focusing on the skin), forensic pathology (determining cause of death) and hematopathology (focusing on diseases of the blood cells). Dr. Chan is a neuropathologist, which is a pathologist who specializes in tissue and molecular diagnoses of anything neurologic such as the brain and the spinal cord.

Pathology residency programs at uCalgary

the Department of Pathology and laboratory Medicine accepts three anatomic pathology residents, one neuropathology resident, and two general pathology residents each year. the residency programs are five years. For more information on pathology training at the University of Calgary, see pathology.ucalgary.ca/residency_programs

04 meDiCine.uCalgary.Ca /magazine serviCe to soCie t y

Quilting for a causeAs part of the university’s annual United way campaign, Faculty of Medicine staff members Carol walsh, leslie Mcgill, valerie Martin, shelley Mohl, robin Fisher and Anne heiligsetzer crafted a beautiful quilt, on behalf of the libin Cardiovascular institute of Alberta, that was raffled off for nearly $1,000. in the photo: Carol walsh, valerie Martin, leslie Mcgill and shelley Mohl. the Faculty of Medicine raised over $10,000 for United way this year.

A day in the lifehigh school students got a first-hand glimpse of what being an MD student is like when they were invited to the Faculty of Medicine for a morning in December 2012. the annual event put on by first-year medical students is designed as an opportunity for high school students to explore medicine as a career possibility. Approximately 150 high school students participated—21 of which visited from rural locations.

An apple a dayin response to the rise of childhood obesity rates and the increase of unhealthy food choices available to children, medical students from the University of Calgary’s Faculty of Medicine created the Apple a Day program—a program designed to teach children about the importance of making healthy food choices. the initiative sends student volunteers into elementary school classrooms where they use fun and interactive tools to teach students about nutrition. this past fall, the program visited eight classrooms in the Calgary area, and organizers anticipate visiting another eight this spring.

In the newsIn the community

When BaCteria enterthebloodstream,it’spossiblethatsepsis—morecommonlyreferredtoasbloodpoisoning—canoccur.Anewstudyhasdiscoveredoneofthewaysthebodyclearsbacteriafromthebloodstream,whichcouldpotentiallyhelpresearchers

understandwhysomepeoplebecomesepticandothersdonot. Thestudy,whichwasconductedinanimalmodels,foundthatneutrophils—atypeofwhitebloodcell—releaseslargespider-likewebsthathelptocatchthebacteria.Thenetsarecoveredintoxicchemicalsthatnotonlydestroythebacteria,butcanbeharmfultothehumanbody.PaulKubes,PhD,oneofthestudy’sauthorsandamemberoftheUniversityofCalgary’sSnyderInstituteforChronicDiseases,saysthateventhoughthisprocesshasbeenshowntobeanessentialpartoffightingoffsepsis,it’snowthoughtthatitmayalsocontributetothedamaging,andpotentiallyfatal,effectsofthedisease.

6 Paul Kubes, PhD, is supported by Alberta innovates – health solutions.

CaLgary BUsinessman,

philanthropist,andsupporteroftheUniversityofCalgary,DavidO’Brien,wasinductedintotheCalgaryBusinessHallofFameinOctober2012.TheHallofFamehonoursthelifetimeachievementsofoutstandingsouthernAlbertacitizenswhohavehelpedshapeourprovincethroughtheirbusinesssuccess,entrepreneurialspiritandphilanthropiccontributions,andaresubsequentlyservingasrolemodelsforsociety. O’BrienandhiswifeGailhavebeenkeysupportersoftheUniversityofCalgaryandtheFacultyofMedicineforyears.A$5-milliongift

fromthecoupleplayedapivotalroleinthedevelopmentoftheBachelorofHealthSciencesProgram,whichisnowhousedprimarilyintheO’BrienCentrefortheBachelorofHealthSciencesProgram—namedinrecognitionandappreciationofthegift.

universitysuPPOrterreCOGnizeDsePsisDisCOveryMaDe

a team oF Canadianscientistsandclinicians,ledbyDr.MichaelHilloftheCalgaryStrokeProgramatFoothillsMedicalCentreandtheUniversityofCalgary’sHotchkissBrainInstitute(HBI),havedemonstratedthataneuroprotectantdrug,developedbyDr.MichaelTymianskiattheKrembilNeuroscienceCentre,locatedattheTorontoWesternHospital,protectsthehumanbrainagainstthedamagingeffectsofstroke.

Thislandmarkclinicaltrialwasarandomized,double-blinded,multi-centretrialthatwasconductedinCanadaandtheU.S.ThestudyevaluatedtheeffectivenessofNA-1[Tat-NR2B9c]whenitwasadministeredaftertheonsetofsmallstrokesthatareincurredbypatientswhoundergoneurointerventionalprocedurestorepairbrainaneurysms.Thistypeofsmallischemicstrokeoccursinover90percentofaneurysm

patientsaftersuchaprocedure,butusuallydoesnotcauseovertneurologicaldisability.

5 Dr. Michael Hill is supported by Alberta innovates – health solutions.

CLiniCaLtriaLshOwsDruGPrOteCtsBrainFrOMstrOkeDaMaGe

23 news

5

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25UCALGARY MEDICINE SPRING 2013

In the newsIn the news

researChers at the

UniversityofCalgary’sAlbertaChildren’sHospitalResearchInstituteforChildandMaternalHealthwillbeexaminingtheuseofnon-invasivebrainstimulationasapotentialnewtreatmentfordepressioninadolescents.PrincipalinvestigatorFrankMacMaster,PhD,willteamupwithpediatricneurologistDr.AdamKirtontoleadthepilotstudy—afirstofitskindinCanada.

a stUDy From theUniversityofCalgary’sHotchkissBrainInstituteshowsthereisevidencetosupportanewdrugtherapycallednabilonetotreatdiabeticneuropathy,ornervepain.Researchersenrolled60patientswithdiabeticneuropathyina12-weekplacebocontrolledclini-calstudy.Attheendofthestudy,patientsreportedlesspainandanimprovementinsleepandanxietywhentakingnabilone.Thestudygivesdoctorsmoreevidence

CanaDa’s greatest

knoW-it-aLL returnedtotheDiscoveryChannelforasecondseasonandfeaturedaUniversityofCalgarymicrobiologistasoneofthecontestants. CarlaDavidson,PhD,specializesinvaccinedevelop-mentandscienceoutreach.Sheisoneof10contestants

Thepilotinvolvestheuseofnon-invasivetechnologycalledtranscranialmagneticstimulation(TMS)tostimulatethefrontallobe—theexecutivedecision-makingpartofthebrain—tooffsetnegativethoughtsproducedbyotherpartsofthedepressedbrain. TMShasalreadyprovedeffectiveintreatingadultswithdepression,helpingtoputsomeintoremissionafterafewweeksoftreatment.

tosupportitsprescriptionfortreatingneuropathypainindiabetics. NabiloneisapprovedforusebyHealthCanadaandtheFDA,andiscurrentlyusedinCanadatotreatnauseainchemotherapypatients.Itisasyntheticcannabinoid,whichmimicssomeofthechemicalcompoundsofcannabis,ormarijuana.

competingintherealitytelevisionshowforthetitleofCanada’sGreatestKnow-it-All. Thecontestantswerepickedfromover3,000submissionsandcomefromawiderangeofprofessions,experiencesandeducationalbackgrounds.Duringtheshow,theycompeteinaseriesofphysicalandmentalchallengesdesignedtoputtheirproblemsolvingskillsandteamworktothetestbyansweringquestionslikehowthingsareengineered,driven,built,poweredandevenblownup.

DruGOFFersnewPainManaGeMenttheraPyFOrDiaBetiCs

researChers at the

UniversityofCalgaryarehopingtohelppeoplewithosteoporosisbypredictingwhichpatientsaremorelikelytofracturetheirbones.Havingthisinformationwouldbetterallowdoctorstodecidewhichpatientsmayneedpharmaceuticalorlifestyleinterventions. Usingahighresolutioncomputedtomography,ormicro-CT,scannertoanalyzethearchitectureofthebone,scientistsscannedthewristsof44womenwithahistoryoflow-traumafractureand88age-matchedcontrolsubjectsthatdidnothavelow-traumafracture.Basedontheresults,researchersdemonstratedthatthemachinecould

identifybonemicro-architecture,densityandstrengthinformationandcouldthereforebeausefulpredictiontool.ThefindingswerepublishedaspartofastudyintheNovember2012onlineeditionofOsteoporosis International.

OsteOPOrOsisstuDyLOOksatBOnearChiteCturetODeterMineFraCturerisk

COMPetinGtOBeCanaDa’sGreatestknOw-it-aLL

a neW DiagnostiC tooL isnowbeingusedattheUniversityofCalgary’sFacultyofMedicine.TheBioFlashallowsresearcherstodetectbiomarkers,suchasantibodies,inthebloodofpatientswithvariousautoim-munediseasessuchaslupusandarthritis.Thetechnologyisarapidassaythataidsintheearlydiagnosisofpeople

affectedbythesediseases.UsingtheBioFlash,researchershavetheabilitytoprocessupto1,000bloodsamplesinlessthanaday—somethingthatcouldtakeseveraldaysusingotherbiomarkertechnologies.ThemachineisalreadyapprovedforusebyHealthCanadaandiscurrentlybeingusedtoprocessbloodsamplesfromsouthernAlberta,acrossCanadaandaroundtheworld.Inaddition,itisbeingusedtodevelopnewadvanceddiagnostictestsforavarietyofautoimmunediseases.

8 Dr. Marv Fritzler, a University of Calgary rheumatologist and member of the University’s McCaig institute for Bone and Joint health and snyder institute for Chronic Diseases, with the BioFlash Machine.

newMaChineCOuLDheLPDiaGnOseautOiMMuneDiseasesearLier

heLPinGteenswithDePressiOn

meDiCine.uCalgary.Ca /magazine news

aCCorDing to the CanadianLiverFoundationtherearemorethan100typesofliverdiseaseaffectingmen,womenandchildren.TheJointLiverInstitute,auniquepartnershipbetweentheUniversityofCalgary’sFacultyofMedicineandCapitalMedicalUniversity(CMU)inBeijing,China,aimstoadvanceresearch

andpatientcareforthoseaffectedbyliverdiseaseinbothcountries. Theinstitute,whichofficiallyopenedinCalgaryinDecember2012(June2011inBeijing),hascreatedopportunitiesforcollaborativeresearchandtrainingexchanges.Theinstituteisalsocurrentlyworkingtocreatejointbiobankaccessbetweenthetwoinstitutions.Biobankshouselargenumbersofbiologicalsamplesnecessaryforresearchandallowforfasteraccesstodatabymultipleresearchers.

9 Dr. Ning Li (left), president of youAn hospital in Beijing, and Dr. Sam Lee (right), Calgary head of the Joint liver institute.

JOintLiverinstituteOFFiCiaLLyOPen

the University oF CaLgary’s

iGemteamtooktheBestHumanPracticesAwardatthe2012worldchampionshipheldatMITinBostoninNovember.Theteamwasnamedoneofthetop16teamsintheinternationalcompetitionwhichincluded72finalistsfromsomeoftheworld’smostprestigiousuniversities.Thetop16globalrankingforCalgary’s2012iGEMteamcomesafter192universitiesparticipatedinlocalandregionalpreliminary

competitions.Theaward-winningprojectfeaturesFREDandOSCAR,twobiologicalsystemsdesignedtodetectanddestroytoxinsinAlberta’stailingsponds.FRED(FunctionalandRobustElectrochemicalDetector)measurestheleveloftoxinsinamorecosteffectivewaythanconventionalchemicalmethods,whileOSCAR(OptimizedSystemforCarboxylicAcidRemediation)removesthetoxiccomponentsfromtailingsandconvertsthemtohydrocarbonssuchasdiesel.

GLOBaLreCOGnitiOnFOriGeMteaM

7 iGem Team

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estaBLisheD in 1967, withthefirststudentsadmittedin1970,theUniversityofCalgary’sFacultyofMedicineisoneoftheyoungestmedicalschoolsinCanada.Despiteitsyouth,anewhistorybookisnowintheworkstoshowcasetherichhistoryofthemedicalschoolandthoseinvolvedinitspast,presentandfuturesuccess,andtodemonstratetheimpacttheschoolhashadonthecommunitylocally,nationallyandinternationally. AnearlyeffortbyDrs.LaurieFisher,CyrilLevineandTomSaunderstowriteafacultyhistorywasstartedbutnevercompleted.ThenewbookprojectisbeingspearheadedbyDr.RobertLampard,formerdirectoroftheFoothillsHospitalandamemberoftheCalgaryHistoryofMedicineSociety,incollaborationwithDrs.DavidHogan,JamesWrightandFrankStahnisch.LampardisnostrangertowritingbooksonthehistoryofmedicineinAlberta,havingindividually

authoredthreeandco-authoredafourth. Theteamofauthorsisaimingfora2017publicationdatetocoincidewiththe50thanniversaryofDr.WilliamCochrane’sappointmentasthefirstdeanofmedicine.

Why tell the story of the Faculty of medicine?“ThestoryoftheFacultyofMedicineneedstobetold,”saysLampard.“Primarilycreatedtotrainfamilyphysiciansatatimewhentherewasaperceivedshortage,thefacultyhasmovedbeyondthis,evolvingintoaschoolthateducatesphysiciansforafullspectrumofactivities:fromprimarycaretospecialtycare;tocareersineducation,managementandresearch.” Hesaystheundergraduatemedicalprogram,oneofonlytwoinNorthAmericawithathree-yearprogram,hasproducedcountlessphysiciansandcontinuestobringmanyhighprofilephysicianstoCalgarytodotheirresearch.

Additionally,despitebeinganationalleaderinhealthresearchwithanexcellentinternationalreputation,inLampard’sview,thefaculty’srecordofsuccesshasbeenunderacknowledged.

What story will the book tell?Thebookwillconsistofsixchapters,eachofwhichwillfocusonthefirstsixdeansofthefaculty.Lampardalsohopestoincludepersonalstoriesfromfacultyandstudents,bothcurrentandalumni. Dr.FrankStahnisch,anassociateprofessorwithajointappointmentintheDepartmentofCommunityHealthSciencesandtheDe-partmentofHistory,believesthebookwillprovideanexcitinghistoryofthefaculty,highlightingitsgreatachieve-mentsandshowcasingtheconditions(local,regionalandnational)underwhichitoperated. Dr.JimWright,headoftheDepartmentofPathology

andLaboratoryMedicine,hasformaltrainingasamedicalhistorian.WrightsaysthefinishedprojectwillprovideasenseofhowtheFacultyofMedicinehasevolvedandwillprovideinsightintoitsdeansandthechallengesoftheirrespectivetimes. Dr.DavidHogan,aprofessorintheDivisionofGeriatricsinthedepartmentsofmedicine,clinicalneurosci-encesandcommunityhealthsciences,saystheprojectwillgivereadersasenseofhowtheFacultyofMedicinegottowhereitisandinwhatdirectionit’sheaded.“Ifwewanttocontinuetoprosper,wehavetolearnfromourpastsuccessesandfalsestarts,”hesays.

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thehistoryof,andgivesaframeworkfor,howandwhythingsarethewaytheyare.Andtherearealwaysthingshappeninghere.Thefuturelooksbright.”

Good reads

taking history to heart By lynda sea

traCe the FaCt thatoverthelastdecadeCalgaryhashadthelowestdeathrateinCanadafromheartattacksandyou’llfindthereasonbehindthiscity’sworld-classreputationincardiovascularsciencesstemsfromtheLibinCardiovascularInstituteofAlberta—anentityofboththeUniversityofCalgaryandAlbertaHealthServices. Hearts, Minds & Vision: Roots of the Libin Cardiovascular

Institute of Alberta,1930-2010(KingsleyPublishing,2012),tellsthestoryofLibinresearchersandclinicianswhodedicatethemselvestosaving,extendingandimprovingthehealthandlivesofsouthernAlbertans.AuthorsDr.D.GeorgeWyse,Dr.J.RobertLampard,BarbaraKermode-ScottandAl-KarimWallicapture80yearsofchangesinthelocalcardiovascularlandscape

andshareinspiringhumanstoriesofthepeoplebehindthediagnoses,treatmentsandlife-savingresearch. “TheLibinstory,inaway,reflectsthegeographicmovementofthecentreofthecountrypolitically,economically,scientificallyandsociallyinawestwarddirection,”saysWyse. Theblendofarchivalimages,writtenmemoirsandinterviewswithleadingcardiovasculariconsoffersaninsightfulinsiderperspectiveonhowCalgaryhasevolvedsincethe1930s,whenCalgary’sfirstheartspecialist,Dr.EarleP.Scarlett,arrivedwithanelectrocardiograph(ECG)machine.ProgramsandbreakthroughshavesinceputCalgaryontheinternationalmapforcardiovascularresearch,educationandpatientcare. “ThebookisagreatrecordofwhathasgoneoninCalgary,”saysDr.Eldon

Smith,professoremeritusattheUniversityofCalgaryandformerDeanoftheFacultyofMedicine.“It’sareadablebookthatreallydoeslayout

The Libin story, in a way, reflects the geographic movement of the centre of the country politically, economically, scientifically and socially in a westward direction.

Hearts, Minds & Vision: Roots of the libin cardiovascular Institute of Alberta, 1930 – 2010 (Kingsley Publishing, 2012), $24.95, is available through the university of Calgary bookstore and online at amazon.ca.

Be part of the History of the Faculty of Medicine project

if you would like to share personal stories about the Faculty of medicine and are a current or former faculty member, student or alumni, please contact Dr. robert lampard at j.robert.lampard@gmail.com

new book to showcase rich history of the Faculty of medicine By Aisling gamble

news26 MeDIcINe.ucAlGARy.cA/MAGAzINe

and the alumnus of Distinction award goes to…

AlUMnimeDiCine.uCalgary.Ca /magazine

“it means a Lot tomethattheUniversityofCalgary’sFacultyofMedicinewouldrecognizeme,”saysAdams.“Iknowtheytookachanceonmelongagoasadiffer-enttypeofmedicalstudent,comingfromtheartsandasanaboriginalstudent,butI’dliketothinkthatI’veshownthatadiverseclassroombegetsdiversepracti-tioners.I’velovedworkingwithandforaboriginalcommunitiesastheirdoctor.” AftercompletinghismedicaldegreeattheUniversityofCalgary,Adamsservedaschiefresidentintheaborigi-nalfamilypracticeprogramatSt.Paul’sHospitalinVancouver,B.C.HealsocompletedamasterofpublichealthatJohnsHopkinsUniversityinBaltimore,Md.Hewentontowinthe2005(provin-cial)FamilyMedicineResidentLeader-shipAwardfromtheCollegeofFamilyPhysiciansofCanada(CFPC)andwasthe2005nationalwinneroftheMurrayStalkerAwardfromtheCFPCResearchandEducationFoundation. Currently,AdamsisaboardmemberoftheCanadianPartnershipAgainstCancer,amemberoftheProvincialCommitteeonFirstNationsHealthandservesontheadvisorycommitteeoftheNationalCollaboratingCentreforAboriginalHealth.Additionally,heiscurrentlyinvolvedinresearchtoimprovemodelsofhealth-careservicedeliverytoinner-cityaboriginalsandisalsoinvolvedinastudytodeterminewaystoimproveaccesstomentalhealthandaddictioncareforthesamepopulation. InApril2012,AdamswasappointeddeputyprovincialhealthofficerfortheprovinceofB.C.Heisthepast-presidentoftheIndigenousPhysiciansAssociation

ofCanadaandthepastdirectorofthedivisionofAboriginalPeoples’Health,FacultyofMedicine,UniversityofBritishColumbia.Hewasappointedthefirst-everaboriginalhealthphysicianadvisorintheOfficeoftheProvincialHealthOfficer,B.C.MinistryofHealthandwiththe(B.C.)FirstNationsHealthCouncil. Adamsisalsoasuccessfulactorappearinginnumeroustelevisionseries,movies,andlivetheatreproductionsincludingtheEmmy-winningLostintheBarrensanditsnominatedsequelCurseoftheVikingGrave.HealsostarredasThomasBuilds-The-FireinSmokeSignals,whichwonthecovetedAudienceAwardforbestfilmandtheFilmmakersTrophyattheSundanceFilmFestivalin1998.HehaswonbestactorawardsfromtheAmericanIndianFilmFestivalandtheFirstAmericansintheArts,aswellasa1999IndependentSpiritAwardforBestDebutPerformanceforhisportrayalofThomasinSmokeSignals.Recently,healsowonaGeminiAwardforco-hostingthe2011NationalAboriginalAchievementAwardswithAdamBeach.

14 + 15 Dr. evan Adams receiving the 2012 Alumnus of Distinction Award.

Dr. evan Adams, MD 2002 (pangolin), was awarded the 2012 Faculty of Medicine Alumnus of Distinction Award owing to his outstanding contributions to the community. By leigh hurst

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University of Calgary researcher Dr. Marvin Fritzler took the top honour, outstanding Contribution to the alberta science and technology Community, at the prestigious alberta science and technology Leadership (astech) Foundation annual awards gala.

Awards and recognition

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FacultyofMedicinegraduatestudentsBraedon McDonaldandSachin PendharkarwerehonouredwiththeprestigiousChancellor’s Graduate Medal and Governor General’s Gold Medal,respectively,attheNov.13,2012convocationceremonywithboththeGovernorGeneralandtheChancellorinattendance.EstablishedtoacknowledgethecontributionsofthechancellorsoftheUniversityofCalgary,theChancellor’sGraduateMedalcelebratesexcellenceinacademicachievementatthegraduatestudieslevel.TheGovernorGeneral’sGoldMedal(Master’s)recognizesastudentwhohasachievedthehighestacademicdistinctionthroughoutaprogramofstudy.

EachyeartheCanadianAssociationofGastroenterology(CAG)recognizestheoutstandingteachingandresearchachievementsof

Award.Dr. Richard Frayne and colleaguesreceivedtheKillamInterdisciplinaryResearchPrize.Dr. Sylvain CoderrewasawardedtheKillamAwardforLeadershipinTeaching.

IncelebrationoftheCalgaryStampede’sCentennial,the2012WesternLegacyAwardshonoured100OutstandingAlbertanswhohavepromotedwesternhospitality,prideofplace,integrityandcommitmenttocommunity.FourofthehonoureeshavetiestotheFacultyofMedicine:Dr. Abdul Rahman, Dr. Greg Powell, Dr. Robert Church andMrs. Ann McCaig.

TheAlbertaMedicalAssociation(AMA)honouredsevenFacultyofMedicinemembersfordistinguishedservice,long-standingserviceandlong-termmembership.TheAMAMedalforDistin-guishedServicewasawarded

itsmembersthroughtheprestigiousCAGResearchandEducationAwards.Threeofthesixawardrecipientsfor2013arefromtheUniversityofCalgary’sFacultyofMedicine:Dr. Sylvain Coderre,CAGEducationExcellenceAward;Dr. Paul Beck,CAGVisitingResearchProfessorship;Dr. Gil Kaplan,CAGYoungInvesti-gatorAward.

AvenueMagazine’sTop40Under40isanannualselectionofCalgary’sbrightestandmostactiveleadersundertheageof40.TheUniversityofCalgaryalumniandcampusconnectionstothisyear’slistareasstrongasever.TheFacultyofMedicineextendscongratulationsto:Christophe Altier, PhD, Dr. Shelagh Coutts, Dr. Breanne Everett, Deborah Kurrasch, PhD, Minh Dang Nguyen, PhD,andDr. Nicola Wright.

ThreemedicinefacultymemberswererecognizedbytheKillamTrustorganizationfortheiroutstandingleadershipcontributions.Dr. Cy FrankwasawardedtheKillamResearchLeader

toDr. Ian LangeandDr. Eldon Smith.TheAMALong-ServiceAwardwasawardedtoDr. Christopher J. (Chip) Doig, Dr. Ronald T. Garnett, Dr. David B. Hogan,andDr. M. Daniel McGowan.Dr. J. Paul RyanreceivedthedistinctionofMemberEmeritus,whichrecognizessignificantcontributionstothemedicalprofession,seniorityandlong-termmembershipwiththeAMA.

Dr. Douglas Hamilton,formerNASAFlightSurgeon,wasawardedtheExceptionalEngineeringAchievementMedalbyNASA.ThisAgencyHonorAwardisgivenforaccomplishmentsfaraboveothersinquality,scope,andimpactwhichareexplicit,significant,anddemonstrateresults.

10 Braedon McDonald 11 sachin Pendharkar 12 2012 western legacy Award 13 Dr. Douglas hamilton

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What is a pangolin?

a pangolin is a scaly anteater. The university of Calgary’s Faculty of medicine began formally naming its mD classes after animals in 1975 when a professor became frustrated with his class and called them “a bunch of turkeys”. The name stuck and so did the tradition, with each medical class naming the class behind them. For obvious reasons, the inaugural medical class, the class of 1973, identify themselves as guinea pigs.

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Learning &The 3rd Annual Dr. Clarence Guenter Lecture on Global Health

Health Development in Rural Nepal: learning fromthe Kathmandu experience

4:00pm, Thursday, April 4th, 2013Reception to follow

Featuring

Professor Keder BaralChair, Department of Community Health Sciences,Patan Academy of Health Sciences, Kathmandu, Nepal

Professor Arjun Karki, MDProfessor of Medicine and Medical EducationPatan Academy of Health Sciences, Kathmandu, Nepal

Public lecture hosted by:The Office of Global Health & InternationalPartnerships and the Institute for Public Health

Limited seating

Pm agreement no. 41095528

Return undeliverable Canadian addresses to:

university of calgary Faculty of Medicinecommunications and Media Relations7th Floor, TRW Building3280 Hospital Drive NWCalgary, Alberta T2N 4Z6

41095528