UBC Medicine

Imagine your boss coming to your cubicle and, in the course of dumping yet another assignment on your desk, says, “Oh, and one more thing: Eat more fruits and veggies. You’ll thank me for it. Carry on!” A more subtle version of that scenario is unfolding at three universities in B.C., thanks to research by Carolyn Gotay, a professor in the School of Population and Public Health. An expert in cancer prevention, Dr. Gotay is leading “Be Well at Work,” a three-year experiment aimed at getting people to live healthier lives by winning their hearts and minds at the workplace. The three research sites — UBC’s Okanagan campus in Kelowna, the University of the Fraser Valley in Abbotsford, and Thompson Rivers University in Kamloops — are using three different programs to encourage employees at those institutions to pursue better nutrition and more exerise. One program is focused on individuals, another is focused on group activities, and a third is a blend of the two. The general premise makes sense, given how employees are such a captive audience – more than two-thirds of Canadians spend 60 percent or more of their time at work. The data will come through health risk questionnaires that employees will be asked to complete at various points during the campaigns. It will be interesting to see whether our bosses are any better than our mothers at getting us to eat our veggies. Read more about “Be Well at Work” in UBC Medicine magazine.

The best innovations often arise from the joining of two distinct, independently developed innovations. Two members of the Faculty of Medicine are on their way to proving that principle yet again. Peter von Dadelszen, a specialist in high-risk pregancies, has devised a model for diagnosing pre-eclampsia (high blood pressure during pregnancy) that is geared toward developing countries. Mark Ansermino, an anesthesiolgist, is co-inventor of a mobile phone-based pulse oximeter, which uses a probe fitted over a patient’s finger to measure blood oxygen levels, and is perfectly suited for use in low-resource health care settings. The latter invention has many potential applications, and one of them happens to be detecting pre-eclampsia. So, in one of those cases of interdisciplinary fusion, Dr. von Dadelszen and Dr. Ansermino have joined forces to customize the mobile pulse oximeter for pre-eclampsia detection. Their proposal was deemed so compelling that it won a seed grant of $250,000 from an international competition, “Saving Lives at Birth: A Grand Challenge for Development” — one of just 19 chosen from among 600 applicants. (The backers include the Bill & Melinda Gates Foundation, Grand Challenges Canada, the U.S. Agency for International Development, the World Bank and the government of Norway.) The doctors will use the funding to test the application and hardware in Zimbabwe and South Africa, comparing results with clinics that aren’t using the technology. Read more about their ingenuity in the fall issue of UBC Medicine magazine.

The biggest challenge facing life scientists — beyond curing disease, of course — is explaining what they do. Most of them are labouring on molecular mysteries that are difficult to visualize and involve a cascade of processes, and thus elude easy comprehension by the general public. And in these attention-deficient times, if it’s not easily understood, people move on. But explaining those mysteries and cascades to people outside the lab is crucial if scientists hope to continue to get support for their work. That was probably why the University of Queensland in Australia created the “Three Minute Thesis” competition. The 3MT, as it’s called, is a geeky version of “American Idol”: graduate students get up before a panel of judges and have three minutes to explain the breadth and signficance of their research to a non-specialist audience, in (you guessed it) three minutes. They can use only one slide and can’t use any electronic media or props. UBC held its first 3MT last spring – the first North American university to do so. To find out what it was like for one of the finalists, read her first-person account in the latest issue of UBC Medicine magazine.

The Verisante Aura detects melanomas. The VELscope highlights oral cancers. The PortaMon looks for bladder disease. Three distinct devices, but all three are examples of UBC researchers developing or deploying various forms of light to find pathologies that elude old-fashioned examination with the naked eye.

• The Verisante Aura (demonstrated in photo at right by one of its co-inventors, David McLean, a Professor and former Head of the Department of Dermatology and Skin Science) exploits a phenomenon known as the Raman shift — the change in energy when light is scattered by a chemical bond, in this case, the bonds found in tissue molecules. “The shift tells you something about the chemistry of the skin,” says Harvey Lui, Head of the Department of Dermatology and Skin Science, and one of the device’s co-inventors.
• The VELscope generates “blue light” that, when reflected and viewed through optical filters, can distinguish between healthy tissue (which emits a greenish glow) and cancerous tissue (no glow). UBC researchers are now leading a trial on 400 patients at nine sites across Canada to evaluate its effectiveness in reducing the recurrence of oral cancer.
• The PortaMon measures how much near-infrared light bounces back from the bladder wall when projected through the skin; the resulting data reveals oxygen levels and blood flow that indicate whether the organ’s muscles are functioning properly. A UBC team has found that the cellphone-sized device is as reliable as the current “gold standard” tests, urethral and rectal catheters, which are stressful and painful for patients.

Read more about these inventions — and UBC’s role in making the most of them – in the latest issue of UBC Medicine magazine.

It’s not terribly difficult to spare a woman from the dangers of pre-eclampsia, the sudden onset of high blood pressure during pregnancy. She must be hospitalized so that her blood pressure can be managed, her seizures prevented and her delivery induced, which is the only sure treatment. But in the developing world, identifying women who are at risk for pre-eclampsia and getting them to a hospital is hardly a given, and that’s why pre-eclampsia is the world’s second leading cause of maternal death. Peter von Dadelszen (pictured on left), an Associate Professor in the Faculty of Medicine, calls it a “social equity issue.” And he is determined to bring some balance to the situation through a multi-pronged, multi-year project that has received $7 million from the Bill & Melinda Gates Foundation. It will seek to monitor, prevent and treat pre-eclampsia in Africa, Latin America, South Asia and Asia-Oceania, tailoring the strategies to the particularities of each locale. One prong of that project will seek to create a “treatment pipeline” from remote villages to properly-equipped medical facilities in urban centres. Read more about Dr. von Dadelszen’s mission in the spring issue of UBC Medicine magazine.

Mark Ansermino (on left) is an anesthesiologist, whose job is to protect patients from pain or complications during surgery. Guy Dumont (on right) is an electrical engineer, whose specialty is control processes for wood pulp processing. Not a whole lot in common — at first glance. But these two UBC professors have been working together for years to make anesthesia safer through computing. One of their inventions precisely and instantly calibrates the amount of anesthesia to a patient’s level of consciousness. Another invention looks for patterns coming from more than 70 different sensors, teasing out signs of danger. They have even developed a vibrating belt that converts the data and warnings into something the anesthesiologist can feel, as well as as see on a monitor or hear through an audible alarm. Now Dr. Ansermino and Dr. Dumont are turning their attention to the developing world, where monitoring of patients under anesthesia is often limited to keeping a finger on someone’s pulse. Their work earned them the prestigious Brockhouse Canada Prize, which recognizes collaborations between scientists in engineering and the natural sciences. Read more about their work in the spring issue of UBC Medicine magazine.

When researchers make a significant new finding, the news is typically shared through publication in a journal, or perhaps a presentation at a conference; if they’re lucky, it might even get some coverage in the news media. But Dianne Miller and her team at BC’s Ovarian Cancer Research Program weren’t content to let their discovery percolate out through those usual channels — it was just too imporant. They had concluded, through painstaking research, that at least two-thirds of cases of a certain type of ovarian cancer actually originate in the fallopian tubes. If women who were undergoing hysterectomies or tubal ligations had their tubes removed, and other women with a proven genetic disposition to this cancer had their tubes removed, the incidence of such cancers could be reduced by as much as half. Half. So they launched a campaign — aimed at all obstetrician-gynecologists — to promote removal of fallopian tubes when performing hysterectomies and tubal ligations, which represents a dramatic change in standard practice. One component of their campaign was an educational video sent to all of BC’s 250 OB-GYNs. Their informal monitoring and feedback has indicated that clinicians in the province and beyond are following their advice. Read more about their efforts in the spring issue of UBC Medicine magazine.

In 2004, UBC embarked on a daring experiment in medical education. It began distributing the training of doctors around the province, beyond Vancouver and the Lower Mainland, to try to correct the imbalances that left many residents in places like northern BC scrambling to find physicians. By educating medical students in places like Prince George and Victoria, the thinking went, those future doctors would be more likely to set up practice throughout BC. Now, the first members of that first distributed class, having completed their four years of medical education and two years of residency, have become full-fledged family doctors.  And true to plan, some of them, like Jennifer Parker (on right) are working in underserved towns like Prince George and Ft. St. John — a trickle of new practitioners that promises to soon become a steady stream of new, BC-trained physicians. Read about three of them in April’s UBC Reports.

Power wheelchairs have brought a new level of mobility to disabled people, particularly for those who don’t have the strength or dexterity to propel themselves in a conventional wheelchair. But the machines aren’t so easy to use, and are often abandoned because of the users’ declining cognitive capabilities — or simply because they were never properly trained. An ideal chair would help its user navigate the obstacles of everyday life when the user needs it. That is the vision of CanWheel, a multi-university project headed up by Bill Miller, an Associate Professor in UBC’s Department of Occupational Science & Occupational Therapy. The six-year project will investigate how older adults use power wheelchairs, how they can use the chairs better, and how the chairs themselves can be improved through such technological tricks as voice commands, collision avoidance, route-planning and even object recognition. Read more about the project in UBC Medicine magazine.

A few years ago, the waiting room at Kelowna General Hospital’s emergency deparment was routinely packed, but not necessarily because there were too many patients and too few doctors and nurses. Sometimes, bottlenecks resulted in the physicians waiting for patients, even as the patients were waiting to see the physicians. Something had to change.  Fortunately, they were able to get coaching from their colleagues throughout BC, through a collaborative called “Evidence to Excellence.” Led by Julian Marsden, a Clinical Professor in the Department of Emergency Medicine, E2E is an “online community of practice,” in which physicians, nurses and front-line administrators share information through teleconferences, webinars and occasionally in person. With guidance from E2E, Kelowna General’s emergency department started “streaming,” whereby patients who don’t need to be put on a bed are tended to in chairs. The result: the waiting room is now usually empty, and patient satisfaction has increased from 78 percent to 92 percent. E2E is similarly credited with helping Chilliwack General Hospital improve its screening procedures for septic patients, lowering the sepsis mortality rate from 44 percent to 7 percent. Read more about E2E in the latest issue of UBC Medicine magazine.