40416 Annual Report - Nova Scotia Health Authority · 2020. 8. 25. · with a bout of depression and can be mistaken for such—but as Capital Health psychiatrist Dr. Claire O’Donovan

Capital Health ResearchAnnual Report 2008 2009

On our cover:

Capital Health Research Annual Report 2008 2009 Page 3

Research at the Point of Care

Dr. Ray LeBlanc, Vice President, Learning, Research and Innovation

Rallying against multiple sclerosis: Researchers tackle a disablingdisease from all angles

Better lives for patientsThe promise of biomarkers


Trudy Campbell (l), nurse practitioner and manager ofthe MS Research Unit, discusses how the MS

treatment is going with endMS summer student CindyMcCarron (centre) and patient Brenda Munro (r).

Destruction from withinIn multiple sclerosis (MS), the body’s own immunesystem attacks the myelin sheath, a fatty layer thatencases nerves in the brain and spinal cord andallows for rapid transmission of electrical signals.As the damage continues, patients develop tinglingand pain, as well as problems with vision, speech,information processing, balance, walking, and otherfunctions.

New avenues to treatment

Medical student Jahnavi Vadaparti (l) and PhD studentCJ MacMillan (r) examine brain maps to see how theblood brain barrier changes as MS progresses. Theywant to know if the formation of new blood vessels

makes it easier for immune cells to breach the barrierand attack the brain and spinal cord.

The call to end MS

A rich source of dataBecause the Dalhousie MS Research Unit at the QEIIHealth Sciences Centre follows most MS patients inNova Scotia—and has been since 1979—itsdatabases offer a wealth of information about howMS progresses and which drugs work best for whichpatients in terms of slowing disease progression,alleviating symptoms and delaying disability.


Funding sources of MS research:MS Society of Canada, endMS, Genome Canada,Canadian Institutes of Health Research

Students aim to endMS

Meghan Cash (BSc, Carleton) worked withDr. Sultan Darvesh to study how proteinscontaining metal ions may play a role in MS.

Saint Mary’s psychology student Jordan Warfordworked with Dr. George Robertson on a potentialnew immune therapy to reverse myelin damage inMS. He hopes to pursue graduate studies withDr. Robertson.

Cindy McCarron (BSc, Saint Mary’s) worked withDr. Virender Bhan and Trudy Campbell to studywhy patients continue, stop or switch medications.She is now pursuing a degree in nursing at theUniversity of Prince Edward Island.

Dalhousie neuroscience student NicoleStrowbridge worked with Dr. Sultan Darvesh toexamine enzyme changes associated with MSplaques in human brain tissues.

A chemistry student at Mount Saint VincentUniversity, Emma Higgins worked with Drs. IanPottie and Sultan Darvesh to synthesize chemicalcomponents of myelin which will be used instudies to identify new treatment targets for MS.

Medical student Ian Sarty (BSc, Dalhousie)worked with Dr. Christine Short in the Division ofPhysical Medicine and Rehabilitation to developthe protocol for a trial to see if botox can improvewalking ability in MS patients.

Medical student Jahnavi Vadaparti (BSc, St.Francis Xavier) worked with PhD student CJMacMillan and Dr. Alex Easton to explore how thepermeability of the blood brain barrier changes asMS progresses.


Seven students receivedfunding through the MS

Society of Canada’s endMSinitiative to pursue

research projects at CapitalHealth, Mount Saint

Vincent University andDalhousie University over

the summer of 2009.Back (l to r) Meghan Cash,

Jordan Warford,Cindy McCarron,

Nicole Strowbridge;front (l to r) Emma Higgins,

Ian Sarty,Jahnavi Vadaparti

Photo: David Grandy

Funding sources for genetics of bipolar research: Canadian Institutes of Health Research, National Alliance for Research inSchizophrenia and Affective Disorders (U.S.), Nova Scotia Health Research Foundation

It’s all in the genes: Dr. Martin Alda searches for causes and cures ofbipolar disorder

Dr. MartinAlda is on a

quest to findbetter

treatmentsfor bipolardisorder.

The importance of diagnostic precisionCorrectly diagnosing and treating bipolar at theoutset is critical. Bipolar disorder often beginswith a bout of depression and can be mistaken forsuch—but as Capital Health psychiatristDr. Claire O’Donovan has found, treating thesepatients with antidepressant medications oftendoes not alleviate their depression. In fact, shefound it can trigger bipolar symptoms such asmood swings, irritability, rage and even thoughtsof suicide.


Good vibrations: Researchers create solutions for hearing andbalance problems

Better bone conduction

Micro technology

The hearing and balance research team:

In the SENSE LAB:Dr. Manohar Bance, Dr. Jeremy Brown,Dr. Rob Adamson, Dr. Ross Deas,Laura Curran, Dr. James Lei, Rachael Schwartz,Alicia Benton, Dr. Phil Garland,Zahara Torbatian

In the EAR Lab:Rene van Wijhe, Dr. Jian Wang,Dr. Vivek Kaushik

At Dalhousie University:Dr. Steve Aiken, Dr. Michael Kiefte,Dr. Aaron Newman, Dr. Dennis Phillips,Dr. Marie Earl, Dr. Janie Astephen

Members of the SENSE Lab team (l to r): Dr. Phil Garland,Dr. James Lei, Dr. Rob Adamson, Dr. Manohar Bance, AliciaBenton, Dr. Ross Deas, and Dr. Jeremy Brown

On the podium is a giant model of a cochlea, the senseorgan in the inner ear that translates sound into nerveimpulses to be sent to the brain.


Funding sources for ear research: Atlantic Canada Opportunities Agency (ACOA) Atlantic Innovation Fund, QEII Foundation,Canadian Institutes of Health Research, Canada Foundation for Innovation, NSERC, Nova Scotia Health Research Foundation,

Dalhousie Medical Research Foundation, inNOVAcorp, Hearing Foundation Canada, Capital Health Research Fund,Department of Surgery Research Fund, Cochlear Corporation

Sensory overlap

Micro sized bone conductionhearing aids that are implantedunder the skin or placed insidethe ear canal, saving the need toimplant a titanium rod into thepatient’s skull, while improvingthe quality of sound.

A vibrating arm band that cuespeople with one sided hearing asto what direction a sound iscoming from, so they can locateand pay attention to the sourceof the sound.

.

New technologies in the works at Capital Health:

Sophisticated imaging devicesthat use ultrasound and fibreoptics (optical coherencetomography) to capture highresolution images of the middleand inner ear. Such images willhelp specialists diagnoseproblems and guide them in thedelicate business of insertingcochlear implants and otherhearing aids.

A new device for testingEustachian tube function and theeffectiveness of new CapitalHealth developed treatments forpatulous Eustachian tube (acondition in which the tubes stayopen and a person hears theirown voice and breathing veryloudly).

A ‘balance belt’ to help peoplewith inner ear related balanceproblems maintain a safe andstable footing.

Laser precisionDr. Manohar Bance is heading the world’s mostadvanced exploration of the mechanics of boneconduction hearing. He and his team are using the 3 DLaser Doppler Vibrator to measure how sound wavestravel over and through the skull, in three dimensions.Their findings will lead the way to more effective, lessinvasive, and less expensive bone conduction hearingaids, so that people with middle and inner eardamage can hear clearly. A large grant from theAtlantic Canada Opportunities Agency’s AtlanticInnovation Fund allowed the researchers to purchasethis sophisticated equipment.



Major new initiatives underway in Capital HealthCanadian Dementia Knowledge Translation Network launches in HalifaxThe Canadian Dementia Knowledge Translation Network marked its official launch this spring inHalifax. Headed by Capital Health’s Dr. Kenneth Rockwood, the network will ensure that researchfindings are widely shared and put into practice to benefit dementia patients everywhere.

“Historically, research results have only been applied in the local area where the research was done,since there hasn’t been a way to centrally gather, package and distribute new knowledge,” saysDr. Rockwood. “This network provides a vehicle for translating research findings and lessons learnedacross the country into more effective treatments and services for people with dementia.”

More than 120 researchers, as well as health care administrators, policy makers, leaders of Alzheimersocieties, caregivers and people living with dementia, have come together to form the network. Thenetwork will ensure that new knowledge is incorporated into clinical practice and education andtraining programs for health care providers. It will also reach out to patients and caregivers to learnmore about their needs and put knowledge in their hands that will help them in their daily lives. The$4 million project is funded by the Canadian Institutes of Health Research (CIHR), the AlzheimerSociety of Canada, the Ontario Ministry of Health and Long term Care, AstraZeneca Canada Inc. andPfizer Inc.

Geriatric medicine researchers:(l to r): Dr. Kenneth Rockwood,Dr. Paige Moorhouse, Dr. Laurie Mallery,Dr. Melissa Andrew. Missing from photo:Dr. Susan Freter, Dr. Chris MacKnight

First steps on the Atlantic PATHThe largest ever population health study in Atlantic Canada rolled out from Halifax in March. TheAtlantic Partnership for Tomorrow’s Health (PATH) opened its first assessment centre for studyvolunteers—at the same time opening a new front in the fight against cancer.

Epidemiologist Dr. Louise Parker is principal investigator of the $7 million Atlantic PATH project, whichwill recruit 30,000 Atlantic Canadian men and women between the ages of 35 and 69 over the next fiveyears. The researchers will collect lifestyle information, biological samples and physical measurementsfrom these volunteers, and follow their health for up to 30 years to determine what role lifestyle, theenvironment, and genetics play in the development of cancer.

“This study will provide an enormous bank of information for researchers to draw upon to help identifythe causes of cancer and, in turn, develop better detection, treatment and prevention methods,” saysDr. Parker, who holds the Canadian Cancer Society (Nova Scotia Division) Chair in Population CancerResearch. “The research is particularly important in the Atlantic provinces, which have the highest ratesof cancer in Canada. Each year, more than 13,400 Atlantic Canadians are diagnosed with cancer and6,300 die of it.”

The Atlantic PATH is part of the $42 million Canadian Partnership for Tomorrow Project.

Teamwork improves thyroid cancer care

Teamwork improves thyroid cancer care

Safer colonoscopy

Automated quality reporting


Research Roundup: Recent AdvancesImproving health care is a slow and steady process that relies on the combined efforts of many individuals,working together in teams. Our research teams involve dedicated staff in a wide range of professions,working across departments, and with colleagues at Dalhousie University and other universities and healthcentres across Canada and around the world. More people than we can name on these pages have giventheir time, energy, and commitment to excellence to achieve the following advances.

Cancer

Cardiovascular Health

ANCHOR aims to prevent acute disease

ANCHOR project coordinator Krista Courtney Coxtakes a patient’s blood pressure.

Canadian Glaucoma Study

St. Kitts Eye Study

A new test for macular degeneration


Vision Health

Genetics and Familial Disorders

Alleviating lifelong pain

Stabilizing kidney function in Fabry disease

Hearts in Motion cuts cardiovascular risk

Complex needs of MRSA patients


Infectious Diseases

Mobility

The power of wheelchair skills training

Mobility of people with lower limb amputations

Customized at home physiotherapy

Better bone repair

Shedding light on Charcot Marie Tooth disease

Accelerating the pace of genetic discovery

Practice makes perfect in brain surgery

Surgical relief for severe headaches


Neurosurgery

Pain

Joining forces to ease chronic pain

Sacral nerve stimulation relieves bladder pain

Respiratory Health

Objective asthma diagnosis

COPD patients breathe easier

Hand in hand: Quality and education programs ensuretop notch research

Research qualityprogram managerMary Kate Needlerand researcheducation programmanager JanetGallant worktogether to makesure Capital Healthresearchers havethe knowledge andtools they need toconduct world classclinical research.

Quality HighlightsIntegrity in Research: This new policy ensures research

conduct meets the highest scientific, ethical, legal andprofessional standards.

Canadian Institutes of Health Research (CIHR) funding:High standards set by the Integrity in Research policyhelped Capital Health attain the right to hold andadminister CIHR funding—a milestone accomplishment.

Research Capacity Award: Capital Health received agrant from the Nova Scotia Health Research Foundationto join Network of Networks, a national initiative toenhance Canada's research capability and capacity.

National leadership: Quality program manager MaryKate Needler gave a presentation on developingresearch quality programs at the 2008 Toronto ResearchManagement Symposium.

Education HighlightsREACH (Research Education across Atlantic Canada’s

Hospitals) launched in 2008, using telehealth to shareinformation about such topics as investigator initiatedresearch, research contracts and regulatory requirements, with research staff across Atlantic Canada.

Integrated Health Research Training Partnership(IHRTP) launched its first series of educational modulesin 2008 09. Involving Capital Health, the IWK HealthCentre and Dalhousie University’s Faculties of Medicine,Dentistry and Health Professions, IHRTP aims to buildindividuals’ research skills while strengtheninginterdisciplinary teams.

More than 250 people have attended the Diving intoClinical Trials? Sink or Swim workshop since 2005.


Fosteringthe professionalismof researchers and

the quality of clinicalresearch protectspatient safety and

the integrity ofresults.


Protecting patient safety: Research Ethics Board ensures studiesmeet high standards

Close scrutiny

Rapid turnaround times

Regional harmonization

Dr. Rick Hall (r), chair of the Research Ethics Board, and Ken Jenkins (l), its manager, oversee the process ofreviewing and providing feedback on more than 360 new research protocols and approximately 800 annualrenewal applications each year.

REB Fast Facts

80 volunteer members in 4 working groups25,000 ‘action items’ per year42 protocol review meetings per year23 REB executive meetings per year48 hour turnaround on initial response to investigators360 – 380 new protocols reviewed each year; up from

less than 100 per year in the mid 1990s1,400 active research studies at any given time


Cornerstones of a successful research program

The QEII Foundation has:

provided $3.4 million to Capital Health researchsince 2006.

played a key role in establishing three endowedresearch chairs: Canadian Cancer Society NovaScotia Division Chair in Population CancerResearch (Dr. Louise Parker); Canadian BreastCancer Foundation Atlantic Chapter Chair inBreast Cancer Research (Dr. David Hoskin); Heartand Stroke Foundation of Nova Scotia Chair inCardiovascular Outcomes Research (tba).

Pillar of support: QEII Foundation helps build thriving research programs

Riding for a causeStefanie Condon Oldreive is the driving forcebehind Craig’s Cause Pancreatic Cancer Society.Her father, Craig Condon, was only 63 when hepassed away in 2006, two months after beingdiagnosed with pancreatic cancer. Galvanized bylosing her father to this poorly understooddisease, Ms. Condon set up a pancreatic cancerresearch fund at the QEII Foundation andlaunched Craig’s Cause to raise money for it.Through bike tours and other events, Craig’s Causehas raised over $150,000. As a result, Dr. MicheleMolinari (Department of Surgery) is now settingup epidemiological and clinical studies to shedlight on the disease and approaches to treatment.

been instrumental in creating the $5.5 millionPET (positron emission tomography) facility, asvital for research as it is for patient care.

attracted research specific endowment fundsworth more than $20 million.

provided funds to launch prevention orientedpilot projects, such as Community CardiovascularHearts in Motion and Compass, a diabetes primarycare initiative.

developed a successful fundraising program thatattracts over 40,000 donations a year and hasraised over $160 million since 1996 .

Working Miracles

Demonstrating excellence:Capital Health researchers receive awards and accolades


End of life care: Dr. Graeme Rocker

Pain management: Dr. Mary Lynch

Diagnostic radiology:Dr. Steve Burrell

Brain imaging:Dr. Ryan D’Arcy

Honouring our own

Research Star Award:Glenda McCarthy

The Quest, The John Ruedy Award The Quest

Tara Leigh McHugh

The Daisy Award:Melanie Yuille

.

Capital Health Research Fund

Support from within: The Capital Health Research Fund

Established in 1996, the Capital Health Research Fund is a crucial source of funding for investigator initiatedresearch. Researchers in any discipline can submit their research proposals to the internal peer reviewedgrant competition, held two times each year.

Sources of revenue for the fund include interest on research accounts, proceeds of the QEII FoundationExcellence in Research annual dinner, and individual donations. To date, the Capital Health Research Fundhas awarded $4,750,000 to 339 of 571 applicants

Mohammed Abdolell (Diagnostic Imaging—Radiology) to develop empirically based BI RADS scales using breastdensity measurements from full field digital mammograms.

Lisa Barrett (Microbiology and Laboratory Medicine) to evaluate immunoglobulin M antibody (IgM) as a meansof diagnosing mumps.

Iqbal Bata (Medicine—Cardiology) to launch the pilot Nova Scotia Nicotine Patch Study.

Chad Coles (Surgery—Orthopedics) for a biomechanical comparison of humeral head fixation provided bydifferent proximal humeral locking plate designs.

Shannon Currie (Diabetes Management Centre/Psychology) to examine healthy eating and physical activityintention and behaviour in people with prediabetes and diabetes.

Louis Fernandez (Medicine—Hematology) to compare two different genetic probes—MLPA vs FISH—as ameans of detecting prognostic markers in Chronic Lymphocytic Leukemia.

Todd Hatchette (Pathology and Laboratory Medicine—Microbiology) to identify mumps mimickers, otherviruses that can present with unilateral or bilateral parotitis.

Lee Kirby (Medicine—Physical Medicine and Rehabilitation) to investigate power mobility use for people withstroke.

Peter MacDougall (Anaesthesia) to study the effects of peri operative pregabalin on post operative painfollowing breast cancer surgery with axillary node dissection.

David Maginley (Spiritual and Religious Care) to explore cancer patients’ experience of Tonglen meditationpractice as a spiritual intervention to relieve distress.

Christopher Naugler (Laboratory Medicine—Pathology) to investigate HLA human leukocyte antigensupergroup diversity in acute myeloid leukemia.

2008 09 Capital Health Research Fund award recipientsMarch 2008 Competition Awards: $170,814


2008 09 Capital Health Research Fund award recipients (continued)

Manohar Bance (Otolaryngology) to explore binaural integration and asymmetric hearing loss.

Christine Beck (Family Medicine) to look at perspectives of health care providers and bereaved familycaregivers on improving end of life care in long term care facilities.

Frederick Burge (Family Medicine) to assess the measurement properties of the Primary Care Practice Survey.

Michelle Chang (Urology) to examine metabolomic changes in renal cell carcinoma.

Frederick Burge (Family Medicine) to assess the measurement properties of the Primary Care Practice Survey.

Sean Christie (Neurosurgery) to study the effect of pregabalin on the development of neuropathic painfollowing experimental spinal cord injury in mice.

Bryan Chung (Plastic Surgery) to determine the seasonal variation of saw related injuries in a tertiary caresetting in Maritime Canada.

Matthew Kiberd (Infectious Disease) to look at what determines HIV positive adults' decision to acceptinfluenza vaccine and take part in influenza vaccine clinical trials.

Arik Drucker (Medical Oncology) to isolate and capture spiked breast cancer cells from the peripheral blood ofhealthy volunteers.

Christian Lehmann (Anesthesia) to analyze the impact of activated protein C therapy on the intestinalmicrocirculation in clinical sepsis.

Michael Vallis (Psychology) for the development of the Behaviour Change Counseling Scale.

Paul Yaffe(General Surgery) to investigate the growth inhibiting effect of piperine, a phytochemical found inpepper, on human colon cancer cells.

Tallal Younis (Medical Oncology) to examine temporal trends in wait times for early stage non small cell lungcancer.

Hosam Amoodi (Otolaryngology) to map the anatomical distribution of nasal spray in the nasopharynx andnose.

September 2008 Competition Awards: $132,608


01,000,0002,000,0003,000,0004,000,0005,000,0006,000,0007,000,0008,000,0009,000,000

10,000,00011,000,000

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Fiscal Year

$ Am

ount Contracts

Grants

Financial statements

Comparison of research contract and grant revenue

During the past decade, sources of funding have gradually shifted so that grant funding now far exceedscontract funding. Both the total number of studies and the total amount of funding have steadily grown.The higher proportion of grant funding represents a major increase in the number of investigator initiatedstudies. This in turn indicates a thriving culture of academic inquiry.


Capital HealthAll Research Accounts for the Twelve Months—April 1, 2008, toMarch 31, 2009

Opening Balance April 1, 2008 $ 18,195,044

RevenueContracts 5,004,082Grants 9,993,550Archiving fees 28,312Donations and other revenue 88,011Ethics review fees 301,428Indirect cost program 617,169Project set up fees 219,729Interest on investments 213,221Research overhead 596,259

Gross Revenue $ 17,061,760

ExpensesCompensation 10,340,309

Supplies and Services ExpensesClinical laboratory services 182,011Diagnostic imaging services 245,768Equipment 1,071,653Maintenance 53,864Medical/surgical supplies 90,433Other expenses 732,911Overhead 1,155,919Patient travel 213,993Pharmacy services 227,601Printing/computer/office 211,142Purchased services 816,475Recoveries from sponsors 1,047,674Recruiting and advertising 51,489Renovations 134,894Transfers offsite 1,431,702Travel business/education 608,339

6,180,520Total Expenses $ 16,520,830

Net Inflow/Outflow 540,930

Ending Balance March 31, 2009 $ 18,735,974

Contract Overhead Distribution 2008/09Capital Health 596,259Faculty of Medicine, Dalhousie University 335,797Departments, Dalhousie University 223,864TOTALS 1,155,919

Financial statements


Research Fund CommitteeDr. Kim Good, Co ChairDr. Gordon Gubitz , Co ChairMohamed AbdollelDr. Manohar BanceDr. David BarnesDr. Raewyn BassettDr. Chris BlanchardDr. Susan BowlesCarla BurgessDr. Gail EskesDr. Wenda GreerDr. Tomas HajekDr. Todd HatchetteDr. Ed HanadaDr. Stephanie KaiserDr. Christian LehmannDr. Robert MacaulayDr. Paige MoorhouseDr. Marcelo NicolelaDr. Tallal Younis

Research Advisory CommitteeChair, R. P. LeBlanc, Cm, MD, FRCSCVice President, Learning, Research and InnovationSusan Martin, Executive Assistant

Dr. Stacy Ackroyd StolarzDr. Casely AgoDr. David BarnesDr. David BellBill BeanDr. Bal ChauhanMadeleine ClareDr. Alan CruessDr. Fred BurgeDr. Sam CampbellDr. Ben DavisDr. Nicholas DelvaDr. Rick GibsonDr. Reginald GooddayDr. Gordon GubitzMary Ellen GurnhamDr. Rick HallDr. Godfrey HeathcoteAnne HiltzDr. Greg HirschDr. Orlando HungDr. Gerry JohnstonDr. David KirkpatrickDr. Patrick McGrathDr. Michael MurphyDr. Allan PurdyDr. Ricardo RendonDr. Ben RusakJulia TaylorDr. George TurnbullLisa UnderwoodDr. Don WeaverDr. Derek Wilke

Research Ethics BoardDr. Rick Hall, Executive ChairLarry Broadfield, Co ChairDr. Sarah Kirby, Co ChairDr. Chris MacKnight, Co ChairDr. Shelly McNeil, Co ChairGredi Patrick, Co ChairDr. Kevork Peltekian, Co Chair

Research Services StaffLisa Underwood, DirectorAngela Kirby, Administrative AssistantDr. Raewyn Bassett, Qualitative Research MethodologistJanet Gallant, Program Manager, Research EducationDenise Hatchette, Manager, Research Funds & InfrastructureSara Lavender, Contract/Grant CoordinatorAmanda Morash, Assistant, Contracts/GrantsMary Kate Needler, ProgramManager, QualityJulia Taylor, Research Development CoordinatorJudith Thompson, Human Resources ManagerJennifer Thurlow, Coordinator, Grant Facilitation & SupportEmily Walker, Communications Coordinator

In addition to the Research Ethics Board executive and office staff, the board has anadditional 72 volunteer members. These members are drawn from the community,from the legal profession, medical staff and hospital employees.

Ken Jenkins, ManagerStarla Burns, Ethics CoordinatorAmanda Henneberry, Ethics CoordinatorJoan Morrison, Ethics CoordinatorNadine Gillam, Administrative Assistant

Capital Health Research Annual Report 2008 2009: produced by Research Services;content—Melanie Jollymore; design—Emily Walker;cover and original photography—Gerard Walsh

Capital Health ResearchAnnual Report 2008 2009Contact: 902.473.7906

Documents

40416 Annual Report - Nova Scotia Health Authority · 2020. 8. 25. · with a bout of depression and can be mistaken for such—but as Capital Health psychiatrist Dr. Claire O’Donovan