The Department’s annual faculty and staff recognition event was held on May 29th, 2014, in the Medical Student and Alumni Centre.
In addition to the awards presentation, Dr. Teresa Tsang gave an update on the exciting work underway in the DOM Research Office, and Drs. Andrea Townson and Anita Palepu spoke to the audience about the departmental Equity Committee’s activities.
Congratulations to all of our outstanding department members!
Dr. John Cairns, Professor of Medicine, Division of Cardiology, has been selected to receive the Order of British Columbia. The Order of British Columbia recognizes those who have served with the greatest distinction and excelled in their field, benefiting the people of BC or elsewhere. The Order is the highest form of recognition the Province can extend to its citizens, and is only bestowed on the most outstanding British Columbians.
As one of Canada’s most distinguished health researchers, Dr. Cairns has made outstanding contributions to the medical and academic communities in BC and in Canada. His research focuses on improving the lives of people with heart disease by studying the causes and prevention of heart attacks, as well as the optimal management of patients who have experienced heart attacks. He proved through a multi-centre clinical trial that aspirin can reduce by more than half the incidence of heart attacks and death among patients with unstable angina. This finding revolutionized treatment of these at-risk patients, shifting the focus toward limiting the growth of clots in coronary arteries.
As Dean of Medicine at UBC from 1996 to 2003, he led substantial expansion of facilities, including the UBC Life Sciences Centre and the Diamond Centre at the Vancouver General Hospital. By 2002, the UBC Faculty of Medicine was in second place among its Canadian counterparts in total research funding. Dr. Cairns also led efforts to double the enrolment of medical students and residents. BC is now educating its own physicians to provide more doctors for the people of BC, rather than depending on other provinces to provide physicians. Much-needed opportunities for rural health training are also being provided.
Dr. Cairns is dedicated to educating, training and mentoring the next generation of physicians in BC. He continues to teach undergraduate medical students, postgraduate trainees and practicing cardiologists. He has served on many national health bodies, and is President of the Canadian Academy of Health Sciences, the most prestigious organization for health sciences academics in Canada.
The UBC Heart and Stroke Foundation Professorship in Women’s Cardiovascular Health is the first research program in BC to focus on how gender-based differences affect cardiovascular disease.
The Professorship, held by Dr. Karin Humphries, strives to integrate cardiovascular care, education and research for women throughout the province, including rural communities.
Dr. Humphries’ research focus is on the detection and early treatment of cardiovascular disease. She aims to find new ways to improve the education of physicians, women and their families on heart disease and stroke. She will also develop strategies to improve outcomes for women at highest risk, including Aboriginal and South Asian women and those of poor socio-economic status.
“For decades, cardiovascular disease was considered a man’s disease,” Dr. Humphries recalls, “but the reality is that more women are dying of heart disease than men. Although evidence suggests that gender differences can affect the prevalence, symptoms, diagnosis, treatment and outcomes of cardiovascular disease, we haven’t seen enough research in this area of study.”
Dr. Humphries is a leading research scientist at the Centre for Health Evaluation and Outcome Sciences (CHÉOS) at St. Paul’s and Associate Professor in the Division of Cardiology in the Department of Medicine at the UBC Faculty of Medicine with extensive experience studying gender-related differences in cardiovascular disease. As a professor, she is also a national Heart and Stroke Foundation of Canada spokesperson on women’s cardiovascular disease issues.
Andrei Krassioukov, a Professor in the Division of Rehabilitation Medicine, Department of Medicine, is travelling to the 2014 Sochi Paralympic Games to research the effects of spinal cord injury (SCI) on the cardiovascular health of Paralympic athletes. He is a world expert on SCI and its connection to cardiovascular function. He is also an expert on the practice of boosting – intentional injury – that can increase blood pressure and may improve performance.
What will your research involve and what do you hope to learn?
My team will be holding education-research clinics for wheelchair athletes with SCI, and their coaches, to collect data related to the athletes’ cardiovascular health. Abnormal blood pressure is a common issue for individuals with SCI – it can be either extremely low or extremely high (a condition known as autonomic dysreflexia). There is increasing evidence that cardiovascular functions and specifically blood pressure and heart rate significantly affect wheelchair athletes’ performance. My goal is to ensure International Paralympics Committee classifications take into account the important variable of athletes’ cardiovascular and autonomic dysfunction.
Why would Paralympic athletes intentionally injure themselves to improve performance?
Injury to the spinal cord disrupts control of heart and blood vessels that are normally regulated by the autonomic nervous system that provides non-voluntary control to organs. Following SCI, blood pressure is typically low leading to fatigue and decreased performance. This creates significant disadvantages during competition, leading some athletes to use boosting through intentional injuries as a drastic measure to correct functions lost through injury.
What are the greatest risks of boosting this way?
Boosting is an extremely dangerous practice. Apart from the injuries inflicted, such as overfilling the bladder, fracturing toes or applying electric shocks to testicles, the greatest risk is the sudden spike in blood pressure and heart rate. The uncontrolled spikes could cause blood vessels in the eye to burst, stroke, heart attack or death.
Why do some athletes still practice this kind of boosting even though it was banned in 1994?
Paralympic athletes are first divided into categories based on disabilities, which determines who they will compete against and what sports they can participate in. They are further divided by the severity of their injuries and placed into an event with similarly challenged competitors.
Under the current system, depending on the sport, some athletes with different disabilities can compete in the same event. This is the motivation for boosting. My hope is that the proposed addition,to the classification–taking into account the athletes’ cardiovascular and autonomic dysfunction–would level the playing field for wheelchair athletes and eliminate the necessity for boosting.
Dr. Krassioukov is co-director of the International Collaboration on Repair Discoveries (ICORD), part of Vancouver Coastal Health Research Institute (VCHRI). He is also a physician-scientist at Vancouver Coastal Health’s GF Strong Rehabilitation Centre.
More information may be found here.
In the UBC Annual Report, Dr. Mark FitzGerald, Professor of Medicine and Head, Division of Respiratory Medicine at UBC and VGH, talks about gaining intercultural insight to communicate more effectively with asthma patients.
For many people, asthma is a disease that can be quite easily controlled through proper usage of medication and avoiding irritants. But if you don’t understand how to take your medication or what irritants to avoid, asthma can quickly become a very serious problem.
That was Dr. Mark FitzGerald’s concern when he realized that entire communities in Vancouver were not receiving the clear communication they needed. “Simply translating existing materials into other languages isn’t enough,” says Dr. FitzGerald, UBC Professor of Respiratory Medicine and Co-Director at the Institute for Heart and Lung Health. “We must take into account the attitudes and perspectives of the audience, which are sometimes quite different from those of the medical professionals who create the material.”
Rather than complain about the current material available, Dr. FitzGerald and Senior Health Evaluation Scientist Iraj Poureslami set out to create something better. Through focus groups within various ethnic communities they gained insights into what was missing in current communications and how to more effectively communicate and reach these groups.
The discoveries were surprising to say the least. Punjabis revealed that they are often inclined to hide their asthma because it’s associated with tuberculosis, a stigmatized disease in their culture. Chinese people expressed that they would be more willing to quit smoking if it is harming a loved one.
Armed with a stronger intercultural understanding, Dr. FitzGerald and Dr. Poureslami created ‘community videos’ in Punjabi, Cantonese and Mandarin featuring actual focus group participants as they acted out scenarios conveying messages about asthma management. Patients from these communities who watched the videos dramatically improved their inhaler skills and their understanding of the steps they needed to take to control their condition. The CIHR funded study showed significant improvement in patients ability to manage their asthma at the end of the study period.
“We’re not wasting their time with medical mumbo-jumbo,” says Dr. FitzGerald who sees asthma patients at Vancouver General Hospital’s Lung Centre. “We’re speaking in the patients’ own languages – not just linguistically, but culturally.”
See more from the UBC annual report
I am very pleased to announce that Professor Dawn E. DeWitt BA, MSc, MD, FACP, FRACP, FRCPC, will be honoured by the American College of Physicians with advancement to Mastership. The award will be presented during ACP’s annual Convocation ceremony in April 2014 in Orlando, FL.
Mastership is one of the highest honours bestowed by the College. ACP Bylaws state that Masters shall be Fellows who have been selected because of “personal character, positions of honour, contributions towards furthering the purposes of the ACP, eminence in practice or in medical research, or other attainments in science or in the art of medicine.” Masters are highly accomplished individuals who are distinguished by the excellence and significance of their contributions to medicine. Of the College’s 1,238 Masters, less than 8% are female physicians. Dr. DeWitt is the second Fellow in the BC Chapter to be advanced to Mastership.
Dr. DeWitt is a Professor of Medicine; Regional Associate Dean, Vancouver Fraser; and Associate Dean, MD Undergraduate Education at the Faculty of Medicine, University of British Columbia. As the Foundation Chair of the Rural Health Academic Centre, Melbourne Medical School and Clinical Dean, Rural Clinical School, she led the development of Australia’s first purpose-built inter-professional learner-centred teaching clinic. Her team won the Melbourne Medical School and University of Melbourne Program Innovation in Education Awards in 2009 and 2010, respectively. In addition to organizing state meetings and organizing sessions and speaking at Annual ACP meetings, she is a co-author of the ACP “Teaching in the Office” book, and has edited, authored and reviewed for MKSAP. She is a past Chair of the Step 3 NBME Chronic Illness Committee. Her interests include addressing rural workforce shortages and health disparities, career choice, and diabetes. She was a co-Investigator on a recent NHMRC grant on the “Efficacy, acceptability and feasibility of laparoscopic gastric banding surgery as a treatment for type 2 diabetes in Indigenous Australians”. Her systematic review of insulin use in the ambulatory setting (JAMA 2003) is still cited by the American Diabetes Association guidelines as one of a few “excellent reviews” on the subject. Widely recognized as an outstanding clinician and teacher, she was peer-voted one of the “Best Doctors in America” in 2002, before moving to practice in rural Australia, and now in Vancouver, Canada.
Dr. DeWitt is an outstanding physician and educator who has made significant contributions to academic medicine, and is highly deserving of this honour. Please join me in congratulating Dawn on this achievement.
Graydon S. Meneilly, MD, FRCPC, FACP
Governor, American College of Physicians, British Columbia Chapter
The Department of Medicine is very pleased to congratulate three of its department members; Dr. Jason Andrade, Dr. Andrew Krahn, and Dr. Kenneth Madden on a successful outcome in the 2013/2014 Heart and Stroke Foundation Grant-in-Aid peer-reviewed competition. UBC researchers received 8 of the total 102 awards distributed through the prestigious Grant-In-Aid program, which provides approximately $30 million per year in program support.
Jason Andrade, Clinical Assistant Professor of Cardiology studies atrial fibrillation (AF), the most common heart rhythm disorder which increases the risk of stroke and death and affects the quality of life of many Canadians. Despite advances in drug treatment, AF remains uncontrolled in many patients. In most cases, abnormal electrical impulses that set off AF come from the pulmonary veins, which carry blood from the lungs to the left upper chamber (atrium) of the heart. Catheter ablation, a procedure used to remove faulty electrical pathways, has been developed to cure AF. The procedure involves placing a catheter into the upper left chamber of the heart via the veins in the groin and then burning or freezing the heart tissue responsible for AF, potentially curing the arrhythmia.
Dr. Andrade, and his collaborators including Department of Medicine member, Anthony Tang, will investigate whether new procedures utilizing shorter durations of freezing are more effective and safer than procedures using longer freezing durations, or procedures using radiofrequency energy. The outcomes of this study have the potential to fundamentally change the way in which cardiac cryoablation is performed. If a superior efficacy with shorter freezing durations is shown it will result in improved procedural outcomes for patients undergoing AF ablation, resulting in a reduction in AF recurrences, as well as a reduction in arrhythmia related symptoms, hospitalizations, and health care utilization.
Cardiology Division Head, Andrew Krahn is a leading expert in the field of genetic heart arrhythmias and is working to create a nationwide network of clinics, able to diagnose and treat individuals born with inherited electrical abnormalities. Approximately 30,000 Canadians die suddenly every year. Patients that are born with a genetic arrhythmia may experience abnormal heart racing resulting in blackouts or sudden death during childhood or adulthood. Identifying the cause and its implications for family members is paramount to preventing these tragedies. The Canadian Genetic Hearth Rhythm Network, coordinated here at UBC, will study patients experiencing cardiac arrest and blackouts, 2 very common presentations of heart disease. Proper recognition and testing will save lives, particularly in otherwise healthy children and young adults that are at risk.
Kenneth Madden, Associate Professor in Geriatric Medicine received funding for a three year study examining “Acarbose and Older Adults with Postprandial Hypotension”. Fainting that leads to falls in older adults is a serious problem, the consequences of which include hip fractures, death and hospitalization. In a quarter of these adults, postprandial hypotension (PPH), a drop in blood pressure after a meal, is responsible for the fainting spells. Currently, there is no cure for PPH. This study will evaluate the use of acarbose, an anti-diabetic drug, to diminish PPH in older adults. Dr. Madden postulates that following a meal, the increased blood flow to the digestive system induces the blood pressure decrease, which decreases blood flow to the brain and causes the fainting. As acarbose slows digestion and carbohydrate breakdown, the drug shows promise in limiting the post-meal blood pressure reduction. In providing a possible cure for PPH, his research could improve the quality of life for older Canadian adults and result in cost savings of up to one billion dollars a year for the health care system.
The Department of Medicine is extremely proud of all the research endeavors of its investigators, as exemplified by these projects which seek to improve patient care, outcome and health policy not only here in British Columbia, but throughout Canada.