Imagine a Healthier Tomorrow Research at the IWK Health Centre 2011-2012 Remembering a Woman of Great Imagination

This edition of the IWK research annual report is dedicated to the memory of an extraordinary woman, Ruth Goldbloom. Her vibrant personality, unbridled enthusiasm and generous spirit have made an indelible impression on the hearts and minds of the people in our community.

Ruth had the vision to see the possibilities – to imagine what the IWK community could achieve in its quest to improve the lives of women, children and families. She firmly believed that research was essential to realizing this potential and dedicated her time, talent and energy to fundraising efforts that have helped the IWK to establish itself as a world-class research institution. A longtime volunteer with the IWK Auxiliary and IWK Imagine What We Can Accomplish Foundation, Ruth co-founded and ran The Gift Horse gift shop, helped organize Kermesse, and took Telethon pledges for more By Patrick McGrath, Integrated VP of Research and Innovation, IWK and Capital Health than 25 years. At the same time, she was able to inspire others with the depth of her passion for this work and to fire their Our research report this year asks you to “imagine,” as it really our featured researchers has a vision of the change that she or imaginations with the possibilities she could see, just on the is the power of imagination that propels our research efforts he wants to lead – through a new medicine, diagnostic tool or horizon. forward. This is true for the scientists and clinicians who dream vaccine, or through new approaches to education, professional imagine of a healthier world and use their fertile imaginations to create practice or public policy. All are transforming their dreams into Ruth Goldbloom will ever be remembered for her radiant smile, new ways to get there. It’s also true for donors and volunteers, reality. whose imaginations are captured by our researchers’ quests and warm presence, courageous leadership and unflagging efforts who dedicate their time and/or money to help them on their way. You’ll notice another sort of change – my title is no longer VP on behalf of the many projects and causes she supported. The Research at the IWK. I am now Integrated VP of Research and IWK community will continue to be inspired by the depth of her This year, we are saddened by the loss of a great friend to the Innovation at the IWK and Capital Health. This expanded new I commitment and the breadth of her imagination. IWK, Ruth Goldbloom. Ruth's close connection to the IWK began mandate reflects the collaborative nature of research in our in 1967, when she and her husband Dr. Richard Goldbloom community and a desire among our academic health care moved to Halifax and he became our chief of research. Ruth was institutions to strengthen our research efforts through increased at Richard’s side throughout the years, observing and supporting partnership and integration. We believe that we can accomplish the development of research programs at the hospital. She more by pooling the research expertise of our two organizations shared his vision of what could be possible and threw herself – to learn from each other, to harmonize our processes for greater wholeheartedly into the hard work of raising money to make it efficiency, and to identify new opportunities for collaboration. As happen. She was a driving force and the spirit of her passion for more researchers share ideas and pursue common goals, we progress will guide and motivate us for years to come. will come closer to realizing our vision of better health care, and better health, in the Maritimes and beyond. As you peruse this report, I hope you will find yourself imagining “What is now proved was once only imagined.” – William Blake, English poet and thinker the progress that our researchers are making possible. Each of

IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 1 Imagine Curing Cancer with Measles

Chris Richardson imagines a powerful new treatment for virus on canine cancer cells,” he explains. “We’re very excited cancer that uses the measles virus to target and kill cancer about the possibility of engineering the distemper virus into a cells. His discovery that many types of cancer cells are cancer treatment for dogs.” covered with measles receptors opens the door to just such a cure. Chris Richardson is the 2011 winner of the IWK Research Star of the Year award. While most people see measles as an unpleasant childhood illness that has virtually disappeared thanks to vaccines, Dr. Chris Richardson sees the virus in a different light. Through many years of examining measles virus, he has identified three key receptor molecules that allow the virus to latch onto cells so it can infect them. But his most startling – and hopeful – discovery is that these measles receptors are more than a thousand times more plentiful on many types of cancer cells than they are on normal cells.

“Because of these receptors, it’s actually much easier for the measles virus to infect cancer cells than it is for it to infect normal cells,” notes Chris, an IWK-affiliated scientist and prof- essor in the departments of Microbiology & Immunology and Pediatrics at Dalhousie Medical School. “This is good news, because we’ve found measles receptors in abundance on lung, Level 3 Containment Lab Opens breast, colon, bladder and prostate cancer cells.” at IWK Health Centre

The measles receptors are the keys that allow the virus to Gary Sisson, a senior lab technician and manager of enter the cancer cell. Once inside, the virus wreaks havoc on Dr. Chris Richardson’s lab, played an instrumental role in the cancer cell and its malignant neighbours. “The invading setting up the new Level 3 containment facility at the measles virus blows away the cancer cell membranes, creating IWK. This research facility meets stringent government one giant measles-infected cancer cell that then explodes,” regulations for the safe storage and handling of live Chris says. “This leads to the rapid infection and destruction of viruses and viruses from outside of Canada. Chris and the cancer cells in the area, without harming the healthy cells. Gary will use the containment lab in their work with their It’s incredible to watch through the microscope.” partners in Morocco to develop a vaccine against goat pox and PPRV (Peste des petits ruminants virus). These Chris and his team are now working with the vaccine strain of highly contagious diseases kill thousands of goats in the the measles virus to see if they can develop it into a safe and developing world each year, taking an enormous toll on effective treatment for cancer. He says that people’s immunity the herds and the people who rely on them for a living. to the virus – from being either infected or vaccinated – would actually enhance the treatment. “Cancer cells are typically able to hide from the immune system,” he explains. “Infecting them with the measles virus is like putting little flags on them, so that the immune system can see them and go in for the attack.”

An animal lover, Chris also imagines using a virus to save dogs from cancer. “We’ve found receptors for the canine distemper

2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 3 Imagine More Confident, Well-Informed Parents

Amy Ornstein imagines new parents having the knowledge “Parents who took part in our Emergency Department study and confidence to handle all aspects of infant care – including agreed that the PURPLE Crying materials were a valuable re- how to calmly cope with prolonged bouts of intense crying. source and strongly agreed that all families with young infants should receive the program,” notes Amy, who has received three As IWK staff pediatrician Dr. Amy Ornstein discovered when IWK grants for her research. She believes that the information surveying new parents in the Family and Newborn Unit, most can help parents feel more confident in their parenting abilities don’t expect their baby’s crying to be a problem for them. In this and less stressed when their baby cries – which is better for 2009 study, Amy found that parents received very little pre-natal the health and wellbeing of everyone in the family. education about crying – and that those who had the least information about crying were the most confident in their ability to handle it.

But, as Amy points out, ALL babies cry. “Some cry more than others, but they all go through a developmental stage from about two weeks to four months of age when they cry for no apparent reason,” she says. “There is nothing wrong with them – they just need to cry. And they may not settle for hours, in spite of parents’ best efforts, which can lead to a lot of frustration if parents don’t understand the crying behaviour.”

The knowledge gap she uncovered in her research inspired Amy to launch further studies to test an infant crying education program called ‘The Period of PURPLE Crying,’ developed by Purple Hats Top Off PURPLE Dr. Ron Barr at the University of British Columbia. PURPLE is Crying Program an acronym that describes the key features of infant crying: Thanks to crucial support from the IWK Auxiliary, the IWK P – Peak of crying (around two months of age) was able to launch The Period of PURPLE Crying infant U – Unexpected (comes and goes and parents don’t know why) crying education program in February 2012. Dr. Amy R – Resists soothing (no matter what parents try) Ornstein (above) and her team are evaluating how P – Pain-like face (even when there is no pain) successfully the program improves parents’ knowledge L – Long-lasting (up to five hours a day or more) and attitudes about infant crying, while working with E – Evening (the most likely time for crying) the Auxiliary, the IWK, the Department of Community Services, Public Health, and Extra Support for Parents “The PURPLE Crying program teaches parents that infant crying on a plan to expand the program. “Our nurses are now is normal, while providing tips and advice to help them learn to talking to parents about crying and soothing as part of soothe their baby,” Amy says. “But it also emphasizes that it’s our overall discharge teaching,” says Marlene Duperre, okay to put your baby down in a safe place and walk away if a nurse supervisor in the Family and Newborn Unit. the incessant crying is making you frustrated or angry.” Families also receive a DVD and booklet, along with a hand-knit purple hat for their baby. The IWK Auxiliary Prolonged infant crying is a trigger for shaken baby syndrome, has been building an enthusiastic network of volunteer a serious form of infant physical abuse. While the PURPLE Crying knitters to make the purple hats (clickforbabies.org). program’s primary aim is to prevent these tragedies, Amy says it has many other benefits for families as well. Facing page: Baby Emmeline was born to Alison Capstick and Geoffroy Chevallier at the IWK in May 2012.

4 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 5 Imagine a Blood Test for Depression

Kathleen Pajer imagines a day when depression can be conduct disorder or other problems. “These subtle differences precisely diagnosed with a simple blood test, to enable early have a huge impact on which treatments will work and which treatment and prevent lifetimes of suffering. ones won’t,” she says. “This is critical, because the sooner we start the right treatment, the better our chances of success.” While depression often emerges in adolescence, it’s not always easy to distinguish early mental illness from normal teenage Kathleen came to Halifax from Ohio State University and angst. Nationwide Children’s Hospital in 2011. She is co-leading a comprehensive re-structuring of the IWK’s mental health and “All we have to go on is a verbal report of symptoms and addiction services, with the service’s director, Dr. Ruth Carter. our own observations,” notes Dr. Kathleen Pajer, chief of the Department of Psychiatry at the IWK and head of the Division of Child & Adolescent Psychiatry at Dalhousie Medical School. “Teens don’t always show the same signs as adults – for example, some are more hostile than sad – and symptoms that seem like depression could be something else.”

The lack of an objective test means some young people receive treatment they shouldn’t, while others who really need treat- ment are missed. These young people are at risk for problems at home and school, substance abuse, homelessness, suicide, or recurrent depression throughout their adult lives.

Kathleen is determined to bridge the diagnostic gap, with a simple blood test that gives a definitive ‘yes’ or ‘no.’ For the Addressing the Earliest Roots of past five years, she’s been working with Dr. Eva Redei at Conduct Disorder Northwestern University in Chicago and Dr. Bill Gardner, who divides his time between Ohio State University and the IWK, to Dr. Kathleen Pajer has found that females with identify biomarkers of early onset major depression. Their efforts abnormally low stress responses are likely to pass have been so successful, their proof of concept paper was the same traits on to their unborn children – along with published this spring to wide acclaim in Translational Psychiatry. the tendency to display such antisocial behaviours They are now seeking funding for clinical studies to validate the as stealing, lying and cheating. She believes that an genes that comprise the biomarker panel. underactive stress response is passed along not just through genes, but also through neurological and bio- “In the new study, we will take blood from several hundred chemical signals that the unborn child receives from the patients aged 15 to 25 who’ve been diagnosed the traditional mother during pregnancy. Kathleen has launched a study way – sampling first while they’re still depressed and again to see if re-training mothers’ abnormal stress responses when they’re feeling better,” says Kathleen. “Our colleagues at during pregnancy – using such techniques as meditation Northwestern will analyze the blood and send the data back to – will result in healthier stress responses in their babies. us, so we can see how well the biomarkers worked to identify Healthy stress responses provide important warnings depression, pinpoint the sub-type, and monitor the effective- that prevent people from acting in ways that could bring ness of treatment.” them negative consequences.

As Kathleen explains, there are several types of depression; some involve anxiety, while others involve bipolar disorder,

6 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 7 Imagine Fit and Healthy Mothers and Children

Christy Woolcott and Stefan Kuhle imagine a day when Christy and Stefan are examining other facets of the complex the childhood obesity epidemic will be over. Their findings ties between a woman’s health and the health of her children. suggest that intervening before a child is even conceived may For example, Christy wants to know how pregnant women’s be the place to start. patterns of sleep, sedentary behaviour and physical activity affect their babies’ weight. Stefan is studying how the method Obesity researchers in the Perinatal Epidemiology Research Unit of delivery – cesarean or vaginal – may have an impact. They (PERU) at the IWK are examining data about the health of hope their findings will yield new insights to inform policies that thousands of pregnant women in Nova Scotia. They’re linking will help women and their children to be healthier in the future. these findings to data sources that reveal the status of women’s and children’s health in the province. Their goal is to learn how a woman’s pre-pregnancy weight – and the weight she gains during pregnancy – affect both her future health and the health of her unborn child.

“We’ve found that maternal obesity is the strongest risk factor for childhood obesity… children of obese mothers are four times more likely to become obese than children of mothers with healthy weights,” says Dr. Stefan Kuhle, an obesity researcher in PERU. “This clearly points to the need for education and pro- grams – not just for women but for health professionals as well – to help women reach a healthy weight before they conceive.”

The issue is critical, says Stefan, who was involved in a recent study of all Nova Scotia grade five students which found that 35 per cent of the children were overweight or obese. A Growing Capacity For Obesity Research In addition to a higher-than-healthy weight before pregnancy, excessive weight gain during pregnancy may also contribute to Over the past few years, researchers and leaders at the an unborn baby’s risk of becoming an obese child. Stefan and IWK and Dalhousie University have taken new steps to fellow PERU obesity researcher Dr. Christy Woolcott want to reveal and address the root causes of childhood obesity. know to what extent. They’ve recruited a number of obesity researchers, including: Drs. Christy Woolcott and Stefan Kuhle “Our preliminary findings show that far too many women in (above), epidemiologists with a strong shared interest in Nova Scotia are gaining much more weight during pregnancy obesity; Dr. Sara Kirk, a Canada Research Chair who than Canadian guidelines recommend,” says Christy. “It’s im- studies lifestyle and environmental factors that in- portant to learn how great an impact this could have on their fluence childhood obesity, and Dr. Younes Anini, a children’s health – and on their own health as well.” physiologist who explores hormones that contribute to obesity and diabetes. These researchers work together Christy and IWK colleagues, Drs. Louise Parker and Linda and with others – including IWK nurse researcher Dodds, recently received funding from the Nova Scotia Health Dr. Erna Snelgrove-Clarke and affiliated family Research Foundation and Canadian Institutes of Health Research medicine researcher, Dr. Helena Piccinini-Vallis – to to explore how excessive weight gain during pregnancy may advance our understanding of obesity and inform new affect a woman’s long-term ability to maintain a healthy weight practices and policies to help reduce the burden of – and how this, in turn, influences her chances of developing obesity in future generations. type 2 diabetes and other obesity-related health problems.

8 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 9 Imagine a Vaccine Against Cavities Imagine Closer, Happier Couples

Farhan Khan imagines a world where tooth decay and gum Farhan and his supervisors at the IWK and Dalhousie Medical Natalie Rosen imagines couples using supportive approaches Negative responses – such as expressing frustration or anger – disease no longer take a toll on people’s health and lives. School – Drs. Song Lee and Scott Halperin – hope his discovery that help them build stronger relationships as they cope with also increase women’s pain. There is a third style of response, He’s made a discovery that could lead to a revolutionary oral will lead to a new oral vaccine for preventing dental cavities and the woman’s sexual pain. however, that Natalie has found to be most helpful. She calls it vaccine. gum disease. “The plan is to create a vaccine in which a good the facilitative response. “Facilitative responses acknowledge oral bacterium will continually produce antibodies against As many as 16 per cent of women experience significant pain women’s pain while encouraging adaptive coping,” Natalie Dental cavities are a major public health issue around the world Fusobacterium,” Farhan says. “This would protect the teeth and during sexual intercourse. For many women, this pain has explains. “For example, men might suggest other, non-painful – especially for young children, whose nutrition, growth, speech gums from the bad disease-causing bacteria.” negative effects on their mental and emotional health and on sexual activities that allow loving closeness. This creates a more and self esteem can all suffer. According to the Public Health the intimacy of their relationships with their male partners. And, positive context for continuing the sexual activity and reduces Agency of Canada, cavities affect 60 to 90 per cent of school- In June 2012, Farhan presented his research at the International of course, it can interfere with a couple’s ability to conceive a women’s anxiety, which decreases their pain. Women whose children and most adults, even in developed countries. Association for Dental Research/Unilever Hatton Competition in child. IWK clinical psychologist and affiliated scientist Dr. Natalie partners take this approach are less likely to avoid sex and Brazil, placing second in the senior basic science category. Rosen believes that the negative effects of sexual pain – and they and their partners report higher sexual function and While conducting research for his Masters degree in the Previously, he received the Heinish Studentship and Thompson even the pain itself – can be reduced by helping men learn the satisfaction.” Canadian Center for Vaccinology at the IWK, Farhan discovered Scholarship from the IWK, awarded to the highest-scoring most effective ways of responding to their partners’ pain. a way to disable a key agent in the formation of dental plaque applicant to the centre’s summer and graduate student funding Natalie and colleagues at the University of Montreal received – a sticky bacterium called Fusobacterium. “This bacterium programs. “Our research has found that if men are overly solicitious – $100,000 from the Canadian Institutes of Health Research and binds to the teeth and makes a bridge for other disease-causing meaning they express a great deal of concern – it increases $50,000 from the IWK for a pilot study to test couples’ therapy bacteria to join the plaque,” explains Farhan. “I found that Now that he has received his MSc in microbiology and women’s pain,” says Natalie, who is also an assistant professor for managing women’s sexual pain. She is also studying introducing antibodies against Fusobacterium effectively immunology, Farhan is embarking on a new phase of his in Dalhousie’s departments of Obstetrics & Gynecology and Psy- genital pain after childbirth with IWK anesthesiologist Dr. Ron neutralizes the stickiness, so bacteria slide off the teeth instead academic career. He is training to be a physician at Dalhousie chology & Neuroscience. “Even though caring and sensitive, this George, psychologist Dr. Jill Chorney and nurse Dr. Erna of forming plaque.” Medical School. No matter what specialty he ultimately kind of response can make women feel anxious and incapable Snelgove-Clarke. pursues, he will always make research a priority. of coping with the pain – which makes the pain worse and may cause them to avoid sex.”

10 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 11 From Imagination to Reality New Minds Bring New Ideas

Over the past year, a number of IWK researchers have reached major milestones in their journeys to translate what were once Our newest researchers bring knowledge and experience in many fields. They will play key roles in advancing our efforts to improve ideas into innovations that will make a real difference in the world. the health and wellbeing of women, children and families.

Strongest Families Provides Mental Health Services Far and Wide Bill Gardner, Pediatrics, Obstetrics & Gynecology, Community Health & Epidemiology Dr. Bill Gardner is the newest addition to the IWK’s Perinatal Epidemiology Research Unit (PERU). Bill is More than ten years ago, child psychologist Dr. Patrick McGrath imagined that providing mental interested in children’s health services and outcomes research, particularly in the areas of mental health health services to families in their homes – using educational materials and telephone coaches and interventions involving information technology. In addition to his work with PERU, Bill divides his – could empower parents to solve their children’s mild to moderate mental health issues. He and time between Halifax and Ohio – as professor in the departments of Obstetrics & Gynecology, Pediatrics, Dr. Patricia Lingley-Pottie in the IWK’s Centre for Research in Family Health conducted and Community Health & Epidemiology at Dalhousie Medical School, and professor in the departments rigourous studies that found the distance programs they had developed were able to overcome of Pediatrics, Psychology, and Psychiatry at Ohio State University. barriers that prevent families from accessing services, while successfully resolving children’s problems. Launched in 2012, the independent not-for-profit Strongest Families Institute now Paul Hong, Otolaryngology delivers these programs to health authorities all across Nova Scotia and in Ontario, Alberta and British Columbia, and is cultivating interest in several other countries. The institute recently won Pediatric otolaryngologist Dr. Paul Hong joined the IWK in 2010 after completing fellowships in pediatric an Innovation in Practice Award from Progress Media and a Social Innovation Award from the head and neck surgery at the University of California in San Diego. He holds appointments in Dalhousie Mental Health Commission of Canada. imaMedical School’s Department ofgi Surgery and the School of Human neCommunication Disorders in the Faculty of Health Professions. Paul’s research interests include tissue engineering, craniofacial reconstruction and pediatric hearing loss. He is collaborating with IWK plastic surgeon Dr. Michael Bezuhly and psy- Post-Operative Patient Safety Modules Go Global chologist Dr. Jill Chorney to explore clinical and psychological outcomes of craniofacial surgery.

Gynecologic surgeon Dr. Donna Gilmour imagined that women would recover better from Stefan Kuhle, Pediatrics, Obstetrics & Gynecology, Community Health & Epidemiology imasurgery if they had moregi information to support them duringne recovery. She mobilized a team of gynecologic surgeons and other experts to develop the SAFER (Studying Adverse events From A physician with advanced training in epidemiology, Dr. Stefan Kuhle has recently joined the Perinatal Elective surgery Research) online learning modules to help women take care of themselves and Epidemiology Research Unit (PERU) and departments of Pediatrics and Obstetrics & Gynecology at the screen themselves for symptoms of adverse events after hysterectomy. SAFER modules for IWK and Dalhousie Medical School. Stefan’s focus is childhood obesity and its impact on children’s current self-care after cesarean section soon followed. In 2012, the Patient Safety Company licensed the and long-term health – as well as on use of health services and costs to the system. He is also conducting SAFER applications from Dalhousie University and is now making the apps available to patients, an economic evaluation of school-based obesity prevention programs in Nova Scotia and Alberta, while health care providers and hospitals around the world, to track and analyze post-surgical compli- exploring maternal and perinatal factors that may affect children’s health. cations and improve safety and quality of care. Ismail Mohamed, Pediatric Neurology New Antibiotic Moves Closer to Commercialization Dr. Ismail Mohamed comes to the IWK from the University of Calgary and Alberta Children’s Hospital. In addition to his role as director of the IWK’s epilepsy clinics, Ismail is an associate professor in the IWK-Dalhousie Medical School scientists Drs. David Byers and Chris McMaster recognized a Department of Pediatrics at Dalhousie Medical School and a key member of the brain imaging research new potential target for antibiotics when they discovered that bacteria form their cell membranes team. Ismail conducts much of his research in the Magnetoencephalography (MEG) Lab, where he studies in a way that’s completely different from humans. They imagined a new antibiotic that could acquired brain injury and perinatal stroke, as well as cognitive changes in children with epilepsy and destroy bacteria by dissolving their membranes, without harming human cells. They teamed up how these changes may help locate the source of epileptic seizures. with Dr. Don Weaver, a pioneer in computer-aided drug design, Dr. Chris Barden and the staff in the Cheminformatics and Drug Discovery Lab at the IWK to discover, synthesize and test such Kathleen Pajer, Child & Adolescent Psychiatry a drug. They’ve been so successful that they’ve formed a spinoff company, DeNovaMed, to develop and market the first new class of antibiotics in more than 30 years. The company received Dr. Kathleen Pajer is chief of the Department of Psychiatry at the IWK and professor and head of the an early commercialization award from Innovacorp in 2012 to prepare for clinical trials of its Division of Child & Adolescent Psychiatry in Dalhousie Medical School’s Department of Psychiatry. most promising compounds. In lab studies, these have proven themselves capable of wiping out Before coming to Halifax, Kathleen was associate professor of pediatrics, epidemiology and psychiatry two extremely dangerous superbugs, MRSA and VRE. at Ohio State University and its affiliated Research Institute at the Nationwide Children’s Hospital. She is exploring how abnormal maternal stress responses during pregnancy may transmit antisocial behaviours from mother to child, while working on a diagnostic test for early-onset depression.

12 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 13 Imagination Fuels IWK Foundation Leader’s Quest

The vision, ambition and optimism of IWK researchers has so fired the imagination of IWK Foundation CEO Jennifer Gillivan, she has embarked on a quest to take donor support of research to new heights.

Donors are increasingly turning their attention to research and the hope that it offers, notes Jennifer. Many seek to support causes that are close to their hearts, while others are interested in social investing. “There is a small and growing number of people who want to be early adopters, the first to support a new initiative,” she says. “They want to seed innovation for social change.”

Jennifer and her team are working hard to connect donors to researchers and initiatives that are meaningful to them – and that will lead to important breakthroughs. At the same time, they’re broadening their geographic horizons in their search for support. “I have so much confidence in the quality and potential of research in this community, I feel we can attract support from Research Facility Working Group Addresses Safety, all across the globe,” she says. “I’m not afraid to put a stake in the ground and say, ‘We’re going for best in the world!’” Consistency and Quality

Joining the IWK Foundation has been like coming home for In 2011, investigators, research personnel and IWK and Dal- • current emergency contact lists and standard callout Jennifer. In the mid-1990s, she was manager of corporate housie administration departments joined forces to form the IWK procedures “I’m constantly amazed by the number of brilliant people we fundraising for the foundation. Now, after 14 years in senior Research Facility Working Group. Their goal was to harmonize • monthly fire safety training have here and how passionate they are about their research,” leadership positions with the Canadian Broadcasting Corpora- policies and operating procedures for all research personnel • online tracking of material safety data sheets (established says Jennifer Gillivan, CEO of the IWK Foundation. “They tion, she is thrilled to return to the IWK. “The IWK is part of my working in laboratories at the IWK. Over the course of a year, under the IWK process while meeting Dalhousie impress me, because they want to drive the change that will heart and soul,” she says. “It plays an incredibly important role requirements) the group examined all aspects of lab operations to establish make the difference in people’s lives.” in the lives of Maritime families, it’s part of the fabric of our so- • training in area-specific responses to IWK emergency common policies and procedures to ensure research is con- ciety. And while we might think that health care and research codes, i.e. code red = fire, code brown = hazardous ducted in the safest, highest-quality manner possible in IWK Since joining the IWK Foundation early in 2012, Jennifer has are more advanced somewhere else, the groundbreaking work substance spill, etc. research labs. They acted to address such key issues as: immersed herself in learning what researchers hope to is happening right here!” • initiation of an annual Chemical Amnesty Day program to accomplish – and what donors want to support. “I’m interested encourage the safe disposal of unused or out-of-date • optimal waste disposal practices in what is possible and what we need to do to get there…so I chemicals – a unique and innovative program that earned • signage and standard operating procedures dive in and find out,” she says. “What I’m seeing is the potential the group an IWK STARS team award. • electronic sharing of reference materials, communications for us to lead the world in many areas… we’re already there in and ongoing projects Over the past year, the IWK Research Facility Working Group has quite a few. It’s our job, at the IWK Foundation, to share that • orientation for new researchers, students and volunteers expanded its focus beyond laboratory-based research – so it vision and enthusiasm with donors, to fire their imaginations so • security requirements, upgrades and standard operating is now operating with a broader mandate and increasing we can help the researchers accomplish their goals.” procedures for restricted access participation from clinical, population health and health services • annual scheduling and certification of equipment, such as researchers and support staff. Now involving more than 30 bio-safety cabinets and fume hoods imagine • ongoing review and upgrade of lab safety facilities, such members, the group is discussing and taking action on such key as fire safety cabinets and eyewash stations issues as facility operations and maintenance, human re- • initiation and training in the IWK intranet-based adverse sources, safety, certifications, IT and institutional-level policy events reporting/management system (AEMS) for all labs and procedures affecting all areas of research. • pandemic plans specific to each lab • emergency response to secured areas Above: Some members of the IWK Research Facility Working Group.

14 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 15 Awards and Recognition Chris Nash, Emma Plaskacz and Robyn MacQuarrie, all residents in the Department of Obstetrics & Gynecology, have each received a Ross Stewart Smith Memorial Fellowship in IWK investigators successfully competed for funds from granting agencies, enabling them to launch and sustain a wide variety of Medical Research from Dalhousie University. research initiatives. An especially large number of researchers were recognized for the impact and quality of their work. Chris Richardson received a grant from Dalhousie Medical National Research Awards Research Foundation for essential equipment to advance his studies of measles receptors on cancer cells. Victoria Allen is part of a cross-country team that received a Canadian Institutes of Health Research (CIHR) Emerging Team Johane Robitaille was successful in her application to the Cap- Grant to explore means of preventing severe maternal morbidity ital Health Research Fund for a grant to develop novel therapies associated with pregnancy and childbearing. She’s also involved for treating rare vascular disorders of the eye. in a new CIHR-funded team project to see if magnesium sulphate can be used to improve neurodevelopmental outcomes Jun Wang and co-investigator David Hoskin (Dalhousie in preterm infants. Medical School) received funding from the Beatrice Hunter Cancer Research Institute and QEII Foundation to evaluate a Jason Berman was awarded an operating grant through the potential immune therapy for breast cancer. CIHR-Nova Scotia Health Research Foundation (NSHRF) Regional Partnership Program to test new targeted therapies against Recognition Awards Camille Hancock Friesen is the most recent recipient of high-risk acute myeloid leukemia. Chris McMaster (above, left) and Conrad Fernandez are a Progress Women of Excellence Award in the health and leading IGNITE, a large-scale initiative to fast-track the Jill Chorney was recognized for the excellence and potential of wellness category. A surgeon, researcher and president of Linda Dodds is studying the vitamin D status of pregnant women discovery of treatments for orphan diseases – rare genetic her research with an Emerging Professional of Distinction Award the Maritime Heart Center, Camille was recognized for her and their newborns in Canada, to determine what levels best diseases such as the one that cost Tara Sawler (above, at the 2011 Discovery Awards gala. contributions to cardiac surgery and cardiac health – in protect mother and baby from adverse pregnancy outcomes. centre) her sight. Genome Canada and a consortium of particular for her leadership role in developing the Heart CIHR has awarded her an operating grant to complete this work. funding partners are providing $5 million to the project, Ryan D’Arcy and the team that worked with him to develop the Healthy Kids (H2K) initiative. Now running in a number which involves a team of more than ten scientists and NeuroTouch neurosurgery simulator received two prestigious of Nova Scotia schools, H2K promotes heart health Scott Halperin received a grant through the CIHR’s ‘Network clinicians in the fields of medical genetics and genomics, awards from the National Research Council in recognition of this knowledge and active lifestyles among children. Catalyst’ program to help build a national human immunology molecular biology, pathology, ophthalmology, hematology- important innovation: the Public Service Award of Excellence network. This network will encourage national and international oncology, nephrology and pediatrics. The researchers have and the Breakthrough of the Year Award. collaboration, resource sharing, capacity building and know- already identified several promising gene targets and are Patrick McGrath achieved the highest Hirsch-Index Bench- ledge translation. beginning to screen potential treatments. Patients like Tara Farhan Khan placed second in the senior basic science cate- Sawler and her mother Cathy (above, right) are strongly gory in the International Association for Dental Research/ marking of Academic Research (HiBAR) score in Canada in the field of psychology. HiBAR provides a broad measurement of Stacy O’Blenes is working with support from a CIHR operating supportive of the IGNITE project. Unilever Hatton Competition for his work as a Masters student how much influence researchers wield in their disciplines. grant to optimize the protection of hearts from ischemic damage to identify antibodies that neutralize the bacteria that help during cardiac surgery. He is tailoring protective solutions cavity-causing bacteria bind to the teeth (see story on page 10). The Canadian Paediatric Society presented Peter Camfield according to the age of patients, who range from newborns to Local and Regional Research Awards and Carol Camfield with the Career Research Award, Natalie frail seniors. Stan Kutcher received several important honours, including DeNovaMed, a start-up company launched by IWK-affiliated the Dr. Robert Bortolussi Research Mentorship Award from the Yanchar with the Victor Marchessault Advocacy Award, and Bob Bortolussi with the Member Recognition Award. Chris Richardson has received a CIHR operating grant to researchers David Byers, Chris McMaster, Don Weaver and IWK for his exceptional contributions to mentoring the next explore the nature of PVRL4 (Nectin 4), a measles virus receptor Chris Barden received an early commercialization award from generation of researchers. The Schizophrenia Society of Canada Don Weaver is one of a select few non-chemical engineers which he has recently identified and which has important Innovacorp to prepare to take its new class of antibiotics to presented Stan with the Michael Smith Award for his efforts to to receive the prestigious Bantrel Award from the Canadian implications for potential measles-based cancer therapies. clinical trials (see story on page 12). improve quality of life for those affected by schizophrenia, while Dalhousie Medical School recognized his outstanding contribu- Society for Chemical Engineering. He also received the Jonas Salk Award, a lifetime achievement award presented by Sanofi Neale Ridgway is studying the regulation of nuclear membrane Jason Berman received the Peggy Davison Clinician Scientist tions to global health with the Dr. John Savage Memorial Award Pasteur and the March of Dimes Canada. The Canadian College architecture and cell proliferation with an operating grant Award from Cancer Care Nova Scotia and the Beatrice Hunter in International Health. of Neuropsychopharmacology presented Don with the Heinz through the CIHR-NSHRF Regional Partnership Program. Cancer Research Institute to further his studies of cancer in the zebrafish model. Senior residents Elinor Lu-Olaco and Darrien Rattray won first Lehman Award for his outstanding contributions to neuro- psychopharmacology and psychiatry. Don Weaver is continuing to design, synthesize and optimize and second prizes, respectively, in the Society of Obstetricians new chemical entities for use as antimicrobial agents, with Patrick McGrath was awarded a Scotia Support Grant from the and Gynaecologists of Canada’s annual poster competition. support from the CIHR-NSHRF Regional Partnership Program. NSHRF. This two-year award will support trainees in the Centre for Research in Family Health at the IWK.

16 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 17 IWK Research Awards Special Honours Research Funding and Activity In 2011-2012, the IWK granted close to $786,000 through its The following awards are named in honour of a donor or per- Continued Investment and Growth internal research award programs. Awards include a variety son affiliated with the IWK and presented to those applicants 5 of operating grants, salary awards, scholarships, equipment who receive the highest ratings from the Scientific Review grants and start-up funds. Here are some highlights: Committee. The IWK Health Centre operates in a complex, challenging and 4 ever-changing environment. Research is the critical tool that Category A Operating Grants (up to $4,000 each) were awarded Thompson Scholarship: Jillian Filiter compared the effect of provides the answers we need to make the right decisions – to 14 investigators, including Christy Woolcott, who seeks repeated exposure to stimuli on high-functioning adolescents about treatments, service delivery, system design and many 1 other facets of health care. We and our valued partners – the to understand how behavioural and biological factors during with Autism Spectrum Disorder to the effect of this exposure 3 pregnancy influence the development of maternal and child on typically developing youth. Supervisor: Shannon Johnson IWK Foundation, Capital Health, the QEII Foundation, Dalhousie 2 obesity. Another recipient, Brett Taylor, is using his award to University and Dalhousie Medical Research Foundation (DMRF) work with his team to develop a smart phone application that Heinish Studentship: Ashley Bitar focused on antigen tar- – continued to invest heavily in our research programs at the uses a decision-support system to help diagnose brain injuries geting as a means of enhancing immune responses to antigens local level. This local investment is allowing us to build research IWK Operating Grants $282,528 – in particular, concussions. produced by Streptococcus Gordonii. Supervisors: Scott Halperin skills and capacity in our community, while supporting our 1 Category A & B Grants $135,008 researchers’ initiatives and attracting external funding and and Song Lee 2 Equipment Repair & Maintenance $16,687 talented investigators with new ideas. Category B Operating Grants (up to $15,000 each) were 3 Partnership Awards $24,358 awarded to six investigators, including Celeste Lefebvre, who Burnstein Studentship: Katherine Anderson examined how The past year was a very active one at the IWK, with more than 4 Recruitment & Establishment $98,809 is examining the demographic, psychological and risk profiles abnormal phospholipid synthesis in cancer cells alters the struc- 600 research projects on the go. The IWK Research Ethics Board 5 Bringing People Together $7,666 of Nova Scotia youth who engage in criminal behavior. Fellow ture of the membrane surrounding the nucleus and contributes reviewed and approved 153 new research projects involving recipient Ismail Mohamed is using novel imaging analysis to a proliferative phenotype. Supervisor: Neale Ridgway humans or their tissues or information, and renewed ethics methods to understand the mechanisms of brain recovery in approvals on 483 ongoing projects. The goal of these human congenital hemiplegia. studies, and the many basic science projects underway, is to improve health and wellbeing through gaining and applying Establishment Awards (reaching a total of $98,809) were knowledge. awarded to several new researchers. These include Paul Hong, who hopes to improve the results of ear reconstruction surgery. Internal Research Funding He is developing a way to generate ear cartilage in the lab that could be used during surgery to help avoid healing The IWK invested slightly more than $1 million in research in complications associated with current surgical methods. 2011-2012, including nearly $786,000 to support research programs and more than $215,000 to support research infra- Graduate Studentship Awards ($13,400 each) were awarded structure. This substantial investment fosters research capacity to three new graduate students for a two-year period. One of by investing in people, facilities, equipment and projects. these is Robert Junkin who, with his supervisor Tong-Jun Lin, Auxiliary Grant Award: Alexa Bagnell plans to further Building Medical Residents’ is investigating new approaches to treating Pseudomonas validate the effectiveness of the IWK communication Research Skills infection – a major cause of death in cystic fibrosis. 6 1 questionnaire as a tool for assessing parent-adolescent 5 communication. She feels the questionnaire could play Dalhousie Medical School surgery resident Dr. Scott Research Investigatorship Funding ($60,000 per year for four a valuable role in mental health promotion and early Hurton meets with IWK consulting scientist Dr. Jill years) was awarded to Janet Curran to develop, implement intervention initiatives 4 2 Hatchette to discuss progress on his resident research and evaluate methods for enhancing and sustaining involvement project. He is building a database to monitor quality of in research in pediatric and emergency care settings. care and health services utilization of pancreatic cancer McCarlie Graduate Studentship: Katelynn Boerner looked patients in Nova Scotia – an important step in efforts to Summer Studentships ($2,500 each) were awarded to 12 3 at the accuracy of various health professionals in detecting ensure these patients receive the best possible care. Jill students, including Nathanael Crawford. He and his supervisor deception and assessing pain severity based on children’s facial and fellow consulting scientist, Dr. Krista Ritchie, are Aaron Newman are developing a technique to more accurately expressions. Supervisor: Christine Chambers IWK Human Resource Development Awards $503,212 helping surgery, pathology and anesthesia residents investigate the brain networks involved in reading. 1 Scholar Award $30,000 develop the knowledge and skills to conduct high-quality McCarlie Postdoctoral Fellowship: Dr. Liang-Tzung Lin used 2 Investigatorship $155,000 research. They have tailored their 10-module Fundamen- this award to identify host factors in an infected liver cell that 3 Fellowships $148,500 tals of Research Design course to residents’ needs and help the Hepatitis C virus replicate. He also explored several 4 Associateships $54,360 provide ongoing advice as residents complete the research plant-derived natural products as potential antiviral therapies 5 Graduate Student Scholarships $85,352 projects that are a required part of their training. against Hepatitis C. Supervisor: Chris Richardson 6 Summer Studentships $30,000

18 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 19 External Research Funding Publications Our Research Community Leaders and Volunteers Funding for medical research has declined in recent years, mak- In 2011, IWK researchers published their findings in a total ing competition for available monies extremely stiff. In spite of of 272 publications. These included 260 journal articles and 12 While imagination is the spark that ignites the research process, the process itself requires a lot of hard work. In addition to the intense competition, IWK researchers were able to secure more book chapters. efforts of researchers and their trainees and staff members, the IWK’s successful research program relies on ongoing direction, than $14 million in external funding in 2011-2012. While funding coordination and support from a wide range of very active committees and the dedicated team in Research Services. from disease-specific foundations and national and international While translating findings to clinical practice and/or improved agencies increased overall, there was a significant decrease in public health is the ultimate aim of research, publishing the find- April 1, 2011 – March 31, 2012 funding from the Canadian Institutes of Health Research (CIHR). ings for the scientific community to review is an essential step This is due to a number of exceptionally large CIHR-funded proj- along the way. Publications are an important measure of Research Ethics Audit Debbie Matheson Patrick McGrath Patrick McGrath ects, which had boosted funding to record highs in the past few research productivity, quality and impact. Committee Patrick McGrath Anne McGuire Roger McLeod years but are now nearing the end of their life cycles. Most other James Morrison Joanne Nozick Amy Ornstein categories of funding remained relatively stable. Publications of Members of the IWK Research Community Darlene Baxendale Tony Otley Kathleen Pajer Chris Sinal 2001-2011 Jill Beis Christy Simpson Marjorie Sullivan Marjorie Sullivan 7 8 6 Debbie Matheson Joan Wenning Anita Unruh Brett Taylor 5 360 James Morrison Jocelyn Vine 4 Tony Otley Research Management Research Services Staff 340 3 Steve Van Iderstine Committee – Programs Research Space Allocation (as of March 31, 2012) 1 320 Karin Wallace and Utilization Committee Victoria Allen Ashley Aalders 300 2 Research Ethics Board Susan Bryson Christine Chambers Yasmin Ali 280 Linda Dodds Linda Dodds Frank Bezanson Bob Bortolussi Ron El-Hawary Donna Gilmour Mackenzie Bartlett External Awards $14,040,143 260 Jill Chorney Allison Gray Tong-Jun Lin Kelly Brophy 1 Canadian Institutes of Health Research $7,387,926 240 Elaine Cumming Scott Halperin Patrick McGrath Yvonne Cake 2 Cora Fanning Joe Hyndman Kathy McKay Denise DesLauriers National & International Agencies $1,186,258 220 3 Clinical Trials $2,692,312 Eleanor Fitzpatrick Thomas Issekutz Dawn McLellan David Fillmore 4 Canada Foundation for Innovation $196,711 200 Margo Fulmer Patrick McGrath Marjorie Sullivan Jill Hatchette 5 Disease-Specific Foundations $903,813 180 Linda Hamilton Brett Taylor Don Weaver Kathleen Leadon Adam Huber Vicky Veitch Wolfe David Young Joanne Leonard 6 Provincial Funds & Foundations $1,324,301 160 Faye Jacobson Christy Woolcott Patrick McGrath 7 Dalhousie & DMRF $333,822 140 Sarah Matheson Scientific Review James Morrison 8 Industry $15,000 Susan McKinney Research Oversight Committee Alyson Rees 120 Douglas McMillan Committee Krista Ritchie Grants and Awards 2002-2012 100 James Morrison Victoria Allen Marjorie Sullivan 80 Victoria Price Vicky Allen Megan Aston Beverley White 24 Pierre Schmit Tony Armson Jason Berman 60 22 Valerie Shaffner Mark Bernstein JoAnn Brock 20 40 Isabel Smith Krista Connell Ryan D’Arcy Marilyn Tiller Gerard Corsten Ron El-Hawary 18 20 16 Martha Crago Kirk Feindel 14 0 Research Management Jennifer Gillivan Scott Halperin 01 02 03 04 05 06 07 08 09 10 11 12 Committee – Ethics Allen Horsburgh Jill Hatchette 10 PUBLICATIONS BOOK CHAPTERS BOOKS Joe Hyndman Paul Hong 8 Jen Feron Krista Jangaard Thomas Issekutz

AWARDS IN MILLIONS IN AWARDS 6 Joe Hyndman Gerald Johnston Fergall Magee 4 For a complete list of 2011 publications by IWK researchers, 2 visit: www.iwk.nshealth.ca and follow the links from Credits: Project coordination and writing, Melanie Jollymore; design and layout, Greg Tutty; original photography, John Sherlock; additional photos, Gerard 0 ‘Research.’ 02 03 04 05 06 07 08 09 10 11 Walsh (pages 13 and 19); special thanks to Calnen Photography for the photo of Ruth Goldloom, to Saltcapes Ltd. for the Perry Jackson photo on page 4, EXTERNAL INTERNAL to the IWK Foundation for the Sue Siri photo on page 14, to Genome Canada for the photo on page 16, and to the Maritime Heart Center for the photo on page 17.

20 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 IWK Health Centre Research Annual Report 2 0 1 1 - 2 0 1 2 21 Thanks to:

IWK Foundation Beatrice Hunter Cancer Research Institute Canada Foundation for Innovation Canadian Institutes of Health Research Dalhousie Medical Research Foundation Nova Scotia Health Research Foundation QEII Foundation and many others for their generous support of research at the IWK Health Centre.

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