New Horizons in Health Care

Meet six people who are challenging the clichéd image of a researcher hunched over a Petri dish or crunching data until the wee hours.

You'll find these health-care leaders out in the community, making clinical visits and making a difference. And, yes, sometimes even hard at work in the lab. But wherever their work takes them, their efforts will help improve your quality of life in the next decade.

Aging Population

Sharon Anderson, '10 MSc Health Promotion

Current position: PhD student with Research on Aging, Policies and Practice in the Faculty of Agricultural, life & environmental sciences Field: Community living after stroke Why she's one to watch: she expands our understanding of personal relationships in rehabilitation and quality of life. She recently received a Queen Elizabeth II Graduate Scholarship.

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In 1997, Sharon Anderson and her husband, John, had a stroke.

The event itself occurred in John's brain, but it transformed them both as a couple. It also drastically rerouted Sharon's career path. She left her job as a dental hygienist and headed back to school, eager to expand on her own experience in a marriage affected by stroke. She earned two master's degrees - one at the University of Calgary and one at the U of A. Now she's working on a PhD, studying the experiences of other couples who have survived strokes, and how their relationships affected their recoveries.

When John suffered his stroke, at age 46, the prognosis was grim, recalls Sharon.

The neurologist told me to put him in a nursing home. I said that wasn't an option."

Instead, Sharon brought her husband home and hired private therapists. Within a month, John had improved enough to be accepted into a rehabilitation program. Today, he maintains his own website, stroke-survivors.org.

The couple's effort not only improved their quality of life, it spared the health-care system an estimated $73,000 per year for care in a nursing home, says Sharon.

"My husband is now 15 years out of stroke. If you look at the cost of keeping him in a nursing home for 15 years, that's a lot of money."

Anderson is delving into the experiences of couples in a similar situation. "What happens in that couple's relationship to help the stroke survivor get better, or to keep the couple together?" she wonders. Existing data already show stroke survivors in stable relationships recover better and require significantly less long-term care. Anderson's findings could maximize the benefits enjoyed by stroke patients in relationships, while finding ways to provide better community support for all.

Anderson is particularly excited to be working with Norah Keating, U of A professor of human ecology, who is helping her explore medical questions from a holistic perspective.

She also continues to look forward to her shared future with John. "When people refer to me as a caregiver, I say, no - I'm my husband's wife."

Sci-Fi Diagnostics

Current positions: Professor in the Departments of Computing Science and Biological Sciences, with adjunct appointments in Pharmacy and Laboratory Medicine & Pathology; Co-founder and Chief Scientific Officer for two companies (Chenomx and BioTools) and Project Leader of The Human Metabolome Project Field: Metabolomics Why he's one to watch: Wishart and his colleagues have made the University a leading centre of metabolomics, a technique that could revolutionize the way we diagnose illness.

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Chances are you've never heard the word metabolomics (pronounced metabo-LOH-mics) but it just might revolutionize medical diagnostics around the world - and the U of A stands at the global epicentre of this emerging field.

"It's clinical chemistry on steroids," explains David Wishart, project leader for the U of A's Human Metabolome Project. Metabolomics seeks to identify and catalogue every chemical we produce in our bodies, and to look for the patterns that correspond to various illnesses and conditions. Instead of looking for one or two compounds - for example, blood glucose - metabolomics measures hundreds or even thousands of compounds all at once.

By doing so, metabolomics vastly expands the amount of information that we can derive from a single tissue or fluid sample, says Wishart. "In the past, it was like looking at the world through a keyhole. But now, we can look at the world through a picture window."

In other words, metabolomics allows diagnosticians to see the big picture. "Blood glucose tells you if you have diabetes or not," explains Wishart. "But there's a whole bunch of other compounds that can tell you how bad the diabetes is, whether it's going to progress, or even if you're going to get diabetes."

That kind of detail opens the door to personalized health care. "You can actually have a metabolic profile that could be used to diagnose, or predict, or prognosticate, or assess the risk for a whole bunch of different conditions."

Eventually, Wishart hopes, a urine sample could be as useful a diagnostic tool as a Star Trek tricorder (if not quite as sexy).

The Human Metabolome Project, launched by Wishart's lab in 2005, has catalogued about 40,000 different chemicals found in the human body. Although the project hasn't yet made its way into everyday medical practice, that day is definitely coming. Several companies, including three in Edmonton, have already started developing specific tests based on the data, including one for pre-colon cancer and another for HIV.

Meanwhile, the U of A's Human Metabolome Project database is accessed by millions around the globe every year. It just might be time for a new sign on Gateway Boulevard: "Welcome to Edmonton - City of Metabolomics."

Food Safety

Kamaljit Kaur

Current position: Associate Professor, Faculty of Pharmacy & Pharmaceutical Sciences Field: Research in Medicinal Chemistry Why she's one to watch: Kaur's work with peptides - compounds that occur naturally in foods such as yogurt - holds great potential in food safety and cancer treatment.

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When Kamaljit Kaur contemplates a container of yogurt, she sees much more than a topping for her morning granola. The lactic acid bacteria in yogurt produce peptides, compounds that lie at the very centre of her research. "These peptides are very friendly to humans," she says.

In fact, they're more than just friendly. Those peptides, it turns out, are very effective in killing pathogenic bacteria, like listeria, a foodborne illness that can cause serious infections. By harnessing the power of peptides, Kaur and her colleagues could potentially banish listeria from our food industry, along with other deadly microbes such as E. coli and salmonella.

Because they are derived from food sources, these antimicrobial peptides, also known as bacteriocins, could provide industry with a much healthier way to fight pathogens. "Current practices use a lot of chemical preservatives and conventional antibiotics," Kaur explains.

Kaur's work earned her $495,000 in funding from the Food Safety Research and Innovation Program, with the support of Alberta Innovates Bio Solutions and the Alberta Livestock and Meat Agency. During a three-year research project, Kaur and her colleagues hope to develop new methods for mass-producing these bacteriocins.

The project teams Kaur with longtime colleagues David Wishart, Computing and Biological Sciences; Lynn McMullen, Agricultural, Food and Nutritional Science; and industrial partner CanBiocin Inc.

Kaur has another major research area also focusing on peptides - using them to target cancer cells, including breast cancer. "That's equally exciting," she says modestly, "but this grant is mainly for our antimicrobial work."

Above all, Kaur is grateful for the atmosphere of support and collaboration at the U of A. "The funding makes it possible for our team to pursue our ideas," she says. "These peptides are very promising, and they haven't been explored to the extent they should have been."

Kidney Disease

Marcello Tonelli

Current position: Canada Research Chair in Optimal Care of People with Chronic Kidney Disease Field: Care delivery and quality of health care Why he's one to watch: Kidney disease affects more than two million Canadians. Tonelli is one of Canada's top experts in identifying kidney patients at greatest risk, and in partnering with health policy-makers to get patients the most effective care possible.

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Most people needn't lie awake at night worrying about kidney disease, says Marcello Tonelli. But if you have high blood pressure, diabetes or a family history of kidney disease, Tonelli wants you and your doctor to be aware of the stakes.

"People with kidney failure have very poor quality of life and they are very likely to die," Tonelli says. "But, fortunately, there are effective treatments available that prevent the kidneys from failing. The major focus of my work is to try to figure out which patients are at highest risk, and what treatments we can use to reduce that risk and improve their outcomes.

"I'm also looking at how we can make the health system work better, to deliver those treatments in a way that's easy for them to take."

Currently, Tonelli is focusing on a relatively low-tech strategy. "We're returning to an older test, for detecting protein in the urine," he says. "With a very simple and cheap urine test, you can discriminate between someone who is only at slightly greater-than-average risk, and someone who's at a very high risk."

With research partners throughout Alberta and around the world, Tonelli has his hand in a wide range of initiatives. "We meet every week or more by teleconference, and we're talking on the phone several times a day," he says. "Honestly, it's one of the best things about my job. I get to work with such a great group of people."

Tonelli also works to see that same approach reflected in patient care. "Policy-makers in Alberta are quite interested and engaged," he says. "Whether that's Alberta Health or Alberta Health Services or other organizations - people are willing to share their priorities. That helps us to do research that matters."