A little blogging break…

The blog isn’t going anywhere. However, I’ve been on a little blogging break.

Between my research, involvement in ParkinGo, teaching yoga and growing a new little member of our family (yup! due this month!), I’ve had to prioritize how I spend my time.

I’m not going anywhere. However, I’m going to spend the next 6 months focusing on parenting.

I don’t plan to leave the Internet world altogether. If you want to know where to find me to ask a question or simply say hello, you can comment below or find me HERE

 

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If you’re new to the blog and want to dig in a bit, you’re welcome to read through my archives. And if you’ve been (patiently!!) waiting for new content, that will come in the Fall (2016).

For now, THANK YOU for understanding. I’ve appreciated interacting with so many of you and look forward to doing so again soon.

much love, K.

 

Wearable health data monitoring – is it really useable? Implications for physicians and Parkinson’s research.

With the availability of devices that can track health information – you know, those wristbands and phone apps that measure how much exercise you’re getting or how many calories you’re eating – it’s no surprise that patients are bringing this information to their primary care physicians.

Wearable-digital-health-information industry is a fast growing market – worth between $3 billion and $5 billion (Credit Suisse) – with over 50,000 health apps, has the power to transform health care. But the information collected can be overwhelming to physicians – pages of excel sheets that includes symptoms, medication, heart rate data –  information these devices collect can be overwhelming.  And begs the question, are the data coming in digitally accurate? There are limited validation studies on these ‘low risk devices’  – meaning those not monitored by the FDA, such as FitBits and Apple Watches.

However, these devices can also put the power back into the hands of individuals, as they are able to track healthy behaviours and likely promote positive lifestyle choices.

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These tools are also powerful in a research context. Especially in the context of Parkinson’s disease. I used portable monitors – things like GPS watches, accelerometers and devices that measure muscle activity – during my PhD dissertation research to examine how people with PD move about their day in the context of their own community (publications: HEREHERE HERE, and HERE). In PD, these devices have the power to represent the real fluctuations people experience in daily life, due to medications or environment – outside of the ‘sterile’ and isolated clinical appointment setting.
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NPR reports on a Michael J Fox Foundation trial (here) that is looking whether an activity tracker made by Intel would be useful to track the severity of tremors. It creates a digital diary showing how tremors respond to minor changes in diet, sleep patterns or what time of day medication is taken. Parkinson’s is a 24-hours-a-day, seven-days-a-week disease. Patients and their doctors need a better way to monitor PD, and researchers need a more objective way to measure the effect of new drugs. The solution might come through the use of ‘low risk’ wearable devices, such as smart watches or apps. The data collected from these devices may highlight trends or differences among people with PD, or therapy’s effect, and may point researchers to new areas of interest in our pursuits of learning more about Parkinson’s and of developing a cure. “Data science and wearable computing hold the potential to transform our ability to capture and objectively measure patients’ actual experience of disease, with unprecedented implications for Parkinson’s drug development, diagnosis and treatment” said MJFF CEO Todd Sherer, PhD.

Bret Parker (who blogged HERE), a 46-year old lawyer from NYC is participating in this trial: “When I heard there was a trial that involved a wearable that would help me better manage my symptoms and my condition, I said to myself, ‘Well, that’s a pretty cool thing. I’ve got to try that’.

As well, Dr. Gareth Jones (my PhD supervisor) at the University of British Columbia Okanagan and Dr. Petrella from Western University have created a new app called “Health e Steps” with the intention of communicating specific health information to physicians. You can watch their video HERE.

Finally, if you are a person with Parkinson’s disease living in the Victoria BC area, there may be an upcoming opportunity to participate in a trail for a wearable device in partnership with ParkinGo. Check out their great website and get in touch if you are interested in finding out more information!

8 weeks to a better brain? Meditation changes your brain’s gray matter.

Our brain’s gray matter can change in shape and size (for the better!) after just eight weeks of practicing meditation.

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16 participants took part in an eight-week meditation practice at The University of Massachusetts’ Center for Mindfulness (est.1979!) (more info HERE). The participants meditated “on nonjudgmental awareness of sensations, feelings, and state of mind” and also incorporated mindful yoga and movement. They practiced daily guided mediation via audio recordings at-home, and went to weekly two and half hour group mindful meditation practices. In the end, study participants reported spending an average of 27 minutes each day practicing mindfulness meditation. Harvard researchers at Massachusetts General Hospital used MRIs (magnetic resonance imaging) to take pictures of the participants’ brains two weeks before and two weeks after the program.

The results demonstrated increased gray matter density in the hippocampus, a brain area for learning and memory, self-awareness, compassion, and introspection. Also, participants who reported decreased stress levels also showed associated decreased gray matter density in the amygdala, a brain known for anxiety and stress. Full article HERE. much love.

“Although the practice of meditation is associated with a sense of peacefulness and physical relaxation, practitioners have long claimed that meditation also provides cognitive and psychological benefits that persist throughout the day. This study demonstrates that changes in brain structure may underlie some of these reported improvements and that people are not just feeling better because they are spending time relaxing.” – Sara Lazar of the MGH Psychiatric Neuroimaging Research Program and a Harvard Medical School Instructor in Psychology
“It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life. Other studies in different patient populations have shown that meditation can make significant improvements in a variety of symptoms, and we are now investigating the underlying mechanisms in the brain that facilitate this change.” – Britta Holzel, first author of the paper and a research fellow at MGH and Giessen University in Germany

Other references:

http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to-a-better-brain/

Being a woman with Parkinson’s disease – does it make a difference? A call for research and advocacy.

Absolutely.

We have different bodies, different hearts, different experiences and have different care needs. We know that Parkinson’s disease is very individual from person-to-person, but both sex (biology) and gender (social/cultural constructs) may contribute to these differences.

There is a need to understand the particular impact of this disease on women, in general – we need to better understand and address the realities of women with Parkinson’s disease (PD). Robin Morgan,  author of 22 books and host of “Women’s Media Center Live with Robin Morgan” (WMCLive.com and iTunes), wrote an incredible piece for PDF’s Fall 2014 newsletter that really rings true. Also, Parkinsonswomen.com offers moral support, encouragement and camaraderie for women with PD.

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Function

My research, especially during my PhD, not only focused on frailty and daily function in PD, but specifically sought to understand the implications of PD for women (you can read more Roland et al. Maturitas, 2010). In Europe and North America the incidence of PD is 1.5–2 times lower and symptom onset is two-years later in women than men. Conversely, in Yamagata Japan PD incidence is reported to be greater in women (91.0/100,000) compared to men (61.3/100,000). The reasons for this diversity have yet to be determined. Symptom expression differs: women experience greater fluctuations in motor symptoms, depression, pain, dyskinesias, and instability leading to falls then men. This may lead to greater need for hospital care and reduced quality of life. Also, the underlying effect of estrogen may also influence medication effectiveness, dyskinesias and disease progression.

In terms of function, the literature suggests women have greater loss of lower-body strength, reaction time, poor poor balance confidence, increased freezing of gait, and lower exercise tolerance. Also, more difficulty in ADL tasks, like getting dressed. However, cognitive issues seem to be less prevalent in women. These functional limitations can greatly affect HOW women manage the disease. 

And what about the impact of gender roles on disease expression and what it means to be a women with PD? The growth of same-gender support groups, in which a person may feel more comfortable discussing intimate details than in a mixed female-male group, brings to light about differences in women’s symptoms, side effects, care and participation in research.

Care

Women are 22% less likely than men with PD to see a neurologist – does this increase suffering in women?

What about caregiving? The entire family is affected with PD. In society, women are often the “tent poles” of the family and most likely to become the primary caregiver. How are we helping women whose relatives live with PD? Or women who is diagnosed herself with PD? Women who become ill may be at greater risk of finding themselves without a partner compare to men. Studies show 6x greater risk of divorce among older heterosexual couples when the wife becomes ill (work done by: Amelia Karraker, Ph.D., Kenzie Latham, Ph.D., Michael Glantz, M.D.) Clearly, we need to do more work around the implications of care for women with PD.

Research and advocacy

The presence of women in research has improved since the National Institutes of Health (NIH) policy in 1986 was established to correct any imbalances – but not enough has been done and women are still underrepresented in medical and drug trials. Including women in studies is important so we can understand how a woman’s physiology determines  treatment.

Robin Morgan works with PDF’s Parkinson’s Advocates in Research program to understand and end inequalities in research and treatment, and to better meet the needs of women. They’re just getting started, and need and welcome your participation! You can start by taking PDF’s survey here, to help us understand the specific experiences of women with PD. Please contribute, whether you are a women living with Parkinson’s disease, a care partner to a person living with Parkinson’s disease or a health professional working with women who live with Parkinson’s disease. Another idea might be contacting PDF about its Women and PD Initiative, which is launching in spring 2015! much love.

“We need to fix inequalities in research for everyone living with PD who hopes for more effective treatments.” Allison W. Willis, M.D. Faculty member, PDF Parkinson’s Advocates in Research program; Assistant Professor of Neurology, University of Pennsylvania.

“Women typically fulfill many roles within their lives … everything from super mom, holiday organizer, caretaker for both aging parents and grandchildren, while managing a household and a career. Despite living with PD, the expectations for women often remains the same. The complexity of managing our commitments along with living with a chronic progressive disease can be overwhelming. We are launching the first PDF Women and PD Summit so women have the chance to come together with others who are traveling the same path. Our hope is for each woman to leave the Summit with a new cache of life-enhancing skills that she can share with women in her own community.” Karen Smith, Vice Chair, PDF People with Parkinson’s Advisory Council, PDF Research Advocate.

Predicting cognitive changes in Parkinson’s #parkinsons #PDdementia #cognition

So, it’s not new information that you can develop some cognitive changes with Parkinson’s disease (PD). Not everyone with PD experiences some changes to memory, language, executive function, mood, personality or behaviour; however, people with PD are 6x more likely to develop one of these issues (to differing levels of severity) compared with persons of the same age without-PD.

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If you’re interested, I’ve looked at cognitive changes and dementia in Parkinson’s previously HERE and HERE. These posts details what cognitive changes are common in PD and how they differ from ‘dementia’ or ‘alzheimer’s’.

Research published this fall, based in Montreal QB, described factors that increase chances of developing cognitive changes. Being older, male, suffering from REM sleep behaviour disorder, high blood pressure, or orthostatic blood pressure drop. Motor impairments (falls, freezing) can also indicate increased risk for cognitive impairment (Anang et al. Neurology, 2014).

… but what does this really mean? Just because you’re an older man who experiences freezing of gait with PD, doesn’t mean you’ll develop executive dysfunction. However, it helps Clinicians (doctors, neurologists) begin to understand who may be affected and what to look for in early screening. If we can ID cognitive changes early, we can start to implement programs and supports for people sooner.

much love.

“Virtuous Ageing”: another way to be who you are

Did you know I teach an online course for the School of Public Health and Social Policy at UVic on ‘Healthy Ageing’?

The ageing of the world’s population – in developing and developed countries – is an indicator of improving global health. Older people make important contributions to society as family members, volunteers and as active participants in the workforce. The wisdom they have gained through life experience makes them a vital social resource. (WHO, 10 facts on ageing and the life course, Oct 2014).

  • The world’s population of people 60 years of age and older has doubled since 1980 and is forecast to reach 2 billion by 2050.
  • By 2050 the world will have almost 400 million people aged 80 years or older.
  • The main health burdens for older people, even in the poorest countries, are heart disease, stroke, arthritis and dementia.
  • The need for long term care is rising; the number of older people who are no longer able to look after themselves in developing countries is forecast to quadruple by 2050.
  • Creating “age-friendly” physical and social environments can have a big impact on improving the active participation and independence of older people.

But, what does it mean to ‘age’? We need to re-evaluate our assumptions around ‘old age’.

the 4 people who are my role models for being 'old'... my grandparents. LtoR: Grampy Roland, Nanny Roland, Nanny Sainthill & Poppy Sainthill with baby Kate (that's me!) at my Christening

the 4 people who are my role models for being ‘old’… my grandparents.
LtoR: Grampy Roland, Nanny Roland, Nanny Sainthill & Poppy Sainthill with baby Kate (that’s me!) at my Christening (1984).

Dr. Hanne Laceulle, who writes about the philosophy of aging at the University of Humanistics in the Netherlands, proposes 3 ways to think about ageing:

1. Age well… which can sometimes be (mis?)interpreted at doing everything you can to  ‘stay young’.

2. Give in to the inevitable decline … give up and get old.

3. Or, why not consider ageing simply another process of becoming who you are?

She points out that both ‘staying young’ or ‘giving up’ are problematic because they add no value to late life in itself and set people up for defeat. By considering aging as ‘who you are’, it gives people permission to success at some thing – wisdom, tolerance, humour, love – and fail at others – bad hips, bad hearing. This freedom to fail as you age is liberating! It stops blaming ourselves for dependences that come with age, while acknowledging this loss.

Ageing is a part of life to negotiate like any other.

So instead of “active aging” or “positive aging” or “anti-aging,” Laceulle thinks we should take a cue from ancient thinkers like Aristotle and embrace what she calls “virtuous ageing.” much love.

 

 

Resources:

Herald Tribune. B. Peters Smith (Nov 2014).

 

Postdoc 101

kaitlynroland   February 5, 2015   No Comments on Postdoc 101

I get a lot of people very cautiously approaching the question: what is a postdoc? what do you actually do? TRANSLATION: *do you have a real job? If so, what is it?

*NOTE: it is NOT national postdoc appreciation week. ... is that a thing? This comic is from September.

*NOTE: it is NOT national postdoc appreciation week. … is that a thing? This comic is from September.

I was a fairly successful graduate student. I had an amazing support team (PhD co-supervisors, committee members, colleagues and good friends) and some tri-council research funding; I completed my doctorate in the required timeline and published my dissertation work, all while maintaining my sanity and relationships. Phew!

So, I scored some funding and an opportunity to work with a world-class supervisor as a “postdoctoral fellow”. This is what I’ve been doing since 2012.

But, what does that mean? Well, it’s kind of like an internship – I get paid (*my funding agency keeps a roof over my head and supports my coffee consumption, as well as sends me to far away conferences/presentations – valencia! washington! nice! campbell river!) to conduct research projects, analyze data sets that my supervisor has, get my research out to the public… and publish, publish, publish!

What do I do as a postdoc? Well, postdocs typically finish writing up their PhD dissertation into a publishable format – either articles for scientific journals or in book form. Luckily, I can check that off my list. I conduct research (*mainly, interview and collect data from caregivers of persons with Parkinson’s disease and/or dementia, at the moment), I write papers (*which, hopefully, are published in scientific journals), I teach (*an online course on ‘healthy ageing’), I get to mentor undergraduate students who help me with data entry and analysis, I present at conferences (*you can see some of my recent ones here and here) and for the public, all while keeping my eyes on the job market. Academic job positions are typically posted once a year (Aug-Sept), resulting in applications submitted in the fall, interviews in the winter, and (if you cross your fingers and toes real tight!) a start date of July or September. In other words, AN ENTIRE YEAR. You get one shot a year. [pause for effect] So, this is a huge motivator to be productive with research and writing for your CV (*curriculum vitae, aka a resume of your academic accomplishments and involvements that can be infinitely long… my postdoc supervisors is over 100 pages!!!! Something to work up to, right?!).

And, how do I manage to do all this? Simple. Coffee.

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… aaaand a good support team. Throw in a dash of focus, determination, and enjoyment (*no, the last one is not a typo).

It’s a pretty great place to be, actually. I make my own schedule. I have the opportunity to learn a new area of research and have a world-class supervisor who has really taught me independence and to trust my skills. I get to share my work with a community of my peers and those with Parkinson’s and their care partners. I’m getting great experience teaching, and am able to be as productive as possible. TRANSLATION: getting line-by-line closer to that 100+pg CV. much love.

 

Yoga is as good for your heart as aerobic exercise : a new study

A new study found that yoga can be just as beneficial to your heart as other aerobic activity. The study, by Paula Chu, a doctoral candidate in health policy at Harvard in the European Journal of Preventive Cardiology, found that practicing yoga “lowered blood pressure, cholesterol, heart rate and other cardiovascular risk factors in increments comparable to those seen with aerobic exercise.” These positive results compared similarly to the people who did aerobic exercise instead. However, MORE studies need to be done, especially on what types of yoga are the most helpful.

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The findings were based on 37 randomized and controlled clinical trials involving 2,768 people with an average age of 50 monitored for anywhere from 12 weeks to one year through December 2013. The study examined participants who practiced yoga compared to no exercise or yoga compared to aerobic exercise.

Those who did yoga had significant improvements in a range of risk factors. Systolic blood pressure (the top number) dropped by an average of 5.21 mm Hg, and diastolic pressure (the bottom number) dropped 4.9 mm HG. LDL “bad” cholesterol fell by an average 12.14 mg/dl and HDL “good” cholesterol rose by an average 3.20 mg/dl. Average heart rate was lower by a little over 5 beats per minute and weight loss averaged a bit over 5 pounds.“-

… Sun salutations and downward dogs for the win! much love.

other sources: yogadork; reuters

Drug developments in Parkinson’s disease

Have you heard the latest drug developments in Parkinson’s disease? I thought I’d take a minute to break it all down for you…

 

RYTARY™

Impax Laboratories Inc.‘s drug called “RYTARY™” was approved by the US Food and Drug Administration early January (and available in 4 weeks). RYTARY™ is an extended release carbidopa-levodopa available in 4 strengths. Patients taking RYTARY™ in a clinical trial experienced significantly less “off” time and more “on” time without troublesome dyskinesia each day. RYTARY™ is designed to address one of the most significant unmet needs: reduce the amount of time during the day when symptoms are not adequately controlled.

MJ Fox Foundation has a great podcast explaining what causes “OFF” episodes in PD. You can listed to it HERE.

DUOPA™

On January 12th, AbbVie Inc.’s drug called “DUOPA™” was approved by the US Food and Drug Administration. DUOPA™ is a small portable infusion pump that delivers the carbidopa-levodopa directly to the small intestine. It is thought to be effective for 16 hours as opposed to existing oral formulations that last for up to four hours following a single dose.

National Parkinson Foundation reports that in a clinical trial, patients treated with DUOPA™ experienced significantly greater improvement in “off” time than patients treated with oral carbidopa-levodopa immediate release tablets. This is especially important for people with Parkinson’s suffering from motor fluctuations and other disabling symptoms.

Here is Dr. James Beck, from Parkinson Disease Foundation, discussing Duopa.

NEURODERM

Israeli company Neuroderm announced in December, 2014 that it saw clinically significant levels of levodopa in plasma in a Phase II trial of its pump system to deliver a liquid form of levodopa/carbidopa (funded by MJFF). Neuroderm is also testing a pump-patch product to deliver the drugs under the skin. That product resembles a nicotine patch with microneedles to inject the drug. Similar to DUOPA™, the aim is to maintain consistent levodopa concentrations.

What do you think – are you interested in trying any of these new medications if/when they are available in your area? much love.