Clinical

People with or approaching kidney failure requiring dialysis often develop protein-energy wasting (PEW), which is characterized by loss of body stores of protein and energy fuels, and is associated with increased risk of death, heart disease, infections, and poor quality of life. The extent of PEW, its consequences, and its management have not been previously characterized among kidney patients in Canada, yet nutritional management remains a top research priority from the patient perspective.

Up to 73% of people who are able to walk post-stroke suffer a fall, commonly within the first few months after discharge home. Optimizing the approach to rehabilitation of walking balance remains vital to long-term outcomes post-stroke.  A fall poses a significant risk of injury and erodes confidence. The loss in confidence alone can lead to decreased activity levels, loss of independence and social isolation that affect quality of life and overall health, even hastening death.

Personal identity--one's psychological sense of personal continuity--is an important aspect of mental health, informing one's motivations, behaviours, and social relations. Disruptions in identity can contribute to prevalent conditions such as personality disorders. Indeed, distorted identity is a core aspect of personality dysfunction and disorder, contributing to considerable negative health and social outcomes--and a prominent challenge for health care providers and systems.

Among office workers, physical activity has been shown to have the potential to improve absenteeism, work productivity and psychological and physical health.

Dr. Stork’s research will incorporate physical activity into the workplace using high-intensity interval training (HIIT) – short-duration exercise that consists of multiple brief, high-intensity efforts, separated by periods of rest.

Spinal cord injury (SCI) is a complex pathophysiology, characterized not only by paralysis but also severe autonomic cardiovascular dysfunction. After SCI, strokes are 300 - 400% more likely to occur compared to non-disabled individuals.

Many seniors aged 65 or older experience “age-associated memory impairment,” a normal aging process. However, Alzheimer’s disease is different, and not a normal part of aging. Alzheimer’s is a progressive brain disease with gradual loss of nerve cells and resulting problems with thinking, memory, and movement. Changes in the brain can start to happen 20 years before any memory problems appear.

Currently, no treatments are available to cure Alzheimer’s disease; however, if the disease is diagnosed and treated at an early stage, patients have a greatly improved quality of life.

Interstitial lung disease (ILD) is a group of disorders characterized by fibrosis and inflammation of the lungs. Dyspnea (i.e., breathlessness) is the most common symptom in ILD. To minimize dyspnea, ILD patients commonly avoid physical activity, leading to a progressive decline in exercise capacity, and eventually the inability to perform daily activities. Maintaining exercise capacity is important, given that ILD patients with the lowest physical activity levels have the lowest quality of life and the highest mortality.

Bioprosthetic heart valves (BPHVs), valves made of biologic tissues rather than synthetic materials, have revolutionized the treatment of heart valve disease, which constitutes a significant health and economic burden in BC, Canada and around the world. BPHVs serve as an alternative to mechanical valves, which require lifelong treatment to prevent clotting and therefore lead to an increased risk of bleeding.

Exogenous ketone body (KB) ingestion is an emerging therapeutic strategy for combating the harmful health conditions associated with type 2 diabetes (T2D), including a heightened risk for neurological disease and cognitive decline.

Evidence from animal models and early studies in humans supports its potential; however, high-quality research trials examining the effect of KB ingestion on brain function in humans with T2D have not been performed.

Resistance training has been shown to improve myriad health indicators, including quality of life, in people with rheumatoid arthritis (RA). However, resistance training participation rates among people with RA are remarkably low (1-14%), even in those with well-controlled disease. Anecdotally, unique barriers exist that prevent those with RA from participating in resistance training, including fear, health care provider knowledge, and functional limitation.

Inflammatory bowel disease (IBD) is characterized by chronic, relapsing inflammation of the gastrointestinal tract, and includes Crohn’s disease (CD) and ulcerative colitis (UC).

The gold standard induction therapy for treating active pediatric CD is “exclusive enteral nutrition” (EEN), which is a nutritionally complete liquid diet provided by tube feeding that excludes normal food intake. This nutritional strategy is superior to standard induction therapies; however, treatment must be maintained for 6-12 weeks to induce remission, and relapse rates are high after stopping EEN.

Youth with obsessive compulsive disorder (OCD) often experience distressing experiences (for example, unwanted thoughts) which they try to prevent or relieve through obsessive strategies such as repeated hand-washing. Without treatment, OCD tends to remain a problem for youth and makes their lives very difficult.

Cognitive behavioral therapy (CBT) has been shown to reduce symptoms and improve quality of life for most youth with OCD. However, CBT is a broad term that can include different strategies and exactly which strategies are the best to use has not been carefully studied.

Dementia with Lewy bodies is the second most common form of dementia following Alzheimer’s disease. This disease can be challenging to identify because symptoms can resemble those of Alzheimer’s disease, Parkinson’s disease, and/or mental illness. Currently, there is no test that can spot dementia with Lewy bodies and the only way to confirm the presence of this disease is by autopsy.

Myocarditis is defined as inflammation of the heart muscle, most often associated with viral infections. While the true occurrence of myocarditis is difficult to establish, it affects all ages and sexes and is a major cause of sudden death in young people.

Recognizing myocarditis in the clinic is challenging. Current tools for making a diagnosis are invasive (requiring access to heart tissue) and imprecise, leading to poor patient outcomes. Any delay in proper diagnosis may lead to dramatic measures like heart transplantation to ensure patient survival.

Acute spinal cord injury (SCI) is a devastating neurological condition resulting in permanent morbidity and impaired quality of life. In spite of advancements in the acute treatment of SCI, preventing neurological deficits in affected patients is highly limited. The hemodynamic management of acute SCI patients to maintain blood supply and maximize oxygenation of the injured spinal cord tissue is currently one of the few aspects of critical care in which clinicians can improve neurologic outcomes.