Health Professional-Investigator Award

Heart attack, heart failure, and stroke are major causes of disability and death in BC and worldwide. The main cause of these conditions is the buildup of blockages or "plaque" in arteries in a process called atherosclerosis.

My goal is to improve treatment for children and youth with eating disorders (ages 8-24 years). Eating disorders typically develop during adolescence. Eating disorders can become lifelong, and cause permanent health problems and even death. Making sure that each child gets the right kind of treatment can lead to the best outcomes. But, current guidelines do not consider how to match a child to the best type of treatment.

Tests to determine whether an individual has a disease or not are often expensive and performed on complex instruments in laboratories. As such, there is currently an important unmet need for tests to diagnose infectious diseases with highly accurate, inexpensive and simple methods that could be performed nearer to the patient.

Regular physical activity is known to produce significant physical and mental health benefits, yet only 15% of Canadian adults meet the recommended guidelines. Running is one of the most popular leisure-time physical activities and is effective even in low doses. However, runners sustain a high rate of musculoskeletal injury, with up to 50% suffering an injury annually. Many injuries are due to abnormal running form. The emergence of wearable technology has presented an opportunity not only to collect information on running form outside of a research lab setting, but also remotely.

Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world. Ibrutinib, a new drug that works differently from chemotherapy, is a major breakthrough for CLL treatment and allows patients to live longer; however, it comes at a high cost to the BC health system.

Objective

• Our goal is to determine which patients benefit most from ibrutinib at what point in their disease, so that ibrutinib, and other drugs like it, are given to the right patients at the right time and avoided in those who will only suffer side effects.

Methods

Motor vehicle crashes result in 78 million injuries worldwide each year. Some crashes might be prevented by restricting driving for individuals with medical conditions that might cause sudden incapacitation while diving (eg. epilepsy, sleep apnea).

Each year, more than 18,000 British Columbians have joint replacement surgery for hip or knee osteoarthritis. Many face challenges in getting timely, quality rehabilitation before, and especially after surgery. I have developed quality indicators that set minimum standards of rehabilitation care for joint replacements. Focusing on 10 of these quality indicators for care after surgery, my team of clinicians, patients and researchers have created online toolkits to help make these indicators available to patients and clinicians who provide joint replacement rehabilitation in BC.

The main determinant of patient outcome following revival from cardiac arrest (heart stops pumping blood and oxygen to the body) is the brain injury that occurs in the days after hospital admission. This injury, termed hypoxic ischemic brain injury, partly arises from a lack of oxygen delivery to the brain after resuscitation. The cornerstone of post-cardiac arrest management has involved increasing the delivery of oxygen to the brain to facilitate recovery.  This logic assumes that the transport of oxygen from the blood system into the brain tissue is normal after cardiac arrest. I have re

The mental health of healthcare providers is understudied and inadequately supported, especially given the current pandemic. Workplace stress can lead to burnout, Post-Traumatic Stress Disorder (PTSD), and Treatment Resistant Depression (TRD), which affects morale, absenteeism, retention, and patient care. The focus of this application is to address PTSD and TRD with a combination therapy involving Roots to Thrive (RTT) Communities of Practice (CoP) with Ketamine-Assisted Psychotherapy (KAP). The RTT CoP have documented enhanced efficacy for resilience, mental wellness and cognition.

Testicular germ cell tumors (GCTs) are the most frequent solid tumors in young men. Chemotherapy can cure most patients even when the tumor is advanced. However, there are still two main issues of concern.

Two out of every five individuals will develop cancer during their lifetime. My research program focuses on cancer prevention and diagnosis, using skin cancer as an initial platform. Skin cancer accounts for two thirds of all cancer cases and is an easily accessible organ to study using optical devices. Biopsies are typically used to detect skin cancers. Disadvantages of skin biopsies include possible disfigurement and complications, lengthy processing time, and occasionally inaccurate or inconclusive results.

Aggressive B-cell lymphomas are the most common form of lymphoma and ~50% of patients are cured with modern treatments. However, the outcomes for patients whose disease is not cured are dismal with ~10% of those patients alive at 5 years. This shows that these lymphomas, although grouped together on the basis of what they look like down the microscope, represent clusters of different lymphoma groups. A better understanding of the 'molecular wiring'of these lymphomas is critical to identify patients at high risk of resistant lymphoma and providing better treatments.

Spontaneous coronary artery dissection (SCAD) occurs when there is a tear in the inner layers of a blood vessel in the heart, causing blockage and reducing blood flow and oxygen to the heart. It is an emergency condition that can result in heart attack and even death. Unfortunately, the causes of SCAD are poorly understood, and it is often misdiagnosed and mistreated.

Interstitial lung disease (ILD) is a progressive lung disorder with no effective treatment. Oxygen is often used to relieve symptoms at the end of life, but the evidence supporting oxygen use in these patients is based on limited data from other diseases. The lack of data on the benefits of oxygen in patients with ILD has resulted in uncertain criteria for its use and limited access to this potentially important medication.

Acute kidney injury (AKI) complicating critical illness is an important problem, contributing to roughly 1.7 million deaths worldwide per year. Treatment is limited to dialysis, which is costly and frequently unavailable. Preventing AKI is a critical step to reduce deaths. Acetaminophen (Tylenol) has the potential to reduce AKI caused by oxidative damage from hemoglobin (released from red blood cells) and myoglobin (released from muscle cells).