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The goal of this quasi-experimental feasibility study is to determine if a home based exercise program, that is supported virtually by a physiotherapist, is feasible for frail adults that are waiting for cardiac surgery. The main questions it aims to answer are: * Will patients be interested in participating in a virtual home-based exercise program before surgery? * Is the prescribed program practical? Will participants complete the exercises as prescribed, 3x/week? * Are the exercise images, videos, and live, virtual sessions with the physiotherapists good enough to allow the participant to be independent with good exercise technique? * Are the 4 virtual sessions able to be done in the specified time frames (1hr initial assessment, 30 minute follow ups)? * Can the exercise program be done with out any major adverse events? * What are the physical activity behaviours of frail participants awaiting cardiac surgery? Do they improve with an exercise program? Participants will be required to: * meet with a physiotherapist virtually (Zoom or Microsoft Teams) 4 times over a 3 week period. 1. the first session will be 1 hour to complete an interview about current health and upcoming surgery, a physical assessment, followed by individual exercise demonstration and education. 2. the second and third session will be follow up sessions to review exercise technique and progress, the presence of abnormal responses, provide encouragement and to address any barriers to activity completion. 3. the fourth, final session will be at the end of week 3 and will take 30 minutes to review exercise progress, presence of abnormal responses with activity and complete a reassessment of physical function. * Complete an individualized exercise program 3x/week independently as instructed by the physiotherapist following the initial assessment. * Complete a home exercise diary to track exercises done and intensity of exercise, in addition to documenting any abnormal responses For participants who reside in Winnipeg: * Accelerometers will be delivered to the patients home to wear for: 1. 7 days prior to the initial assessment 2. 14 days, from day 8 - 21 of the initial assessment. * Accelerometer diaries will be provided for participants to complete during the days when the accelerometers are worn.
Conditions:
Cardiac Surgery | Frailty | Prehabilitation | Telerehabilitation | Pre-operative ExerciseLocation:
- St Boniface Hospital, Winnipeg, Manitoba, Canada
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Over 18The investigators propose to conduct a multi-center randomized pilot feasibility trial comparing therapeutic plasma exchange to standard of care in patients diagnosed with septic shock.
Conditions:
Septic ShockLocation:
- University of Alberta, Edmonton, Alberta, Canada
- Ottawa Hospital, Ottawa, Ontario, Canada
- Southern Health Campus, Calgary, Alberta, Canada
- St. Joseph's Hospital, Hamilton, Ontario, Canada
- University of Manitoba, Winnipeg, Manitoba, Canada
- St. Michael's Hospital, Toronto, Ontario, Canada
- Foothills Medical Centre, Calgary, Alberta, Canada
- Hamilton Health Sciences - Juravinski, Hamilton, Ontario, Canada
- Universite Laval, Quebec City, Quebec, Canada
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Over 1618F-sodium fluoride (18F-NaF) was already investigated numerous times in the last 40 years as a PET alternative to standard 99m-technetium-derived bone scintigraphy. However, lack of universal tracer availability and higher costs contributed to the failure of 18F-NaF to systematically supplant bone scintigraphy as a standard of care. Recently, an isotope shortage crisis occurred and evidenced the need to have non-reactor-derived alternatives for many nuclear medicine procedures, including bone scintigraphy. Since 18F-NaF is cyclotron-produced, it could become a necessary alternative to bone scintigraphy in case of another worldwide isotope shortage. The study aims to evaluate the safety profile of 18F-NaF injection. Moreover, a patient registry will be compiled in order to perform sub-studies on 18F-NaF diagnostic performance on diverse bone and articular diseases.
Conditions:
Infectious Disease | Bone Cancer | Articular DiseaseLocation:
- Université deSherbrooke, Sherbrooke, Quebec, Canada
- CHUS, Sherbrooke, Quebec, Canada
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AnyThe purpose of this study is to assess the safety, tolerability and preliminary effectiveness of CC-92480 (BMS-986348) in novel therapeutic combinations for the treatment of Relapsed or Refractory Multiple Myeloma (RRMM).
Conditions:
Multiple MyelomaLocation:
- University Health Network UHN - Princess Margaret Hospital PMH, Toronto, Ontario, Canada
- Alberta Health Services AHS - Foothills Medical Centre FMC, Calgary, Alberta, Canada
- University of Alberta - Cross Cancer Institute, Edmonton, Alberta, Canada
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Over 18The percentage of loss time claims receiving Loss of Earnings benefits at 3 months has continued to rise amongst injured workers in Ontario despite the Workplace Safety and Insurance Board (WSIB) approach of "Better at Work". The primary health services to address loss time claims associated with musculoskeletal injuries include the evidenced-based programs of care, occupational health assessment program and musculoskeletal specialty programs, however, these are set to be revised and relaunched in Q1 2023. Across treatment protocols there are challenges that, at least in part, appear to contribute to the increasing percentage of workers on full loss of earnings at 3 months include (1) inconsistent early identification of workers who should be triaged to various health services and (2) reliable determination of the optimal timing of referral to the most targeted care to enable a safe and sustainable return to work. The investigators aim to develop and evaluate a predictive assessment model to triage workers to the best service within the first 8 weeks of their claim to increase the rate of early return to work, with the long-term goal that the triage protocol becomes part of a person-centric protocol that reduces the duration of work-related disability. The investigators will develop and evaluate an assessment protocol for injured workers that enter any of the musculoskeletal-specific WSIB programs of care, which have been consolidated into a single program as of 2023. This study will be a prospective inception cohort design using data collected from injured workers receiving WSIB musculoskeletal programs of care services at CBI Health clinics in Ontario Canada. Worker data will be collected at intake to the program of care service and again approximately four and eight weeks after intake (or earlier if a worker completes the program of care). The investigators will complete data analysis in three steps including descriptive and bivariate associations, Maximum Likelihood-based Latent Profile Analysis, and evaluation of results against successful work outcomes and secondary outcomes. Qualitative data will be mined for alternative indicators of recovery / non-recovery. The study recruitment goal is 300 - 350 workers with complete follow-up within a 2-year period.
Conditions:
Low Back Pain | Lower Extremity Problem | Neck Pain | Musculoskeletal Strain | Musculoskeletal Injury | Work-related...Location:
- CBI Health, Multiple Locations, Ontario, Canada
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ALLAges:
18 - 100Mild cognitive impairment and Alzheimer's disease are conditions that involve memory difficulties. Transcranial direct current stimulation is a type of brain stimulation. It may help improve these memory difficulties. However, it works better on active brain areas. This study looks at if combining exercise and applying current to important parts of the brain can help improve memory in people with Mild Cognitive Impairment or Alzheimer's disease.
Conditions:
Alzheimer Disease | Mild Cognitive ImpairmentLocation:
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Over 50Does Volume-based Enteral Feeding Improve Nutrient Delivery in Hospitalized Critically Ill Children?
Background Some critically ill children have malnutrition which may worsen while they are in hospital and delay their return home. They can recover faster when they are given tube feedings to improve their nutrition. Unfortunately, in the hospital these feedings are often interrupted and so these children do not get all the nutrition they need. The usual procedure is to set hourly rates for the tube feedings and to accept that they get less when feedings are interrupted. The researchers would like to test if children are fed better if the bedside nurses were to check the volume provided through the day and then ensure the child gets closer to the prescribed volumes. Aim To determine the feasibility of performing a Randomized Control Trial assessing the use of a Volume-based feeding algorithm in critically ill children admitted to the Alberta Children's Hospital Pediatric Intensive Care Unit (PICU). Objectives 1. Obtain information to inform sample size calculations for nutrition and clinical outcomes for a larger RCT: energy adequacy and protein adequacy, feed tolerance, infections, changes in anthropometric measurements at transitions of care, 28-day ventilator free days, length of stay, 60-day mortality, and 60-day hospital readmission? 2. Assess adherence of medical staff to the study protocol 3. Evaluate the timing of study enrollment and participant allocation 4. Evaluate the proposed deferred consent strategy. Methods The researchers will conduct a randomized control feasibility trial of critically ill children admitted to the Alberta Children's Hospital (ACH) Pediatric Intensive Care unit who require tube feedings. Children will be randomly assigned to the intervention arm (Volume-based algorithm) or the comparison arm (rate-based algorithm). Significance The proposed study will provide evidence of whether a novel approach to feeding critically ill children is feasible during PICU admission. This trial will inform a larger Randomized Control Trial on this topic that will assess if using a Volume-based feeding algorithm will improve outcomes of clinical importance including energy adequacy, protein adequacy, feed tolerance, infections, changes in anthropometric measurements at transitions of care, 28-day ventilator free days, length of stay in PICU and hospital, 60-day mortality, and 60-day hospital readmission.
Conditions:
Enteral FeedingLocation:
- Alberta Children's Hospital, Calgary, Alberta, Canada
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1 - 18There is currently little symptomatic therapy for Alzheimer's Disease (AD) and nothing effective for individuals with Frontotemporal dementia (FTD). However, neuromodulation with transcranial direct current stimulation (tDCS) has the potential to be a clinically effective therapy for both AD and FTD. The challenge now is to specify the parameters and conditions under which tDCS is most effective to transition from the laboratory to clinical medicine. tDCS studies typically report significant group effects despite the variability demonstrated among participants, with some showing clear, meaningful improvement, while others only show statistical improvement or none at all. These variable results may be related to the conventional stimulation intensity level of 2mA. The investigators predict that administering tDCS at 4.0 mA, a more significant number of participants would show a meaningful response, and those who improve at 2mA may improve even more from 4.0mA due to having a larger electric field produced. The investigators aim to test this hypothesis in people with Alzheimer's Disease.
Conditions:
Alzheimer DiseaseLocation:
- Baycrest Health Sciences, Toronto, Ontario, Canada
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50 - 90The goal of this prospective, open label cohort study is to assess functional and motor outcomes in individuals with cervical spinal cord injury who have undergone nerve transfer surgery, with the goal of increasing upper limb function. We will also compare these outcomes to a cohort of similarly matched individuals who have not undergone nerve transfer surgery, using robust outcome measures, rigorous pre-operative clinical and neurophysiological assessments, and standardized rehabilitation. At the end of this project we aim to develop a model for predicting nerve transfer outcomes using pre-operative clinical and neurophysiological characteristics.
Conditions:
Spinal Cord Injury | Upper Extremity Paresis | Tetraplegia | Upper Extremity Dysfunction | SCI - Spinal Cord...Location:
- GF Strong Rehabilitation Hospital, Vancouver, British Columbia, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
- Kingston Health Sciences Centre, Kingston, Ontario, Canada
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18 - 70Rheumatoid arthritis is a disabling arthritis that affects young women disproportionately. Although the physicians have some excellent treatments, they do not know which treatment is best for which patient. The investigators want to find ways to identify the right drug for the right patient at the right time. This is what personalized medicine is all about.
Conditions:
Rheumatoid ArthritisLocation:
- Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada