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Family inclusion in adult intensive care unit (ICU) rounds is recommended by critical care professional societies, yet widespread uptake of this practice is limited. A key barrier cited by ICU clinicians is insufficient evidence to support this practice. There is a need for robust evidence to support family participation in adult ICU rounds and influence change to routine clinical care. The primary purpose of this study is to assess whether family participation in adult ICU rounds improves family engagement in care. The secondary objectives are to assess family satisfaction, and anxiety and depression, to explore user experiences of family participation in ICU rounds, and to evaluate strategies to improve family member recruitment and retention rates. This is a stepped-wedge cluster randomized trial (n=194) at 6 Canadian ICUs. The stepped wedge cluster randomized trial is a pragmatic study design that overcomes methodological limitations in evaluating a healthcare service delivery intervention. In the stepped-wedge cluster design, there is random and sequential crossover of clusters from control (phase 1) to intervention (phase 2) until all clusters are exposed. The stepped-wedge design also allows each site to function as its own control. The stepped-wedge design is more powerful than a parallel design when substantial cluster level effects are present.
Conditions:
Health Care Delivery | Critical Care, Intensive Care | Physician Rounds | Family-centered Care | Family...Location:
- McGill University Health Centre, Montreal, Quebec, Canada
- Jewish General Hospital, Montreal, Quebec, Canada
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Over 18Developmental dysplasia of the hip (DDH) is the most common hip condition affecting infants and children. DDH represents a spectrum of issues affecting the hip joint - a "ball-and-socket" joint. When the femoral head (the "ball) is seated properly in the acetabulum (the "socket"), the hip is stable and can develop normally. However, when the femoral head is not well-seated, the hip can become unstable or dislocate. This instability or dislocation of the femoral head prevents the hip joint from developing normally during infancy and early childhood. If left undetected or untreated, it can lead to debilitating complications later in life. Development of a comprehensive, prospective international registry for all infants and children with DDH will provide the potential to impact all infants born, not only in British Columbia, but around the world. The purpose of this initiative is to identify best practices and standardize treatment and management strategies in order to optimize clinical and functional outcomes for patients with DDH. This registry includes targeted specific outcomes that will be investigated, in addition to the general collection of data on all patients diagnosed with any form of DDH up to the age of 10 years.
Conditions:
Congenital Hip Dysplasia | Congenital Dysplasia of the Hip | Dysplasia, Congenital Hip | Hip Dislocation,...Location:
- British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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1 - 10A Study of HS135 for the Treatment of Pulmonary Arterial Hypertension in Adults
Conditions:
Pulmonary Arterial Hypertension (PAH)Location:
- Site-501, Edmonton, Alberta, Canada
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Over 18Congenital heart disease (CHD), the most common birth defect, is present in nearly 1% of the population. CHD patients are associated with intense resource utilization and premature death in adulthood. The risk of premature death is linked with reduced exercise capacity, a finding consistently noted in youth with CHD. Reduced exercise capacity in this population has also been associated with reduce physical activity and health-related quality of life. Cardiac rehabilitation (CR) in adults with acquired heart disease is an established secondary prevention strategy that improves exercise capacity. The investigators propose a prospective clinical trial of a home-based high intensity interval training (HIIT) program using a novel telemedicine-equipped video game-linked cycle ergometer (MedBIKE™) for 10 to 18 year olds with repaired moderate-complex CHD. The pilot study with the MedBIKE has shown promising results. The investigators now seek to study the efficacy of this program in a broader CHD population.
Conditions:
Congenital Heart Disease | Pediatric ALLLocation:
- University of Alberta, Edmonton, Alberta, Canada
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10 - 18The purpose of this study is to demonstrate the comparability of ianalumab exposure following the sub-cutaneous (s.c.) administration of one injection of 300 mg/2 mL auto-injector (AI) versus two injections of 150 mg/1 mL pre-filled syringe (PFS), and to evaluate the safety and tolerability of ianalumab following the s.c. administration of both devices in participants with rheumatoid arthritis (RA), Sjögren's disease (SjD), or systemic lupus erythematosus (SLE). A second optional cohort may be included with the objective of demonstrating the comparability of pharmacokinetics of ianalumab between 1 x 2 mL Pre-filled Syringe (PFS) and 2 x 1 mL PFS.
Conditions:
Rheumatoid Arthritis | Systemic Lupus Erythematosus | Sjögrens DiseaseLocation:
- Novartis Investigative Site, Trois Rivieres, Quebec, Canada
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18 - 70The purpose of this study is to compare pembrolizumab (MK-3475) in combination with sacituzumab govitecan with pembrolizumab alone with respect to progression-free survival (PFS) and overall survival (OS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as assessed by blinded independent central review (BICR) among adults with metastatic non-small cell lung cancer (NSCLC) with programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) ≥50%).
Conditions:
Carcinoma, Non-Small-Cell LungLocation:
- BC Cancer Abbotsford-Medical Oncology ( Site 0433), Abbotsford, British Columbia, Canada
- Centre integre universitaire de sante et de services sociaux-oncology ( Site 0431), Trois-Rivières, Quebec, Canada
- St. Marys Hospital Center-Oncology ( Site 0434), Montreal, Quebec, Canada
- Southlake Regional Health Centre-Oncology Clinical Trials ( Site 0435), Newmarket, Ontario, Canada
- Centre Intégré de Santé et de Services Sociaux de la Montérégie-Centre ( Site 0430), Greenfield Park, Quebec, Canada
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Over 18There is a significant lack of adequately powered randomized clinical trial (RCT) data to determine the comparative safety and effectiveness of sedative treatments in pediatric patients. In many centres the standard of care for sedation in pediatric critical care unit (PCCU) patients includes the use of benzodiazepines despite the known negative effects of increased patient agitation and delirium, which can contribute to longer PCCU and hospital length of stay (LOS). The use of an alternative sedative, dexmedetomidine may reduce negative effects in this population. As such, the investigators plan to conduct a well designed comparative RCT to determine the most effective and safest sedative in this vulnerable population utilizing clinical assessments of sedation levels and delirium instance, electroencephalography (EEG) analysis and patient important outcomes.
Conditions:
Mechanically Ventilated, Critically Ill ChildrenLocation:
- Children's Hospital - London Health Sciences Centre, London, Ontario, Canada
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1 - 17This study will explore the efficacies of several practical short-term (peri-procedural) intravenous fluid regimens in the prevention of post- endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). PEP is the most common serious ERCP-related adverse event (AE), occurring in 5-15% of patients, and associated with significant morbidity, mortality, and healthcare utilization. Given the current lack of data on effectiveness of short-term fluid regimens in PEP prevention to inform practice, the results of the proposed study have the strong potential to impact ERCP practices worldwide, whether positive or negative.
Conditions:
Post-ERCP Acute PancreatitisLocation:
- Peter Lougheed Centre, Calgary, Alberta, Canada
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18 - 75The purpose of this study is to learn about the effects of an investigational medicine, PGN-EDODM1, to see how safe and tolerable multiple administrations of PGN-EDODM1 are for people with myotonic dystrophy type 1 (DM1) compared to placebo.
Conditions:
Myotonic Dystrophy 1Location:
- CIUSSS du Saguenay-Lac-Saint-Jean, Chicoutimi, Quebec, Canada
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16 - 60The purpose of this study is to establish a safe and tolerable dose of BMS-986393 in combinations with alnuctamab, mezigdomide, and iberdomide in participants with relapsed and/or refractory multiple myeloma (RRMM).
Conditions:
Multiple MyelomaLocation:
- Tom Baker Cancer Center, Calgary, Alberta, Canada
- Local Institution - 0024, Toronto, Ontario, Canada