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The goal of this clinical trial is to evaluate the effectiveness of the online modality of the Make the Connection (MTC) program in caregivers of infants and young children. The main questions it aims to answer are: * Does the MTC online program result in changes in the child-caregiver relationship, caregiver self-competence, caregiver stress, caregiver depression, as well as caregiver and child emotion regulation, as compared to a waitlist control? * Are caregivers who experience psychosocial risks (e.g., elevated depression scores, social isolation) deriving similar benefits in the child-caregiver relationship, caregiver self-competence, caregiver stress, caregiver depression, as well as caregiver and child emotion regulation as caregivers who are not? * What are some of the barriers, facilitators, perceived benefits, and risks to participating in the MTC online program from the perspective of caregivers? Participants will be randomly placed into either the intervention group or the waitlist control group. Both groups will be asked to complete a pre-intervention questionnaire, the intervention group will be invited to complete the 8-week MTC online program consisting of a weekly 15-minute module, and both groups will lastly be asked to complete a post-intervention questionnaire. Researchers will compare the intervention group and the waitlist control group to see if the MTC online program results in improved caregiver-child bond, caregiver self-efficacy, caregiver stress, and caregiver depression.
Conditions:
Parent-Child RelationsEmplacement:
- University of Ottawa, Ottawa, Ontario, Canada
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ALLÂges:
Over 18A recent report showed that maintaining indoor temperature at or below 26°C safeguards older, heat vulnerable adults against potentially dangerous increases in thermal and cardiovascular strain during an extreme heat event (PMID: 38329752). However, this proposed limit does not consider the potential cumulative effect of successive days of heat exposure, which could lead to a progressive deterioration in thermoregulatory and cardiovascular function and necessitate adjustments to upper indoor temperature limits. Further, thermal comfort and quality of sleep may be negatively impacted when bedroom temperatures exceed 24°C (PMID: 3090680). On this basis, some health agencies have recommended that bedroom temperatures at night should not exceed 26°C unless ceiling fans are available (PMID: 3090680). Currently, however, it is unknown whether indoor overheating impairs sleep quality and physiological strain on a subsequent day in older adults and, if so, whether maintaining indoor temperature at 26°C is sufficient to prevent these adverse health impacts. With rising global temperatures and more extreme heat events, energy management strategies to limit the strain on the power grid during the daytime are now increasingly commonplace. Thus, understanding the benefits of maintaining indoor temperature at the recommend upper limits of 26°C during the nighttime only on surrogate physiological indicators of health is an important step in understanding how to optimize protection for heat-vulnerable older adults when power outages occur. The investigators will assess the efficacy of proposed indoor temperature limits (i.e., 26°C) in mitigating increases in core temperature and cardiovascular strain over three consecutive days (3 days, 2 nights) in older adults (60-85 years) with (indoor temperatures maintained at the recommend 26°C at all times throughout the three days) and without (daytime temperature fixed at 34°C (temperature experienced in homes without air-conditioning during an extreme heat event) with nighttime temperature at 26°C) access to daytime cooling. By quantifying the effect of daylong indoor overheating on surrogate physiological outcomes linked with heat-related mortality and morbidity in older adults, the investigators can determine if refinements in the recommended upper temperature threshold is required, including best practices when power outages may occur during an extreme heat event.
Conditions:
Heat Stress | Physiological StressEmplacement:
- University of Ottawa, Ottawa, Ontario, Canada
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ALLÂges:
65 - 85This study aims to show that the addition of carboplatin and paclitaxel chemotherapy to a palliative course of external beam radiation treatment improves both dysphagia relief and patient quality of life in patients with unresectable esophageal cancer.
Conditions:
Esophageal CancerEmplacement:
- Tom Baker Cancer Centre, Calgary, Alberta, Canada
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ALLÂges:
Over 18Oral supplements containing exogenous ketones have recently become available and represent a novel tool for increasing plasma ketone bodies without the need for dietary restriction. Early evidence suggests that oral ketone supplements may enhance cerebral blood flow (CBF). However, a higher dose of a ketone monoester has been shown to slightly lower blood pH and reduce end-tidal CO2 (PetCO2) due to compensatory hyperventilation, which is accompanied by parallel reductions in CBF. Whether reductions in PetCO2 causes reductions in CBF is currently unknown. The purpose of this study is to investigate the effect of manipulating PetCO2 at normocapnia (PetCO2 maintained at baseline) or poikilocapnia (no PetCO2 targeting; breathing room air), following the ingestion of a dose of a ketone monoester on CBF and cerebrovascular reactivity to CO2 in young adults.
Conditions:
Cerebral Blood Flow | Cerebrovascular FunctionEmplacement:
- McMaster University, Hamilton, Ontario, Canada
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ALLÂges:
18 - 35Every year, thousands of Canadians are diagnosed with degenerative cervical myelopathy (DCM), a form of non-traumatic injury caused by spinal cord compression in the neck. While DCM causes a range of symptoms, one of the most disabling is loss of hand dexterity. Surgical decompression is standard treatment for DCM, but reduced dexterity often remains. The investigators have developed a portable, easy-to-use dexterity assessment tool for measuring hand dexterity. Hand function is often assessed using tools incapable of measuring subtle changes in function, limiting a clinician's ability to monitor progression of or recovery from a disease over time. The hope is that if subtle changes in function are identified early, leading to an early DCM diagnosis and treatment, this may prevent patients from experiencing a greater loss of hand function. The goals of this study are to determine the relationship between dexterity and myelopathy severity, as well as to establish the validity and reliability of the dexterity tool. This will be done by assessing dexterity using the dexterity tool in DCM patients (to determine the relationship between disease severity and dexterity, and measure validity) and healthy participants (to establish reliability).
Conditions:
Spinal Cord Compression | Cervical Spondylosis | Myelopathy CervicalEmplacement:
- LHSC - University Hospital, London, Ontario, Canada
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ALLÂges:
18 - 75This Randomized Control Trial will directly compare helmet non-invasive ventilation (NIV) combined with high flow nasal oxygen (HFNO) versus HFNO alone in patients with Acute Hypoxemic Respiratory Failure (AHRF).
Conditions:
Acute Hypoxemic Respiratory FailureEmplacement:
- University of Calgary, Calgary, Alberta, Canada
- London Health Sciences Centre, London, Ontario, Canada
- St. Michael's Hospital, Toronto, Ontario, Canada
- Kingston General Hospital, Kingston, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Ottawa Hospital, Ottawa, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Hamilton Health Sciences- Juravinski, Hamilton, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
- University Health Network Toronto General, Toronto, Ontario, Canada
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ALLÂges:
Over 18Endoscopic Mucosal Resection (EMR) is the current standard for effective endoscopic resection of such colon adenomas. If resection is possible in one piece (so-called "en bloc" resection) then recurrence rates are low. However, most non-pedunculated polyps \>2 cm are removed in pieces ("piece-meal" resection) which leads to disease recurrence rates between 12-30%. In the March 2019 issue of Gastroenterology Bourke et al. presented that post-EMR ablation of the resection margins using soft coagulation with the tip of a resection snare reduces adenoma recurrence to 5% compared to 21% recurrence found in the control group. Hybrid Argon Plasma Coagulation (h-APC) combines an ablation technique (APC) with the option for submucosal saline injection using a high-pressure water jet. The technique allows to lift of dysplastic epithelium thus creating a safety cushion under the mucosa is lifted with a saline injection and then to ablate larger areas more thoroughly and with a higher energy setting, with a low risk for side effects or complications.
Conditions:
Colorectal Cancer | Polyp of ColonEmplacement:
- Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, Quebec, Canada
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ALLÂges:
18 - 89Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric illness beginning in childhood. Effective OCD treatments include cognitive-behaviour therapy (CBT) and medications but access to treatment is difficult and does not systematically include parents. The investigators will evaluate clinical and neural effects of Group-based Family CBT (GF-CBT), via a case-control study including: Group 1 - OCD cases receiving GF-CBT (N=90); Group 2 - OCD waitlist cases (N=90). Effects will be measured between baseline and completion of 12 GF-CBT sessions: comparing OCD severity and functioning changes between Groups 1 and 2.
Conditions:
Obsessive-Compulsive DisorderEmplacement:
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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ALLÂges:
5 - 18The aging population is growing rapidly. For the first time ever, Canadian seniors outnumbered young adults in 2016. Aging is associated with many physical and metabolic deteriorations including the loss of muscle mass and strength, insulin resistance, increased inflammation and oxidative stress. The muscles of our bodies are composed of proteins and proteins are made of small building blocks called amino acids. Our bodies have the ability to make some amino acids which are called the non-essential amino acids. However, there are certain amino acids that our body's need to make protein but can only be supplied from the foods that we consume. These are called essential amino acids. Tryptophan is one of the essential amino acids that the body needs. Tryptophan is required for protein synthesis and acts as a precursor for serotonin and nicotinic acid. Therefore, there may be a need for more threonine in the diet of older adults. However, the current requirement for threonine is based on studies conducted exclusively in young adults. Thus, the purpose of this study is to find out how much tryptophan older adults need.
Conditions:
Healthy AgingEmplacement:
- Hospital for Sick Children, Toronto, Ontario, Canada
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ALLÂges:
60 - 90Given the rising rates of concussion in youth ages 10-19 and the significant proportion of young people who remain symptomatic for months following concussion, research evaluating the efficacy of multifaceted treatment options following concussion is imperative. Studies examining the efficacy of treatment strategies following concussion in children and adults are surprisingly limited, and most focus on one treatment approach, have small sample sizes, are not randomized controlled trials, and focus on individuals with prolonged recovery (months). There is a need for a multifaceted treatment trial to examine the early implementation of treatment approaches that may reduce prolonged recovery while considering the heterogeneous presentation of symptoms and patient preferences in the sub-acute stage following concussion. Randomized controlled trials that consider a multifaceted transdisciplinary approach to treatment in the early period following concussion are needed to raise the bar regarding evidence-informed management following concussion
Conditions:
Mild Traumatic Brain Injury | Neck Pain | Dizziness | Headaches PosttraumaticEmplacement:
- University of Calgary, Calgary, Alberta, Canada