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Last update 08 May 2025

Applied Health Research Centre

Nonprofit|Canada

Last update 08 May 2025

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Translational Medicine

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Clinical Trials associated with Applied Health Research Centre

NCT06955260

/ Not yet recruitingPhase 3IIT

A Randomized Trial of SGLT2 Inhibition With Empagliflozin in Adults With Fontan Circulatory Failure (EMPA-HEART 3 CardioLink-12)

Some people are born with a birth defect where they only have one functioning ventricle (lower chamber) in their heart. This condition can be initially managed with a Fontan operation, but there is a risk of developing Fontan Circulatory Failure (FCF) later in life. FCF occurs when the single working heart ventricle is no longer strong enough to pump blood throughout the body. This also means the heart has difficulty supplying oxygen to keep up with the needs of the body. As a result, individuals living with FCF may have some challenges carrying out day to day activities. A heart transplant is currently the only therapeutic option for individuals living with FCF. The investigators are conducting this trial to determine whether a medication called empagliflozin can help these people have a better quality of life.

Start Date01 May 2025

Sponsor / Collaborator

Boehringer Ingelheim GmbH

[+1]

NCT05477628

/ Not yet recruitingNot ApplicableIIT

Nutrition Recommendation Intervention trialS in Children's Healthcare

NuRISH is a suite of clinical trials for children from low-income families which will determine whether primary healthcare prescription for: 1) Optimal breastfeeding with support from a mobile lactation consultant vs. usual care and 2) High-quality childcare starting at 1 year vs. usual care can prevent childhood obesity, and improve cardiovascular, developmental and mental health at 2 years of age.

Start Date01 Feb 2024

Sponsor / Collaborator

The Hospital for Sick Children

[+6]

NCT05537519

/ Active, not recruitingPhase 1/2IIT

Phage Therapy for the Treatment of Urinary Tract Infection

This is a single-patient, phase I/II clinical trial that aims to evaluate the potential of bacteriophage therapy to treat and prevent the recurrence of a drug-resistant urinary tract infection with serious long-term effects. This study will follow a minimally invasive phage therapy approach consisting of oral, topical (opening of the urethra) and bladder installations of a 3-phage cocktail comprised of HP3, HP3.1 and ES19.

Start Date01 May 2023

Sponsor / Collaborator

Unity Health Toronto

[+1]

100 Clinical Results associated with Applied Health Research Centre

0 Patents (Medical) associated with Applied Health Research Centre

464

Literatures (Medical) associated with Applied Health Research Centre

01 May 2025·The American Journal of Occupational Therapy

Serial Trichotomization to Determine Fitness to Drive: Results From a Cohort of Clients Referred to a Neurology Program

Article

Author: Cummings, Shayna ; Bédard, Michel ; Weaver, Bruce ; Maxwell, Hillary ; Swoluk, Chelsea ; Colosimo, Andrew ; Dubois, Sacha ; Stinchcombe, Arne ; Schurr, Stephanie

Importance: Determining cognitive fitness to drive is challenging. A previous study used serial trichotomization with five cognitive tests to determine whether drivers should continue driving, undergo further evaluation, or stop driving.Objective: To examine agreement between serial trichotomization and fitness-to-drive determinations made by occupational therapists.Design: Drivers referred for cognitive screens completed all tests used in the previous study. Occupational therapists provided fitness-to-drive recommendations (safe, indeterminate, or unsafe) using all clinical information available. We examined the agreement between the tests’ results (using cut points from the previous study) and occupational therapists’ recommendations.Setting: Outpatient neurology program at a chronic care and rehabilitation hospital.Participants: 279 clients (M age = 66.35 yr; SD = 13.25).Outcomes and Measures: Tests included the Trail Making Tests A and B, the Clock Drawing Test (CDT), the Montreal Cognitive Assessment, and the Motor-Free Visual Perception Test, using a road test as the gold standard. The previous study used dual cut points with 100% sensitivity and specificity to reduce false positives and false negatives.Results: Weighted κs ranged from .03 (95% confidence interval [CI] [−.01, .08]) for the CDT to .54 (95% CI [.46, .62]) for the Trail Making Test, Part B. Although the agreement between serial trichotomization and the final recommendations was moderate (κ = .59; 95% CI [.50, .67]), serial trichotomization appeared useful for identifying unsafe drivers.Conclusions and Relevance: These results remind us of the variability inherent in stand-alone cognitive tests, even within a serial trichotomization framework, and the importance of clinical judgement and road tests in decision making about driving.Plain-Language Summary: It can be challenging for occupational therapists to accurately determine a client’s cognitive fitness to drive. Many occupational therapists lack the time, have limited training, or do not have access to comprehensive driving evaluation tools. A serial testing approach can support occupational therapists in assessing a client’s cognitive fitness to drive. This study used an approach based on a series of five cognitive tests to determine whether a client should continue driving, undergo further evaluation, or stop driving. The series of tests were used to classify drivers as safe, indeterminate, or unsafe. In principle, a driver would take the second test only if the driver was classified as indeterminate on the basis of first test, and so on. By applying the tests in sequence, few drivers should remain classified as indeterminate at the end of the series of tests. This serial approach has the potential to streamline the decision-making process for occupational therapists by classifying the more extreme unsafe cases while still providing an accurate assessment of cognitive fitness to drive.

01 Apr 2025·Intensive and Critical Care Nursing

Patient-psychologist telemedicine interactions in an intensive care unit recovery clinic: Qualitative secondary analysis

Article

Author: Kiehl, Amy ; Hussain, Ali A. ; Eaton, Tammy L. ; Danesh, Valerie ; Hussain, Ali A ; Jones, Abigail C. ; Hosey, Megan M ; Boehm, Leanne M. ; Jackson, James C ; McPeake, Joanne ; Jones, Abigail C ; Su, Han ; Hosey, Megan M. ; Boehm, Leanne M ; Toth, Kelly ; Jackson, James C. ; Eaton, Tammy L

OBJECTIVESWe aimed to describe the content of patient-psychologist mental health related dialogues during a telemedicine intensive care unit recovery clinic visit.RESEARCH METHODOLOGY/DESIGNQualitative descriptive study nested within a randomized controlled pilot trial to assess a telemedicine intensive care unit recovery clinic feasibility and preliminary efficacy. Participants included adults hospitalized with sepsis and/or respiratory failure. Telemedicine visits occurred at 3- and 12-weeks post-discharge involving a critical care pharmacist, physician, and psychologist. The psychologist conducted cognitive and mental health screenings, providing tailored brief psychotherapy and education. Audio-recorded visits were transcribed verbatim and underwent inductive reflexive thematic analysis.SETTINGIntensive care unit recovery clinic at an academic medical center in the southeastern United States.MAIN OUTCOME MEASURESN/A.FINDINGS17 participants completed 31 telemedicine intensive care unit recovery clinic visits between December 2019 and March 2022. Caregivers participated in 13 visits. Participant experiences and psychologist responses were identified and separated into two overarching themes: 1) Patient-Identified Challenges and 2) Psychologist-Delivered Strategies. Patient subthemes included 1) mental health challenges (negative thoughts), 2) minimization of mental health impact, and 3) use of coping methods. Psychologist subthemes included 1) rapport building and validation 2) use of psychological assessments, and 3) psychological interventions.CONCLUSIONThe collaborative effort, including a psychologist, exemplifies the role of a mental health professional within the multidisciplinary intensive care unit recovery clinic team, contributing to a comprehensive approach in identifying and managing post-intensive care syndrome impairments. The focus extends to shaping compassionate care strategies for addressing mental health challenges associated with post-intensive care syndrome, fostering a holistic approach to whole-person recovery.IMPLICATIONS FOR CLINICAL PRACTICEA mental health professional (e.g., psychologist, psychiatrist, psychiatric nurse practitioner) can contribute to shaping care strategies for the mental health symptoms associated with post-intensive care syndrome, fostering whole-person recovery after hospital discharge.CLINICAL TRIAL REGISTRATION NUMBERNCT03926533.

01 Apr 2025·Critical Care Medicine

Time to Renal Replacement Therapy Initiation in Critically Ill Patients With Acute Kidney Injury: A Secondary Analysis of the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial

Article

Author: Kirkham, Brian ; Harvey, Andrea ; Bagshaw, Sean M. ; Jeong, Rachel ; Young, Paul J. ; Wald, Ron ; Joannidis, Michael ; McAuley, Danny ; Ghamarian, Ehsan ; Quenot, Jean-Pierre ; Ostermann, Marlies

OBJECTIVES:Among critically ill patients with severe acute kidney injury (AKI) who lack emergent indications for renal replacement therapy (RRT), a strategy of preemptive RRT initiation does not lead to improved outcomes. However, for patients with persistent AKI and without urgent indications for RRT, the safety of prolonged delays in RRT initiation is unclear. We sought to assess the association between progressively longer delays in RRT initiation and clinical outcomes.DESIGN:A post hoc secondary analysis.SETTING:The multinational STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial.PATIENTS:Participants allocated to the standard strategy of the STARRT-AKI trial.INTERVENTIONS:The exposure was time from randomization to RRT initiation, evaluated in quartiles and as a continuous variable.MEASUREMENTS AND MAIN RESULTS:The primary outcome was all-cause mortality at 90 days. Secondary outcomes were RRT dependence, RRT-free days, and hospital-free days, all at 90 days, as well length of ICU and hospital stay. Of the 1462 participants allocated to the standard strategy group, 903 (62%) received RRT. Median time (interquartile range) to RRT initiation was 12.1 hours (8.3–13.8 hr), 24.5 hours (21.8–26.5 hr), 46.8 hours (35.2–52.1 hr), and 96.1 hours (76.7–139.2 hr) in quartiles 1–4, respectively. Prolonged time to RRT initiation was associated with a lower risk of death at 90 days (quartile 4 vs. 1: adjusted odds ratio, 0.63 [95% CI, 0.42–0.94]); further analyses using cubic splines and inverse probability weighting to account for immortal time bias showed no association with the risk of death. There was no association between time to RRT initiation and RRT-free days, hospital-free days, or lengths of ICU or hospital stay. Longer delay to RRT initiation had a linear association with RRT dependence at 90 days.CONCLUSIONS:Among patients with no urgent indications and who received RRT in the standard strategy of the STARRT-AKI trial, longer deferral of RRT initiation was not associated with a higher risk of mortality.

100 Deals associated with Applied Health Research Centre

100 Translational Medicine associated with Applied Health Research Centre

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Applied Health Research Centre

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