Heat-related Illness

The trial investigates how the drugs propranolol and metoprolol affect core body temperature in older adults during extreme heat exposure. It aims to understand why adults over 65 have higher rates of heat-related illness and death, especially since beta blockers are commonly prescribed for cardiovascular conditions in this age group. This is important because previous studies in younger people showed beta blockers affect sweating and blood flow, but their impact on older adults in heat is unknown. Participants will experience 3 hours of heat exposure in a chamber set to 41°C with 40% humidity. They will receive different sequences of propranolol, metoprolol, and placebo in a randomized, double-blind manner to compare effects on their body temperature and sweat rate. The study involves multiple treatment arms rotating these drugs to assess their influence during simulated heat waves. During the study, researchers will continuously measure internal body temperature, heart rate, and blood pressure while also tracking whole body sweat rate before and after heat exposure by measuring body mass. The trial focuses on healthy adults aged 65 and older who meet specific health criteria. The total observation lasts through the 3-hour heat exposure, with close monitoring of cardiovascular and thermoregulatory responses to understand drug effects in aging individuals.

Researchers are studying preterm infants born between 25 and 32 weeks of gestation to compare two methods of incubator temperature control and their effects on infant weight growth and health. The study is based on earlier findings that lower body temperature on admission relates to higher illness and death rates in preterm infants. It aims to see if using a new software to calculate personalized air temperature in incubators can improve growth and reduce side effects compared to the traditional skin temperature control method. The study compares two incubator control methods: air temperature control (ATC), which uses software to set air temperature to reduce body heat loss to zero, and skin servocontrol (SSC), which adjusts incubator temperature based on the infant's skin temperature. Both methods are evaluated in closed incubators for preterm infants. The trial randomly assigns infants to one of these two methods to study their effects during the first 10 days of life. Participants will be monitored for changes in body weight until day 10, along with comfort, thermal stress, and humidity challenges. The study also tracks neonatal illness occurrences up to 40 weeks of amenorrhea and length of hospital stay until discharge or 40 weeks of amenorrhea. Parents provide written consent, and infants are included within the first day of life. The study continues through hospitalization, assessing health outcomes and safety related to the incubator settings.

Researchers are evaluating the need for antibiotic prevention in patients with chronic liver disease who have gastric varices and are treated with elective endoscopic injection of cyanoacrylate (GVO). Gastric varices can cause serious bleeding with a high chance of rebleeding and mortality. While endoscopic injection of tissue glue is effective in stopping acute bleeding, it still carries risks of rebleeding and infection, which are important concerns for patients with weakened immune systems due to liver conditions. The study compares two groups: one receiving an antibiotic called ertapenem injected intravenously before the endoscopic cyanoacrylate injection, and the other not receiving this antibiotic before the procedure. The trial is randomized and aims to clarify whether giving this antibiotic can help prevent infections and complications after GVO treatment. The treatment is delivered during an elective endoscopic procedure to manage gastric varices. Participants will be monitored for three years to evaluate key outcomes such as the prevention of sepsis, rebleeding rates, refractory bacterial infections, and mortality. Assessments will include tracking infections and bleeding events over time. The study is designed to provide long-term data on the benefits and risks of using antibiotic prophylaxis in this patient group, with ongoing safety monitoring throughout the follow-up period.

Heat stroke is a serious condition caused by an imbalance between heat production and loss in the body, often triggered by exposure to hot, humid environments or intense exercise. It is characterized by a core body temperature above 40°C and brain dysfunction, often leading to damage in multiple organs. The severity depends on the highest temperature reached and how long the body remains overheated. Rapidly lowering body temperature can stop cell damage, reverse organ problems, and improve recovery. However, there is currently no standardized method for emergency teams to manage body temperature effectively in these patients. This study evaluates a new early in-hospital temperature management protocol developed to guide rapid cooling and precise temperature control for heat stroke patients. The protocol includes early detection, selection of cooling methods, target temperature management, and ongoing monitoring. Patients in the experimental group will be treated using this protocol, while data from patients treated with previous standard methods between 2021 and 2022 will be collected retrospectively as a comparison. Participants admitted with heat stroke will be closely monitored for their cooling rate and body temperature within the first 30 minutes and at two hours. Researchers will also track survival rates in the hospital and at three months, along with any complications that arise. The total observation period for outcomes extends to three months, helping evaluate the protocol's impact on patient recovery and safety over time.

Extreme heat events pose a serious health risk in Canada, particularly highlighted by the 2021 heat wave that caused over 600 deaths. Most heat-related fatalities occur indoors and are preventable. This trial evaluates whether sending tailored digital health messages from primary care providers to their patients can encourage protective behaviors against heat-related illnesses. The study also aims to enhance collaboration between primary care and public health to improve community resilience and reduce health disparities related to extreme heat. The study is a cluster randomized controlled trial involving primary care practices in Eastern Ontario. Patients in the intervention group will receive personalized digital messages encouraging heat safety behaviors, such as creating heat safety plans and forming social support groups, along with alerts during heat advisories. The control group will receive digital messages unrelated to heat waves. Messages are sent via email or text, in English or French. The trial will follow participants for up to two years to assess behavioral changes and heat-related health impacts. Participants will be adults registered with participating primary care providers who have had recent visits and can receive digital messages. Data collection includes patient surveys, electronic medical records, and health administrative data to measure behavior changes and healthcare use during heat events. Researchers will assess awareness, preparedness, and health outcomes related to heat exposure. The study also monitors engagement with messages and aims to develop scalable heat adaptation strategies for vulnerable populations.

Researchers are evaluating whether AI-enabled, nurse-led treatment planning can match or improve the quality of clinical reasoning and management compared to standard physician-led care in adults aged 18 years and older. The study focuses on patients in rural and semi-urban India presenting with hypertension, diabetes mellitus, fever, breathlessness, or musculoskeletal pain. It aims to determine if nurse consultations supported by a large language model (LLM) achieve clinical quality scores that are not worse than those of physician consultations and to assess patient acceptance and satisfaction with AI-assisted nurse care. Participants receive two consultations during the same visit: one led by a nurse using an AI-based clinical decision support tool and one by a physician providing standard care. The nurse-led consultation involves routine history taking and clinical assessment, with interaction through a digital interface to the LLM for assistance in diagnosis, reasoning, and treatment planning. The physician consultation follows usual clinical practice without AI support. The study compares these two approaches in a randomized order within each participant. Throughout the study visit, both consultations are audio recorded for blinded clinical quality evaluation. After the nurse + LLM consultation, participants complete an exit survey measuring communication, trust, and satisfaction. Researchers also gather nurse-reported feedback on acceptability and feasibility through interviews after nurses complete at least 10 AI-assisted consultations. The main outcome measured is the clinical quality of the consultations immediately after both visits, with additional assessments of patient experience and nurse perspectives over up to nine months.

Increasing heat exposure caused by climate change is affecting communities worldwide, especially those living in poor housing conditions such as informal settlements and low-income households. This research aims to study the impact of applying sunlight-reflecting cool roof coatings on indoor temperatures and overall health. The trial is a global, multi-center, cluster-randomized controlled study conducted in five urban climate hotspots across Africa, Asia, Latin America, and Oceania, where heat exposure and vulnerable housing conditions pose significant health risks. The study compares households that receive a cool roof coating, which reflects sunlight and reduces indoor heat, with those that keep their original roofs. The cool roof coating works by reflecting ultraviolet and visible sunlight and radiating absorbed heat, thus lowering indoor temperatures and energy use. The trial will run over a 12-month period, including the hottest months of the year, to measure the effects on health, indoor environment, and economic outcomes. Participants will undergo repeated measurements including resting heart rate, blood glucose control, depression symptoms, and various health and environmental factors over the course of the study. Data will be collected at baseline and multiple times during the hottest months and alternate months. Researchers will monitor indoor air temperature, humidity, heat index, and household energy use continuously. The study seeks to provide evidence on whether cool roofs can improve physical, mental, and social wellbeing in vulnerable populations facing extreme heat.

Climate change involves rising global temperatures, melting glaciers, and warmer oceans, leading to increased greenhouse gases like nitrogen and carbon dioxide that harm air and water quality. These changes contribute to extreme weather events such as heat waves, floods, and hurricanes. This research focuses on understanding how climate change and air pollution affect individuals with chronic lung diseases including COPD, asthma, bronchiectasis, and interstitial lung disease. The study aims to assess patients' awareness of climate change, heat waves, air pollution, and how these factors interact with their physical activity, anxiety, and depression levels.

Researchers are investigating how providing air conditioners and educational resources affects heat-related stress, mental health, and healthcare use among older adults living in high-risk neighborhoods without home cooling. This randomized stepped wedge trial focuses on adults aged 55 to 95 who have chronic health conditions or recent hospitalizations and may face material hardships. The study aims to understand how air conditioning impacts health and usage patterns during hot weather. Participants are randomly assigned to receive window-mounted air conditioning units and an electricity cost subsidy either in the first or second year. Both groups receive heat health education and cooling kits at baseline. The trial spans two warm seasons, comparing those with and without AC in the first summer, then evaluating the effect of electricity subsidies in the second year when all have AC units. Throughout the study, participants complete surveys assessing heat stress, mental health, and healthcare utilization. Environmental sensors continuously record indoor temperature and air quality, while AC use is tracked via monitoring devices. The primary outcome is self-reported health status measured by a modified Environmental Symptoms Questionnaire, supplemented by assessments of thermal comfort, mood, emergency visits, and hospitalizations. Data collection occurs before and after interventions each summer, supporting a comprehensive evaluation over approximately two years.

Researchers are studying how exposure to high environmental temperatures during pregnancy affects the health of pregnant women and their babies in rural Sindh, Pakistan. The study aims to understand how heat stress impacts pregnancy complications and birth outcomes like early birth or low birth weight. It also explores biological pathways through which heat affects maternal, fetal, and infant health, considering factors such as socio-demographics and nutrition. This observational study enrolls pregnant women in their first trimester (under 14 weeks) and follows them through pregnancy and up to 12 months after birth. Participants wear devices measuring temperature and humidity, and some wear additional sensors to track skin temperature, heart rate, physical activity, and sleep. Researchers perform ultrasounds, collect blood and urine samples, and use questionnaires about heat exposure and coping strategies. After delivery, data on newborn size, birth timing, and complications are collected, along with placental and breastmilk samples for a subset. During the study, women attend clinic visits in the second and third trimesters for ongoing assessments. Researchers monitor heat exposure, physiological stress, hydration, and pregnancy progress through repeated ultrasounds and lab tests. The mother-infant pairs are followed monthly for a year to track health, growth, feeding, immunization, and development. The primary outcomes include low birth weight and small vulnerable newborns, with safety monitored throughout. This research will help inform protections for pregnant women and infants against climate-related heat risks in low-resource settings.