Brandon

Researchers are conducting a phase 3, randomized controlled trial to evaluate the best dosing and use of intravenous tenecteplase for patients with acute ischemic stroke (AIS). The study aims to compare standard-dose tenecteplase (0.25 mg/kg) versus low-dose tenecteplase (0.18 mg/kg) and to assess whether intravenous thrombolysis should be used in patients who recently took direct oral anticoagulants (DOACs) or are eligible for emergency endovascular thrombectomy (EVT). The study also examines how patient factors like diabetes, prior antiplatelet therapy, renal failure, frailty, age, and brain imaging findings influence treatment effects. Participants will be randomly assigned to receive either standard-dose or low-dose intravenous tenecteplase, or no tenecteplase upfront with rescue intra-arterial tenecteplase if needed in EVT-eligible patients. Those who took DOACs within 48 hours before stroke onset may not receive tenecteplase initially. The treatments involve a single intravenous bolus of tenecteplase. The trial follows patients for 90 days after treatment or until death if earlier. During the study, participants will undergo evaluations including assessments of functional dependence using the modified Rankin Scale at 90 days. Researchers will monitor safety and effectiveness, focusing on reducing disability after stroke. The trial includes blinded outcome assessment and gathers data to guide clinical decisions on thrombolysis dosing and use in various patient groups. Total participation lasts up to 90 days from enrollment.

Researchers are evaluating the implementation and effectiveness of the Small Steps for Big Changes (SSBC) program, an evidence-based diabetes prevention program aimed at reducing the risk of developing Type 2 Diabetes (T2D) among adults with prediabetes. This study partners with YMCAs across 8 Canadian provinces to deliver and assess the program in diverse urban communities. The study uses a hybrid type 2 implementation-effectiveness design to examine clinical outcomes such as T2D status, blood glucose levels, weight, exercise, and diet, along with program adoption and sustainability metrics. The SSBC program consists of a 4-week behavior change intervention delivered at YMCA locations by community facility trainers. It includes six supervised exercise sessions combined with brief counseling to teach self-regulatory skills for healthy lifestyle changes, plus three independent exercise sessions outside the YMCA. The counseling focuses on promoting regular exercise and dietary improvements like reducing sugar and processed carbohydrates while increasing vegetable intake. Program delivery and adaptations will be monitored from the start through sustainment planning up to 208 weeks. Participants will be involved in assessments over two years following the intervention, including evaluations of T2D status, changes in HbA1c, fitness, body measurements, and health behaviors. Data on program reach, attendance, delivery fidelity, adaptations, patient and staff receptivity, costs, and membership rates will also be collected. The study aims to provide comprehensive insights into the clinical effectiveness, implementation success, and cost-effectiveness of the SSBC program in real-world community settings.

Researchers are evaluating a smartphone app-based mindfulness intervention called the Mindfulness-Based Cancer Survivorship (MBCS) Journey app in adults who have completed cancer treatment. The study aims to address the ongoing psychosocial needs of cancer survivors, such as stress, anxiety, depression, fatigue, and quality of life concerns, by offering a safe, accessible, and affordable mind-body program delivered via mobile technology. This randomized waitlist-controlled trial seeks to provide evidence on the effectiveness of this digital mindfulness program for people living with cancer (PLWC) after treatment. Participants will be randomly assigned either to an immediate group, which starts the 4-week mindfulness intervention right after enrollment, or a waitlist group, which begins the program after a 3-month delay. The intervention uses the AM smartphone app platform to deliver personalized mindfulness lessons and guided meditation playlists. The app also gathers emotional and biometric data to tailor support. Assessments will take place at baseline, after the intervention, 3 months after baseline, and 6 months post-intervention to evaluate stress levels and other health outcomes. During the study, participants will engage daily in 20-30 minute mindfulness practices through the app. Researchers will measure stress using the Calgary Symptoms of Stress Inventory and assess anxiety, depression, fatigue, physical functioning, and quality of life with validated questionnaires. The study includes ongoing monitoring of participants' app usage and self-reported stress, with follow-up extending up to 6 months after completing the intervention. This trial aims to generate rigorous data on a mobile mind-body program's impact on cancer survivorship care.