Grande Prairie

Researchers are evaluating the effects of therapeutic-dose heparin compared to usual care pharmacological thromboprophylaxis in patients hospitalized with community-acquired pneumonia CAP. This international, open-label, randomized controlled trial aims to understand if higher doses of heparin can improve outcomes by addressing inflammatory and thrombotic processes that contribute to respiratory, cardiac, and organ complications in CAP. The study builds on findings from COVID-19 patients, where therapeutic-dose heparin showed benefits in non-critically ill patients. Participants are randomly assigned to one of two groups. One group receives a daily therapeutic dose of low molecular-weight heparin LMWH or unfractionated heparin UFH for up to 14 days or until hospital discharge. The other group receives usual care with thromboprophylactic dose anticoagulation following local protocols, with doses not exceeding half the therapeutic level. The investigational arm prefers LMWH but may use UFH, especially in cases of renal compromise, with dosing tailored to patient weight and local standards. During the study, participants will be monitored for survival over 30 days as the primary outcome. Secondary outcomes include bleeding events, heparin-induced thrombocytopenia HIT, thrombotic events, invasive mechanical ventilation, mortality at multiple time points, hospital-free days, and health-related quality of life. The study involves hospital assessments, close monitoring of safety and clinical status, and tracking of various health measures up to 180 days, ensuring comprehensive evaluation of the treatments under study.

Researchers are evaluating the effects of a child-focused goal-setting approach called Enhancing Child Engagement in Goal Setting ENGAGE on therapy outcomes for children with neurodevelopmental disabilities aged 5 to 12 years. This pragmatic trial compares ENGAGE with usual therapy practice across six pediatric rehabilitation sites. The study aims to understand how ENGAGE influences goal performance, satisfaction, functional abilities, participation, and quality of life for children and their caregivers, while also considering cost-effectiveness and service use. Therapists at participating sites are randomly assigned to either the ENGAGE intervention group, where they receive training on goal-setting strategies and tools like the Canadian Occupational Performance Measure COPM, or to a control group that provides usual care. Children receive therapy based on their therapists group allocation. Treatment length varies from 3 to 8 sessions over 2 to 8 weeks. Therapists document treatment details and goal-related feedback during sessions to monitor adherence and compare practices between groups. Participants undergo assessments at baseline before treatment, immediately post-treatment within 10 days, and three months after treatment ends. These include measures of goal performance and satisfaction, child engagement, confidence, participation, functional abilities, and quality of life. An economic analysis evaluates costs from family and service perspectives. Interviews with parents, children, and therapists explore factors affecting ENGAGE implementation and sustainability. The total participation duration varies according to therapy schedules and follow-up assessments.