Clinical Research Directory

Biomarkers of Brain Health in Blast Overpressure Exposure

The purpose of this study is to learn whether headsets that measure brainwaves can find early signs of changes in brain health in tactical operators who train near explosive blasts. Tactical operators are often near blasts during training. These blasts might change how the brain works over time, even if a person feels fine now. This study uses headsets that measure electrical brainwaves to see if they can detect early changes before they cause problems such as memory loss or blurred vision. The main questions it aims to answer are: * Can useful brainwave data be recorded during real breaching training, using sensors built into tactical hearing protection? * Do brainwave patterns change after blast exposure, compared with a person's own Day 1 baseline? * Do those brainwave changes line up with the amount of blast pressure a person was exposed to, with changes in balance and thinking, and with the symptoms they report? This is an observational study. It adds no new training activities and does not change how close participants stand to a blast or how many blasts they are near. The research team observes and records during training that is already scheduled. About 12 people taking part in Guild Solutions breaching training near Ottawa, Canada will join. The study lasts five days. Most sessions take about 5 to 10 minutes, except the Day 1 baseline session, which takes longer. Participants will: * Answer questions on Day 1 about sleep, stress, and habits; about any symptoms they have now, such as dizziness; and about how many blasts they were near in the past three months * Take balance and thinking tests on a phone or tablet using the Sway Concussion app by Healthy Roster. On Day 1 these take about 15 minutes together (about 7 minutes each). On later days they take about 3 minutes each * The balance test asks the participant to hold certain stances, such as one foot in front of the other, or standing on one foot. The thinking tests ask the participant to move the device when the screen changes color, and to remember three letters while playing a Simon-Says-style game * Sit still for 3-minute "neural snapshot" brainwave recordings, alternating between eyes open and eyes closed. On training days these are collected in the morning, before and after each breaching exercise, and in the evening * Answer a short symptom questionnaire in the morning, before and after each breaching exercise, and in the evening, plus a daily log of sleep and substance use * Wear a Blast Tracker 4 blast sensor during breaching exercises * Wear the AMP Neuro headset, which is built into tactical hearing protection, during breaching exercises. Because each breaching round has three active breachers, participants wear it in rotating groups of three, so everyone wears it at some point during the week The headsets use passive sensors that only listen to the brain's own electrical activity. They do not send electricity into the head. These devices have not been approved by Health Canada. They are used in this study only as non-invasive tools to record research data; the study is not evaluating the devices for medical safety or effectiveness. Anyone who feels uncomfortable or no longer wants to take part can remove the headset and leave the session at once. On the breaching range, participants should speak with an onsite instructor first, for their own safety. Taking part is voluntary. Individual results are not shared with Guild Solutions leadership or instructors in any way that would identify a participant, and the decision to join or not join has no effect on training, performance appraisal, or employment.

KAP TB in Senior Management Officials of Companies With Increased Silica Exposure

The study was designed as a descriptive cross-sectional survey conducted between February and October 2022. Senior management officials were targeted because of their role in workplace policy and oversight. The sample was drawn from companies registered under the Zambia Chamber of Commerce and Industry (ZACCI), focusing on those with known silica dust exposure. Each company was asked to provide one or two senior officials to participate. A total of 118 individuals completed the survey. Data collection was carried out using a self-administered electronic questionnaire developed in line with WHO recommendations for TB KAP surveys. The questionnaire contained 28 mandatory closed-ended questions: 7 on knowledge, 8 on attitudes, and 13 on practices (with 5 practice questions excluded from scoring as they were programmatic). Responses were validated by three medical doctors, and scoring was based on correct answers. Knowledge, attitude, and practice scores were categorized into "poor" or "good" using mean or median cutoffs depending on distribution. Logistic regression was applied to explore associations between participant characteristics and KAP outcomes.

Non-Invasive System to Deliver Therapeutic Hypothermia for Protection Against Noise-Induced Hearing Loss

The goal of this interventional clinical study is to investigate the use of mild therapeutic hypothermia devices for preservation of sensory structures in the cochlea after noise exposure. The main aims of the study are: 1. To test the safety and best duration for use for a new hypothermia device. 2. To determine if the hypothermia device helps decrease noise-induced hearing loss in a group of firefighters. Participants will wear the mild therapeutic hypothermia therapy devices immediately after a fire service shift serially over a year. Researchers will compare results from those receiving the therapy to those from a control group (individuals receiving no therapy and a sham therapy).

The Effect of Intelligent Exercise and Ergonomic Recommendations on Surgeon Musculoskeletal Discomfort

The goal of this clinical trial is to investigate the effects of Intelligent Physical Exercise Training (IPET) and ergonomic recommendations on musculoskeletal pain among abdominal and pelvic surgeons. The main question it aims to answer is: • Is IPET superior to ergonomic recommendations in rehabilitating or preventing musculoskeletal pain? 12 weeks ahead of trial start, all participants will be familiarized with ergonomic principles in the operating room. In the 20-week trial, the control group is asked to resume practicing and applying the ergonomic principles when they operate. In addition to applying the ergonomic principles, the Intervention group will be asked to perform 50 min. per week of individually tailored physical exercise training. The program is delivered via an application (app).

Anisakis Blastocystis Cryptosporidium Fish Prevalence

Anisakidae frequently infect fish species that are commonly eaten by humans. Some of them are recognized as zoonotic agents, and have a high impact on human health. Infestation results from the ingestion of living larvae from contaminated fishes. It can be asymptomatic or symptomatic, resulting in acute gastric, acute intestinal or chronic forms. Allergic manifestations are frequently encountered in gastric forms, but isolated allergic symptoms can occur after ingestion of Anisakidae antigens in raw or cooked fish. Cutaneous contact or Anisakis allergen inhalation have also been reported to induce allergy/anaphylactic reactions or sensitization in the occupational setting in Spain, Italy, Sicilia or South Africa. But no data is available in France. In this context, the investigators propose to determine and compare the frequency and characteristics of fish allergy in fish workers (fishermen and fish-processing factory workers) and a control population of workers without occupational exposure to fish, in Boulogne-sur-Mer, which is an important fishing port in France, and the first European center for fish processing.

A Multicentre Randomised Controlled Trial of the Norwegian Health in Work Service. The NSAC Efficacy Study

The Norwegian Sickness Absence Clinic (NSAC) is a publicly funded specialist outpatient health service, which is uniquely available for the work force. The overall aim of the NSAC is prevention of sickness absence, promote return to work (RTW) among those on sickness absence and prevent long term disability benefit dependency. In addition to being a health service, the NSAC has a focus on work and functional recovery, including also non-health related factors. Patients can be referred by general practitioners for mental health problems and musculoskeletal problems. The NSAC has a lower threshold for severity than specialist health services generally, and in particular for mental health problems. The efficacy of this service is unknown. The NSAC Efficacy Study is a randomized controlled multicentre trial which aims to assess the effect of the NSAC service. "Helse i Arbeid" is the Norwegian name for NSAC, and the Norwegian abbreviation is "HiA". The Norwegian study name is HIANOR. The NSAC Efficacy Study involves five different NSACs across northern Norway, and will recruit 2500 patients, randomized to in equal proportions to three treatment arms: 1. NSAC - rapid: treatment at the NSAC at- or within 4 weeks 2. NSAC - ordinary: treatment at the NSAC after 10-14 weeks 3. NSAC - active control: monodisciplinary examination at the NSAC close to diagnosis-specific deadline for examination as suggested by guidelines (8-26 weeks, the majority at the end of this interval) The overall aim is to assess the effect of the NSAC service, with the hypothesis that the NSAC service is superior to what resembles treatment as usual (TAU) for outcomes such as return to work or improved health (waiting list control). Many of the diagnoses or problems for which patients are referred to the NSACs naturally improve regardless of health interventions, and - as of date - no research has been conducted to assess the efficacy of the service.

AI-Supported Gamified Training for Sharps Injury Prevention in Nurses

This study aims to evaluate the effect of a Health Belief Model (HBM)-based, artificial intelligence (AI)-supported gamified training program on nurses' knowledge and attitudes toward the prevention of sharps injuries. Sharps injuries remain a significant occupational risk for healthcare workers, particularly nurses, despite existing standard precautions. The study will be conducted in two phases. In the first phase, the validity and reliability of the Sharps Injury Prediction Scale will be tested in a nurse population. In the second phase, a quasi-experimental pretest-posttest control group design will be used to assess the effectiveness of the intervention. The study will be carried out in two hospitals from the same healthcare group located in different cities to prevent interaction between groups. A total of 36 nurses will be included, with 18 participants in the intervention group and 18 in the control group. The intervention group will receive a structured, HBM-based training program consisting of seven sessions incorporating AI-supported content, gamified scenarios, interactive materials, and feedback mechanisms to enhance engagement and promote behavior change. The control group will receive routine institutional training on sharps injury prevention. Data will be collected at baseline, immediately after the intervention, and two months later. Outcome measures include nurses' knowledge, attitudes toward safe sharps use, and sharps injury risk perception. It is expected that the AI-supported gamified training program will significantly improve knowledge, attitudes, and risk awareness compared to routine training. The findings may support the integration of innovative, theory-based educational interventions into institutional training programs to enhance occupational safety.

A Multilevel Intervention to Prevent Noise Exposure in Farmworkers

This study will test a program to reduce noise exposure and prevent hearing loss among farmworkers. Farmworkers are often exposed to high levels of noise from machinery, which can lead to hearing loss over time. Farms will be randomly assigned to either receive the program or serve as a comparison group. The program includes a short educational video, group discussion, and hands-on training on how to use hearing protection (such as earplugs). Supervisors will also receive brief training on how to support hearing protection use in the workplace. Participants will wear a small device (dosimeter) during a work shift to measure noise exposure before the program and again about one month later. Participants will also complete surveys about their knowledge, attitudes, and behaviors related to hearing protection. A subset of participants will be invited to take part in interviews to understand barriers and facilitators to using hearing protection and implementing the program. The results of this study will help inform future efforts to improve hearing health and reduce noise exposure in agricultural settings.

Lung Cancer Screening CT for Firefighters

Firefighters are at increased risk for cancer due to exposure to carcinogenic substances. Current lung cancer screening guidelines are predominantly based on smoking history and do not take into account high risk occupational exposures such as firefighting. This study aims to provide chest computed tomography (CT) scans to firefighters to determine the prevalence of lung cancer, other cancers detectable on CT chest, and lung diseases associated with increased cancer risk.

A Naturalistic Trial of Nudging Clinicians in the Norwegian Sickness Absence Clinic. The NSAC Nudge Study

The Norwegian Sickness Absence Clinic (NSAC) Nudge Study is a naturalistic randomized controlled multicentre trial which aim is to measure the efficacy of nudging clinicians' attention towards patients' motivation for work, barriers for return to work and work environment challenges, on functional recovery as primary outcome, and health outcomes as secondary outcome. Patients will be recruited in five different NSACs across northern Norway. In total 1100 patients will be randomized to two equal probability treatment arms: 1) NSAC with the nudge, and 2) NSAC without the nudge. The nudge is tailored to the individual patient's needs using survey, and the clinicians are presented with a summary of this patient survey prior to consultations highlighting health problems and challenges as reported by the patient in the survey.

Unloading Maneuvers During Spinal Flexion Exposure

An experimental study, which will aim to investigate the acute effects of unloading maneuvers during an intermittent spinal flexion protocol on changes in trunk mechanical and neuromuscular properties.

Prehospital Inhaled Methoxyflurane Non-Clinical Occupational Exposure Study

Methoxyflurane is an anesthetic gas and at low doses has shown to help with pain. Methoxyflurane was approved in Canada in 2018. Low-dose methoxyflurane is self-administered by patients via a handheld inhaler. Exhaled methoxyflurane is captured by an activated carbon (AC) chamber fitted to the inhaler in order to minimize environmental and occupational exposure. It provides rapid (\<1 minute), short-term (30-45 minutes) pain relief within six to ten inhalations and has been shown to be effective and safe in emergency care and for minor surgical, radiological, and dental procedures. The current dosing recommendation is 3 ml bottle. However, the frequency at which methoxyflurane treatment can be safely used by paramedics is not established. From the product monograph, a patient's maximum daily dose of 6 mLs and weekly 15 mLs of methoxyflurane. The treatment course of methoxyflurane for patients should not be repeated at an interval of less than 3 months. Despite the activated carbon chamber to capture the exhaled methoxyflurane, when paramedics are supervising patients receiving inhaled analgesia within a confined area (like the back of an ambulance), it is possible that a paramedic may experience intermittent exposure to methoxyflurane vapour. Multiple use of the methoxyflurane Inhaler, with or without the AC chamber, creates additional risk. Elevation of liver enzymes, blood urea nitrogen, and serum uric acid, have been reported in healthcare professionals regularly exposed to methoxyflurane inhalational products. 8 A formal limit regarding levels of occupational exposure to methoxyflurane has not been established. The risk of occupational exposure of methoxyflurane will be evaluated in a controlled laboratory setting, recruiting 30 health, screened (history and blood work) volunteers to participate in the back of an ambulance which meets the Ontario Ministry of Health Standards. The participants will consent and follow a protocol while active samplers are placed in the rear of the ambulance to capture the off-gassing of the methoxyflurane. This will inform the risk of occupational exposure of methoxyflurane to paramedics, as well as, hoping to inform the risk of multiple administrations by paramedics to different patients during a single shift, to ensure a medical directive can be created to support patient care and evaluate and support paramedic safety.