300,000+ clinical trials. Find the right one.

50 active trials for Respiratory Disease

Urban Transformations and Health: The Case of TransMiCable in Bogotá

Cable cars are means of transportation with urban mobility benefits for vulnerable populations living in areas with geographic barriers. Despite their popularity, there is no evidence of cable cars' potential health effects. TransMicable, located in "Ciudad Bolivar", Bogota, Colombia will open in late-2018 presenting an unprecedented opportunity to assess the health impacts and accessibility improvements. The investigators aim is to assess the effect of theTransMiCable implementation on social determinants of health (social capital, employment, crime, transport, microenvironment pollution, built environment), healthy behaviors (leisure and transport physical activity) and health outcomes (health-related quality of life, respiratory diseases and homicides). The investigators are conducting a controlled quasi-experimental pre-post study with six elements: 1) The co-construction of a conceptual framework using a causal loop diagram with stakeholders of multiple sectors. 2) A (non-intervention - intervention) quantitative study of social capital, community participation, travel time, costs, demand, modal choice, physical activity and health-related quality of life using repeated in-person questionnaire, anthropometric measurements and physical activity using accelerometers. 3) A transport trajectory study in a subsample of the population of the quantitative study using a mobile application to track journeys. 4) A subsample of environment evaluations 5) Our Voice in the Neighborhood qualitative study to address the potential change in perceptions of the neighborhood using Citizen Science "by the people" involving the community and local public and private stakeholders and 6) A Secondary-data analysis of Crime and Respiratory diseases using time trends from official surveillance systems for homicides and acute respiratory diseases. The investigators' main hypothesis are 1) There is an increase in the Social Capital and Quality of life indicators in the TransMicable target area after the implementation when compared to other neighborhoods without TransMiCable. 2) There is a significant decrease in travel time and cost for trips to downtown Bogota and an increase in the total number of trips for residents of "Ciudad Bolivar" neighborhoods with TransMiCable, after the implementation of TransMiCable when compared to other neighborhoods without TransMiCable in the locality of "San Cristobal". 3) There is a significant shift in modal choice for the resident of "Ciudad Bolivar" from informal transport service to the TransMiCable system with a positive association in terms of proximity to TransMiCable stations. 4) Most TransMiCable users are former informal bus transit and formal bus feeder users. While most users will access TransMiCable by walking, some living further from stations will take informal transport services to access to TransMiCable. 5) There is a reduction in the microenvironment pollution around the target area of TransMiCable when compared to the control area. 6) There is a change in the perception of the neighborhood for residents of the target area of TransMiCable when compared to the control area. 7) There is a significant decrease in the prevalence of homicides and acute respiratory diseases in the area of the TransMiCable implementation in comparison to the control area without TransMiCable. The results of this study will allow us to understand baseline dynamics, while, in the long-term, allowing us to assess the changes in travel and health behaviors.

Start: February 2018
Nasal High Flow Therapy in the Paediatric Home Setting

High flow nasal cannula (HFNC) therapy is non-invasive respiratory support designed to deliver a high flow of heated humidified air, with or without entrained oxygen, via specifically designed nasal prongs. Initially developed for preterm infants, the application of the technology is rapidly spreading to include pediatric patients with various indications, including bronchiolitis, obstructive sleep apnea (OSA), tracheomalacia, asthma, post- extubation support, and even adult hypoxemic respiratory failure. Since it appears to be better tolerated than traditional modes of non-invasive ventilation, such as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP), it is increasingly used outside the intensive care setting, despite limited evidence of its safety and efficacy. In Israel, HFNC is approved for home support of children requiring non-invasive respiratory support on the recommendation of a paediatric pulmonologist or intensivist, provided that CPAP and BiPAP have been trialed and deemed not tolerated by the patient. At Schneider Childrens' Medical Center of Israel (SCMI), a tertiary paediatric hospital, therapy is commenced during a brief inpatient stay, at a period of clinical stability. Parents are trained in the use of the device and flow rate is titrated to clinical response. The investigators aim to describe the safety, indications, parameters of utilization, length of treatment, clinical outcomes and parental satisfaction of HFNC in the paediatric home setting.

Start: March 2019