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Culturally appropriate healthcare is needed to support safe medication use by Aboriginal and Torres Strait Islander Australians. This feasibility study, partnered by Griffith University, the National Aboriginal Community Controlled Health Organisation, and the Pharmacy Guild, seeks to provide a culturally responsive, individualised, medication review service delivered collaboratively by community pharmacists and Aboriginal and Torres Strait Islander health services (both Aboriginal Community Controlled Health Services [ACCHS] and government Indigenous Health Services [IHS]. Researchers will pilot and evaluate the service to ensure delivery is feasible across diverse locations. A total of 540 adults with long-term conditions, or who are pregnant, or within two years postpartum AND who are at risk of medication-related problems will work with pharmacists and staff from nine ACCHO/IHSs across Queensland, New South Wales and the Northern Territory to resolve medication-related problems. Stakeholder feedback will refine service development, training and outcome measures for a future randomised controlled trial.

Myopia (short sightedness) is a refractive condition where the distance from the front to the back of the eye is too long for the refractive strength of the eye, leading to light being focussed in front of the retina (light sensitive layer on the inside back of the eye) and subsequently causing blurred vision. Myopia typically develops in childhood while the eye is growing and is believed to be accelerated by correcting the myopia with glasses. When myopia first presents the child complains of poor distance vision which is corrected by glasses. Unfortunately, myopia continues to progress requiring the child to return at regular intervals to get ever stronger glasses, until they reach adulthood. Orthokeratology (OK) lenses are specialised contact lenses that are worn during sleep to reshape the front surface of the eye to temporarily correct myopia. Recent research has shown that OK lenses are effective at slowing progression of myopia by 50%. These encouraging results have led contact lens manufacturers to develop OK lens designs with greater effectivity in slowing progression of myopia. While these ‘Myopia Control’ OK lenses are now being supplied to optometry practices and marketed as being more effective in slowing progression of myopia compared to standard OK lens designs, there is no scientific evidence to support that they are any more effective than standard OK designs. The aim of this project is to increase understanding on how myopia control OK lens designs will affect known stimuluses for myopia progression compared to standard OK lens designs. The scientific literature reveals that OK causes peripheral light rays to be focussed further towards the front of the eye than central light rays, which is termed peripheral myopic defocus. Peripheral myopic defocus has been shown to slow progression of myopia in animal models, and this same mechanism is believed to be the reason why OK lenses slow progression of myopia. The manufacturers of myopia control OK lens designs claim that they are more effective at slowing progression of myopia compared to standard OK lens designs because they create a greater amount of peripheral myopic defocus. We are going to investigate the potential for greater slowing of myopia progression with myopia control OK lens designs, by measuring the effect that the different OK designs have on myopic defocus in young adults over 1 week of wear, which is the reported shortest duration of time for the full refractive effect to be achieved. This study is important as optometrists need to know the true effect that OK lenses marketed to slow myopia progression have on refractive mechanisms that have been shown to retard progression of myopia, if they are to be effective in managing myopia in their child patients. Outcomes will also assist the design of future longitudinal studies using standard and myopia control OK lens designs.

This project aims to evaluate the results of a relatively inexpensive, noninvasive Liver MRI using an algorithm called “Proton Density Fat Fraction MRI (PDFF)” which uses “multi-peak spectral modelling and R2*”, and compare them against an alternative, more expensive technology called “Liver Ferriscan®” (Resonance Health, Western Australia), which is accepted as a reference standard for determining liver iron content.

Adequate iron stores are essential for the ability of the body to produce new red blood cells, and the key component of those red blood cells, haemoglobin. A low blood concentration of haemoglobin is referred to as “anaemia”, and is often due to low iron stores, or an inability for the bone marrow to access them. This latter phenomenon is referred to as “iron deficiency”. Iron deficiency and anaemic may exist in a patient separately, or together. A combination of the two is termed “iron deficiency anaemia”, and patients with the condition are said to be “anaemic”. Iron deficiency anaemia has long been associated with worse outcomes for patients undergoing cardiac surgery. Compared to a normal person, the patient with iron deficiency anaemia has a higher risk of requiring a blood transfusion, sustaining a kidney injury, or dying following their operation. There is another group that, up until now, has been poorly studied: those patients who are iron deficient, but not anaemic. Whilst these patients may have a normal haemoglobin concentration in their blood prior to surgery, inevitable blood loss during surgery and the inflammation during and afterwards causes the haemoglobin concentration to fall. If the patient has inadequate stores of iron, or is unable to access those stores, these patients will be unable to increase their production of haemoglobin. Hypothetically, these patients are at risk of many of the complications that patients with anaemia prior to their operation will face. However, because this research question is yet to be formally studied, it is not known whether or not this is correct. Proposed trial and investigators The IDOCS study has been designed to test this theory. Patients with iron deficiency, but who are not anaemic before their operation will be followed during and after their surgery and compared to a cohort of normal patients (who are iron replete and not anaemic) as a reference point. If the trial hypothesis is correct, patients who are iron deficient but not anaemic will have worse outcomes than those patients who are not anaemic and iron replete. IDOCS will be undertaken at two major tertiary hospitals in Melbourne: The Alfred and the Austin Hospital. Significance If the hypothesis of IDOCS is proven, it will identify a new group of patients who are at risk of poor outcomes following cardiac surgery, opens an exciting new frontier in preparing patients for these procedures, and improving survival and reducing complications from the operation.

Orthokeratology (OK) lenses are rigid contact lenses that are designed to be worn during sleep. Their purpose is to reshape the front surface of the eye (cornea) in order to temporarily correct short-sightedness, also known as myopia. Although their primary aim is to correct myopia and provide clear unaided vision during the day, studies have shown that they also have an effect on slowing or stopping the progression of short-sightedness in children, termed myopia control. Currently, research is underway to understand centration of OK lenses and the optical effects as a result of centration which may promote myopia control. Hence this prospective study aims to understand the effects of peripheral corneal shape on lens decentration by determining treatment zone decentration resulted through lens decentration during OK lens wear. Outcomes of this study would help in designing OK lenses that help in achieving myopia control in a more desired manner.

What is this study about? The purpose of this study is to investigate if ZYN002 applied by massaging it into the upper thighs provides the same amount of drug as when it is applied by massaging it into the arms/shoulders after repeat doses (applied twice daily for 13 days and on the morning of Day 14). Two concentrations of ZYN002 will be tested; one concentration containing 4.2% cannabadiol (CBD) and one containing 7.5% CBD. The study will look at blood levels of the drug in the body after it is administered in these three body locations in different people. How safe and well tolerated ZYN002 is will also be investigated. Who is it for? You may be eligible to join this study if you are aged between 18 and 70 years and are in general good health. Study details: This study will enrol a maximum of 40 participants across 4 treatment groups with 10 participants in each group, and will investigate the amount of ZYN002 detected in blood samples after administration of the treatment. In each group, 8 participants will receive the active drug (ZYN002) and 2 will receive the placebo. A placebo is a gel that looks like ZYN002 but does not contain any active ingredients. You will not have a choice as to whether you receive ZYN002 or the placebo (you will be assigned randomly, like flipping a coin). Neither you nor the study staff will know if you are assigned to receive ZYN002 or the placebo as the allocation will be masked, although in an emergency, the study staff can find out. What does study participation involve? Participation in the study includes a screening visit during the 28 days before the first study treatment. Throughout the study participants will have various medical tests (physical examinations, vital signs measured, ECG measured, C-SSRS assessment and will have several blood and urine samples collected for laboratory analysis. Participants will report to the study centre on the day prior to the first day of treatment (Day 1) and will be required to remain in the study centre overnight for 15 nights, until Day 15. The study treatment will be applied twice daily for 13 days with one treatment on Day 14. Days 1-13, while at the study centre, you will apply your AM and PM treatment of ZYN002 or placebo gel. You will apply the study treatment to the treatment site assigned to you (either your upper arms/shoulders and/or your upper thighs). You will apply your dose of the study drug to clean, dry, intact skin, thoroughly massaging it into the application sites assigned. You will continue to massage study drug into the application site until the application site feels dry to the touch. This will take approximately 2-4 minutes. On Day 14 there will be only an AM dose. You will be discharged on Day 15 and return to the study centre on Day 20 for a follow-up assessment visit.

Adults diagnosed by a Neurologist with Functional Neurological Symptom Disorder with residual symptoms despite diagnosis and treatment as usual will be seen for four two hour sessions of psychodynamic therapy with a Psychiatrist incorporating a comprehensive psychiatric history and formulation followed by management recommendations. Family and carers will be invited to join the planning component of sessions. At the final session a personalised "farewell" letter will be given to participants and a medical letter will be sent to referring and other treating doctors incorporating managment recommendations. All participants will complete a questionnaire in person before each interview and again three months after the last session by phone. A clinician administered measure of dissociation will be completed in the first appointment and again at the final session and during the follow up phone call. A modified adult attachment interview (AAI) will be incorporated into the first session for subsequent analysis. The assessments will be voice recorded for later assessment of interaction and adjherence to protocol by a supervisor and will be transcribed externally for thematic analysis and production of a case series. The clinician will also complete a HoNOS measure about the patient after each session and after the follow up phone call three months after the last session.. Statistical analysis will compare measures from before the first and last sessions as well as the measures at follow-up. The therapeutic interactions and patient narratives will be explored for themes. Rates and nature of additional psychiatric diagnoses in this population will be described. Modified Adult Attachment Interviews and Shutdown Dissociation interviews will be scored to indicate rates of each attachment style and rates of dissociation. Collaborative formulations which are agreed upon with the participants will be used to produce a case series.

PRE-BIOTIC will be the world’s first randomised controlled trial (RCT) of anabolic exercise (high intensity PRT) for patients with active inflammatory bowel disease (IBD) who remain symptomatic despite robust medical treatment. Although current treatment is effective in controlling a number of their symptoms, there is a need for better options to prevent disease, increase response and sustain remission. Exercise is one potential complementary strategy to combat IBD and other diseases, and there is rapidly growing evidence that it may also positively and substantially affect the gut biome, and thus could play a role in both prevention and treatment of IBD. Among exercise modalities, the rationale for resistance training (PRT) in IBD is extremely strong, as it has many of the same benefits of aerobic exercise with regards to cardio-metabolic profile and inflammation, but in addition, due to its anabolic nature, provides unique benefits not seen with aerobic exercise, including increases in muscle strength and mass, bone density and appetite. An anabolic/anti-inflammatory intervention such as PRT is theoretically able to change the underlying pathophysiology of this condition, in addition to addressing important physical and psychological symptoms. The global impact and relief of suffering for these individuals and their loved ones would be unprecedented.

About 20-30% of patients with angina have no obstructive coronary artery disease on coronary angiogram (NoCAD). Despite no significant obstructive coronary artery disease, most of these patients continue to experience recurrent chest pain without any definitive diagnosis. Comprehensive invasive coronary haemodynamic studies at the time of diagnostic coronary angiogram will provide important diagnostic and prognostic implications for the management of coronary vasomotor disorder, but routine assessment is difficult. The hyperaemic microvascular resistance (HMR) is a reliable but invasive measure to assess coronary microvascular function. The planned project will evaluate whether left ventricular contractile reserve (CR), measured with strain imaging on low dose dobutamine stress echocardiography (DSE), is a reliable non-invasive measure of coronary microvascular function.

Preliminary evidence now exists for the efficacy of the K-SLP approach. Recently, a case report was published which used a multimodal approach combining K-SLP with sign language and oral-motor therapy (Tierney, Pitterle, Kirtz, Nakhla, & Todorow, 2016). This was followed by two separate single case multiple-baseline within-subject experimental designs (SCED) on a total of 6 children (Gomez, McCabe, Purcell, & Jakielski, 2017; Gomez, McCabe, Purcell, & Jakielski, in press). The results of the two SCED studies has provided some positive results indicating feasibility and positive treatment outcomes. This research will continue to expand the evidence base for CAS treatment by completing a pilot randomized controlled trial (RCT) comparing the K-SLP approach to standard treatment. This research may also provide insight into what comprises standard treatment for CAS. This research is important as it provides speech-language pathologists with additional external evidence to ensure that they are providing an efficacious treatment approach for CAS, in accordance with their ethical obligation as allied health professionals.