ANZCTR search results

The purpose of this research is to test an exercise and wellness program for haematology in-patients receiving cancer treatment. Who is it for? You may be eligible for this study if you are undergoing treatment for a haematological malignancy at the Calvary Mater Newcastle Hospital which requires you to be in hospital for at least 7 days. Study details Each participant will be assessed by a physiotherapist (face to face) and provided with a personalised exercise program (30-60 minutes duration of strength and balance + walking) tailored to be performed daily while in hospital. Each participant will also be given written information on diet, nutrition, and exercise. This study will help to determine adherence and satisfaction of patients and staff to a personalised exercise program while in hospital.

The aim of the study is to determine the impact of pre and post-operative rehabilitation provided through a digital application on Clinical and Hospital Outcomes. Clinical outcome will assessed with patient reported outcome measures and knee range of motion. Hospital outcomes measured will include length of stay and inpatient and rehabilitation costs attributed to care after TKA. Patients who are selected for Total Knee Arthroplasty (TKA) and agree to participate in the study will be randomly assigned to a control or experimental group. The control group will be provided current standard care prior to and after their surgery. The experimental group will be provided a pre and post-operative rehabilitation program consisting of Physiotherapy exercises through a mobile electronic application. The program will be monitored and modified by one Physiotherapist. The experimental group will be able to contact the Physiotherapist via telephone or email at any point during the program to discuss their progress. Patients can choose to opt in and opt out of the digital rehabilitation program and will be included in the analysis on an intention to treat basis. Prior to surgery, patient reported outcome measures will be collected to determine the patient’s pre-operative state. After surgery, various patient reported outcomes measures will be collected at two weeks, six weeks and three months to assess patient satisfaction, self-perceived confidence, pain levels and return to function. Patient reported outcome measuress will be captured via a tablet, email and / or letter, based on patient preference. Patient range of motion will be collected pre-operatively and at six weeks post-operatively by the treating surgeon. Hospital data collected will include length of stay, decision for ongoing rehabilitation and complications, which are collected as part of the hospital record. The digital application collects data on patient compliance and reported pain levels whilst using the program. Analysis will be performed between the two groups to determine the impact of pre and post-operative digital rehabilitation on clinical and hospital outcomes after TKA surgery.

This study will design and test the feasibility, acceptability and potential effectiveness of a tailored implementation strategy to improve speech pathologists’ uptake of evidence in two areas of practice: Goal Setting and Information, Education and Aphasia-friendly information. Multifactorial interventions targeting the main barriers identified in the qualitative study will be designed, using evidence-based behaviour change interventions The aims of this project are: (1) To design and test the feasibility, acceptability and potential effectiveness of an implementation strategy to improve speech pathologists’ provision of tailored information to people with aphasia and their carers in the acute hospital setting, (2) To design and test the feasibility, acceptability and potential effectiveness of an implementation strategy to improve speech pathologists’ use of collaborative goal setting with people with aphasia in the acute hospital setting, and (3) To investigate the effect of the implementation strategy/ies on the hypothesised predictors of clinician behaviour (the main barriers). It is hypothesised that a targeted implementation strategy will change clinician’s behaviour in the area of interest (i.e. information provision or goal-setting) and have no effect on the behaviour not being targeted. A pilot cluster randomised controlled trial will be used. Clusters will be speech pathology departments within hospitals. Medical records will be audited pre- and post- intervention at all hospitals to assess the proportion of patients who received aphasia-friendly information and who engaged in collaborative goal setting with their treating speech pathologist. Focus groups will be conducted to determine participants' feedback on the interventions and to determine feasibility and acceptability of the interventions.

This project will comprise of a randomised control trial (RCT). The hypothesis will be tested by randomly allocating participants into two groups; the ImPress intervention and a control group. Clinical differences between these groups will be assessed at 6 and 12 months follow-up. The primary goal of conducting this trial is to evaluate if the ImPress intervention is more effective than usual care in achieving optimal blood pressure control, medication adherence, behavioural risk factors and body mass index in general practice. Randomisation will occur at a practice level and data will be collected by the GPN at baseline, six and twelve months when patients attend the practice. A total sample of 200 patients across 20 practices will be sought. .Once Practices have been recruited, participating GPNs will conduct a structured electronic search of the practice medical record database to identify a list of eligible patients. Following the assessment visit and study enrollment, patients will attend three face to face GPN appointments and two telephone consultations throughout intervention. All consultations will be underpinned by a person centred approach with the GPN utilising motivational interviewing techniques and the 5 As’ to build rapport, set goals and offer support for self-management. While the aim of first GPN consultation is to record baseline BP, biometric measures and lifestyle risks, this initial encounter is an opportunity to build rapport and shared understanding. Subsequent visits will focus on individualised action planning in partnership with the patient, goal setting and feedback on progress. Templates to structure each nursing assessment will be uploaded to the practices computerised clinical files in Director or Best Practice. GPNs will be encouraged to collaborate with the participating GP(s) to share information around the nursing care being provided.

Background: Sepsis and the systemic inflammatory response syndrome (SIRS) characterises up to 80% of critical illness in children. The fundamental pathophysiological features underpinning sepsis/septic shock (and SIRS) are changes to the vascular endothelium, which include:1) increased permeability to fluid and protein ("leaky") and, 2) increased activation ("sticky"). Therefore, monitoring the permeability of the vascular endothelium should inform clinicians about the stage and severity of sepsis and assist in clinical decision making regards fluid resuscitation and fluid balance management. Positive fluid balance i s a poor prognostic sign, but without clear science, opinion on fluid management in septic shock i s divided. We recently published data which confirms a direct role for Eph/ephrin signalling in endothelial leakage both in a mouse gut ischaemia/reperfusion injury model and in vitro in TNF-a induced vascular leakage in human umbilical venous endothelial cells. Hypotheses: That vascular endothelial function can be monitored in the intensive care unit by: (a) quantifying interstitial protein levels by microdialysis; and (b) measuring plasma levels of Eph/ephrins as endothelial activation markers. Aims: The aim of this project is to determine whether it is feasible to monitor the integrity of the vascular endothelium in critically-ill children by: a) using microdialysis to quantify interstitial protein levels; and (b) measuring plasma levels of Eph/ephrin proteins as endothelial activation biomarkers. Objectives: Our experiments are designed to improve monitoring of vascular endothelial activation and integrity, in order to guide rational fluid therapy and thereby, reduce ventilator bed days and lower mortality. Methods: In previous experiments in paediatric cardiac surgical patients, we have tested the feasibility of monitoring interstitial protein, fluid and cytokines. In these experiments, we will prospectively identify infants and children admitted to the paediatric intensive care unit (PICU) of Lady Cilento Children’s Hospital (LCCH) with sepsis/septic shock. Briefly, a microdialysis catheter (CMA60) will be inserted subcutaneously into the forearm of septic children (n = 100), and perfused with electrolyte solution and the dialysate collected for protein and cytokine determination. Serial routine blood tests will be analysed for biomarkers of endothelial activation. Approximately 100 infants and children are admitted annually with sepsis/septic shock to LCCH PICU, and are treated according to the paediatric Surviving Sepsis Guidelines. Control patients will be healthy children (n = 20) undergoing routine elective surgery at LCCH. Significance: We will introduce new diagnostic test to identify endothelial activation and a new tool (i.e. microdialysis) for monitoring vascular endothelial integrity. This may improve supportive care in the ICU and result in reduced ventilator days,

Contrast-induced nephropathy is a relatively common complication for chronic kidney disease patients who are undergoing a procedure involving contrast dye, such as a coronary angiogram, affecting around 15% of patients in this population. This condition is characterised by kidney damage that occurs a short time, usually within three days, after having the contrast procedure. We know when a patient experiences contrast-induced nephropathy by observing the levels of creatinine, an enzyme produced by the kidney, in the blood. Creatinine levels are observable from a blood test. Rates of contrast-induced nephropathy can likely be reduced using hydration and forced diuresis (increased urine output using medication). Currently, we try to reduce the incidence of contrast-induced nephropathy by hydrating patients with intravenous saline before and after the angiogram. However, it may be possible to reduce the rates of contrast-induced nephropathy even further by implementing a new regime of hydration and forced diuresis. This research project aims to identify a new, effective method of reducing rates of contrast-induced nephropathy in patients with advanced stage III, IV and V chronic kidney disease who are having a coronary angiogram at the Lyell McEwin Hospital. Patients who consent to participate in this research project will be randomly sorted in one of two groups: the control group (patients who will receive the current usual standard of care, which involves receiving saline through an intravenous drip) and the experimental group (patients who will receive a dose of furosemide for forced diuresis and euvolemic fluid replacement). Participants will not be randomised into a group until they have provided written informed consent agreeing to participate. The primary outcome for this study is development of contrast-induced nephropathy. The secondary outcomes is length of hospitalisation.

The study aims to delineate the electroanatomical remodelling in obese patients with atrial fibrillation. Importantly, it will analyse the impact of contiguous epicardial fat deposits on the electrophysiological properties of adjacent atrial tissue. It is a retrospective study based on the analysis of prospectively collected database. The patients underwent cardiac MRI prior to the ablation. Electrical remodelling and fat deposits and their association will be analysed

This observational study will evaluate smoking cessation and its impact on treatment outcome and survival in patients with head and neck cancer. Who is it for? You may be eligible to join this study if you are aged 18 years or older and have a confirmed diagnosis of Stage I-IV squamous cell carcinoma of the oral cavity, pharynx, larynx, nasal cavity or paranasal sinuses, for which you are deemed suitable for curative treatment at Townsville Cancer Centre. Study details Participants will undergo cancer treatment and may participate in the existing smoking cessation program as per standard of care at Townsville Cancer Centre. They will then be followed up at 3 months, 6 months, 9 months, 1 year, 2 years, 3 years and 5 years post treatment to evaluate a number of outcomes, including smoking cessation rate among smokers, treatment toxicities, and clinical response to treatment. It is hoped that the results of this study will help inform patients and health care providers and facilitate improvement in quality of care and patient compliance leading to improved disease control, survival and quality of life.

In Australia, 35,000 people have cerebral palsy (CP), and between 60-70% of these have difficulties with movement on both sides of their body. There are currently no effective interventions for children with CP that affects both sides of their body to improve their ability to use their hands, walk and perform daily life tasks. We will test the efficacy of Hand Arm Bimanual Intensive Training Including Lower Extremity (HABIT-ILE), in 126 children with cerebral palsy and compare results to usual care.

We know that asthma is a common but serious illness that causes deaths in otherwise healthy people, including young people and children. While asthma can’t be cured, it can be managed but this does require regular review of symptoms and medications, particularly because the disease can vary in severity over time, with different triggers affecting this. One strategy to improve asthma management is an asthma action plan. This is a written document that outlines how a patient’s asthma can be managed. It is individualized for each patient, and for different levels of asthma severity. It has been shown that having an asthma action plan reduces asthma mortality, yet many patients with asthma do not have a current up-to-date action plan. Part of the reason for this is that many patients with asthma only attend when they are unwell and do not attend for a planned visit to review their asthma care. Our aim is to see if a simple short messenger service (SMS) sent by the GP clinic (Banyo Clinic) increases the number of patients who attend for a planned asthma review, and as such get a current asthma action plan as part of this. To do this, we plan to design and use a computer program to search the existing general practice database and identify those patients with asthma who are eligible. Performing such a search and identification is a usual part of good practice care and clinicians regularly carry out similar audits of their databases. In this project, we additionally wish to send a SMS message to half of the population identified, inviting them to book an appointment for an asthma review. The other half of the population won’t receive an SMS and therefore will receive usual care. After two months, we will send a follow up reminder SMS to those who haven’t attended for an asthma visit with the same SMS reminder. After data collection, we will analyse the data to see if the group who received the SMS attended at a different proportion to the control group for asthma visits and supply of action plans. Our hypothesis is that, compared to usual care in the control group, receiving an automated SMS reminder prompting patients to attend for an asthma management review will: 1: Increase the attendance at the clinic for a planned asthma review 2: Increase the proportion of patients with asthma management plans The population target will be active patients with asthma who have attend the Banyo Clinic at least twice in the preceding two years who have a mobile phone number attached to their file. Eligible participants will be defined as those who have asthma in their active past history. Participants will be identified from the clinic's data base and recruited by mail from the clinic. It is estimated that there will be approximately 300 eligible people in both the control group and the intervention groups. The participants will be randomized by computer to either the intervention (SMS receiving group) or the control (care as usual) group.