ANZCTR search results

RHD is a priority health issue for Aboriginal and Torres Strait Islander people and improving delivery of secondary prophylaxis is the major outstanding deficiency in our current attempts to control this disease. Surprisingly this topic has never been researched to any substantial extent. This project hypothesises that a package of interventions, primarily aimed at enhancing effectiveness and efficiency of service delivery for RHD at the primary health centre level, will increase the proportion of clients receiving 80% or more of their SP injections, which will translate to reduced recurrences of ARF, and reduced severity and, eventually, prevalence of RHD.

Mandibular Advancement Devices (MAds) are an established treatment for OSA however it is not widely used in people with quadriplegia. This project will assess the feasibility of MAds in people with quadriplegia.

Ectopic pregnancy is an unpredictable, non-viable and potentially life-threatening condition caused by ectopic (abnormal) implantation of an early embryo into the Fallopian tube instead of the uterus (womb). Ectopic pregnancy occurs in about 2% of pregnancies in Australia. Recent research by our group and others has suggested possible reasons for the embryo failing to implant in the correct place in ectopic pregnancy. To allow us to study this further, we are setting up a bank of stored Fallopian tube tissue collected from women who are having the tube removed as treatment for an ectopic pregnancy. To study possible causes of miscarriage and infertility we will compare affected Fallopian tubes to healthy Fallopian tubes obtained from women who are having operation for non-malignant disease or tubal ligation. A Fallopian tube removed during surgery is not usually kept once it has been examined for diagnosis. We have set up a process by which we can collect and appropriately store the tissue after it is examined by the pathologist. The Biobank of human Fallopian tubes, a repository of disease-specific human samples will promote cutting edge biomedical research in the area of fertility, early embryogenesis and implantation, human reproduction, and carcinogenesis by decreasing reliance on animal models and allowing open access to human samples for scientists. The open access Biobank of human Fallopian tubes will facilitate data dissemination and will help to generate more studies refining methodologies in human research.

Active gaming technologies are rapidly evolving and increasingly being used in therapeutic environments. The current range of commercially available software is of limited use in the context of stroke rehabilitation. This research study will investigate the safety, feasibility and effectiveness of a suite of customised gaming activities in a stroke population. We hypothesise that the gaming activities will be safe and feasible to use in a stroke population and will improve physical outcomes when used in additional to usual care.

The primary purpose of this study is to determine if panobinostat maintenance in patients with multiple myeloma (MM) who have failed to achieve complete remission (CR) following high-dose chemotherapy conditioned autologous stem cell transplantation (ASCT) will lead to an increased/improved rate of conversion to CR or very good partial response (VGPR). You may be eligible to join this study if you have previously been treated with a thalidomide, and/or lenalidomide and/or bortezomib containing induction regimen pre-ASCT. Participants in this trial will receive the oral drug panobinostat at a dose of 45mg three times per week every other week as part of a 4-week (28 day) treatment cycle. You will be treated for 6 cycles and then assessed for response. If after 6 cycles you have not achieved a very good partial response (VGPR) or CR, your panobinostat treatment will cease. If, however, you have achieved the required response, you will continue on panobinostat until disease progression or unacceptable toxicity.

This study aims to evaluate the effect of changing the current model of care in 15 BUPA nursing homes, to a model that employs GPs directly within the homes, in terms of resident health and healthcare resource use outcomes (primary outcomes: polypharmacy, unplanned hospital transfers, general practitioners’ out of hours calls). Nursing homes in four states and in metropolitan and regional locations will be inducted into the program in a randomised and step-wise order, with seven weeks of preparation in the facility before the GP is employed. It is envisaged that employment of GPs will improve several important factors, including medical access and care for residents; increased satisfaction to residents and relatives of residents; reductions in medical costs associated with aged care; improved job satisfaction for employees with subsequent decreased turn-over rates and absenteeism.

We know that after an acquired brain injury (ABI), a number of adolescents experience increased levels of anxiety. So far, very little research has looked at the ways we can help young people with ABI overcome these difficulties and improve the way they are able to get along with others at school, home and in the community. Our aim is to trial a program for managing anxiety for adolescents with ABI. The program incorporates cognitive behaviour therapy which previous research has shown to be helpful for adolescents who do not have brain injury. Components of the program have been especially adapted for young people who may have cognitive difficulties associated with TBI (e.g., memory impairments). This study aims to evaluate this adapted program for managing anxiety in a sample of young people who have had an ABI. The program aims to reduce anxiety and increase levels of participation in everyday activities of young people following ABI. If effective, the program used in this trial will be developed into a manual thereby allowing for applicability of the program in a range of therapeutic settings.

To properly manage type 1 diabetes, individuals are required to measure blood glucose levels (BGL's)regularly and adjust the amount of insulin to be given accordingly. This has been done by matching the amount of insulin with the amount of carbohydrate in a meal. Recent studies have shown that meals high in protein can also significantly increase the BGL. There are recommendations that additional insulin be given with meals containing high levels of protein to prevent post prandial hypergycaemia (elevated BGL's after a meal). However, at this time there is insufficient data to determine how these additional insulin doses should be calculated. A current algorithm used to calculate additional insulin based on protein content in a meal has been shown to cause unacceptable levels of hypoglycaemia. We will recruit 31 people with type 1 diabetes between the ages of 7 and 40 years diagnosed for more than 1 year, using either insulin pump therapy or multiple daily injection therapy. Participants will have a glycated haemaglobin of <8.5% and body mass index <91st centile. Exclusion criteria will be those with co-existing medical conditions. The aim of this study will be to: Define the impact of variable protein loads on post prandial BGL's up to 8 hours. The participants will be contacted daily for the first week to monitor BGL's and adjust insulin doses. A continuous glucose monitoring system (CGMS) which provides continuous measurement of BGL's will be inserted on the first day. For 5 consecutive days participants will be instructed to eat a standardised evening meal containing consistent quantities and type of carbohydrate. The participant will give a standard insulin bolus for the carbohydrate in the meal. They will then be instructed to eat a test meal (protein shake) 4 hours after the evening meal. The participant will fast over night and check the BGL in the morning prior to eating breakfast. If the participant has has a BGL <3.5 mmols/L or has symptoms of hypoglycaemia at any time they will eat 15 grams of carbohydrate as per their usual management. During the test meal study days exercise and evening food will be standardised.

Research question: Does therapeutic ultrasound reduce the severity of rhinosinusitis in adults with cystic fibrosis (CF)? Methods: Adults with CF and chronic rhinosinusitis will be randomly allocated to receive ultrasound or sham ultrasound in a hospital outpatient clinic, 6 times in 2 weeks. The primary outcome will be the severity of rhinosinusitis symptoms, measured using the 22-item Sino-Nasal Outcome Test after the treatment period. Secondary outcome measures will be peak nasal inspiratory flow, lung function, global rating of change, a generic health-related quality of life questionnaire, medication use, and adverse events. Measurements will occur during and 6 weeks beyond treatment. Significance: This study will determine whether therapeutic ultrasound reduces rhinosinusitis symptoms in adults with CF to a clinically worthwhile extent and whether any effect extends beyond the treatment period. Growing evidence indicates that sinusitis seeds the lower respiratory tract with infection, so an effective rhinosinusitis treatment may also have respiratory benefits, which are crucial for people with CF. Ultrasound use has decreased since it was shown to be ineffective for many conditions. If the study shows ultrasound is effective for CF rhinosinusitis, physiotherapists’ apply their skills and this equipment to treat CF rhinosinusitis.

The Analgesia nociception index (ANI) is a novel score aiming to enable anaesthetists to estimate pain perception in anaesthetized patients. It work via 2 sticky (single use) electrodes applied to the chest (like ECG electrodes) from which it derives ECG data. This is then transformed into an index from 0-100, the ANI which will be larger in states of comfort and smaller in states of more pain. Although non-invasive and risk free, very few data exist to show the association of ANI with standard measures of nociception/pain in unconscious subjects: changes in blood pressure, heart rate or patient movement. We aim to do an observational trial on 30 patients in which we attach ANI monitoring to anaesthetized patients, record the ANI score continuously and match these records with other patient data obtained at the same time (blood pressure, heart rate, patient movement). This should enable us to get a better idea about the predictive value of ANI changes to preempt changes in above mentioned standart observations.