ANZCTR search results

Survey of discharge prescribing of analgesia after surgery and Emergency Department (ED) attendance is a study designed to target Resident Medical Officers (RMOs), Specialist Trainees and Consultants in Royal Brisbane and Women's Hospital (RBWH) and Townsville University Hospital (TUH). This study seeks to understand the attitudes behind prescribing analgesia by doctors in specific clinical settings, to allow policy makers make targeted interventions with regards to opioid-prescribing. We hypothesise that there may be varying levels of understanding and confidence with regards to analgesia prescribing after surgery and in ED. There may also be differences in teaching, guidance and supervision, provided for RMOs. The survey will be distributed electronically to doctors in RBWH and TUH working in Emergency Department or Surgical Departments (including General Surgery, Cardiothoracic Surgery, Vascular Surgery, Neurosurgery, Orthopaedics, Colorectal Surgery, Urology and Gynaecology) for participants to fill in anonymously. Survey results will be analysed by project members for publication in a peer reviewed journal, presented as a poster at scientific meetings and used by local clinical leads to inform the development of targeted interventions.

The COVID-19 pandemic has resulted in a range of unprecedented changes to the way healthcare is delivered in all Australian public hospitals. In maternity hospitals across Victoria, these changes have resulted in an altered schedule of visits for antenatal care. The aim of this study is to monitor monthly trends in key perinatal services performance indicators and maternal and newborn outcomes at the largest VIC maternity health services before, during and after the COVID19 pandemic. This is a multi-centre retrospective cohort study that will gather routinely collected data on births from January 1 2018 to December 31 2024. The first half of the study period (from Jan 1 2018 to commencement of study following HREC and local governance approvals in mid-2020) will be retrospectively collected in order to provide baseline rates of all outcomes. Data will then be prospectively collected each calendar month from each of the participating sites, and this will be continuously updated to provide timely reports on maternity services. These seven health services, including 12 hospitals, collectively look after 100% of all public births in metropolitan Melbourne. The participating health services are: • Mercy Health (Mercy Hospital for Women, Werribee Mercy Hospital) • The Royal Women’s Hospital, The Women’s at Sandringham • Monash Health (Monash Medical Centre, Casey Hospital, Dandenong Hospital) • Northern Health (The Northern Hospital) • Western Health (Joan Kirner Women’s and Children’s Hospital) • Eastern Health (Box Hill Hospital and The Angliss Hospital) • Peninsula Health (Frankston Hospital) The approximate number of births captured during the study period is approximately 300,000. An estimated 44,000 women give birth in the participating hospitals each year.

This randomised controlled trial will investigate the feasibility of an allied health assistant providing physiotherapy to people following hip fracture surgery. The allied health assistant will provide all therapy to people in hospital. All therapy will be prescribed by a physiotherapist and will include daily walking, and standing and seated exercises. We hypothesise that it is feasible for allied health assistants to provide physiotherapy to people after hip fracture surgery.

Although school staff are well positioned to identify possible changes in their students' mental health, many classroom teachers report they feel a lack the confidence and knowledge in knowing how to recognise and best respond to possible signs of mental health changes among students. While best practice guidelines recommend schools offer professional development to teachers that addresses reducing stigma towards those with mental health problems, there are very few programs available that are evidence-based and target the skills required beyond classroom teaching. In response to this training gap, the Black Dog Institute developed Building Educators’ Skills in Adolescent Mental Health (BEAM), an online training program designed to educate secondary school educators in leadership positions (such as Year Advisors, Heads of Wellbeing, and Deputy Principals) about adolescent mental health. BEAM is based on a theory of change which posits that an increase in educators’ mental health knowledge will improve their positive attitude and self-reported confidence in managing student mental health-related issues, and thereby increase the frequency of helping behaviours directed towards students. This unique, flexible, blended-model of training aims to bridge the gap between e-learning and face-to-face training, and allows for the program to be completed when users are available without taking leave from their school. In 2019, a pilot trial of BEAM assessed the acceptability, feasibility, and preliminary effectiveness among 70 Year Advisors across NSW. The pilot found the program to be both acceptable and feasible to deliver, with participants reporting moderate to high satisfaction with the program, most indicating they would use the program again, and all would recommend it to others. Furthermore, preliminary effectiveness of BEAM was demonstrated, with participants reporting decreases in their own levels of psychological distress at 6-weeks post-test, and higher levels of self-reported confidence in managing students’ mental health needs at post-test, with their confidence levels continuing to increase at 12-week follow-up. Additionally, at follow-up, participants reported an increase in the number of helping behaviours directed towards students. However, users reported that ‘lack of time’ was a significant barrier to program completion, along with forgetfulness, and not prioritising the program. The program is ready to be formally assessed for its effectiveness on increasing educators’ self-reported confidence in managing students’ mental health. Additionally, its effectiveness for improving educators’ mental health knowledge, increasing the occurrences of helping behaviours towards students, and reducing stigma and personal distress will also be evaluated.

A pressure injury, or pressure ulcer, is localised damage to the skin and/or underlying tissue caused by unrelieved pressure, shear or friction. Some hospital patients develop pressure injuries- with those in intensive care units at increased risk because they are critically ill and immobile. Several strategies are recommended in the international clinical practice guidelines for the prevention of pressure injuries. One strategy is the use of prophylactic foam dressings to prevent sacral pressure injuries, yet it remains unclear if these dressings prevent pressure injuries. More recently, sub-epidermal moisture scanners, which detect the early tissue damage associated with pressure injuries, are used by some clinicians during their daily patient skin assessment. A benefit for clinicians is they can use the scanner measurements to implement early and targeted pressure injury prevention strategies before skin redness is visible to the naked eye. The aim of this pilot study is to determine the feasibility of conducting a larger three-arm randomised controlled trial that will test the effectiveness of two different prophylactic foam dressings, sub-epidermal moisture scanners versus usual care to prevent sacral pressure injuries in adult intensive care patients.

The health and well-being gap between Australia's First Nations peoples and non-Indigenous population has not been closing satisfactorily. Evidence indicating the effectiveness of Birthing on Country services is building. Building on Our Strengths (BOOSt) aims to develop, implement and evaluate a Birthing On Country service for First Nations Australians, with an integrated Community hub and birth centre. The study is of important national and international significance. A Birthing on Country Service is a complex intervention that reorients maternity services in terms of governance, workforce, continuity of midwifery carer, collaborative care, a focus on strengthening family capacity and cultural connection to improve health and well-being, a community hub, and if feasible, a free-standing birth centre for women with uncomplicated pregnancies, and for women with complex pregnancies - birthing services in the local or tertiary hospital. Culturally safe care is another component and the model recognises the connection between Aboriginal and/or Torres Strait Islander peoples with land and country and a holistic view of health. The BOOSt study will capture both pre- and post-intervention data, while embedding a full evaluation to investigate the processes of model development in context, and those around model implementation. A variety of data sources will be utilised to ensure accuracy and completeness, and to capture psycho-social health and well-being outcomes and behaviors, as well as medical outcomes.

Optimal outcomes in total hip arthroplasty (THA) require accurate implant positioning, which is improved with the use of navigation systems. This study aims to assess the validity of intraoperative data captured using a new handheld imageless navigation device with limited clinical evidence. Data will be collected in a prospective observational cohort study, and informed consent will be required from eligible participants. Patients will undergo standard of care consultation for diagnosis and treatment, including the collection of demographic and surgical data. Patients will be referred to pre and postoperative CT imaging as per the study protocol. An accuracy analysis will compare intraoperative surgical positioning data from the navigation device to measurements from preoperative and follow-up CT scans. The primary outcome is the agreement between intraoperative data captured by the navigation system, compared to postoperative measurements performed on CTs.

The primary aim of this project is to examine the feasibility, consumer acceptability and behavioural outcomes associated with take-home fentanyl test strips (FTS), providing an evidence base for implementation and expansion across services in Australia. People who use heroin (n=80) will be trained in how to use FTS to test their heroin (or other illicit substances) for the presence of fentanyl, and how to interpret the results, Upon completion of the training, participants will complete a short baseline survey, and be given ten strips to take home and use as they wish. Participants will be followed-up four weeks later to assess uptake and consumer acceptability of the strips, as well as associated behavioural changes.

SCUlpTOR is a 24-month research study sponsored by the University of Sydney, evaluating the efficacy and cost-effectiveness of stem cell injections compared with placebo in people with knee OA. Currently, the medical opinion about stem cell therapy for treating osteoarthritis remains highly controversial, given the considerable cost of treatment and very limited scientific evidence of efficacy and safety. Therefore, we aim to conduct this trial to ascertain whether or not intra-articular stem cell injections improve symptoms and slow disease progression in people with mild to moderate knee OA. The stem cells being used were originally sourced from a healthy donor/master cell bank following a standard manufacturing process and release tests to optimise safety and batch to batch reproducibility.

This study will compare the ‘best possible’ treatment delivered during the COVID-19 pandemic to ‘ideal’ treatment before the pandemic for newly diagnosed early breast cancer patients Who is it for? You may be eligible to join this study if you are aged 18 and above, have been newly diagnosed with early breast cancer at Westmead Breast Cancer Institute during the COVID-19 pandemic and discussed by the Westmead multidisciplinary cancer team (MDT) between March and June 2020. Study details MDTs, consisting of surgeons, medical oncologists, radiation oncologists, pathologists, breast physicians, genetic oncologists and other specialty representatives, will discuss and assess participants’ ‘ideal’ and ‘best possible’ treatment options at team meetings. All participants assessed by an MDT will have discussions about the ‘ideal’ and ‘best possible’ treatment with their treating specialist. The reasons for any treatment that varies from ideal will be explained to the participant. When the COVID-19 pandemic finishes, the participant will be recalled to discuss further treatment if their treatment differed from the 'ideal.' At various stages of treatment, the MDTs will meet and assess participants’ treatment options. All discussions and treatment delivered will be documented in medical records. It is hoped that this research will give insight into the challenges that the COVID-19 pandemic has presented for breast cancer treatment. It will also identify participants who have not had ideal treatment and they can be followed closely in the future.