ANZCTR search results

This project aims to address core goals of the National Palliative Care Strategy, by integrating specialist palliative care into aged care. The intervention is a new model of care: whereby specialist palliative care nurses will help facilities prioritise residents who have palliative care needs. The prioritisation will occur through ‘needs rounds’ which are staff-only meetings to discuss residents who may die in the next six months. Education to staff will also be provided. Following pilot work in 2014-5, this stepped wedge trial will seek to establish whether a new model of care will: 1. reduce length of stay in hospital, leading to significant cost savings 2. improve residents’ ability to die in their preferred place 3. improve care staff understanding of death and dying, and staff capacity 4. reduce symptom burden at end of life 5. reduces relatives' distress.

To estimate the effect on carriage, all year 10, 11, and 12 students will be offered 4CMenB vaccination in South Australia through schools over the study period with 50% of the students enrolled receiving the vaccine in 2017 and 50% in 2018. In year 10 and 11 students, posterior pharyngeal swabs will be obtained at baseline and 12 months post baseline to estimate the difference in carriage prevalence of all genogroups of N. meningitidis between vaccinated and unvaccinated participants.

The aim of this study is to examine effectiveness of perampanel in the control of tumour associated epilepsy (TAE) in patients with grade II-III gliomas. Who is it for? You may be eligible to join this study if you are aged 18-65 years and have a diagnosis of World Health Organisation grade II-III supratentorial glioma and have experienced a pre-operative seizure. Study details Patients will be randomized (allocated by chance) to receive perampanel, or levetiracetam for 52 weeks. Doses will be escalated over the first four week before patients enter an assessment phase for the remainder of the trial. The primary outcomes are i) proportion of patients seizure free for 6 or more months in the assessment phase and ii) time to first post-operative seizure in the assessment phase. Secondary endpoints include measures of drug safety, tolerability and quality of life. Glutamate concentrations will be measured before drug treatment is commenced to assess whether it can be utilized to predict both post-operative seizure and response to perampanel. This will be the first monotherapy epilepsy RCT utilizing perampanel. A positive study would support a larger randomized phase III trial examining perampanel monotherapy in tumour associated seizures. The novel use of 7T MRI to quantify glutamate offers the opportunity to assess if a non-invasive biomarker can help stratify seizure risk and perampanel response. This can pave the way for individualised and targeted epilepsy treatment.

The aim of this study is to examine effectiveness of perampanel in the prevention of tumour associated epilepsy (TAE) in patients with grade II-III gliomas. Who is it for? You may be eligible to join this study if you are aged 18-65 years and have a diagnosis of World Health Organisation grade II-III supratentorial glioma and have not experienced a pre-operative seizure. Study details Patients will be randomized (allocated by chance) to receive perampanel, or or placebo for 16 week. Doses will be escalated over the first four week before patients enter an assessment phase for the remainder of the trial. Patients will be followed up for 52 weeks. The primary outcomes are i) time to first seizure after escalation phase (weeks 5-52) and ii) proportion of patients seizure free during 12 week assessment phase. Secondary endpoints include measures of drug safety, tolerability and quality of life. Glutamate concentrations will be measured before drug treatment is commenced to assess whether it can be utilized to predict both post-operative seizure and response to perampanel. This will be the first monotherapy epilepsy RCT utilizing perampanel. A positive study would support a larger randomized phase III trial examining perampanel monotherapy in tumour associated seizures prophylaxis. The novel use of 7T MRI to quantify glutamate offers the opportunity to assess if a non-invasive biomarker can help stratify seizure risk and perampanel response. This can pave the way for individualised and targeted epilepsy treatment and prevention.

This research is aimed at improving outcomes for patients with chronic rhinosinusitis post endoscopic sinus surgery. A dissolvable dressing Chitodex (CD) gel has already been known to be beneficial to postoperative bleeding and healing after endoscopic sinus surgery. We aim to further improve its effects by combining the current formulation with budesonide (a steroid solution) and mupirocin (an antibacterial agent). We have specifically targeted patients in the immediate post endoscopic sinus surgery setting because in previous studies, we have found that biofilm-positive patients compared to biofilm-negative patients have worse outcome post surgery in both symptoms and nasoendoscopy scores, requiring repeated courses of antibiotic treatment and extra postoperative visits (Singhal et al 2008). Therefore in this study we hope to investigate if the eradication of biofilms combined with the improved wound healing properties of using Chitodex gel incorporated with mupirocin and budesonide (CBM gel) could prevent patients from progressing to the subset of recalcitrant disease. The specific aims of this study is to 1. To investigate the effects of Chitodex + Budesonide + Mupirocin (CBM) gel in post sinonasal surgery patients with chronic rhinosinusitis (CRS) 2. Compare the change in nasal microbiome post endoscopic sinus surgery The primary end point is measured by: 1) Eradication of bacteria confirmed with microbiological swab 2) Independently scored video endoscopic examination of sinuses pre and post treatment 3) Patient's symptoms score pre and post treatment The secondary end point is to: 1. Compare the change in nasal microbiome post endoscopic sinus surgery

The primary purpose of this study is to evaluate the treatment information needs for people with non-small cell lung cancer (NSCLC). Who is it for? You may be eligible to participate in this study if you are aged 18 to 80 years, and have been diagnosed with, or are the support person for somebody who has been diagnosed with NSCLC for which surgical or radiotherapy treatment finished between three and twenty months previously. Study details All participants enrolled in this study will participate in an 30-60 minute interview (either face-to-face or over the telephone). It is hoped that the findings from this study will provide information on the views of NSCLC patients and their support people on participation in treatment decision making, understanding treatment options and confidence in communication with clinicians.

This study is aimed at collating and analysing data of paediatric urinary tract infections, identifying antibiotic resistance patterns in different groups of children by age, gender, presence of renal tract abnormalities. It will also assessed the level of bacteraemia in younger children. The data will be used to evaluate whether current empiric antibiotics guidelines are adequate and suitable for all groups of patients and whether there is a need for new guidelines for high risk patients and younger patients.

The aim of this study is to explore the experiences of graduate nurses during their first year of mental health nursing. Research questions Superordinate question: 1.What are the experiences of graduate nurses when encountering the culture of mental health nursing? Secondary questions: 2.Are there links between the experiences of graduate nurses and their intention to remain in the field of mental health nursing? 3.What are the processes of assimilating new nurses into the workplace? 4.Where does the new graduate fit into the organisations hierarchy, and how is this perceived by the new graduate? The research design is an ethnographic study utilising non-participant field observation; semi-structured interviews; analysis of cultural artefacts; and analysis of reflexive researcher notes as data collection methods. Data will be analysed using thematic analysis via NViVO software. The theoretical lens guiding this research is ‘viewing mental health services through the eyes of the new graduate nurse’. It is based on the organisational of mental health services and the impact of the culture on those early experiences of new nurses.

The aim is to assess the effectiveness and cost-effectiveness of a nurse-led, tailored survivorship care intervention using telehealth delivery, relative to ‘Information Only’ and ‘Usual Care’, for improving health-related quality of life (HRQoL) in people with Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma. Who it focuses on: Patients within four weeks of completion of treatment with curative intent for HL, or aggressive NHL. Others include speaking and reading English; 18 years of age or older; an ambulatory patient at the time of recruitment; Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1; and have access to the Internet and a smart device and/or computer. Study Details: Recruited patients will be randomly allocated to one of the three arms. . The intervention group will receive the nurse-led tailored Survivorship Care intervention between the last cycle of chemotherapy and four weeks post treatment completion for people who have completed their defined active treatment for Hodgkin's Lymphoma or Non-Hodgkin's Lymphoma. In total, this group will receive three nurse-led consultations via video conferencing. The first consultation will be 60 minutes, involving the provision of treatment summary, evidence-based patient education, survivorship care plan, follow up schedule, and appropriate patient referrals. The second and third consultation will take 30 minutes each. These 30 minute consultations will focus on patient education and amendment to the care plan depending on the needs of the individual patient. The ‘Information Only’ group will receive an evidence-based information booklet via post at the end of treatment. The booklet is entitled "Post-treatment Wellness Booklet for Patients diagnosed with Hodgkin's and Non-Hodgkin's Lymphoma". This booklet is designed by the Cancer Nursing Professorial Precinct Team, Royal Brisbane and Women's Hospital in collaboration with Queensland University of Technology and the Leukaemia Foundation. The control group will receive usual care. Usual care is the absence of any structured survivorship intervention, involving traditional physician follow up.

Aim: To test the effectiveness of an invasive device assessment and removal tool (I-DECIDED) in improving Intravenous (IV) catheter care in hospital patients. Significance: Each year in Australia, almost 10 million patients are admitted to hospital. Around 70% will need an IV catheter for fluids or medicines. Yet 30-50% of IVs have painful complications or stop working before treatment is finished. Complications leading to failure include infiltration, extravasation, occlusion, accidental removal, or symptoms of phlebitis (pain, redness, swelling, palpable cord, hardness of the vein, red streak along the vein, and/or purulence). The failure of an IV catheter before treatment is completed requires the re-siting of a new device, leading to discomfort for the patient and often delays in treatment. A recent economic analysis of data from a multi-site Queensland randomised trial showed the mean cost of catheter replacement was approximately $70 when staff time and equipment was calculated. Expected outcomes and benefits: As well as being an assessment tool, the I-DECIDED mnemonic encourages patient participation. I-DECIDED is also an audit and education tool, teaching nurses and doctors the essential components of IV care. A structured and comprehensive approach to IV assessment and care would promote early detection of complications, and prompt removal of IV catheters when no longer needed. This will reduce unnecessary pain and suffering for patients, decrease the risk of potentially deadly bloodstream infection, and reduce treatment delays and hospital costs. This could benefit millions of Australians annually. Future directions The proposed study will test the utility of the I-DECIDED tool in guiding assessment and care of peripheral IV catheters. Following the collection of pilot data and feedback from staff and patients, it is likely that the study will be expanded to test the tool for assessing other IV catheters (non-tunnelled central venous catheters, peripherally-inserted central venous catheters) in other hospital units. Additional approvals will be sought at that time, as appropriate. I will work towards I-DECIDED being implemented in partnership with the Australian Commission of Safety & Quality in Healthcare. I-DECIDED will provide a platform for innovation and research projects in other invasive medical devices, including urinary catheters. The mnemonic I-DECIDED works in Spanish, Portuguese, French and Italian, and could be made global. Nurse collaborators from my existing Australian and international research networks have expressed interest in trialling the I-DECIDED tool.