ANZCTR search results

Cardiovascular disease remains a leading cause of death and disability in our community, with atherosclerosis being the major disease process underlying the majority of heart attacks. Atherosclerosis is a disease in which plaques made up of fat (cholesterol) builds up in the wall of an artery. As plaque builds up it can narrow the coronary artery and reduce blood flow to your heart muscle. There is also a risk that the plaque may rupture causing a sudden blockage of the artery. This can cause a heart attack, which results in permanent damage to heart muscle. However, there is little understanding of how plaques grow in the arteries and what makes certain plaques at high-risk of causing a heart attack. Recent experimental data has suggested that the force the blood exerts on the wall of the artery (shear stress) may be important in promoting plaque growth and even rupture. Measurement of shear stress in humans is challenging and is currently performed via a coronary angiogram combined with specialist invasive imaging. These images allow us to create a three-dimensional model of the arteries to the heart on a computer. Shear stress can then be calculated using highly specialist software that models blood flow in the arteries. At present, shear stress calculations can only be performed following an invasive medical procedure. This means we cannot calculate shear stress for the majority of patients with suspected coronary artery disease. CT coronary angiography (CTCA) is an established, safe, rapid and convenient non–invasive method to diagnose the presence of coronary artery disease. CTCA also provides useful information on the size and composition of coronary plaque. However, the ability of CTCA to calculate shear stress in coronary arteries is unknown. If this project is successful, then shear stress calculations could be performed based on CTCA images, which would allow clinicians to explore whether this force is responsible for plaque growth or rupture in humans.

This study aims to investigate the utility of the use of whole blood for point of care testing for B-hCG to rapidly differentiate pregnant and non-pregnant patients. This is important in time-critical conditions such as ruptured ectopic pregnancy. It would also expedite things in the situation where medical imaging involving ionising radiation is delayed until pregnancy can be excluded. The current testing options are a urine point of care test, or a serum sample sent to the pathology lab. The point of care test pack inserts state that whole blood cannot be used with them, but in practice they have been used that way and expedited decision-making. A convenience sample of female patients of reproductive age presenting to the Emergency Department who would typically have their pregnancy status checked, will be recruited to the study. A whole blood B-hCG (point of care), a urine B-hCG (point of care), and a serum sample for quantitative hCG will be tested. The blood sample will be sent to pathology for a quantitative serum B-hCG result, and will be used as the standard for comparison. A result of <1.2 units/L is a negative pregnancy test. The results from the urine and whole blood point of care tests will be compared against this, to determine their sensitivity and specificity in a separate analysis. The time taken to obtain a result from the point of care B-hCG testing using urine and whole blood will be compared against the time taken to obtain a result from the sample sent to the lab. We will then be able to compare the differences between length of time taken to obtain a urine or blood sample, and the differences between length of time taken to obtain test results for each of these samples.

Purpose of the research Significant weight gain and poorly controlled blood pressure are commonly seen in patients with end stage renal disease on intermittent hemodialysis. There is evidence that these complications are due to not enough salt being removed from the body during hemodialysis. The hemodialysis machine currently uses a standard strength of sodium during each hemodialysis session. If this concentration is reduced, this may improve blood pressure control and decrease the amount of weight gained between dialysis sessions. The reason we are doing this research is to find out if the low sodium fluid is better than the regular concentration that is currently being used.

It is well recognised that rates of T2DM are increasing at dramatic rates in Australia. A number of interrelated factors are associated with increased risk of developing the condition, however, much of the cause can be attributed to obesity as a result of high energy, high fat and high animal protein diets along with a lack of regular physical activity. Currently, there is no known medical cure for the condition. However, studies conducted on participants enrolled in a number of lifestyle modification programs suggest that the symptoms of T2DM are reversible where energy intake is reduced resulting in improved body weight and Body Mass Index. Previous studies conducted on individuals with abnormal blood glucose levels also indicate that the adoption of the Complete Health Improvement Program (CHIP) lifestyle intervention significantly reduced blood sugar levels in compliant individuals. This study will investigate: The effect of the CHIP intervention on obesity, blood sugar and medication levels of a group of participants with established T2DM. It will also examine the cost benefit of such an intervention. This will be done by evaluating the following: The blood sugar, HBA1c, cholesterol and blood pressure readings in those participating in the CHIP intervention delivered over a period of 12 weeks with additional monthly follow up for another nine months compared to a control group receiving their usual diabetes care. The levels of compliance over a 12-month period in those participating in the CHIP intervention delivered over a period of 12 weeks with an additional follow up for another nine months compared to a control group receiving their usual diabetes care. The cost benefit (over a 12-month period) of implementing the CHIP intervention delivered over a period of 12 weeks with an additional follow up for another nine months compared to a control group receiving their usual diabetes care. The outcomes of this study have the potential to inform decisions about patient treatment and potentially provide an incentive for the provision of funded lifestyle based preventive and restorative programs for patients diagnosed with T2DM.

The purpose of this study is to investigate the brain signalling in sleep after TBI. We want to know if sleep problems improve as time passes after the brain injury, and whether the recovery of sleep, sleep quality, and cognition are related. It is also possible that some patients after a severe TBI have breathing problems in sleep. It is possible that breathing problems in sleep could affect their recovery. The sleep study will include monitoring for breathing disorders during sleep.

The primary purpose of this trial is to compare the efficacy of three types of core biopsy needles used for Endoscopic Ultrasound-Guided (EUS) fine needle biopsy. Who is it for? You may be eligible to enroll in this trial if you are aged 18 years old or older and require endoscopic ultrasound and tissue sampling of solid lesions in the pancreas, which are suitable for EUS fine needle aspiration. Study details All participants enrolled in this trial will have tissue sampling performed using three different biopsy devices: the ProCore, the Shark Core and Acquire devices. The order in which each device is used will be randomly allocated (by chance). Only a single pass (i.e. a single attempt at sampling) will be completed for each device. The tissue obtained using each device will be stored and analysed by cytologists and pathologists to determine the diagnosis and adequacy of samples obtained using each device. It is hoped that the findings from this trial will provide information on which of the three devices provides the most sufficient samples for analysis and diagnosis of pancreatic lesions.

The aim of this research was to investigate the direct effects of children’s exposure to food advertising on their dietary intake and its potential influence on the development of childhood overweight. Across a series of six-day holiday camps, children (n=160, aged 7-12 years) were exposed to food and non-food advertising in an online game and/or a television cartoon in a randomised within-subject, cross-over, counterbalanced design. The primary aim of the study is to explore whether short-term increases in snack intake following food advertising exposure are compensated for at a subsequent lunchtime meal; and hence identify if food advertising contributes to a positive energy balance likely to contribute to childhood overweight.

Exercise is well known to induce multiple physical and psychological benefits, although the nature of these benefits is dependent on the type of exercise performed. For instance, resistance training can increase muscle strength and mass, while endurance exercise can enhance the ability and efficiency to use energy so that exercise can be performed at higher intensities or longer durations. Many individuals who undertake exercise, particularly those involved in team sports, perform a combination of resistance and endurance exercise so that all the physical benefits of exercise can be attained. However, previous research has established that the gains in muscle strength and mass with resistance exercise can be reduced when resistance exercise is performed concurrently with endurance exercise. The mechanisms responsible for this reduced response are not completely understood, but may be related to a combination of factors including fatigue, inadequate exercise intensity and/ or duration, and poor diet to facilitate muscle growth. In this regard, it is well established that protein ingestion can enhance muscle growth responses with resistance exercise. Whether protein can similarly enhance muscle growth following combined resistance and endurance exercise is not known. Accordingly, the aims of this research project are to: 1. Determine whether a high protein diet can ‘rescue’ the loss of muscle growth following 12 weeks of combined resistance and endurance exercise compared to resistance exercise only. 2. Characterise the effects of 12 weeks of combined resistance and resistance and endurance exercise on several performance tests measuring strength and power, and compare these responses to resistance or endurance exercise performed in isolation.

Accidental falls due to slips and trips are among the most commonly reported hospital adverse events, accounting for between 20 and 40% of all incidents. Older inpatients are especially predisposed to falls due to multiple risk factors, including gait and mobility problems. Consequently, ensuring safe patient mobilisation is a central priority for inpatient fall prevention programs. Current fall prevention guidelines and best practice evidence promote the use of well-fitting closed footwear among older inpatients. Unfortunately, in acute settings, many patients do not have access to suitable footwear, due to factors such as unplanned admissions, patient oversight, or foot pathology. Due to the short average length of acute hospital stays, it can be challenging for wards to resolve patient footwear needs in a timely fashion. As a result, many Australian facilities have begun adopting the practice of providing non-slip socks (NSS) to all older admitted inpatients; yet, the value of this practice is unclear. NSS are otherwise similar to conventional socks but provide various forms of rubberised tread on the sole. Commercial providers of NSS have advanced claims of reduced fall rates after implementing an NSS strategy although reliable, controlled studies have not been undertaken. Despite a continuing lack of evidence on the effect on falls rates, usage of NSS in the state of Queensland has escalated from one facility in 2008, to >10 in 2014. Ipswich Hospital is among the few facilities where NSS are not routinely used. It is possible that NSS could be effective in reducing inpatient falls due to factors such as lower slip resistance than no or alternate footwear, acting as an alert for high risk patients and reminder to staff about falls prevention, however the diffusion of practice despite the lack of effectiveness data is a cause for increasing concern. In order to provide clear guidance to facilities on the use of NSS, reliable data is required. The primary aim of the proposed research is to investigate the effect of a pragmatic, ward-level implementation of NSS on rates of falls and fallers in an inpatient population at a regional hospital in Ipswich, Australia and understand the implementation of the intervention. The secondary aim is to evaluate the likely cost-effectiveness of this approach.

The primary aim of this research project is to compare the effectiveness of heel lift shoe inserts versus rehabilitation therapy (calf muscle eccentric exercise) for the treatment of Achilles tendinopathy. This study is a parallel group, pragmatic randomised controlled trial with a 12 week follow-up. Participants will be randomised to receive treatment with heel lift shoe inserts (Clearly Adjustable®) or a calf muscle eccentric exercise program. Primary and secondary measures will be collected at baseline and at 2, 6 and 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire. Secondary measures will include Achilles tendon structure (assessed using ultrasound imaging), calf muscle function, self-reported global change in symptoms, severity of pain at the Achilles tendon during the previous week, self-reported physical activity, health-related quality of life, as well as use of paracetamol rescue medication and co-interventions.