ANZCTR search results

Thromboelastography (TEG) allows rapid, comprehensive and accurate identification of an individual’s haemostasis condition in a laboratory or point-of-care setting. Until now, different TEG assays had to be performed individually, with each assay requiring lengthy preparation and calibrated pipetting. TEG6s and TEG5000 (Haemonetics Corp, USA) are commercial haemostasis analysers that measure viscoelasticity properties of whole blood. Both use different mechanisms to assess identical coagulation variables. The aim of this study was to assess agreement and clinical interchangeability between the TEG6s and TEG5000 analysers. After Ethics Committee approval, we systematically collected 3.5mL whole blood in citrated tubes from 25 adult patients in a tertiary level intensive care unit (ICU). A trained operator, proficient in the use of both the TEG6S and TEG5000 systems performed all the measurements. Interdevice agreement between the TEG6S and TEG5000 analysers was measured using Lin’s condordance coefficient, and further validated this using intraclass correlation coefficients and reduced major axis regression, which allowed separation of the observed bias into fixed and proportional components. As this is an observational device study, no results results will be used by any clinician to influence patient care.

The purpose of the study is to investigate the effectiveness of MiCBT group interventions to improve psychological symptoms such as depression and anxiety for patients with a range of common mental health conditions. It is hypothesised that MiCBT delivered in a private practice setting will lead to clinical symptom improvement in depression, anxiety and stress compared to a wait-list control group at post-intervention and maintained at 6 months follow up. Improvements are also expected in psychological well-being. The mediators of clinical change are expected to be reflected by changes in awareness (metacognitive and interoceptive), non-reactivity, and interpersonal skill.

The aim of the project is to evaluate the effectiveness of a self-help mobilephone application-based health intervention aimed at reducing subclinical and mild social anxiety symptoms. The mobile app program delivers a standalone (without therapist support) version of exposure therapy for social anxiety in 4 mobilephone application-based modules aimed at improving the literacy about exposure therapy, and at providing exercises to prepare and conduct exposure therapy in moments when a person experiences symptoms. The main hypothesis is a mobile application-based health intervention will significantly be more effective in reducing symptoms of social anxiety, anxiety, depression, and stress than an waitlist control group.

We will conduct a feasibility study for a randomised controlled trial examining the effectiveness of pregabalin to prevent chronic pain following whiplash injury in ‘at-risk’ individuals. This feasibility study will hone eligibility criteria, test recruitment strategies, and develop a model for recruitment for the subsequent full scale trial. The primary aim of this current study is to assess the feasibility of the RCT by measuring recruitment rates (number of patients approached, number consenting to participate, and number eligible to to be randomised; missing data and participant attrition). and obtaining qualitative feedback from patients and doctors about their experience of the trial and suggestions for improvement. The secondary aims are to: 1) Investigate the effectiveness of pregabalin to decrease disability, depression, posttraumatic stress symptoms, and pain catastrophizing; 2) To conduct an economic evaluation of the pregabalin intervention. We hypothesise that pregabalin used in acute whiplash injury will prevent or modulate pro-nociceptive mechanisms and improve health outcomes for this treatment resistant condition, and that the study will be feasible.

This study comprises part of a PhD project. It aims to investigate whether light-load blood-flow restriction training in the legs can improve the muscle size of an active arm. This will be compared with the non-active arm of these participants that perform blood-flow restriction in the legs as well as either arm of participants who performed traditional light-load strength training. The purpose is to investigate whether muscle size adaptations are transferable between limbs. This will be investigated in a seven week strength training study in participants that perform either blood-flow restriction or traditional strength training in the legs.

This project will investigate the effectiveness and feasibility of implementing an exercise physiologist (EP) led, 12 week therapy program to individuals living independently and in residential care at MercyCare. Our hypothesis is that through a prescribed exercise program, levels of activity and the capacity to engage in daily tasks will be enhanced thus providing an increased quality of life for participants. A mixed-methods design will provide evidence to support future decision making by management as to the feasibility of employing an EP, and will identify barriers and facilitators to the effective delivery of EP services within this environment and organisation.

The aim of this study is to determine the feasibility of running a randomised controlled trial in which participants with dementia and sleep disturbance are randomised to either participation in a behavioural intervention (sleep hygiene program), taking melatonin or usual care.

Interstitial lung disease (ILD) is a group of chronic lung diseases of different causes which lead to symptoms of breathlessness, fatigue, reduced exercise tolerance and poor quality of life. There are limited medical treatments available to date for the majority of patients with ILD. Although ambulatory oxygen is commonly prescribed for patients with ILD suffering significant breathlessness or low oxygen levels during exercise, its clinical benefits are uncertain. Potential adverse effects include increased systemic oxidative stress and the negative impact on patients’ mental well-being from such a burdensome treatment. In addition, the use of oxygen therapy has significant costs for both patients and the health care system. Ambulatory oxygen is usually delivered using oxygen cylinders. Portability and comfort of oxygen cylinders are important factors which prevent patients from using ambulatory oxygen as prescribed. The new lightweight portable oxygen concentrator (POC) may be an attractive alternative to oxygen cylinders. This study aims to compare the effects of ambulatory oxygen with room air delivered via portable concentrator on health outcomes, including exercise capacity, symptoms, activity levels, systemic oxidative stress and inflammation, in patients with chronic ILD and low oxygen levels during exercise.

Chronic pelvic pain (CPP) is pain in the pelvis of greater than 6 months duration, and is severe enough to cause functional disability or require medical intervention. Endometriosis, the presence of endometrial tissue outside the uterus, is a common cause of CPP. Worldwide, endometriosis is as common as lower back pain. Endometriosis related CPP includes a variety of pain symptoms including dysmenorrhea (period pain), dyspareunia (pain during sexual intercourse), dyschezia (pain on bowel motions) and dysuria (pain on urination). Current treatments tend to be expensive, invasive or have significant side effects. Acupuncture shows promise in treating endometriosis related chronic pelvic pain however no studies have examined the feasibility of undertaking a fully powered trial in Australia or the effect of acupuncture on a number of objective biomarkers that are altered in women with endometriosis, such as IL-6, an inflammatory marker, or changes in functional connectivity in the brain. The aim of this study is to assess the feasibility and acceptability of acupuncture and to investigate any changes in neurological or biomarkers when using acupuncture to treat endometriosis-related chronic pelvic pain.We are partnering with Endometriosis Australia, a leading not-for-profit in Australia, to recruit women for this study. We will recruit 30 women to either acupuncture plus usual care or usual care alone. We will measure daily pain ratings as well as pain measured during the period and will take blood samples before and at the end of treatment to determine any changes in levels of IL-6. Women will also have an EEG taken to determine if there is any change in the way their brains are processing pain. This data will help provide the important information necessary to help design a larger trial to test if acupuncture is an effective adjunct to current treatments.

The aim of this study is to determine the total cost of administration of a unit of red blood cells for a patient with thalassaemia major treated at Monash Medical Centre, Melbourne, Australia. This study involves determination of the processes and costs associated with administering a unit of RBCs to adult patients with thalassaemia at Monash Medical Centre, Clayton, Victoria, Australia. The unit of observation is the process involved in preparation or administration of a unit of RBCs and as such, patients are not enrolled into this study. Transfusions can be life-saving, but they also carry risks and substantial costs. Alternatives to transfusions exist for some patients, but evaluations and decisions about treatment options are often complex, and may be more difficult when the benefits, risks and costs are not well characterised. Australian governments through the National Blood Authority (NBA) spend in the order of $AUD 1 billion annually in provision of blood products for the community. However, visibility of transfusion-­-related costs is generally low. The “manufacturing cost” is now carried on the blood product label, and for red blood cells (RBCs) at October 2015 this is $AUD 374.72(1). In some Australian states the costs of the product is devolved to the hospital level, but most hospitals have little or no idea of the true costs of transfusion therapy, over and above the costs of providing components, including laboratory and clinical costs. Thalassaemia is associated with significant complications and often requires lifelong therapy, involving red blood cell transfusion every three to four weeks which require the individual to attend hospital for the day. Estimates of the total healthcare costs for a beta thalassaemia major patient experiencing minimal complications are $150K per year, however there are currently no Australian transfusion costing data in the thalassaemia context. Understanding the full cost of transfusion will inform policy development and facilitate safe and cost effective treatments and transfusion support for patients with beta thalassaemia; resulting in improved outcomes for patients and better utilization of limited health resources.