ANZCTR search results

Dementia is now the second leading cause of death in Australia and no cure exists. There is evidence to suggest that bilingualism and changes in lifestyle (e.g. increasing levels of physical activity and improving eating habits) are associated with improved health outcomes. We aim to explore whether studying a new language and health-related advice can improve cognitive performance and related biomarkers in subjective memory complainers (risk factor for AD). Participants (aged 60-85) with subjective memory complaints will be randomly allocated to one of two group: 6-month experimental groups: language learning + one-to-one health-related advice sessions and control (health advice only). Outcome measures include cognitive performance (e.g. episodic memory) and blood markers (e.g. Apoe E 4).

It is very common for people with diabetes to require admission to hospital, sometimes for reasons that are unrelated to diabetes. In the Acute Medical Unit at the Launceston General Hospital, over 50% of the patients admitted have diabetes. There is evidence that people with diabetes admitted to hospital for most illnesses are more prone to develop complications and take significantly longer to recover. This is thought to be related to their blood glucose levels being higher than normal: being unwell, eating different foods, changes to medications, stress, pain and having reduced physical activity can all result in high blood glucose levels. Managing diabetes in these circumstances can be difficult, and many doctors, especially junior medical staff, do not have enough experience in prescribing insulin to be able to keep the patient’s blood glucose levels under good control. We plan to introduce tools into the Acute Medical Unit that will improve the way patients with diabetes are currently managed: these tools consist of a specialized chart for prescribing insulin and specific education on how to control glucose levels in acutely ill patients. We will measure the effect of this intervention by collecting information on blood glucose levels in patients in the Acute Medical Unit before and after the new tools are introduced, as well as surveying patients for their opinions on their diabetes care at both time points. We will also determine if our intervention has changed the attitudes of doctors to managing diabetes in their acutely ill patients. Our objective in carrying out this project is to improve outcomes for patients with diabetes who are admitted to the Acute Medical Unit: we anticipate that our intervention can achieve this, with significant benefits to the patients themselves and also potentially to hospital healthcare costs.

Anxiety-related mental health disorders, particularly social anxiety disorder, are common comorbid conditions among adults who stutter. Our research has discovered that social anxiety disorder and other DSM-V disorders involving anxiety prevent effective speech treatment for adults who stutter. We have developed and trialled an innovative Internet cognitive behaviour therapy (CBT) program specifically designed to target the social anxiety experienced by people who stutter. This CBT program has been shown to reduce the social anxiety experienced by adults who stutter and even eliminate social anxiety disorder diagnoses. The proposed study aims to investigate whether access to an Internet cognitive behaviour therapy (CBT) program immediately after completing treatment designed to reduce stuttering behaviours, improves speech and/or psychological outcomes. The research will be a randomised clinical trial of speech restructuring treatment alone or speech restructuring treatment plus Internet-based CBT treatment for adults who stutter. The outcomes of this research will generate new knowledge about the benefits of concurrently controlling the speech problems and the anxiety related mental health disorders of adults who stutter.

The weaning of long term tracheostomised ICU patients from prolonged mechanical ventilation can be difficult, challenging and at a great financial cost to the health care institution. Humidified oxygen can be delivered via a humidified t-piece at up to 15 litres a minute but this is unlikely to offer any benefit in terms of generating positive airway pressure and increasing end expiratory lung volume.The High flow tracheostomy device (HFT) allows the delivery of warmed, humidified oxygen at a prescribed fraction of inspired oxygen (FiO2) at flow rates much higher than previously allowable with other delivery systems. The use of this method of oxygen and flow delivery in weaning off mechanical ventilation is becoming more common in our ICU and there is a real need to determine if this therapy generates positive airway pressure and increases end expiratory lung volume; to quantify these changes; and also to determine if this treatment has any clinically relevant benefit which will lead to improved outcomes for these patients. Electrical Impedance Topography (EIT) is a relatively new non-invasive radiation-free imaging technique which can be used easily and safely at the bedside to provide real-time dynamic images of regional lung ventilation. Changes in end-expiratory lung impedance (EELI) as measured by EIT have been shown to have a strong linear correlation with changes in end-expiratory lung volume (EELV). Therefore, it will be possible to assess both pressure and volume simultaneously within the lung. This study aims to determine if HFT has any clinically relevant benefit in weaning patients from mechanical ventilation by assessing whether this treatment provides positive airway pressure and an increase in EELV, in addition to assessing their effects on oxygenation, respiratory rate and subjective scoring of dyspnoea

The QUARTET Trial is a double-blind randomised controlled trial of low-dose quadruple combination therapy (LDQT) versus current guideline-based care. This study was funded by National Health and Medical Research Council. It aims to recruit 650 patients with high blood pressure (untreated or not controlled on one medication). Patients will be randomised to LDQT or irbesartan. The primary outcome is the difference between groups in office systolic blood pressure at 12 weeks.

The proposed project aims to investigate: 1) if aerobic exercise in the form of treadmill walking acutely relieves pain through exercise-induced analgesia (EIA); 2) if any EIA varies with the dose of exercise; and 3) the relationships between measures of pain and EIA with physical activity levels, sleep and mood in people with PD. We hypothesize that people with Parkinson's disease will have the usual exercise-induced analgesia response to exercise, and that this response will be stronger with a higher dose of exercise. We hypothesize that increased physical activity, better sleep and better mood will be associated with a better exercise-induced analgesia response and with less pain in people with Parkinson's disease.

In this randomised control trial, we aim to assess the possibility of replacing current outpatient post-operative follow-up after laparoscopic appendicectomy and cholecystectomy with telephone consultation.

Pain is multifactorial and involves both biological and psychological components. Multi-disciplinary treatment approaches incorporating drugs, cognitive-behavioural therapy and exercise interventions are the most efficacious for managing chronic pain. Single sessions of exercise and pain education are both demonstrated to have positive effects on pain in people with chronic pain such as fibromyalgia and osteoarthritis, however it is not known whether pain education delivered immediately prior to exercise can enhance the efficacy of exercise in relieving pain. Recent studies from our group have identified that the pain relieving effects of exercise involve a psychological component that influences the appraisal of pain; this would likely be augmented by a combination of exercise and education. The current project will examine the effect of explicit pain education about the pain relieving effect of exercise, compared to more general exercise and pain education, on pain responses to exercise in people with chronic pain (fibromyalgia and osteoarthritis) and healthy individuals. The results will provide insight into: 1) the impact of pain education on the pain response to exercise; and 2) whether this differs between healthy individuals and people with chronic pain. The outcomes may have implications for how exercise and pain education are combined in clinical practice in the management of chronic pain.

To date, validated depth of anaesthesia and depth of muscle relaxation monitors are available and routinely used in anaesthesia care. However, depth of analgesia has not been specifically monitored and anaesthetists tend to rely on clinical signs (i.e. blood pressure or heart rate) in order to estimate the need for intraoperative analgesics (i.e. opioids). However, the latter may be unreliable and hence a monitor for analgesia is highly desirable. Surgical Pleth Index (SPI) is a score (0-100), which is calculated from the beat-to-beat interval of the heart rate and also the peripheral pulse wave amplitude. Essentially, this data is utilized to reflect the cardiac and peripheral sympathetic tone of a patient – the latter is assumed to correlate with the depth of analgesia. The acquisition of this raw data is achieved via the standard peripheral oxygen saturation sensor and the latter is then computed into the normalized score. SPI requires no change of anaesthesia technique nor any extra monitors or consumables. It’s merely a software patch for GE monitoring systems. Though SPI has been demonstrated to reflect intraoperative stimuli (i.e. knife to skin incision), it cannot be used in awake patients as then the score is subjected to too many artefacts (e.g., arousal is a strong sympathetic stimulant). However, a recent study by Ledowski et al. at Royal Perth Hospital, Perth, Australia has shown a high positive predictive value for SPI more than 30 monitored just before patient arousal to indicate moderate-severe postoperative pain. Though this is promising, no study has yet investigated this matter in children. This observational trial proposes to prospectively investigate the association of SPI with postoperative pain in the recovery room in children from 2 to 16 years. Hypothesis: SPI during the last minutes of surgery may be predictive of moderate-severe acute postoperative pain on recovery room admission.

This study aims to determine whether a blood test can be used to detect prostate, breast, lung, pancreas, oesophageal, stomach and digestive tract cancers. Who is it for? You may be eligible to join this study if you are male or female aged 25 years or older and have a known diagnosis of primary adenocarcinoma of the prostate, breast, lung, pancreas, oesophagus, stomach or a digestive tract cancer (of any pathological stage). You must also be willing to undergo a venepuncture procedure. Study details All participants in this study will have blood collected through venepuncture (i.e. directly from the vein) by trained nurses prior to any type of cancer treatment. A blood sample will be collected before any cancer treatment to measure circulating tumour DNA (ctDNA) markers. In addition, for participants with oesophageal or stomach cancer, follow-up blood samples will then be taken at two monthly intervals up to six months during chemotherapy treatment, and at six monthly intervals up to three years after treatment, to monitor the effect of treatment on the different cancer types. For patients that undergo cancer resection prior to chemotherapy or radiotherapy, consent will be asked to obtain some tissue samples from any excess specimen from surgery. Blood and tissue samples will then be analysed for specific biomarkers of interest. Other information about the cancer (e.g. stage of disease), current medications, and other medical conditions will also be collected. Our research may lead to the development of improved non-invasive diagnostic tests for the detection of adenocarcinomas, including prostate, breast, lung, pancreas, oesophageal, stomach and digestive tract cancers. This would have beneficial health outcomes as early detection can contribute to early intervention and better prognosis. This test may also be beneficial in monitoring the effectiveness of cancer treatment in certain cancer types.