ANZCTR search results

This study aims to compared two methods of delivery for the stimulus control technique of worry postponement; the traditional paper and pencil diary method or a novel smartphone application 'WorryTime' method. The study will examine whether using the technique on a mobile phone platform increases the frequency and duration of use of the technique and improves the effectiveness of the technique, as compared with the traditional paper and pencil methods. Additionally the study aims to explore user satisfaction, acceptability and usability of the smartphone application compared with the paper and pencil diaries. Two hundred young adults (aged 16-25 years) will be recruited to the study via Facebook and asked to use the worry postponement technique for 7 days.

Induction of anaesthesia and management of the airway is designed to prevent a child from suffering a lack of oxygen during the phase from consciousness to deep anaesthesia for a surgical procedure. Current practice provides a very high standard of induction of anaesthesia with a very low number of complications. However if anaesthesia needs to be achieved in emergency settings of in the presence of a complicated airway, the rate of complication rapidly increases. Particularly in emergency settings experienced operators are often not present. In these circumstances newer methods to reduce the risk of complications is desirable. This study investigates under very controlled circumstances in a tertiary children’s hospital a new concept to prolong the time to secure and improve airway management. The results and findings will then be tested in emergency settings in a follow up study.

This research project will investigate the feasibility and acceptability of combined Errorless Learning (EL) and Spaced Retrieval (SR) techniques in a 3 week transfer training program to prevent falls in adults aged 65 and over with mild to moderate cognitive impairment and higher level gait disorders. Participants are recruited from those admitted to St Vincent's Hospital (SVH) under the Geriatric team or community dwelling adults aged 65 years and over who are managed by the SVH Geriatric team . The assessments and intervention are conducted by a senior occupational therapist and/or a senior physiotherapist under the supervision of the geriatricians. The intervention is either conducted on the ward or in the participants home. Follow up assessments at 3 months post intervention are conducted by the occupational therapist at the participants home. This project will form the pilot study for a larger multi-centre clinical trial, which will assess the long-term effect of this novel falls prevention program targeting older adults with cognitive impairment and higher level gait disorders.

The purpose of the Stepathlon study is to determine the impact of Stepathlon on lifestyle and health outcomes including step count, sitting duration, exercise duration and weight.

The aims of this study are to identify the electrophysiological biomarkers that may guide and optimise future management of OCD by DBS. This research project will utilise a new device, the Activa PC+S (Medtronic Minneapolis USA) which is identical to the implantable DBS system utilised over the past 10 years for movement disorder with the addition that the Activa PC+S can be used over many months as a passive recording device of brain electrical activity. The recording of these signals can be stored or "played" in real-time. These electrical signals from the brain offer the strong long term prospect of more accurately guiding the surgeon in the placement of the stimulating electrodes in the targeted region of interest. As such, the hypothesis of the research are: 1. That the brain electrical activity changes in response to stimulation and that the changes in brain electrical activity account for clinical changes in the symptoms associated with obsessive compulsive disorder. 2. That brain electrical activity can be used as a marker to guide electrode placement. 3. That the recorded electrical signals will provide useful information about the electrophysiological basis of Obsessive Compulsive Disorder and the effect of DBS treatment on the biological markers of this condition. In order the evaluate these hypothesis, the proposed research will implant the new Activa PC+S device in a series of ten participants who suffer from treatment resistant obsessive compulsive disorder. The recording functionality of the Activa PC+S does not detract in any way from the likely positive outcomes of DBS for OCD but adds to the prospect of improved outcomes in the future with more accurate placement of electrodes and more informed programming post operatively. This is highly significant in that this work in OCD has not been done anywhere else in the world and as such will not only inform the current treatment of participants in this study, but will inform treatment of other participants world wide. The patients will be rigorously screened with well defined inclusion and exclusion criteria for the procedure and will have thorough medical, psychiatric and neurocognitive testing before implantation and post-procedure and during a very structured two-year follow up.

This is a randomised controlled trial comparing a programme of monitoring unborn babies during labour using ST analysis (STan) of fetal ECG to intrapartum cardiotography. We aim to reduce our emergency caesarean section rate from 18% to 12% with improvement or clinical equivalence of neonatal outcomes, whilst maintaining maternal wellbeing and both maternal and caregiver satisfaction. The WCH is the first Australian centre to introduce STan fetal monitoring, as a part of a comprehensive educational package on fetal monitoring.

Recent research has shown Kyolic aged garlic extract to improve cardiovascular function, including peripheral and central blood pressure and arterial stiffness. Arterial stiffness is inversely correlated to aerobic capacity. Additionally, animal and clinical data have linked aged garlic extract to ameliorate physical fatigue, increase exercise tolerance and increased oxygen uptake. This study aims to investigate the effect of 3-month supplementation of aged garlic extract compared to placebo on arterial stiffness and aerobic fitness measured by oxygen uptake, lactate levels and muscle fatigue (as 'lactate to rated perceived exertion (RPE) ratio), in a group of sedentary adults during moderate intensity exercise.

Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. We systematically review the medical literature to determine the efficacy of existing intervention strategies to increase the uptake of cardiovascular risk factor screening. A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through backward and forward citation search. The quality of studies was evaluated using Cochrane risk of bias assessment tool. Data were pooled using random-effects model..

This study aims to develop a multi-centre trial and to assess which infants and children with acute respiratory failure benefit using High Flow Nasal Cannula Therapy (HFNC). For this purpose we will perform a randomised controlled trial comparing current best practice (standard oxygen delivery via subnasal prongs, facemask, venturi mask) versus HFNC therapy. With the introduction of this simple to use respiratory system in regional and tertiary centres we aim to investigate if HFNC therapy has a lower treatment failure rate in comparison to standard oxygen delivery, and to investigate if there is a reduction in the need for transfer of these patients to a tertiary hospital or admit to an intensive care unit.

Intravenous sedatives and analgesics are commonly administered to mechanically ventilated children post cardiac surgery, however there is substantial variability in sedation practices in different intensive care units and in different countries around the world. The Cardiac BabySPICE pilot study will evaluate the hypothesis that early light sedation with dexmedetomidine reduces length of mechanical ventilation and length of stay in PICU compared to standard practice (midazolam). In addition we will follow up the neurodevelopment (at 6 and 12 months) of the included subjects; infants undergoing cardiac surgery on bypass <6 months of age. The purpose of the Cardiac BabySPICE Pilot RCT is to obtain preliminary data on the feasibility and safety of conducting a study that tests this hypothesis. This is a pilot prospective randomised controlled trial that will be conducted in the Lady Cilento Children's Hospital paediatric intensive care unit in Australia and will recruit 60 patients. The study will recruit patients undergoing repair of congenital heart disease who require a breathing tube at least 24 hours after enrolment AND need immediate and ongoing sedation. Patients will be recruited into one of 2 study groups. The study drug will commence whilst the child is in surgery. The intervention arm will receive dexmedetomidine as the primary agent, with the addition of secondline sedatives as required by infusion, boluses or both. The use of benzodiazepines in this arm will be minimized and clonidine will not be used concurrently with dexmedetomidine. The control arm will have midazolam according to usual practice.In both groups, the default sedation level in PICU is light sedation, as defined by a target State Behaviour Scale (SBS) of 1 to +1, unless otherwise specified by the treating clinician. The primary outcome measure for the pilot study is to demonstrate separation between the intervention group (Dex) and the control group (Mid) with respect to the proportion of patients achieving light sedation (SBS 1 to +1) in the first 48 hours of sedation in intensive care.WE will also examine length of veniltation, PICU length of stay and long term outcomes. Information from the Pilot RCT will be used to design a subsequent phase III trial.