ANZCTR search results

Low back pain (LBP) is a highly prevalent health condition affecting up to 80% of individuals at some point in life. It is acknowledged that abnormal clinical findings, such as structural alterations of the spine found from imaging, poorly correlate with clinical status. Further, current prediction models that take into account psychological, demographical and physical factors explain only a small proportion of the variance in clinical outcomes. In recent years, evidence has accumulated that abnormal somatosensory processing occurs in people with chronic LBP. Psychophysical studies have commonly found pain hypersensitivity to various sensory stimuli in people with chronic LBP compared with healthy controls, not only at the back, but also at non-painful remote sites (e.g. at the hand). These changes in pain sensitivity in areas remote from the low back implicate abnormal central mechanisms. At present, it is not yet established to what extent these sensory alterations contribute to the generation and maintenance of LBP. Also, the temporal aspects of these changes are unknown. However, recent research has shown that somatosensory abnormalities can be detected early (i.e. within 4 weeks) after the onset of LBP. These include augmented spinal cord excitability as well as pressure pain hypersensitivity. Further, longitudinal studies in acute whiplash injury cohorts have shown that widespread pain hypersensitivity persisted only in subjects who did not recover at 6 months. Cold pain threshold was found the sensory parameter that most significantly predicted non-recovery at 6 months. The primary aim of this study is to investigate whether psychophysical measures of pain sensitivity contribute to predicting non-recovery in low back pain and to evaluate the time course of somatosensory changes from the onset of low back pain to 4 months.

Survivors of critical illness experience significant physical, psychological and cognitive compromise during recovery. ICU diaries have been proposed as one intervention that may be effective in helping survivors recover psychological function. Despite support by some members of the intensive care community, there is a lack of empirical work investigating diaries and subsequent concern regarding the potential harm of such an intervention exists. This study is designed to determine feasibility of two proposed psychological interventions for survivors of critical illness: (1) the use of ICU diaries and (2) the provision of an individualised summary of the ICU experience prepared by ICU staff and based on the User Centred Critical Care Discharge Information. The effect size of each psychological intervention to reduce psychological compromise (anxiety, depression, posttraumatic stress symptomatology) will also be determined to inform sample size calculations for a larger efficacy randomised control trial. Other aims of this pilot study are to determine the feasibility of early screening for psychological health for survivors of critical illness, and to validate the Intensive Care Psychological Assessment Tool (IPAT) against recognised depression and anxiety screening instruments in an Australian ICU population.

This randomised controlled trial will compare the effect of an 8-week well-being and performance enhancement program with a wait-list control group for Australian Para athletes with a physical impairments who are competing at a national level or above and aged 18 years and over. Athletes will be asked to complete electronic questionnaires and semi-structured interviews in addition to completing the well-being program.

This project will recruit pregnant women to receive either a prebiotic supplement or a placebo supplement. They will be asked to take the supplement from 18-20 weeks gestation until their baby is 6 months of age. We will then examine whether supplementing the mother’s diet during pregnancy and breastfeeding with the prebiotic powder will reduce the development of allergies in her child. Both study groups will include children deemed to be at high risk of allergic disease (based on family allergy history).

This study aims to invesitgate the neuroprotective effects of ketamine in elderly patients undergoing cardiac and major vascular surgery. Delirium and depression are common effects of cardiac and major vascular surgery. Ketamine is believed to have a protective effect against delirium and depression. Participants will undergo neuropsychological testing prior to surgery and again at day 7 and 3 months postoperatively. Deliriuma and depression will be measured during patient hospital stay. Additionally, inflammatory bloods will be taken to assess the role inflammation plays in the role of postoperative cognitive dysfunction.

UBWELL is a smart-phone app-based continuous, real-time data tracker which can link to current available wearable technology (i.e. Fitbit) and other smart software systems (i.e. HealthKit, Google Fit and Project Synergy) to collect physiological and experiential measures and then monitor, analyse and report these results. Currently, UBWELL can measure physical activity, sleep, mood, anxiety, energy, substance use (alcohol, tobacco), functional engagement (relationships, work, study), healthy eating and weight. This data can be used by an individual to help maintain good health and wellbeing; as well as by health professionals to more effectively plan, implement and monitor treatment to patients, thus providing enhanced, personalised healthcare. The use of this innovative technology has the potential to empower young people to actively engage in their general health and wellbeing (including mental health) by reliably tracking the metrics that are important to them. Unfortunately, the majority of apps for mental health that are currently available lack scientific evidence about their efficacy, and few (if any) have the capacity for the continuous comprehensive integrated assessment that UBWELL offers. This project aims to evaluate the engagement, efficacy and effectiveness of UBWELL (as compared to Recharge and OzHealth) among the Australian general population to improve general health and wellbeing outcomes.

This study investigates whether addition of the drug acetazolamide to a dexamethasone treatment for controlling raised intracranial pressure symptoms, related to high grade glioma brain tumour (such as headache, nausea and vomiting), will allow the dexamethasone dosage to be reduced, and whether this leads to less dexamethasone-related side-effects. Who is it for? You can join this study if you are required to restart or increase a dexamethasone treatment to control recurrent or increased symptoms of intracranial pressure, that may be related to your brain tumour, high grade glioma. Study details: If you like to join this study you will first be screened by your specialist to see if you meet the eligibility criteria to participate in this study. If you are deemed eligible to participate you will be randomly (by chance) assigned to one of two possible treatment groups: Group 1 will receive 1 tablet of 250mg acetazolamide twice per day for 8 weeks, in addition to the dexamethasone treatment. Group 2 will receive 1 tablet of placebo twice per day for 8 weeks, in addition to the dexamethasone treatment. Your chance to receive the group 1 treatment is equally high as to receive the group 2 treatment. You cannot choose to which group you are assigned and both you and your doctor will not know which treatment you received until the study is finished. Participants will be asked to attend clinic visits every 2 weeks during the treatment period and then 1 more time (about 1 month after having received the last treatment). During these visits the specialist will assess your physical and mental health, and ask you about your well-being. Participants will also be asked to undergo tests and procedures, such as blood testing, scans, and questionnaire completion.

Stabilizing the circulation of critically ill patients presenting with severe sepsis or septic can be complicated by a phenomenon called catecholamine hyposensitivity, which leads to a decreased effect of vasoactive drugs. Massive release of endogenous catecholamines like adrenaline and noradrenaline in the setting of sepsis can cause down-regulation and de-sensitization of alpha-1 receptors making the vasculature less responsive to catecholamines. Interestingly, animal studies found that high doses of central alpha2-agonists like clonidine and dexmedetomidine increase vasopressor responsiveness in a septic shock model. In view of the potentially deleterious effects of adrenergic overstimulation and receptor desensitization more research about the effect and use of alpha-2-agonists in clinical doses and critically ill patients is warranted. In the critical care setting, the alpha-2-agonist clonidine has become an established drug for the management of conditions with a high sympathetic activity and it is also commonly used as a supplementary sedative agent. Dexmedetomidine has anaesthetic and analgesic properties and has much higher a2-receptor selectivity than clonidine. Like clonidine, dexmedetomidine is used for sedation in adult critically ill patients. In view of the potential benefits of dexmedetomidine in septic patients, we aim to conduct a retrospective cohort study of the haemodynamic effect of dexmedetomidine compared to standard care sedation in septic patients admitted to the intensive care unit of the Austin Hospital.

This study aims to investigate if, following anaesthesia related healthcare inteventions, individuals with higher levels of inflammation at baseline, have a higher rate of postoperative cognitive dysfunction at 3 months after surgery. Participants will be having surgery with an expected stay of 3 or more days and consent to neuropsychological testing and having bloods taken during their hospital stay. Cognitive and memory testing will take place prior to surgery and at 3 months after surgery. Tests for delirium will also be conducted during the participants time in hospital.

Delivery of air flow by high flow nasal cannula (HFNC) has become increasingly popular in neonatal and paediatric intensive care units throughout Australia and the world. Despite this, there is limited knowledge on how to determine the most appropriate flow rate for the infant. This study will measure the electrical activity of the diaphragm to determine when the work of breathing is optimal and then examine what other physiological measures correlate with this. The aim of this study is to demonstrate the physiological effect of randomly applied levels of high flow on the work of breathing (WOB) indirectly measured with electric diaphragmatic activity. Methods: This is a prospective interventional study of premature infants with respiratory distress admitted to the Neonatal Critical Care Unit (NCCU), Mater Mothers Hospital, South Brisbane and infants with bronchiolitis admitted to Lady Cilento Childrens Hospital (LCCH). Work of breathing (WOB) will be measured with diaphragmatic electrical activity - measured transoesophageal (Edi)and transdermal (Tdi), and respiratory inductance plethysmography (RIP). Using the Edi signals we will measure the WOB during HFNC treatment and assess its impact on patients with respiratory distress. Edi requires inserting a specially designed sensing nasogastric tube into the infants’ nose, Tdi involves placing five regular skin elecrodes on the chest, and RIP consists of two stretch bands placed around the chest and abdomen. Both Edi and RIP signal can be recorded continuously during the entire study period and recorded on a dedicated computer and further analysed. Physiological variables of respiratory rate (RR), heart rate (HR), and oxygen saturations (SpO2) will also be monitored throughout the study. From the collected data the SpO2/FiO2 ratio will be calculated. Study Procedure: Infants recruited into the trial will be on HFNC oxygen therapy using the Fisher & Paykel 850 humidifier. The in situ nasogastric tube will be replaced by the Edi probe. The first measurement will be done when the infant is settled but within the first 24 hours of HFNC administration. Thereafter, flow rates between 2 and 8 L /min will be randomly applied for the preterm infant and between 0.5 L/kg/min and 2 L/kg/min for the infants with bronchiolitis. At the conclusion, initial HFNC settings will be reinstituted.