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Amnestic mild cognitive impairment (a-MCI) is believed to represent a transition period between normal aging and Alzheimer's disease. People with a-MCI experience problems with their memory without it impacting on their daily functioning. As a-MCI represents a stage prior to irreversible neurodegeneration, it is important from a therapeutic perspective that neural changes occurring in a-MCI are determined in order to see if there remains potential for response to treatment. Neuroplasticity refers to the brains ability to re-organize its function in response to the environment. One aspect of this is known as long-term potentiation (LTP), which is imperative in learning and memory. LTP-like plasticity can be induced through brain stimulation techniques including transcranial direct current stimulation (tDCS). Application of tDCS through a gentle electrical current can increase brain activity as measured through electroencephalography (EEG) and behavioural outcomes. When transcranial magnetic stimulation (TMS) is applied in combination with EEG, the cortical excitability of the stimulated and surrounding brain regions can be determined. This provides information about the LTP-like plasticity that is present. Recent evidence has shown that spaced application of tDCS may be more beneficial in enhancing cognitive performance and neural plasticity compared to only a single session. Therefore the aim of our study is to investigate whether LTP can be induced in a-MCI and if there are differences in LTP-like plasticity and cognitive performance with spaced application of tDCS compared to a single active tDCS condition.

This is a Phase IIa, randomized, double-blind, placebo-controlled crossover study to evaluate the efficacy and safety of oral CMX-020 in subjects with lumbosacral radiculopathy (sciatica).

Sacroiliac Joint Dysfunction (SIJD) and Pregnancy Related Pelvic Girdle Pain (PRPGP) can be grouped together under the heading of ‘Pelvic Girdle Pain’ (PGP) which makes up part of the generic ‘Low Back Pain’ (LBP) group. As a main pain source it is reported to account for between 10% and 30% of all nonspecific LBP. The cost to an industrialized country, from PGP, is significant (USA alone in the region of $10 to $60 billion a year). Treatment for SIJD and PRPGP tends to encompass either/and pain relieving modalities (acupuncture, pain medication, use of pillows and belts) and exercise. The overall evidence on the outcome of these modalities is poor. The use of pelvic belts has developed from biomechanical studies that have shown that the external forces from a belt can help increase the ‘force closure’ of the pelvis. Another important aspect is the position of the belt with greater stability being produced on the pelvis with the belts being positioned higher, just below the anterior superior iliac crests, as opposed to the symphysis pubis. The product being investigated is the SpineCor SI Brace (SSIB). The SSIB consists of a unique design of compressive shorts with an integrated belt that allows a variable amount and direction of compression to be applied to the pelvic girdle. It was felt that a more comfortable and biomechanically effective design could help this patient group. The hypothesis of this study is that the use of the SacroFix brace will result in a reduction in pain and disability and an improvement in the emotional state of patients suffering with pelvic girdle pain.

A dressing containing chlorhexidine (Biopatch 'Trademark') has been introduced at the RBWH for all patients requiring a CVC. The dressing is expensive and the evidence for its effectiveness is contradictory. In related work we have some preliminary data showing that Biopatch may not be as effective as first thought in destroying potentially harmful bacteria. Another product, ‘Kendall 'Trademark' AMD Foam Disc’ has shown promise and we propose to compare the two antimicrobial dressings.

The aim of the Healthy Living after Cancer program (HLaC) is to evaluate the integration of a telephone-delivered lifestyle intervention for cancer survivors into the existing Cancer Council 13 11 20 information and support telephone service offered by Cancer Councils New South Wales, Victoria, South Australia and Western Australia. Who is it for? You may be eligible to join this study if you are aged 18 years or above, and have completed curative treatment for any type of localised cancer. Study details All participants will receive up to 12 telephone coaching calls over a period of six months to assist them to increase physical activity, improve their eating habits, and work towards moderate weight loss if appropriate. The calls will be delivered by Cancer Council nurses / information and support consultants trained in program recruitment, intervention and evaluation protocols. Pre- and post-program evaluation will be conducted, with a focus on program implementation (i.e., number of referrals and number of program completions) as well as assessment of patient-reported outcomes (i.e., physical activity, diet, weight, and quality of life).

Oraxol is a combination of an oral tablet, HM30181 methanesulfonate, and capsules that contain paclitaxel. HM30181 is a drug that helps the body absorb paclitaxel, a drug used to treat cancer. Initially this study is intended as an extension study of KX-Orax-002 pharmacokinetic study for patients who wish to continue Oraxol treatment and who are eligible to participate. Once the dose of Oraxol has been confirmed in the KX-ORAX-002 study, then enrolment of patients who have not participated in the KX-ORAX-002 study will be allowed. The purpose of this study is to check the safety and tolerability of Oraxol when it is administered on a weekly basis and to confirm that the blood levels of paclitaxel after several doses of Oraxol are similar to the levels expected. Participants in Group B (N=8) will receive the same weekly paclitaxel capsule treatment as the remainder of the subjects except for 1 dosing week (at least 1 week following the paclitaxel capsule PK sampling period) during which they will receive paclitaxel tablets and undergo PK assessments.

A significant proportion of patients who have survived admission to an Intensive Care Unit (ICU) experience long-term psychological consequences that include anxiety, depression and post-traumatic stress disorder (PTSD). A high proportion of family members of ICU patients also present with varying psychological symptoms of anxiety, depression and PTSD. Currently there are no routine follow ups of psychological well-being of patients discharged from intensive care units in Australia. There are little data from Australia about the incidence of psychological stress in the local population of ICU survivors and family members. Understanding of the incidence of the psychological stress in ICU survivors and their family members could potentially lead to routine assessment of the problem and measures to reduce the incidence. The primary aim of this multicentre study is to determine and compare the prevalence of affective symptoms in intubated and non-intubated ICU survivors and their family members by screening them for PTSD, anxiety, depression and Health Related Quality of Life (HRQoL) over a 12-month follow up period. The secondary aims of this study are to identify the risk factors for adverse psychological outcomes in ICU survivors.

Older people (age 65 and older) account for more than half of hospital bed days, and have longer stays and more hospital adverse events that younger people. A hospital stay is often a decisive point in an older person’s health, with hospitalisation accounting for half of newly acquired disability in elders. Geriatric syndromes (including delirium, functional decline, falls, incontinence and pressure injury) result in longer hospitalisations and greater risk of death and institutionalisation. Research clearly shows that “simple” strategies (early mobilisation, adequate oral nutrition, and meaningful cognitive activities) are effective to reduce geriatric syndromes, improve outcomes and reduce costs. While such strategies have been effectively incorporated in specialist “acute care for elders” wards, only a limited number of patients have access to these specialist services. In order to optimise care we need to embed these principles in all acute wards caring for older people. However, this requires systematic changes in acute care staff attitudes, practices and systems of care. We have piloted a programme of enabling facilitation, based on the i-PARIHS implementation framework, to embed this evidence into practice. The “Eat Walk Engage” programme supports a ward-based multidisciplinary team to identify barriers, trial solutions and embed successful strategies into practice using evidence-based quality improvement methods. In two pilot wards at the Royal Brisbane and Women’s Hospital we have shown promising reductions in length of stay, geriatric syndromes and adverse events accompanying process improvements. The CHERISH (Collaborative for Hospitalised Elders: Reducing the Impact of Stays in Hospital) study is a cluster randomised controlled trial of the “Eat Walk Engage” programme across 4 sites, and will provide robust evidence of the transferability, scalability, effectiveness and cost-effectiveness of the programme to inform further implementation. Comparing 4 intervention wards with control wards in the same hospitals to account for other sources of variation, we aim to demonstrate a reduction in hospital stay, geriatric syndromes, and discharge to a higher level of care within 12 months of implementing the “Eat Walk Engage” programme. The project is supported by a Queensland Accelerate Partnership Grant from the Department of Science, Information Technology, Innovation and the Arts, administered by Queensland University of Technology.

The primary purpose of this study is to determine whether a web-based version of the ReCog program has a greater impact on cognitive function and other wellness measures than standard care in cancer survivors. Who is it for? You may be eligible to join this study if you are aged 18 or over, have experienced adult-onset cancer of any type other than a cancer affecting the central nervous system, have completed treatment at least 6 months ago (and not more than 5 years ago) and have complaints of cognitive function. Study details: On enrolling in this study, participants will be allocated to one of two groups. The first group will receive access to the ReCog online program. You will be required to complete 4 modules, each lasting approximately 60 minutes, plus weekly homework activities taking approximately 30-60 minutes each. Activities will include relaxation training, goal-setting, problem-solving and the learning of new strategies to improve areas of cognitive function, such as memory, fatigue, attention and emotions. Participants will have 4 weeks to complete the modules, and are expected to complete one module per week. The second group will have access to the ReCog program 4.5 months after group 1. All participants will be asked to fill out a series of questionnaires at four timepoints up to 3 months after the end of the intervention period. It is hoped that the findings of this trial will establish the efficacy of the web-based ReCog program to aid cognitive function in cancer survivors.

We propose to follow up 61 participants from a previous randomized controlled trial conducted in 2001-2002 at SCGH and Hollywood Private Hospital, which randomized participants for total hip replacement to either a ceramic-ceramic or metal-highly-crosslinked-plastic bearing surface. The 12-year outcomes, in terms of radiographically measured wear rate and implant migration, and clinical findings will be determined and presented for each group.