ANZCTR search results

To address harm from falls in hospital that disproportionally affects older patients with cognitive impairment, St John of God Midland Private and Public hospital are committed to engaging patient and caregivers as partners in the design and transformation of practice through this realist evaluation of a co-designed dementia-specific caregiver education program. The question we are aiming to answer through the co-design process are, how can existing documentation tools for falls and cognition screening, assessment, and communication be regularly used by the multi-disciplinary team to identify patients with deteriorating mental state, and how can existing workflows be enhanced to support the patient with identified cognitive impairment? Caregiver participants and the researcher will purposefully engage in critical reflection during education sessions and on-ward training to understand real-life situations in their workplace, and create solutions by applying their experience-based knowledge to change practice. We hypothesize that the co-designed caregiver education will be feasible and cost-effective for the hospital and that caregivers will be more prepared to address falls prevention for patients with cognitive impairment, including engaging with their family.

Thrombectomy for large vessel occlusion (LVO) has been the mainstay since publications of 5 landmark trials in 2015. However, these trials had very restrictive inclusion criteria and excluded elderly patients or those with premorbid disability. The aim of this trial is to deliver high quality evidence of the effectiveness of LVO thrombectomy in patients with premorbid disability.

The study explores two approaches to diabetes management in Indigenous Australians living in remote communities. Communities will be randomly assigned to either intensive weekly clinic visits, including tirzepatide injections, blood glucose monitoring and other medication oversight, or standard care with usual clinic visits. The primary goal is to determine if the intensive approach improves blood sugar control. Researchers will also assess whether it reduces complications such as kidney, eye, and heart disease. The study aims to provide insight into which strategy offers better health outcomes for this population.

This study is investigating a novel personalised medicine approach to the use of Hyperthemic Intraperitoneal Chemotherapy (HIPEC) at the time of Cytoreductive Surgery (CRS) for Colorectal Periotneal Metastases (CPM). Who is it for? You may be eligible for this study if you are a patient aged 18-85 years old with synchronous or metachronous peritoneal metastases of colorectal adenocarcinoma origin, who has been deemed suitable for consideration of Cytoreductive surgery and HIPEC (i.e. radiologically has potentially resectable disease either upfront of after neoadjuvant chemotherapy). Study details Participants enrolled in this study will receive a novel personalised medicine approach by preclinically determining an individual patient's tumour response to chemotherapy prior to its administration intraperitoneally (HIPEC) at the time of their routine cytoreductive surgery. Delivery of CRS and personalised HIPEC will be compared to a historical cohort of patients who received non-personalised treatment to determine improvement in peritoneal disease free survival. Data on overall survival, cancer-specific survival, adverse events, surgical complications and patient-reported outcomes will also be collected. It is hoped that findings from this study will help address the current knowledge gap regarding the benefit of HIPEC+CRS, and therefore inform national guidelines for CPM management with international impact.

This study aims to compare an individualised, repetitive computer-based therapy program delivered using the AbleX with a conventional therapist-facilitated task-specific practice program on upper limb (UL) function and quality of life (QoL) for patients with acute stroke. To achieve this aim, the following objectives will be considered. 1. To compare change in UL function of patients with UL motor impairment post stroke between the intervention and control groups. 2. To compare change in patient QoL between the intervention and control groups. 3. To compare the amount of completed UL therapy repetitions between the intervention and control groups. 4. To compare the amount of required direct therapist time between the intervention and control groups. Research question: How effective is virtual reality (VR) at improving UL function and patient QoL when delivered as an adjunct to conventional UL therapy in the acute stage of recovery post stroke? Hypothesis: It is hypothesised that UL rehabilitation incorporating the AbleX will improve patient UL function and QoL when compared to conventional upper limb therapy alone.

This project presents a novel intervention combining mental imagery and episodic future thinking (EFT) in diabetes management, targeting Type 2 diabetes. Modifying delay discounting to help people with Type 2 diabetes focus on the future rather than immediate rewards is an innovative and low-cost approach which can be adopted by individuals easily once they have learnt to generate the future-oriented mental pictures. The present study will apply EFT and mental imagery to people with diabetes and assess the feasibility, acceptability, and potential behavioural impact of offering an intervention that guides people with diabetes to 'imagine the future' using mental imagery.

We spend an increasing amount of time within buildings yet have limited understanding of how the design of interior built environments affect our brain functioning and behaviour. Studies in a controlled laboratory setting using virtual reality have recently shown that enlarged room scale affects brain activity which has been associated with concentration and performance. Although promising that we may be able to optimise cognitive functioning through building design, it is important we understand if the computer-generated modelling and virtual reality presentation of a room elicits the same effect as physically constructed and experienced rooms. In this study, adults (aged 18-40, N=55) will be exposed to two rooms, where they will complete computerised cognitive tasks while neurophysiological measures are recorded. Mixed model analyses will be used to compare the measures between the two rooms. Overall, it is intended this study will help us understand if we can optimise the spaces we inhabit to support our cognitive performance.

Participants will be randomly allocated in a 1:1:1 ratio to receive either i) control (usual care); ii) a prescribed home program with one strength exercise or; iii) a prescribed home program with multiple (five) exercises. The control group will not receive any intervention and will continue with their usual care. Participants in the exercise groups will have three video-conferencing consultations with a physiotherapist (week 1-, 2- and 6-weeks post-randomisation, 30 minutes each) for prescription, monitoring and progression of their exercise program, which will be performed independently at home for 3 months. Participants in the exercise groups will be encouraged to continue with exercises beyond the intervention period. Primary time-point for re-assessment will be 3 months, with a secondary time-point of 9 months, after randomisation. The primary outcome measure will be change in average walking pain over the past week on NRS. Secondary outcome measures will include WOMAC pain and function subscales, quality-of-life; arthritis and exercise self-efficacy; fear of movement; global rating of change; muscle strength; willingness for joint replacement.

This study aims to investigate the risk of thrombosis associated with central venous access devices (CVADs) in neonates and infants undergoing cardiac surgery for congenital heart disease. CVADs are essential for delivering medications and fluids during and after surgery, providing stable access to the central venous system. However, their use in infants with complex cardiac conditions may lead to thrombotic complications, potentially compromising both short- and long-term health outcomes. Infants undergoing cardiac surgery are at particularly high risk of thrombosis due to the use of cardiopulmonary bypass and the inflammatory response to surgery. Thromboses can obstruct critical blood vessels, impacting future cardiac interventions and contributing to complications such as pulmonary hypertension. Although previous studies report a wide range of thrombosis incidence rates, from 11% to 61%, there is limited data on long-term outcomes in this population. This study will prospectively observe neonates and infants requiring CVAD insertion during cardiac surgery, assessing the incidence of thrombosis, identifying modifiable and non-modifiable risk factors, and evaluating long-term effects on health. The hypothesis is that factors such as CVAD type, insertion location, and surgical variables may influence the likelihood of thrombosis, and early detection and intervention could mitigate associated risks. By improving understanding of CVAD-associated thrombosis, this research aims to optimize patient care and enhance surgical outcomes for this vulnerable population.

To assess the effectiveness of Biofeedback Assisted Relaxation Training (delivered via the BrightHearts iOS App) plus routine non-pharmacological care compared to routine non-pharmacological care alone for managing pain for procedures following lower limb orthopaedic surgery in children with physical disabilities. It is hypothesized that BrightHearts will assist with decreasing pain levels during procedures performed during the inpatient admission following lower limb orthopaedic surgery.