ANZCTR search results

Distal radius fractures are one of the most common orthopaedic injuries encountered in Australia. Vitamin C has been identified to potentially decrease the incidence of complex regional pain syndrome post distal radius fractures, however the evidence is still inconclusive regarding pain. It is our intention to identify if implementing daily vitamin C post distal radius fixation reduces pain at 6 weeks.

This trial will compare two commonly used treatments for patellofemoral pain, foot orthoses and hip strengthening exercises. There is evidence to support both approaches, and often debate revolves around counter-posing perspectives as to which may be more effective to use, yet the two treatment approaches have not directly compared before. Previous foot orthoses trials have reported benefits on patient rated outcomes from use of foot orthoses over a flat shoe insert or adopting a wait-and-see approach in the treatment of patellofemoral pain. Recent trials implementing hip strengthening exercises have demonstrated reduced pain and improved ability to climb stairs after strength exercises for the hip, in people with patellofemoral pain. In the FOHX trial, participants will be randomly allocated into either wearing foot orthoses or performing hip muscle strengthening exercises. The clinical trial will compare the outcome of the two treatments, and also identify the baseline profile (physical measures and patient perceptions) that are associated with the greatest response to foot orthoses or hip strengthening exercises.

Bloodstream infections (BSI) are an important cause of morbidity and mortality. Several studies have demonstrated that early, appropriate antimicrobial therapy reduces BSI associated mortality and reduces hospital length of stay. Conversely, antimicrobial therapy should be minimised in patients that do not have infection to reduce the impact of antimicrobial agents on resistance, including in patients where blood culture isolates represent contamination. The aim of this project is to assess the implementation of Antimicrobial Stewardship Team review on time to appropriate antimicrobial therapy in patients with a positive blood culture at The Alfred Hospital.

This project evaluates the effectiveness of a web-based cognitive training tool, MyBrainSolutions, in improving emotional and cognitive function over 30 days. The impact of the cognitive training on both trained and untrained real-world functions will be determined, as well as the minimum time commitment required to see improvement. By comparing identical to non-identical twins, a comparison of the relative impact of genetics versus environment in improving scores can be evaluated.

Glucose sensor technology has been evolving with an ultimate goal of achieving a level of accuracy required for finger-prick capillary glucose measurement replacement and reliability needed for consistent closed-loop functionality. While there have been recent advances in CGM technology, further improvements relating to sensor accuracy and reliability are required. Glucose sensor redundancy (the incorporation of multiple sensing elements onto a single sensor) represents the next logical step toward the ultimate goal of achieving a level of accuracy and reliability required for a stand-alone glucose monitor and a closed-loop system. The Harmony Sensor represents an advance in electro-chemical sensor design and incorporates a redundant sensor system. The Harmony sensor consists of a unique electro-chemical sensor in a fold-over design, so that there are sensing elements on both planar surfaces. This feasibility study will assess the accuracy and reliability of the redundant electrochemical sensor (Harmony) for CGM compared to YSI values and meter glucose values.

This study aims to better understand the healthcare needs of people with severe lung disease. In particular we will investigate whether 'advance care planning' (a process of discussion between patients, family/carers and health professionals, about values and goals for treatment) can result in increased patient satisfaction with care and/or a better match between preferred and actual medical treatments.

The research project is aimed to determine whether Halo-thoracic orthosis fixation (Halo brace) contributes to dysphagia (swallowing dysfunction), which put patients at risk of aspiration (contents of the oral cavity entering the airway) and ultimately pneumonia (chest infection). Using fluoroscopy (special x-ray test), patients with dysphagia will be identified and repositioned in the Halo-thoracic orthosis so that the risk of aspiration and pneumonia is less. First, it determines how many patients have dysphagia when placed into a Halo-thoracic orthosis. These patients are at risk of aspirating, which can cause a life-threatening pneumonia. If patients are found to have dysphagia, determined by bedside testing and fluoroscopy, they will have the Halo-thoracic orthosis re-adjusted so that dysphagia may be alleviated, removing the potential risk of aspiration and pneumonia. This has the potential to benefit a large number of patients in identifying and treating dysphagia which previously may have gone undiagnosed. There is very little literature worldwide on this subject, and the studies so far have a relatively small number of participants. What is known is that being fixated in a Halo-thoracic orthosis can cause dysphagia, and the true extent of the problem is probably underestimated in these patients, particularly the elderly. By exploring this subject, this project will contribute significantly to the limited worldwide literature. An estimated 200 participants will be taking part in the study at The Alfred hospital, over a proposed period of two years. This research is conducted by the principal investigators, Mr Patrick Chan, consultant Neurosurgeon, Dr Philip Chan, radiological registrar, at The Alfred hospital, and Dr Amanda Scott, speech pathology, at The Alfred hospital, in collaboration with Professor Mark Fitzgerald in the Department of Trauma Surgery, along with other heads of department in Orthopaedic Surgery, Radiology, and Orthotics. There are no external organisations involved, and all research is to be conducted within and funded by Alfred Health (Department of Trauma Surgery).

The active management of the third stage of labour involves clamping and cutting the umbilical cord and application of controlled cord traction after adminstration of syntometrine, to deliver the placenta. The optimal timing of cord clamping is unknown and practice varies amongst professionals globally. Many healthy newly born infants experience bradycardia (heart rate less than 100 beats per minute) in the first few minutes. The timing of clamping the umbilical cord may influence the proportion of babies experiencing bradycardia. The aims of this randomised controlled study are 1. To determine if delaying clamping of the cord reduces bradycardia in the first minutes after birth in near term and term infants 2. To determine if delaying clamping of the cord has an effect on the need for delivery room resuscitation 3. To determine if there is a difference in heart rate and oxygen saturation centiles in the first 10 mins after birth in three groups of infants (i) born after early (< 60s after birth) cord clamping compared to (ii) infants born after delayed (90-180 s after birth) cord clamping or (iii) when the umbilical cord is clamped following the onset of regular respirations (10 s after accoucher determines onset of regular respirations) by the infant.

Excessive sitting time has now been detrimentally linked to several health outcomes. For many full-time employed adults, the bulk of this sedentary time occurs at work. The office workplace, in particular, has been identified as a key setting for strategies to reduce prolonged sitting time. This study will evaluate two interventions to reduce sitting time in the workplace: - organisational support only (group 1) - organisational support plus the use of a monitoring device that provides real time feedback (the LUMOback posture sensor, group 2). We expect both groups will reduce their sitting time in the workplace and across the whole day. We expect that the addition of the LUMOback posture sensor will result in group 2 reducing their sitting time more than group 1.

Aims: The proposed research aims to (i) identify cognitive targets for intervention with Cognitive Remediation Therapy (CRT) in people with Borderline Personality Disorder (BPD), and (ii) to investigate self-perceptions of cognitive performance, and the perceived relevance and importance of a psychological treatment that aims to improve cognitive skills. In addition, the proposed research aims to (iii) adapt CIRCuiTS for people with BPD based on the established cognitive targets and (iv) to pilot the new CRT (CIRCuiTS) program to assess the acceptability, and feasibility. Method: The design of the proposed research is a within groups study. Participants will be 30 BPD patients aged 18-65, who are attending/being treated by Metro South Addiction and Mental Health Services. Inclusion criterion requires a confirmed diagnosis of BPD according to the McLean Screening Instrument for BPD (Zanarini et al, 2003). Exclusion criterion includes evidence of an organic brain disorder, or head injury. All participants will be give an information letter, and written informed consent to take part. If participants do not have the capacity to consent but wish to participate, their guardian will be asked to consent to the patients participation in the study.