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The transmission and acquisition of health care associated microorganisms by hospitalised patients is associated with serious morbidity. Critically ill patients are particularly susceptible to serious infections with these organisms due to the nature of their illness and the numerous vascular and intra-cavity devices they have. It is known that persistence of these organisms within the healthcare environment is a major source of these transmissions. Environmental cleaning is important in the control of these organisms and traditionally relies on wet cleaning methods of the patient environment with detergents and disinfectants. This process of cleaning is time consuming, requiring significant resources and personnel. In addition, much of the environment is not easily amenable to these cleaning methods (e.g under surfaces, monitoring devices). Increasing bed occupancy and bed turnover creates added pressure to the effectiveness of these traditional cleaning methods. Hydrogen peroxide vapour (HPV) is an attractive alternative to these traditional cleaning strategies. This is due to being less personnel dependent, the vapour will effectively reach more difficult areas, simplifies complex cleaning process for numerous types of surfaces and recent evidence suggests that it is more effective in eliminating environmental organisms than traditional disinfection treatments. This study aims at assessing the effectiveness and practicality of using HPV compared to traditional cleaning methods in the routine ICU patient discharge cleaning process. Specifically we are looking at the control of the acquisition of hospital acquired organisms by patients in a busy general intensive care unit. Null Hypothesis: “ That Hydrogen Peroxide Vapour is no better than standard double cleaning (viraclean and detergent, no bleach) procedures in regards to acquisition of hospital acquired Clostridium difficile and multiresistant organisms during the course of an ICU admission. “ The Multi Resistant Organism (MROs) acquisitions to be measured include: - Multi Resistant Gram Negative bacteria (MRGN), - Methicillin Resistant Staphylococcus aureus (MRSA), - Vancomycin Resistant enterococci (VRE) and Clostridium Difficile cultures will only be collected if they are clinically indicated. Clostridium Difficile will not be included on routine admission and discharge swabs to Intensive Care. There will be a planned interim analysis at 4 months to re-calculate the sample size required.

Reading is a significant part of our everyday lives. Reading is needed for work, for home life, e.g. reading bills and for pleasure, e.g. reading a novel or reading aloud to grandchildren. The loss of the ability to read as a result of a stroke can therefore have a devastating impact on people’s lives. There is therefore a significant need to find reading therapy approaches that are effective. This project will determine the effectiveness of reading therapy delivered at Curtin University Reading Clinic (CURC) for people who have mild-moderate reading difficulties after stroke. Fifteen participants will be recruited to take part in the study. Assessments will be conducted pre and post therapy in order to determine effectiveness. Gains will be measured in terms of reading accuracy, reading comprehension, reading speed, verbal language, reading confidence and emotions associated with reading. Additional qualitative data regarding identity as ‘a reader’ and participation in reading related activities will also be collected via a post-therapy interview. Therapy will focus on functional reading and use materials selected by the participants e.g. a novel they wish to read. The therapy approach will be individualised depending on the participant’s own goals and the profile of their reading difficulties. We hypothesise that the reading therapy delivered by CURC will result in similar gains to those found with the participants in Cocks et al., 2013 and Cocks et al., 2010. These include significant, positive improvements in: reading comprehension, reading accuracy, reading speed, improved verbal language, pleasure in reading, confidence with reading and participation in reading related activities.

Mental health (MH) problems are a major public health concern. Because the prevalence of MH issues is higher in the Emergency Department (ED) than the general population norm, the ED is a potentially effective (but neglected) setting to target these issues. Detection of mental health problems before they become severe will enable intervention and support to be provided at an early stage, which may improve health and prevent further deterioration. The proposed study focuses primarily on participants with mild and moderate levels of psychological distress as identified by the Kessler Psychological Distress Scales and will exclude those with severe levels of psychological distress as this may indicate an existing mental disorder. The primary hypothesis to be tested is that, compared to patients who receive standard care i.e. no BI, patients who receive early BI (MI and MI follow-up) will report: 1) reduced levels of depression, anxiety and stress; 2) higher levels of motivation to self-manage health needs; 3) increased (appropriate) healthcare-seeking behaviours; and 4) improved quality of life.

The study will investigate how to improve identification of patients with malignant pleural mesothelioma who will derive benefit from treatment with chemotherapy and/or investigational agents, and also identify any potential factors that may predict overall outcome of the patients including survival (prognostic factors) so that individualised therapy is possible for patients with malignant pleural mesotheliom. Who is it for? You may be eligible to join this study if you are aged over 18 years, have a pathological diagnosis of malignant pleural mesothelioma, and about to commence on chemotherapy of choice by the treating physician including first line, second line or experimental regimens. Trial details: Participants with malignant pleural mesothelioma in all stages of disease will be recruited. Participants will be treated with the current chemotherapy of choice by the treating physician, including first line, second line or experimental regimens. There is no study specific intervention. participants will be consented for collection of their tumour tissue, blood samples and answering some questionnaires at baseline and subsequent follow ups.

For many years the phenomenon of involuntary movements provoked by yawning, has been observed in stroke patients with paralysed limbs, particularly the arm. More than a hundred years ago, an analysis suggested that removal of inhibitory pathways, unmasked the associated movements of yawning and limb movements, which had an evolutionary link related back to the swim bladder and pectoral fins of fish. In healthy individuals, yawning is often accompanied by generalised stretching, which may include elevation of the arms, known as pandiculation. The paralysed arm of stroke patients can be seen to move during a yawn, often bringing the hand towards the mouth, before suddenly dropping again at the end of the yawn. Walusinski coined this, “parakinesia brachialis oscitans”. The observation appears to have been regarded as a curiosity, with some texts almost derisively regarding it as something that could potentially give false hope to stroke patients. There has been some investigation into the neural basis of yawning in healthy subjects, with interest in the possible involvement of the mirror neurone pathways, and other regions distant to the motor cortex, including the ventromedial posterior prefrontal cortex. Movement of the paralysed limb during yawning in patients with pyramidal tract lesions, has been suggested to provide evidence for an independent “emotional motor” system, separate to the corticospinal motor tracts. Recruitment of these areas and pathways might provide a potential mechanism for recovery of motor function after stroke, particularly in the arm. There may thus be some potential for somehow utilising arm movements associated with yawning to stimulate upper limb recovery. Another fascinating aspect of yawning, is the common observation that witnessing yawning in others may result in another individual yawning; so called “contagious” yawning. This does not appear to be related to hypoxia or hypercarbia8. Some 42-55% of humans witnessing images of subjects yawning, will yawn themselves and the act of thinking of yawning may provoke yawning. 33% of adult chimpanzees yawned in response to seeing videos of other chimps yawning, possibly inferring advanced self awareness and empathy in this species. It is possible, therefore that yawning could be “evoked”, and thus used as a potential means for stimulating upper limb movements in paralysed patients. The exciting potential could be that yawning could thus be utilised as a neurorehabilitation therapy The primary purpose of the study is determine the incidence of Yawning Induced Movements in stroke survivors. We hope to use this data to guide the development of future studies with the aim of determining if these movements can have an application in the rehabilitation of stroke survivors

AIM: The aim of this randomised controlled study is to investigate the impact, in older adults, of a novel aquatic exercise intervention which optimises the haemodynamic stimulus responsible for improvement in brain blood flow and function. HYPOTHESES: 1. A land-based walking program will improve brain blood flow and function in elderly subjects (>50yrs), relative to a matched but non-trained control group. 2. Water-based walking, involving elevated responses to the circulation when training in water will improve brain blood flow and function to a greater degree than land-walking. 3. Improvement in brain blood flow measures will be significantly related to changes in cognition, memory and clinical measures. RESEARCH DESIGN: The study is a randomised, single-blind controlled trial. METHODS: One hundred fifty healthy, insufficiently active individuals, aged 50 years and older, with subjective memory complaints will be recruited from the community. Participants will be randomised to either a land-based, water-based or non-exercise training group. The exercise groups will attend centre-based exercise sessions 3 times a week for 6 months. The control group will maintain their usual lifestyle and attend 4, one hour centre-based healthy ageing education sessions over the 6 months. Primary and secondary outcome measures will be assessed at baseline, 6 and 12 months. In addition the primary outcomes brain blood flow and peripheral vascular function will be assessed at week 12 during the 6-month exercise training period.

This trial aims to establish the impact of a physical activity and fall prevention intervention compared to an advice brochure on physical activity levels, mobility goal attainment, fall rates, mobility disability, quality of life, fear of falling, mood and community participation in community-dwelling older people. We hypothesise that at the end of the 12 month follow-up period, intervention participants will be more physically active, have fewer falls and improve on measures of mobility goal attainment, mobility disability, quality of life, fear of falling, mood and community participation compared to control group participants.

This project aims to estimate the incidence of preoperative frailty in patients undergoing minor surgery at Peter MacCallum Cancer Centre, and to explore the correlation between preoperative frailty and recovery from surgery. It will also explore the practicality of assessing frailty using the Edmonton Frail Scale in a preanaesthetic environment.

Obstructive Sleep Apnoea (OSA) is a common respiratory disease, caused by collapse of the airway during sleep, which produces oxygen desaturations and sleep disruption. OSA is associated with cognitive deficits, reduced quality of life, and depressed mood. The prevalence of both depressive symptoms and major depressive disorder (MDD) are significantly higher in OSA patients compared to the general community. Currently there is little clinical evidence to support whether treatment of OSA improves depressive symptoms in OSA patients with comorbid depressive symptoms or MDD. The aim of this study is to determine whether CPAP treatment improves depressive symptoms and cognitive functioning over the short and long term. This project is a prospective, randomised controlled trial of an enhanced CPAP treatment program for OSA patients with comorbid MDD and depressive symptoms, compared to a wait list control group, and treatment as usual. This study will provide much-needed clinical evidence of the efficacy of CPAP therapy for improving both depression and cognitive functioning in OSA.

This study aims to investigate if, following anaesthesia-related healthcare interventions, individuals with Mild Cognitive Impairment (MCI) or dementia will suffer cognitive decline at an increased frequency or severity, when compared with a comparable group who do not undergo such interventions. Participants will complete cognitive and memory testing at five time points - once prior to surgery, then 7 days, 3, 12 and 24 months following surgery. Participants in the control group who are not having surgery will complete tests at comparable time points.