ANZCTR search results

The relative effects on V/Q matching in the lung of modern inhalational anaesthetics such as sevoflurane have not been compared with those of the intravenous agent propofol. There are potentially important implications for the management of patients with reduced lung function undergoing surgery.

This pilot study aims to evaluate the feasibility of conducting a large scale multicentre RCT in paediatric intensive care, comparing current sedation practice with a dexmedetomidine based sedation regimen that minimizes benzodiazepines.

This study aims to determine if a specific, one-day education program delivered to allied health and exercise professionals in a workshop format and access to internet-based support materials, results in increased prescription of evidence-based exercises designed to prevent falls in older people. Secondary aims are to determine if the education program results in an increase in the proportion of exercise prescription strategies used in the past month that comply with evidence-based fall prevention guidelines and if fall prevention knowledge increases after three months. We hypothesise that the intervention group participants will prescribe evidence-based fall prevention exercise to a higher proportion of their older clients during the follow-up period than the control participants and that they will prescribe a higher number of evidence-based fall prevention exercises and will perform better on an assessment of fall prevention knowledge at three months follow-up compared with control participants.

Evidence is now emerging to suggest that lifestyle factors, namely physical activity and cognitive stimulation could provide a cost-effective and relatively simple means of protecting the brain against age-related cognitive decline and dementia. This hypothesis can generally be described as a “use it or lose it” philosophy. However, it is unclear which forms, intensity and frequency of physical activity provide the most benefit. Similarly, the optimal level and form of cognitive stimulation remains to be determined. To date, very few intervention studies have demonstrated improvement through standardized tests of memory and cognition (neuropsychological tests) and none have used blood biomarkers as part of the assessment criteria. Therefore, this study is specifically designed to determine whether a home-based lifestyle intervention program, involving physical activity or cognitive stimulation alone, or in combination, can provide measurable improvements in cognition and AD-related blood biomarkers amongst the healthy, community-dwelling elderly. 200 male and female participants aged 60 to 85 will be recruited into 4 intervention groups: physical activity alone, cognitive stimulation alone, physical activity and cognitive stimulation combined or a control group. The intervention period for all of the groups will last for 16 weeks. Participants will be monitored closely throughout the intervention period and assessed at baseline (pre-intervention), during the intervention at 8 weeks and at 2 post-intervention time-points (16 and 52 weeks). The assessment criteria include a battery of neuropsychological and clinical tests and measurement of AD-related blood biomarkers. 20% of participants will undergo a brain imaging scan and body composition analysis to assess the effect of the intervention on brain activity and changes in fat and lean body mass. This project will provide greater insight into the mechanisms underlying the protective effect of physical activity and cognitive stimulation on brain function. The project will also directly assess and compare the efficacy of home-based intervention strategies on a wide range of parameters. Should the interventions prove successful, this study could then be expanded to include a greater number of participants and assess multiple strategies with the ultimate aim being the development of a public health strategy for the prevention/delay of cognitive decline.

Type 2 Diabetes (T2DM) is a significant risk factor for dementia in older people, and vascular disease may underlie this relationship. Greater physical activity is associated with better brain function and is also recommended for people with T2DM to reduce cardiovascular risk. However, it is currently unknown as to whether an exercise intervention can preserve or improve brain health in people with T2DM. The aim of this project is to examine the efficacy of a six month structured exercise program in preserving brain health in late middle aged people with T2DM, and evaluate whether this occurs by improving vascular health. This will be done by using MRI scans to measure brain perfusion and structure, sophisticated measures of large and small artery health, and cognitive function before and after the intervention.

Parastomal hernias represent a significant morbidity for patients who require permanent stomas. Furthermore, they occur in up to 50-80% of these patients, resulting in a significant societal burden. The use of mesh is now standard surgical practice for the repair of all types of hernias, including parastomal hernias. However, repairing parastomal hernias can be very complex, and often carry their own complications such as enterotomies, prolonged ileus, recurrence, mesh infections, and fistula formation. As such, given the high rate of parastomal hernias, there has been increasing interest in using mesh at the time of stoma formation to prevent this complication. Biologic mesh represents a promising solution to this problem. Biologic mesh has been shown to be an effective tool in hernia repair, without the infection and erosion complications associated with synthetic permanent meshes. A single initial study has been promising, demonstrating similarly low hernia rates as with synthetic meshes. However, questions still remain about whether the added costs associated with expensive biologic meshes can be offset by these potential reductions in patient morbidity. This primary aim of this study is to determine the effectiveness of using biologic mesh at the time of formation of a permanent stoma in the prevention of parastomal hernias. The hypothesis is that the Surgisis (Registered Trademark) biologic mesh will reduce rates of parastomal hernia in patients. Secondary aims of this study include the assessment of any complications arising from this technique, as well as to assess the cost effectiveness of using biologic mesh over the study period.

The FNQHAT is a pragmatic randomised controlled trial which aims to reduce avoidable hospitalisations and Emergency Department visits for ‘frequent flyer’ adults with diabetes, cardiovascular disease, renal disease and chronic obstructive pulmonary disease. The primary objective is to improve primary health care-level chronic care processes (such as benchmarking, care planning and guideline concordance) and also patient outcomes (such as clinical indicator change, avoidable hospitalisations and ED visits and disease progression). FNQHAT is funded through the Queensland Department of Health’s Health Innovation Fund (HIF) as a joint project between the Cairns and Hinterland Hospital and Health Service (CHHHS) and James Cook University (JCU) Centre for Chronic Disease Prevention in Cairns. The CHHHS Sponsor is Dr Neil Beaton and the JCU lead is Professor Robyn McDermott. The study aims to recruit up to 530 “frequent flyers” over a 12-24-month period. People with chronic disease who have been identified as visiting one of the three participating hospitals in FNQ (Cairns Hospital, Innisfail Hospital and Mareeba Hospital) will be recruited. At least 25% of participants are expected to be Aboriginal or Torres Strait Islander and therefore the project will be undertaken in collaboration with the relevant Aboriginal Medical Services, WuChopperen in Cairns, Mamu in Innisfail and Mulungu in Mareeba. The study will compare usual best practice for managing chronic disease in the community (referral to GP) with close case management of clients in addition to usual best practice care. The study will also be trialling software which can connect to both the hospital and primary health care information systems. This will enable the use of a single patient record by the whole care team and will assist in communication between different health services, generating patient management plans and reporting on clinical care processes and measures. A Clinical Governance Group will also be established to oversee provision of care provided to participants and a Data Safety and Monitoring Group will monitor data quality and adverse events and to ensure participant safety throughout the study. Potential patients for the trial will be identified from EDIS and HBCIS data in participating hospitals according to the following eligibility criteria: (1) Had 8 or more presentations to the ED and/or hospitalisations in the previous 12 months for a potentially preventable hospitalisation (2) Aged 18-75 and reside within the area of a participating site. (3) Have at least one chronic condition identified (diabetes, cardiovascular disease, renal disease or chronic obstructive pulmonary disease).

This study aims to determine whether adding the drug, Tocilizumab, to standard transplant immunosuppression is safe and effective at preventing acute graft versus host disease (GVHD). You may be eligible to join this study if you are aged between 18 and 65 and are undertaking an HLA-mismatched allogeneic haematopoietic cell transplantation (HPCT). Trial details all participants inthis trial will receive a single dose of 8mg/kg Tocilizumab by a 60 minute intravenous infusion (administered via the vein). This will occur one day before your HPCT. Participants will be assessed for up to 2 years to determine the incidence of GVHD.

Delirium occurs commonly in hospitalised older patients and is frequently under-diagnosed and mistreated. There are two major shortfalls in Emergency Department (ED) care related to delirium: failure to diagnose and treat already established delirium, and failure to prevent the development of delirium. This study will test whether a screening process we have developed to identify delirium risk, coupled with the use of diagnostic and preventative measures in the ED and during hospital admission, will address these shortfalls.

To determine the feasibility and efficacy of 3 months of self-management support for increasing physical activity in people with mild disability after stroke