ANZCTR search results

Atrial fibrillation (AF) is the most common heart arrhythmia affecting at least 240,000 Australians. Prevalence rises with age from approximately 1% of the whole population to 5% in those over 65 years. People with AF are up to seven times more likely to have a stroke than the general population, and AF related strokes are also likely to be more severe. In addition, one in every six strokes is AF related. Stroke is highly preventable in AF with the use of appropriate thromboprophylaxis. Therefore early identification and appropriate evidence based management of AF could lead to subsequent stroke prevention, significant reduction in the overall stroke burden and substantial savings to the health system. Our hypothesis is that a simple community pharmacy based screening program may be effective in detecting those with undiagnosed AF. The specific aims are to: 1. To identify the number of newly identified AF in people aged 65 years and over in a pharmacy setting. 2. Determine the feasibility of screening for AF using a pulse check and handheld singlelead electrocardiography (ECG) device in people aged 65 years and over. 3. Inform refinement of the intervention through the use of process measures with view to establishing a larger crosssectional study. 4. To increase the skills and knowledge of pharmacists regarding atrial fibrillation screening and management. We propose a crosssectional study offered in 10 community pharmacies in the districts surrounding the Concord Hospital. People aged 65 and over, attending community pharmacies will be invited to volunteer for the screening. The screening will consist of a pulse check, brief medical history including pharmacotherapy and screen of AF symptoms and an assessment with a handheld singlelead ECG device. The pharmacist will communicate the provisional diagnosis to the participants treating general practitioner (GP). For those participants suspected of having AF, the research team will contact the both the participant and their GP. We will invite the GP to refer their patient to Concord Hospital cardiology clinic for definitive diagnosis and standard cardiology care as appropriate. The primary outcome measure will be the number of newly identified atrial fibrillation in a community cohort aged 65 years and over. A process evaluation will also be undertaken to better appreciate factors that might influence sustainability beyond the trial setting.

People with bipolar disorder (BD) experience recurrent, extreme highs and lows in mood, which can severely affect their health, career and relationships. BD can often be effectively treated with long-term mood stabilizer (MS) medications. Unfortunately though, MS medications can cause birth defects and complications if taken during pregnancy. If women with BD stop taking MS medications during pregnancy however, they run a very high risk of relapse, and unstable maternal mental health during pregnancy is associated with poor outcomes for both mother and child. In this study, we aim to determine if a natural dietary supplement (omega-3 fatty acids), which is safe for both mother and baby, has the potential to offer women with bipolar disorder an effective alternative to MS medication during pregnancy. Long-chain omega-3 fatty acids (LC-omega-3 FA) comprise a family of essential nutrients which have a variety of vital actions in the body. In particular, LC-omega-3 FA have important effects on brain development and function. Recent studies indicate that LC-omega-3 FA supplementation can affect mood, particularly to reduce depression. In this project, we will undertake a clinical trial to evaluate the efficacy of LC-omega-3 FA supplementation to reduce the occurrence of mood episodes in bipolar women who discontinue their use of MS medication during pregnancy.

Do you worry a lot about the possibility of cancer recurrence? Does this worry affect your life? Almost all cancer survivors worry from time to time about the possibility of their cancer returning. For some people these fears are frequent, very distressing and make it hard to enjoy life. If you suffer from frequent or severe worry about the possibility of your cancer coming back, and it is getting in the way of how you wish to lead your life, you may be interested to join a research study comparing two different psychological treatments to help people to better manage fear of cancer recurrence. Hospitals around Australia are conducting the study together with a team of researchers from the Psycho-Oncology Co-operative Research Group at the University of Sydney, led by Prof Phyllis Butow. Am I eligible to be involved in this study? We are seeking people over the age of 18 years who: 1) Have been diagnosed with stage 0-III breast cancer, stage I-IIIA colorectal cancer, or stage IA-IIB melanoma; 2) Have completed hospital-based treatments (surgery, chemotherapy, or radiotherapy) more than 2 months and less than 5 years ago; 3) Have no medical evidence of active cancer; 4) Can speak and read English well; 5) Experience a high level of worry about their cancer coming back What does this study involve? If you decide to participate in the study, you will receive a psychological treatment focused on either the more physical (tension) aspects or the more mental (worry) aspects of fear of cancer recurrence. Which treatment you get, will be decided randomly (by chance). Both treatments will be provided free of charge and will involve attending five individual sessions with a psychologist or psychiatrist, each lasting 60-90 minutes, over a period of 10 weeks (one session per fortnight). You will also be asked to practice some of the techniques you learn during the sessions at home. In addition to attending treatment sessions, you will be asked to complete a questionnaire to evaluate how well your treatment is working at four time-points: 1) before treatment; 2) immediately after you complete treatment; 3) 3 months after you complete treatment; and 4) 6 months after you complete treatment. You may also be invited to participate in a 30-minute phone interview about your experience and satisfaction with the treatment you received. Where do I find more information? If you are interested in being involved or to find out if you are eligible please contact the research co-ordinator (Stephanie Tesson) at the University of Sydney by phoning 02 9351 4518 or emailing conquer.fear@psych.usyd.edu.au This study has been approved by the Human Research Ethics Committee South Eastern Sydney Local Health District (SESLHD)

Single-centre, randomised-controlled trial with a comparison of two protective ventilation techniques in order to determine the effect on the incidence of acute lung injury/ischaemia-reperfusion injury. Primary aims: 1. To determine the incidence and severity of acute lung injury post lung transplantation. 2. To determine the incidence of inflammatory markers in serum and bronchoalveolar lavage samples during anf after lung transplantation 3. To analyse the association between inflammatory markers and acute lung injury 4. To determine whether there is a decrease in the level of inflammation and incidence of acute lung injury associated with pressure-controlled, high positive end-expiratory pressure and alveolar recruitment Secondary aims: 1. To determine whether further protective ventilation techniques should be incorporated into lung transplantation anaesthesia. Hypothesis: Pressure-controlled ventilation and high positive end-expiratory pressure with the addition of alveolar recruitment will be more beneficial in minimising acute lung injury than low tidal volume protective ventilation alone in lung transplantation after allograft insertion.

We aim to investigate the effect of the drug hyaluronidase on the efficacy of ultrasound-guided fascia iliaca compartment block (FICB). Hyauluronidase is a naturally occurring enzyme that it available as a drug. It possesses spreading properties and it is used as a pharmaceutical agent to facilitate the dispersion of drugs and other substances. It has been proven to be effective in enhancing ocular regional anaesthesia but it has not been adequately studied in peripheral regional blockade. FICB is a safe and effective method of lumbar plexus regional anaesthesia. The goal of FICB is to provide femoral nerve, lateral cutaneous nerve of the thigh and obturator nerve block. While the femoral nerve and lateral cutaneous nerve of the thigh are reliably blocked by FICB the overall success rate of the block is limited by obturator nerve anaesthesia which is successful in only ~44% of ultrasound guided FICB - presumably due to the distance the local anaesthetic must traverse from its site of infiltration to reach this nerve. We hypothesise that adding hyaluronidase to a plain 0.5% ropivacine local anaesthetic solution will increase the success of FICB - chiefly the proportion of patients achieving obturator nerve anaesthesia (weakness of thigh adduction). We will also study effects on the speed of onset and blood levels of co-administered local anaesthetic. An improvement in the success of FICB should improve post-operative pain after knee replacement. If proven, there may also be other peripheral nerve block procedures that may benefit from the addition of hyaluronidase.

This study aims to conduct a feasibility trial to test the efficacy of a Personal Financial Incentive (PFI)-based intervention at increasing smoking cessation in pregnant women attending a public hospital for antenatal care. Ninety consenting women will take part in the trial, with 30 women being randomised into one of three groups: the control group, the small PFI group and the larger PFI group. Women in the intervention groups will be eligible to receive a total of eight PFIs, if they successfully abstain from smoking for a 7 day period. Each time a participant in the intervention groups abstains from smoking their PFI will increase. As this is a Proof-Of-Concept study the main aim of the trial is to assess the viability and acceptability of this intervention.

Intake or phone counsellor screening occurs already though these services, for presenting issues and risk. These services will identify appropriate referrals during their routine service provision to identify parents who might be eligible and benefit from the programs. The identified potential participants will then be given the telephone contact number for the clinical intake worker on our research team. The intake worker will administer a standardized interview assessing the inclusion and exclusion criteria, and other important clinical information. Participants who are referred and screened but do not meet criteria for the programs will be offered suitable alternative referrals.

Supplemental oxygen (O2) is the delivery of O2 when a person experiences O2 desaturation during activity. The use of supplemental O2 during exercise training for people with chronic obstructive pulmonary disease (COPD) is prescribed inconsistently and requires scientific evaluation. Since COPD is the second leading cause of avoidable hospital admissions and there are 47 percent of people with COPD referred to pulmonary rehabilitation who demonstrate O2 desaturation during exercise, whether to use supplemental O2 during exercise training is a substantial issue. Aim and Hypothesis: To determine whether supplemental O2 in people with COPD who desaturate during walking-based exercise provides greater benefit in exercise capacity and health-related quality of life than medical air. Exercise training with supplemental O2 will increase exercise capacity and health-related quality of life more than exercise training with medical air in people with COPD who desaturate during walking-based exercise. Design: This study is a national, multi-centre study where 110 participants with COPD will be recruited from sites in NSW, VIC, QLD, and WA. A prospective, double-blind, randomised controlled trial design will be used with COPD participants randomised into one of two groups: 1) receive intranasal cylinder O2 throughout exercise training (O2 group) or 2) receive intranasal cylinder medical air throughout exercise training (Air group). Participants will be asked to complete exercise tests and questionnaires at baseline, on completion of exercise training and at six month follow-up. This research will provide the first substantial and robust evidence regarding the role of supplemental O2 during exercise training for people with COPD who desaturate during exercise.

This clinical trial is designed to test whether oral corticosteroids are effective in treating children of pre-schol age presenting with wheeze associated with viral upper respiratory tract illness.

Approximately 5-10% of newly born infants receive assistance in the delivery room to establish regular breathing. Healthcare workers provide artificial ventilation using a manual ventilation device and a face mask to fit around the infant’s nose and mouth. Several factors can reduce the effectiveness of mask ventilation. These include poor face mask application resulting in leak or airway obstruction and spontaneous movements of the baby. Airway obstruction may be due to inadvertent manual compression of the soft tissues of the neck, tongue and thus the trachea, or hyperextension or flexion of the head. In addition, if the face mask is held on the face too tight, it may obstruct the mouth and nose. Using a simple device such as an oropharyngeal airway may reduce the prevalence of obstruction during mask ventilation and lead to more effective mask ventilation. This randomized trial is investigating whether for newly born infants requiring positive pressure ventilation in the delivery room, does the use of an oropharyngeal airway with a face mask reduce the degree of airway obstruction compared to using a face mask alone. Physiological recordings of the resuscitation will be made measuring delivered and expired tidal volumes, prevalence and degree of airway obstruction as well as oxygen saturations and heart rate. Data will also be collected and compared between the groups on common neonatal morbidities including duration of assisted ventilation in the nursery.