ANZCTR search results

Tryptophan, an essential amino acid, acts as a precursor to Melatonin and can influence its synthesis and function. Tryptophan is transported across the blood brain barrier by the same transporters as other large neutral amino acids (LNAA) and has to compete with them to cross the barrier, for its availability. Alpha lactalbumin (ALAC), a whey protein, is a good source of tryptophan and has previously been found to increase the TRP:LNAA ratio up to 130%. This study aims to investigate the dose response effect of ALAC on TRP:LNAA ratio to identify the optimal timing and dosage of supplementation. Participants will be administered 4 different doses in a double blind, counterbalanced, crossover trial. Outcome measures include measuring TRP:LNAA ratio at various time-points, plasma melatonin levels and palatability and preference of the different supplement doses. This study outcome will set precedence for further research using to improve sleep outcomes.

All babies with a diagnosis of HIE who require retrieval for therapeutic hypothermia will be approached by NETS WA and randomised to either servo-controlled cooling or current standard care (cold packs). The primary outcome will be baby temperature in range (33.0 – 34.0 degrees Celcius) on arrival at the receiving unit. Secondary outcomes will look at time to achieving therapeutic temperature, duration of time spent out of range, degrees of temperature fluctuation and safety. We aim to recruit 52 babies in 18-months to assess feasibility, efficacy and safety.

Dementia Australia and Deakin University propose to pilot an artificially intelligent Avatar conversational agent called ‘Talk with Ted’ as a learning tool for aged-care staff capacity development. This project aims to contribute to the aged-care sector’s caregiving workforce capability and capacity by implementing evidence-based learning that leads to scalable and translatable solutions and improvements in service delivery, promotes the adoption of technology, and ultimately leads to an improvement in the quality of care experienced by those living with dementia. The project aims to address the following questions: a) Does Ted promote caregivers’ understanding of the impact of positive communication on a person living with dementia? b) Does interaction with Ted influence caregivers’ communication with a person living with dementia? c) What are caregivers’ perceptions of the feasibility of use of Ted in the residential aged care setting? d) What are caregivers’ perceptions of the feasibility of the implementation process? Findings from this study will inform implementation and methodology, including sample size calculations, for a definitive effectiveness study in the future.

AFLUENT is a pragmatic, investigator initiated, open label, randomised, pilot clinical trial that will be undertaken within the Cardiology department at Royal Perth Hospital. This trial will compare an intervention of “early” routine influenza vaccination of patients diagnosed with acute myocardial infarction within one week of the event, to “standard care”, where patients will be advised to seek their influenza vaccination in the community at their own discretion with guidance from their primary care physician. As per guideline recommendations, it is specifically recommended that “high risk” cardiac patients such as those within this study population receive their influenza vaccination in the community prior to the onset of “flu season”. However, enrolment of trial patients into AFLUENT will occur all year round, regardless of whether it is “flu season” or not. It is anticipated that patients within the “standard care” group may delay their vaccination or not receive it at all. Thus, the trial is testing a strategy of routine early administration to all patients in the intervention group, with currently recommended strategy whereby patients are encouraged to access vaccination in the community but often do not. The likely failure of many control patients to seek vaccination plus the inevitable delay in doing so are fundamental to the design of this trial.

This study will ask families who have experienced the unexpected death of a child in PICU about their experience of and their thoughts about bereavement care. The aim of PICU care is to help children to survive serious illnesses and injuries, but unfortunately not all children survive. For those who die unexpectedly, the experience for their family can be very traumatic. These families may struggle to understand what happened in the last moments of their child’s life, and why the efforts of doctors and nurses to save them were not successful. This may make it harder for these families to process their grief in a healthy way and may contribute to conditions such as post-traumatic stress, complicated grief, and problems in the way the family functions. The best way to support families after the unexpected death of a child is currently not well understood, with most research and resources focusing on expected deaths such as cancer. In the case of expected deaths, there is usually time to plan and partner with families, and there are specialist services such as palliative care available to provide support. The experience of families who lose a child unexpectedly can be quite different, and so a different approach is needed. This study will use focus groups and family interviews to ask close relatives of children who have died an unexpected death in PICU about the bereavement care they received, the gaps in care, their perceived bereavement care needs, and their recommendations for PICU bereavement care. The results will be used to design an experimental PICU bereavement service to be implemented as the intervention in Phase Two of the FOOTPRINTS project.

NSW Health smoking cessation policy is evidence-based, yet poorly implemented. We are funded to roll out a TRANSLATE (TRAining in evideNce-baSed ImpLementATion for hEalth) (TRANSLATE- cessation (Tc) implementation intervention in randomly selected hospital wards of three LHDs as part of a quality assurance activity. Random selection aims to distribute limited resources in a fair manner and provides an opportunity to examine the efficacy of the Stop Smoking Start Living (S3L) bundle in intervention (Tc + S3L) versus control wards. The qualitative experience of patients from high-risk populations (HRPs) in intervention wards will be examined. HRPs include women who smoke during pregnancy, people with mental illness, people with diagnoses of drug and alcohol abuse/dependence and Aboriginal and Torres Strait Islander people. Sub-studies include: 1. Effect of Tc on health care professional behaviour. 2. Effect of Tc and S3L on patient smoking behaviour. 3. Qualitative experience of HRPs with the S3L treatments.

More than half the people living in Australia do not exercise regularly, an issue even more acute for adults with cerebral palsy (CP). CP is a condition that affects motor control, skill, and coordination. There is an association between the severity of CP and the presence of additional health and psychosocial issues leading to greater complexity of the condition. People with complex CP have more difficulty achieving the recommended amounts of physical activity. Adults with complex CP have rarely been included in research, particularly studies relating to exercise. Most CP research has focused on children and young adolescents with less complex CP (i.e., those who are ambulant). It is often hard for people with disabilities to exercise because of difficulties accessing places where there are opportunities to be active. In addition, they might not have the right support. The FitSkills program was created to address this issue. FitSkills matches people with disabilities and health students (Nursing, Occupational Therapy, Exercise Science) to exercise together in a gym environment. Studies have shown that FitSkills can engage youth with disabilities in community-based exercise. With additional support, including screening, risk assessment, and additional professional support for the peer-mentor health student, FitSkills can be tailored for young people with complex disabilities. Our project examines how well FitSkills can be implemented in a real-world setting for adults with CP who use wheeled mobility (i.e., wheelchair, frames). In this study, we want to see if we can implement an intervention that has the potential to help younger adults with CP improve their health, well-being, and ability to participate in activities that are meaningful to them. So far, our work has reviewed the findings of existing research and has explored the experiences of adults with CP to learn more about what they want and need to exercise in their communities. From the adult’s perspective, it is important they can access the community and be seen by the community. Our next step is to test the feasibility of FitSkills. We aim to ensure it can be implemented and is practical and acceptable for adults with CP who use wheelchairs using elements of an evidence-based feasibility framework.

A retrospective clinical audit of patients admitted with rib fractures will provide a district wide summary of inpatient rib fracture management. This audit will assess patterns and outcomes of patients admitted with fractured ribs, and patterns in any complications the patients experienced. The audit has the potential to contribute to the body of evidence in the management of patients with fractured ribs. Pain management is a common priority when it comes to the management of patients with fractured ribs. Trends and patterns of analgesic use will provide insight into the current trends of pain management provided to patients with fractured ribs. Foreshadowing future complications from patients with fracture ribs will help refine the current management, pathways, and guidelines for rib fracture management.

Depression and insomnia are important and related public health problems for young people. The recommended treatment for insomnia is Cognitive Behavioural Therapy for insomnia (CBTI). CBTI programs are known to effectively reduce symptoms of depression without directly targeting non-sleep symptoms. However, the mechanisms which underlie the association between insomnia and depression are not well understood. Many candidate mechanisms have been proposed (e.g., cognitive biases), yet, there is a lack of research which investigates these possible mechanisms, and data from treatment studies is greatly needed to investigate the causal role of these mechanisms in the association between insomnia and depression. This randomised controlled trial aims to investigate what psychological mechanisms explain how digital cognitive behavioural therapy for insomnia improves depression in young people. It is hypothesised that the group who receive the brief CBTI program will display greater improvement in symptoms of depression and insomnia, and a greater change in mechanisms thought to underlie the association between depression and insomnia symptoms, compared to the group that receive education (waitlist control).

This study is designed to evaluate the tolerability, safety, and pharmacodynamics of KER-012 in combination with current background therapy at a stable dose in participants with heart failure. Background therapy will be defined by the investigator as appropriate. HF background therapy treatments will be provided by the treating physician based on local treatment guidelines and must remain stable throughout the study. If a participant is observed to show disease progression requiring additional therapy, the participant should receive standard HF treatment following locally relevant guidelines. This study will enroll a total of 12-16 heart failure patients with either preserved or reduced ejection fractions for subcutaneous injections with KER-012 every 4 weeks. Heart Failure is associated with increased activin receptor type II signalling. KER-012 is designed to bind to activins and thereby, potentially reduce activin receptor type II signalling. Therefore, it is anticipated that KER-012 could potentially improve the underlying pathology of heart failure.