ANZCTR search results

The key clinical and psychosocial outcomes of our current, physician-led, multi-disciplinary CKD clinic (M-DCKD clinic) can be sustained by transitioning to a nurse-led, multi-disciplinary CKD clinic. Furthermore, while CKD patients will be reviewed once in the nephrologist-led clinic compared with 2 times in the nurse-led clinic, we propose that the nurse-led M-DCKD will be more economically viable. Aim: To test the above hypothesis in a randomised controlled trial of stage IV-V CKD patients attending a single physician-led multidisciplinary team outpatient clinic compared with attending multiple visits at a nurse-led multi-disciplinary team outpatient clinic. The key clinical outcomes are derived from clinical key performance indicators as well as psychosocial and economic analyses.

Research suggests that psychotherapists tend to report higher levels of work-related stress- and burnout- spectrum conditions than many other occupational groups. Work-related stress has serious implications for the mental and physical well-being of psychotherapists, and may lead to professional impairment, thus compromising the provision of care. As a result, researchers have highlighted the importance of identifying variables that (a) enhance psychotherapists’ psychological wellbeing and resilience to stress; and (b) are capable of development through training. In particular, it has been argued that the development of interventions to improve resilience and psychological health amongst trainee psychologists is of paramount importance, given the elevated levels of stress amongst this sub-group. Recent research suggests that self-compassion is a promising construct for psychotherapists in terms of its ability to promote psychological well-being and resilience to stress; however, the potential benefits of self-compassion are yet to be thoroughly explored amongst this occupational group. Study One will involve conducting a cross-sectional, correlational study of self-compassion amongst practising psychotherapists (including trainees), and using Structural Equation Modelling to explore the relationship between self-compassion and stress, as well as the potential mediating role of happiness and emotion regulation in this relationship. In Study Two, a randomized controlled trial will be conducted to investigate the utility of a self-guided, self-compassion-based intervention delivered via the Internet for increasing self-compassion, and promoting psychological well-being and resilience to stress amongst postgraduate trainee psychology students currently engaged in clinical work.

Vitamin D deficiency is common in patients with chronic kidney disease and has been associated with increased risk of heart disease and death. Correcting vitamin D deficiency may improve risk for heart disease through its effects on blood vessel, immune and bone cell function. Stiffness of the arteries (arterial stiffness) is associated with increased risk of heart disease and can be measured using simple non-invasive methods. The effect of vitamin D replacement on arterial stiffness has not previously been studied in patients with kidney disease. This study will examine the effect of vitamin D, a commonly used over-the-counter medication, compared with placebo (“dummy tablet”) on blood vessel function in people with moderate to severe chronic kidney disease who are vitamin D deficient. In this study, you will be randomly assigned (”like flipping a coin”) to take either vitamin D or placebo (1 tablet monthly) for 6 months. If at 3 months, your vitamin D levels remain low, you may need to take the study medications every 2 weeks till the end of the study. Both the vitamin D and placebo medication will be supplied by a specialist compounding pharmacy with a state of the art compounding laboratory and is accredited by the Pharmacy Guild of Australia as a quality care pharmacy and as such operates under a quality care program. If you enter the full study, you will have blood tests and blood vessel function studies before you start and after you complete the study medication. During the study, you will not know which treatment you are on. Your other medications will remain constant. The study requires you to attend the Research Unit at Sir Charles Gairdner Hospital 4 times over a 6-month period.

This study aims to determine the safety and efficacy of treatment with the drug Sorafenib, in combination with intensive chemotherapy for adults with previously untreated acute myeloid leukaemia (AML). Who is it for? You may be eligible to join this study if you are aged between 15-65 years and have been diagnosed with AML with FLT3-ITD mutation. You must have received no previous treatment for AML. Trial details All participants in this trial will undergo intensive chemotherapy over a period of minimum twelve months. Participants will be randomly (by chance) allocated to one of two groups. One group will receive the oral drug Sorafenib whilst undergoing chemotherapy and for a period of 12 months afterwards. The other group will receive a placebo (inactive) treatment in conjunction with chemotherapy. Participants will not know which group they are in until completion of the trial. Participants will be assessed at regular timepoints for a period of up to 5 years to determine the safety and clinical benefit of Sorafenib treatment in combination with chemotherapy. Treatment Duration will be a minimum of 1 year. This Phase II study will: Investigate the clinical benefit of frontline Sorafenib in combination with chemotherapy and during maintenance therapy in adult AML Optimise the dosing schedule of Sorafenib based on the kinetics of circulating FLT3 ligand levels after chemotherapy Investigate the clinical benefit of Sorafenib in relation to additional molecular AML lesions Identify pharmacokinetic and pharmacodynamic correlates of response predictive of treatment outcome.

Female pelvic organ prolapse, which is a protrusion of vaginal walls beyond the hymen, is both common and have a high burden of suffering. The traditional operation to treat post hysterectomy vaginal apical prolapse has been either abdominal sacrocolpopexy or vaginal sacrospinous fixation. Although the abdominal approach comes with a greater cure rate, it has a longer operating time, longer return to Activities of Daily Living and costs more than the vaginal approach. Modern advances involve the development of minimally invasive procedures which included a laparoscopic approach to abdominal sacrocolpopexy and also the introduction of vaginal mesh kits which provides better success rates when compared to the traditional vaginal operation, although not without its own sets of operative morbidity. These procedures involve inserting synthetic material anchored to the sacrospinous ligament to provide reinforcement and support to the vagina following its repair. Anterior Elevate is a new mesh kit which utilises a standard synthetic mesh using a surgical approach (anterior sacrospinous) that has been well established since 2001. The purpose of this project is to evaluate the success of Anterior Elevate vaginal mesh support or laparoscopic sacrocolpopexy in the treatment of women with vaginal apical prolapse.

This project is a prospective registry which is designed to evaluate the contemporary patterns of care for patients who are admitted to hospital with an acute coronary syndrome (ACS) in Australia and New Zealand. More than 400 centres that treat ACS patients will participate and the researchers expect to enrol approximately 4,000 patients over a 2 week period. The main objective of the registry is to provide a greater understanding of the management and health outcomes of patients across the full breadth of hospitals in both countries. Information on the clinical characteristics, the in-hospital investigations and management patterns will be collected. This will be compared to guidelines for recommended practice. These data will inform future strategies to improve ACS care within Australia and New Zealand.

Samll pilot cross over study comparing two differen tmean arterial pressures in patient having cardiac surgery

Background Asthma is a huge social and economic burden on our community. Acute exacerbations of asthma are linked with worse lung outcomes for children. In school aged children a risk for acute exacerbations include viral infections, which occur mainly in winter, and allergy. A drug called omalizumab may help prevent acute exacerbations by damping the allergy response. Aim We want to see if omalizumab will decrease the number of children with asthma having an acute exacerbation.

This study will assess whether cereals can improve mineral bioavailability in postmenopausal women.

This RCT compares the efficacy of a 2 session enhanced BMI (Quik Fix) compared to assessment/information (AI/F) only control, among young people with cannabis/alcohol use and high levels of psychological distress. It was hypothesized that Quik Fix would result in significantly larger reductions on the primary outcome variables of psychological distress and alcohol/cannabis use. It was also hypothesized that Quik Fix would result in significantly larger improvements on the secondary outcome variables of motivation to change alcohol/drug use, the severity of mental health symptoms and alcohol/cannabis use and functioning.