ANZCTR search results

Gastric emptying (GE) is believed to be a potential mechanism causing individual differences in insulin requirements. However, the role of GE in personalising diabetes management is not well understood, and feasible ways to assess GE in children with T1D in a clinical setting are needed. This project aims to study GE in adolescents with type 1 diabetes (T1D) to examine the relationship between GE and blood glucose levels (BGLs) after eating a mixed meal, and to determine if continuous glucose monitoring (CGM) can be helpful in identifying rates of individuals GE. Thirteen T1D participants using a hybrid close loop system (HCL) will consume a standard meal, and both GE using the breath test technique, and BGLs will be monitored over the subsequent 4 hours. Changes in glucose levels will be monitored by CGM and regular blood sampling throughout the study. CGM traces will be assessed in its potential to use as a marker of GE. The outcomes will provide important information about GE characteristics in young people with T1D and its potential to optimise current strategies of insulin delivery.

The Methylphenidate in Children with ADHD+Autism (MICAA) Trial will use N-of-1 trial methodology to individually test the effectiveness of MPH-IR in ~40 children (aged 6-15 years) with ADHD+autism. Participants will include children who have been taking a stable dose of MPH-IR for at least one month prior to trial enrollment. The children will cycle through 12 randomised weekly periods of “on” (MPH-IR) or “off” (placebo) medication, with allocation concealment. There will be weekly monitoring of primary outcomes (ADHD symptoms), and secondary outcomes, including autistic traits, functional behaviour, emotion regulation, anxiety and medication side effects. Study findings will identify those children who are not responding to their prescribed medication, prompting a review of treatment decisions.

Anorexia nervosa (AN) is a serious psychiatric condition with high morbidity and mortality, for which existing treatment paradigms demonstrate suboptimal therapeutic efficacy and duration of treatment effect. Through the repeated application of focussed electromagnetic energy, Repetitive Transcranial Magnetic Stimulation (rTMS) can modulate cortical neural activity and connectivity downstream, along the brain circuits that the cortical target is connected to. rTMS has the added benefits of being non-invasive, has high degrees of patient acceptance and tolerability, as well as being relatively economical to apply. As an evidence-based treatment for depression, rTMS has received little research attention in AN. Clinical trials to date indicate therapeutic optimism, particularly in relation to subjective anorexia-related experiences and comorbid mood, anxiety, stress, and quality of life symptoms. This study protocol proposes the conduct of a single-site, proof-of-concept, open-label trial to evaluate if this individualised rTMS targeting and stimulation approach is effective in improving the low body mass and psychological symptoms in anorexia nervosa from baseline to the end of week 4, and the durability of these effects at 6- and 12-month follow-up.

This study aims to investigate the feasibility of utilising a smartphone app (Oto) in tinnitus management as determined by trial acceptability, deliverability, and effectiveness. Oto is a novel multimodal app-delivered approach to tinnitus available for iOS and Android. It combines patient education, cognitive behavioural therapy (CBT), relaxation, mindfulness, and sound therapy in a customisable package. Oto has received Medicines and Healthcare products Regulatory Agency (MRHA) certification as a Class 1 medical device in the UK. We hypothesise that the utilisation of Oto in tinnitus management is feasible and deliverable. This study will also test the hypothesis that the use of Oto will significantly reduce tinnitus severity compared to receiving no tinnitus intervention.

This prospective comparative trial embedded in population-based screening, at Maroondah BreastScreen, Eastern Health, will examine screening outcomes of hybrid digital breast tomosynthesis/mammography compared to digital mammography screening (standard of care) in women presenting for routine breast screening. Who is it for? You may be eligible to join this study if you are a woman aged 40 years or above and are attending a BreastScreen service at Maroondah BreastScreen. Study details Current standard of care for breast screening is bilateral two-view (MLO and CC) digital mammography screening which represents 2-dimensional (2D) imaging. Intervention in this study is digital breast tomosynthesis (DBT, quasi-3D-mammography) acquisition for the MLO view only (2D-mammography images will be reconstructed from the DBT to provide synthetic 2D). Standard digital mammography will be acquired for the CC-view. This is referred to as ‘hybrid tomosynthesis/mammography’ screening or the ‘intervention screen’ in this trial. Other aspects of screening and assessment, and any required follow-up, will be based on standard BreastScreen protocols and quality assurance processes. The trial will assess initial detection measures (cancer detection, and recall for further testing) as well as outcomes at follow-up (to determine interval cancer rates).

This project will be built upon a recently published systematic review that the project investigators have conducted. This study is being completed as part of Dr Sachin Kulkarni’s Doctor of Philosophy (PhD) program at Griffith University. Purpose of the study: To determine the efficacy of Photobiomodulation on providing anaesthesia of teeth. Fear of dental aesthetic injection can produce anxiety and contribute to dental phobia. Recently, other methods have been studied for their effectiveness to produce anaesthesia. One such method is known as Photobiomodulation. The purpose of this study is to utilise laser to assess where the sensitivity of the nerve inside the tooth reduces. Public: The purpose of this study, or hypothesis, is that the laser devices should produce some amount of pain relief as tested with a commonly used dental nerve testing device.

The aim of this study is to evaluate the impact of Smart-HF (a mHealth platform) on reducing readmission to hospital and other secondary outcomes. The Smart-HF platform is an app for the patient that delivers educational information, goal-setting, homework tasks, self-monitoring and questionnaires to patients with heart failure, and allows patient progress and outcomes to be measured via a clinician portal. Participants are patients admitted to the general or cardiology wards with Acute Decompensated Heart Failure (ADHF). Enrolled patients classified with a high risk of hospital readmission and/or death - i.e., equal to or greater than median of predicted risk, 33% based on the TAS-Help study algorithm developed by CIs Marwick and Huynh - will be randomised to either usual care or Smart-HF plus usual care, with stratification by study site and type of HF (reduced or preserved ejection fraction). The primary endpoint is quality of life at 90 days post hospital discharge. Secondary endpoints - 30-day readmission, 30- and 90-day composite outcome.

High and variable rates of psychotropic medication use persist in residential aged care facilities (RACFs) despite minimal evidence of benefit and increasing evidence of harm. Knowledge brokers are individuals or groups who facilitate the transfer of knowledge into practice. This study will employ an onsite pharmacist to act as a knowledge broker to implement new Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Aged Care (the Guideline). The intervention will involve the delivery of three implementation strategies: Level 1 - passive distribution of the Guideline; Level 2 - current best practice; Level 3 - employment of a knowledge broker. Each RACF will receive each strategy for one of three psychotropics medication (antipsychotics, benzodiazepines and antidepressants). In the level 3 strategy, the knowledge broker will develop an action plan and will undertake a variety of ongoing local activities to facilitate implementation of the Guideline. It is hypothesised that the level 3 intervention knowledge broker will lead to improvements in Guideline concordant use of antipsychotics, benzodiazepines and antidepressants in RACFs compared to the other two levels.

ESCAPE-CS is the implementation of an evidence-based, best-practice Cardiogenic Shock care pathway that is hypothesised to improve mortality, safety, healthcare utilisation and QoL outcomes, and reduce inequity in access to care. It is a multicentre, two-phase prospective cohort study. Phase 1, a 12-month data collection of ‘usual care’ phase, is followed by Phase 2, a 12-month study intervention phase. The study intervention has three components: a streamlined referral system, a multidisciplinary shock team, and protocol-driven care. The study will be conducted in 7 participating centres across local health districts in NSW. These centres encompass a range of urban tertiary and non-tertiary, regional and rural sites, and have existing referral relationships with either a quaternary centre or another participating centre in the study.

The research project is an investigator-initiated, open-label, randomised controlled trial which will explore the effect of an educational intervention in enhancing the confidence and competence of nursing staff when caring for patients with Haemophilia. The intervention group will receive an educational intervention which will be a PowerPoint presentation. The control group will receive no intervention. The educational intervention is a 30-60 minute PowerPoint presentation. A link to the recording of the Microsoft Teams presentation will be emailed to participants. The presentation will contain information, graphics, and visual aids relevant to Haemophilia and best-practice nursing care for patients/clients with this condition. Participants will be required to review the educational presentation within 2 weeks. A reminder email will be sent at the end of the 1st and 2nd weeks of access, to remind participants to review the educational presentation. The control group will receive access to the educational intervention once follow up assessments have been completed by both groups.