ANZCTR search results

The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.

To audit the results of laparoscopic adjustable gastric banding at Sir Charles Gairdner Hospital with respect to weight loss and reduction of co-morbidities.

The aim of this study is to assess the efficacy of an anti-inflammatory dose of fish oil in the treatment of knee osteoarthritis, both with regard to symptom control and progression of structural changes. These will be assessed using WOMAC questionnaire, analgesic use and knee magnetic resonance imaging (MRI).

The primary purpose of this study is to test the impact of a community-based program aimed at promoting healthy eating, physical activity and water consumption.

A person’s normal blood pressure changes throughout the day, typically being higher during the awake hours and lower during the hours when a person is asleep. There are many factors that could also change the blood pressure during the day: level of activity, pain, stress, disease, hormones, hydration etc. One reliable way of measuring all the daily changes in blood pressure is a device called Ambulatory Blood Pressure Monitor (ABPM). ABPM units indirectly measure blood pressure through vibrational signals associated with blood flow in the artery in the elbow, when a blood pressure cuff is inflated and then deflated. These are non-invasive, automated, lightweight, and are typically battery powered, belt-worn, and of a size and shape similar to that of a walkman or portable CD player. There may be mild discomfort when the blood pressure is being measured, however, this is only brief. With ABPM, multiple automatic measurements of blood pressure are obtained at specific intervals throughout a 24 to 48 hour period, and this information is recorded onto a computer chip, which could be printed out for analysis by a doctor. Blood pressure is one of the parameters routinely monitored when an anaesthetic is given for any operation or procedure. When a person undergoes an anaesthetic, there are many factors that could decrease blood pressure, including the medications that are given. It is usually treated with fluid, or other medications, when the blood pressure is lower than the initial blood pressure measured. However, there has been no study that has looked at how much a person’s blood pressure normally decreases when a person is asleep in comparison with their blood pressure under anaesthesia. Patients may well be treated for low blood pressure during anaesthesia (albeit unnecessarily) despite the possibility that their blood pressure may actually reach lower levels during sleep. To investigate this further, we propose to follow a group of fit and well patients (ie. No pre-existing blood pressure problems) undergoing minor general surgery. They will be fitted with an ABPM for 24 hours when they come to hospital for their pre-admission appointments. When they re-present for operation, their blood pressure under anaesthesia will be recorded (by both the ABPM, and routine BP monitoring), and compared to their normal “asleep” blood pressure. The presence of the ABPM will not affect the patient’s surgery or other management in any way. It is hoped that by establishing a relationship between a person’s normal asleep blood pressure and that during anaesthesia will better enable doctors to manage their patients.

Following stroke few survivors regain full walking ability as impaired balance; slower walking speed and poor cardiorespiratory fitness are frequently evident by rehabilitation end. Treadmills have been used to improve walking in acute stroke patients and fitness in chronic stroke patients. There are no published studies investigating if treadmill walking can improve walking and fitness simultaneously. This single-blind randomised controlled trial will examine the effectiveness of a treadmill-walking program with specific heart rate targets to improve walking following stroke. If effective this intervention has the potential to improve independence and mobility following stroke thus reducing the burden of care in the community. This study will establish effectiveness to support a future larger trial. The aim of this project is to investigate in people with a stroke who are able to walk, does participation in a 6-week treadmill walking program with specific target heart rates: i. improve gait performance and cardiorespiratory fitness without compromising gait quality? ii. result in gains that are maintained 3 months later?

An Italian clinical trials group demonstrated excellent outcomes for the majority of APL patients when intensive idarubicin was added to ATRA for remission induction therapy. Their patients were then treated with conventional consolidation chemotherapy. In the APML3 trial, intensive idarubicin and ATRA are used for both induction and consolidation in order to exploit the unique sensitivity of APL to this combination. In addition, frequent molecular monitoring is used to determine post-remission therapy.

The primary endpoint of the study is to determine if dexamethasone 8mg, administered at the start of an anaesthetic to prevent postoperative nausea and vomiting, reduces the level of cortisol postoperatively. Cortisol is a hormone produced by the adrenal glands in times of stress (such as at operation). Dexamethasone is frequently used to prevent nausea and vomiting after operations and is known to reduce cortisol levels in patients not having operations.

The purpose of the study is to evaluate the safety of rivaroxaban in subjects with recent acute coronary syndrome and to assess the ability of rivaroxaban to reduce the rate of clinical events in those patients.

The purpose of this study is to determine: 1. If a posterior shoulder stretch technique increases shoulder range of movement in people with subacromial impingement syndrome. 2. If a stretching regime for posterior shoulder tightness results in an improvement in subacromial impingement symptoms.