ANZCTR search results

The study aims to examine the short-term effectiveness of a brief reminiscence (mastery experience) intervention on self-efficacy to do prescribed exercises despite pain and adherence to prescribed exercises for patients recovering from total knee replacement (TKR). Participants who receive the intervention are expected to have higher self-efficacy to complete exercises despite pain, higher self-reported exercise adherence, and greater reduction in pain intensity than those in the waitlist control group.

Aortic stenosis is a common valvular abnormality in adults. Its incidence increases with age. The only effective treatment options for severe aortic stenosis are surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). TAVI represents a less invasive alternative to SAVR. In patients with high surgical risk TAVI has been associated with increased 1-year survival compared with SAVR, along with reduced risk of death and hospitalisation compared with conservative management. More recently, TAVI has also been shown to result in significantly lower rates of death, stroke or rehospitalisation compared with SAVR in patients with low surgical risk. As such, we can expect an increase in the number of TAVI procedures in future. Infective endocarditis is a potential complication following TAVI insertion. The rate of infective endocarditis following TAVI has been variably reported between 1 and 3%, which is similar to the rate of prosthetic valve endocarditis (PVE) following SAVR. However, the microbiology of post-TAVI endocarditis is notably different from PVE or native valve infective endocarditis, with a predominance of Enterococci. The reasons for this difference have not been elucidated but may relate to the transfemoral approach utilised for the majority of TAVIs. This raises the possibility of periprocedural bacteraemia and subsequent seeding of the newly placed valve prosthesis. To date there have been no studies investigating the rate of periprocedural bacteraemia in patients undergoing TAVI. There is a paucity of literature surrounding antibiotic prophylaxis for TAVI procedures. The European Society of Cardiology guidelines advise that antibiotic prophylaxis should be considered in patients undergoing TAVI but give no recommendation as to the agent or duration. Cefazolin is frequently used as prophylaxis for cardiothoracic surgery and a number of institutions have extrapolated this to TAVI prophylaxis. However, little is known about the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics including cefazolin in the TAVI population, in whom there are presumably dramatic changes in haemodynamics and organ perfusion periprocedurally. Furthermore, the predominance of Enterococci in post-TAVI endocarditis would suggest that cephalosporins are a suboptimal prophylactic antibiotic. In this study, we aim to explore the incidence of periprocedural bacteraemia in patients undergoing TAVI as a possible explanation for the unique microbiological profile of infective endocarditis in this group. Additionally, we will examine demographic and procedural data for associations with any observed bacteraemia. Given the unique haemodynamic changes observed during TAVI procedures we will also examine the PK profile of prophylactic antibiotics and correlate this with any observed bacteraemia.

Coeliac disease and gluten sensitivity are common illnesses that are associated with unpleasant symptoms caused by the consumption of gluten. These symptoms can greatly impair a sufferer’s quality of life. How gluten causes symptoms is poorly understood. This study aims to understand the bodily processes that are important in the development of symptoms to gluten. This information will be important for the development of treatments that can prevent or treat gluten-induced symptoms. We aim to identify markers in the blood that can be used by doctors to help in the diagnosis of gluten sensitivity and also for monitoring the effect of new treatments for coeliac disease.

This study recruits from a larger Australian cohort and aims to evaluate the value and impact of incorporating personalised risk scores (PRS) into melanoma risk assessments in a high-risk cohort. Who is it for? Individuals who participated in an existing study (the Australian Centre of Excellence in Melanoma Imaging and Diagnosis (ACEMID) Study) and provided a saliva sample for genetic analysis within that study, were eligible to participate. Study details Participants were randomly allocated to either receive a ‘traditional’ melanoma risk scores based on clinical and environmental risk factors (control group), or ‘personalised’ melanoma risk scores based on PRS, clinical, and environmental risk factors (intervention group). Participants received their melanoma risk scores in the form of an information booklet and are offered a follow-up appointment to discuss the results. Individuals in the control group are were offered a personalised risk booklet after 12 months. Participants were asked to complete questionnaires regarding their the perceived utility of the information, any psychosocial impact following receipt of results and the impact on sun-protective and screening behaviours. It is hoped that findings from this study will provide insight regarding the utility of personalised risk information for melanoma and the impact on psychosocial and behavioural outcomes, particularly capturing the relative utility of personalised risk scores which incorporate both PRS and traditional risk factors, compared to risk scores based purely on traditional risk factors.

Functional mitral regurgitation in patients with or without atrial fibrillation without left ventricular dysfunction and/or dilatation, namely, atrial functional mitral regurgitation (AFMR), has been increasingly recognized. It occurs in the setting of left atrial dilatation and or atrial fibrillation in patients with heart failure with preserved ejection fraction (HFpEF). However, there are very limited published data regarding therapeutic strategies of AFMR. We aim to understand the optimal therapeutic options by investigating the outcomes of previously treated patients when this concept was not well recognized.

The purpose of this project is to determine how effective behavioural change strategies are in managing fluid amongst people who are receiving haemodialysis treatment for their kidney disease. Fluid management is important during dialysis because having too much fluid can cause high blood pressure, swelling, breathing difficulties and high weight gain, which can then lead to increased hospitalisation and mortality. Behavioural change strategies have been successfully used in previous research for helping participants to manage other health related behaviours, such as reducing unhealthy snacking, however they have never been used to help manage fluids in patients on haemodialysis treatment. This project aims to address this gap in the research.

This study is intended to identify, adapt, evaluate, preliminary efficacy, and gather patient perspectives of 'off-the-shelf' virtual reality games for use in upper limb rehabilitation after stroke. It aims to find out whether readily available games for virtual reality can be used and modified to best supplement regular physiotherapy rehabilitation post stroke, to also increase therapy hours. The hypothesis is that adapted virtual reality games will be a useful therapeutic tool, and will result in some improvement in upper limb rehabilitation post stroke,.

Large ventral hernias are a source of significant morbidity and pose a considerable surgical challenge. A hernia is abdominal wall muscular defect, allowing protrusion of abdominal contents under the skin. Surgical repair brings the edges of the abdominal wall opening (muscle edges) together. BTA prevents the muscles from contracting (approx 3 months) and thus reduces the lateral pulling 'force' on the surgical repair of the hernia. The study aims to perform a double- blinded randomised placebo-controlled trial to evaluate the effectiveness of BTA as an adjunct to surgical hernia repair of large ventral hernias. Participants will be randomised into two groups: one group will receive BTA injections, the other normal saline injections, into abdominal musculature. All participants will then undergo a surgical hernia repair 4 to 6 weeks after the injections. 84 participants will be recruited to each group (total: 168 participants). Our hypothesis is that BTA can improve the success of hernia repair by better intra-operative closure, better post-operative recovery , reduced recurrence of a hernia and overall reduced health expenditure.

We wish to investigate whether vaccine intentions, attitudes, and knowledge are differentially influenced when presenting general versus specific long COVID and booster-related information. General information presents risk information in regard to long COVID as a whole, whereas the specific presentation shows information on specific long COVID symptom categories. We therefore aim to investigate whether there is a particular presentation of information that more effectively communicates long COVID and vaccine messages. We also wish to see if there are any effects of adding a cognitive load task that some participants will have to allocate their attention to. We predict that participants viewing the general long COVID information will show higher vaccine intention, positive attitudes, and knowledge regarding boosters; we also predict that participants under cognitive load will have less vaccine intention and knowledge, as well as more negative attitudes, compared to participants under no load. Finally, we predict that the benefits of general information on intention, attitudes, and knowledge will be even more pronounced for those under cognitive load.

The Canberra Family Study aims to explore 11 outcomes through use of validated questionnaires administered to new parents. The key questions in our 11 substudies are: 1) How do we enhance maternity models of care? 2) How do we increase healthcare advocacy? 3) What supplements do women take in pregnancy and why? 4) What will enhance the birth experience? 5) How to help IVF parents to parent? 6) How do we help parents of preterm babies to parent? 7) How do we help mothers’ confidence with parenting 8) How do we ensure there is optimal follow up of women who experienced a pregnancy complication? 9) Explore if there is a relationship between sleep and pregnancy outcomes, 10) Helping parents manage chronic disease in the community, and 11) Helping new fathers.