ANZCTR search results

This study is investigating the feasibility of a web-based cognitive rehabilitation program called Cognitive Concerns(eReCog) to address cancer-related cognitive impairment. Who is it for? You may be eligible for this study if you are an adult who has completed chemotherapy for aggressive lymphoma within the past five years and are in remission, and have perceived reductions in cognitive functioning. Study details Participants will be randomly assigned to either the intervention or control group. Those in the intervention group will receive access to an online program containing 4 modules on strategies to address cognitive dysfunction, which are estimated to take 30-60 minutes each. Those in the control group will receive a factsheet on cancer-related cognitive impairment and a list of suggested brain training websites. Participants will be asked to complete measures on the usability of the program and changes in their cognition. It is hoped that information from this study will inform a future, larger trial to test the effectiveness of a novel intervention to improve cognitive outcomes and quality of life in cancer patients following treatment.

White coat hypertension is when a person's blood pressure readings are too high in a medical setting, like a doctor's office, but are normal elsewhere, like in your home. This condition has been considered not malignant in the past, but recent research has shown that it should be a cause for concern due to poor long-term health outcomes which may require further monitoring or treatment. Mindfulness interventions, like specific breathing techniques, have been shown to lower blood pressure in adults with essential hypertension. The techniques, however, have not been tested for white coat hypertension, and in addition, have only been found to work if used for weeks. Therefore, this study aims to explore whether 30-second mindfulness interventions like a mantra chant, a yoga pose, or a breathing exercise can lower blood pressure readings in Australian adults with white coat hypertension.

This study aims to examine the efficacy of a novel CIED remote monitoring management program into a community setting, focussing on clinical patient outcomes, experience, and implementation feasibility. The intervention will be composed of patient engagement initiatives to improve patient involvement in their management and understanding of their cardiac implantable electronic device (CIED) and cardiovascular condition. The patient engagement initiatives will include the using a text-messaging service (TextCare platform) to provide education and lifestyle advice, as well as contacting and educating patient when a clinical issue is detected via their CIED remote monitor. Additionally, the intervention will provide a two-way portal of communication for patients to interact with their healthcare team. The TextCare platform will provide regular (3-4 messages / week) semi-personalised SMS to the participants over a six month. The message personalistion will be based on patient medical conditions, SMS preferences, diet preferences, exercise tolerance and CVD risk factor profile. SMS messages will provide succinct information and aid as a thought-provoking tool. These SMS messages will contain education on CIEDs and remote monitoring, cardiovascular disease (CVD) risk factor modification, information on relevant cardiac conditions and their management, as well as healthy lifestyle education and advice. SMS messages will be accompanied with URL links to websites for further information. The primary analysis is to evaluate the impact of the PARTICIPATE program upon patient self-efficacy managing their CIED compared to those in the control group receiving standard care between 4-8 weeks following intervention commencement. This is a pilot study. It will include a two-arm, randomised control trial of patients with CIEDs and known heart failure and/or atrial arrhythmia, comparing standard remote monitoring to remote monitoring complimented with the PARTICIPATE education. The trial component will also be supplemented by an implementation evaluation.

Total knee replacement (TKR) rates in Australia have increased from 123 to 242 per 100,000 population from 2013-2016. By 2030, this is projected to rise by 276% (I. N. Ackerman et al., 2019; Adie, Harris, Chuan, Lewis, & Naylor, 2019). In the Central Adelaide Local Health Network, since July 2016, there has been 709 total knee replacements (both primary and revision) completed at The Queen Elizabeth Hospital (TQEH). The use of opioids before joint replacement surgery has been associated with poorer postoperative outcomes including both surgical site and periprosthetic infections, higher rates of early revision surgery, less improvement in pain/function, increase risk of persistent post discharge opioid use, longer stays in hospital and higher healthcare costs (Quinlan, Levy, Lobo, & Macintyre, 2021, Shadbolt et al., 2020, Adie et al., 2019). One in two Australian patients is prescribed an opioid in the year prior to joint replacement surgery (Inacio et al., 2018). On average over the last five years (2016-2021) TQEH completed approximately 140 TKR (both primary and revision operations) per year. Audit data from 2016-2021 at TQEH demonstrates that one in three (33%) of patients undergoing primary TKR (219/660) used preoperative opioid pain relief, with a median oral morphine equivalent daily dose (oMEDD) of 40mg. From 2016-2021 TQEH completed 49 revision TKRs with this patient population having a higher incidence of preoperative opioid use (24/49 or 48.9%) and the same median oral morphine equivalent daily dose of 40mg. This result underpins our decision to use oMEDDs of greater than or equal to 30mg for inclusion in the weaning protocol as detailed in the grant synopsis. This high incidence of opioid use within the health network likely has negative effects on patient outcomes as described above in literature examining other TKR patient populations. By designing and implementing a pathway for preoperative opioid weaning in patients presenting for TKR, we aim to improve outcomes without increasing preoperative pain. Opioid weaning in patients with chronic pain has been shown to be achievable with the majority of patients reporting the same or less pain. Implementing a slow, supervised taper from opioid analgesia poses minimal risk to patients (as opposed to rapid weaning), and as detailed below withdrawal symptoms will be monitored throughout the period of intervention. Should any patient experience withdrawal, they will be reverted to their previously tolerated dose and after a period of stabilisation be reintroduced to weaning at a lower intensity.

The purpose of the research is to evaluate the design of the ‘dyspnea challenge’, a two-minute treadmill protocol which has been developed to measure exertional dyspnea (ED) (“breathlessness”). ED is the feeling of discomfort in breathing during exercise/physical activity and it is the most common symptom of chronic heart and lung disease. It is important that a test is designed to precisely measure changes in ED over time as this will allow for the mechanisms behind ED to be better understood and for treatment pathways to be evaluated with greater accuracy. This study is looking at the impact that Pulmonary and Heart Failure Rehabilitation has on ED and whether the dyspnea challenge is able to detect any changes in ED. A minimally important difference for the dyspnea challenge will be established.

Dizziness is a common presentation to the ED. There are a wide range of differential diagnoses to consider, some of which are time sensitive and life threatening and others which are benign, of which benign paroxysmal positional vertigo (BPPV) is the most common. The gold-standard tests to diagnose BPPV are provocative manoeuvres performed during the clinical examination. From the literature we know these manoeuvres are poorly performed and interpreted in clinical practice. There is overuse of neuroimaging and medications, leading to increased health care costs, misdiagnosis, and morbidity. There exists opportunity for quality improvement in the assessment and management of the dizzy patient in the ED. This study aims to determine if educational interventions improve the performance rates of provocative manoeuvres to diagnose BPPV in a tertiary ED. We will be conducting a pre- and post-intervention retrospective chart review to determine effects of the interventions. The primary objective is to determine if the intervention impacts the performance rate of the Dix-Hallpike (DHP) manoeuvre. The secondary objectives are to determine if the intervention impacts performance rate of the supine head turn (SHT), compliance to BPPV guidelines, hospital admission rates, hospital length of stay, cost of presentations, representation rates and stroke rates. Long-term aims include acquisition of funding for translational research and implementation of education programs in collaboration with other LHDs. Future research direction may involve improved access to vestibular physiotherapy, mobile application development or incorporation of video-oculography and telemedicine for rural/remote areas. Our hypothesis is that the interventions will increase the performance rate of provocative manoeuvres for BPPV, improve compliance to BPPV guidelines, decrease use of neuroimaging, reduce hospital admission rates, and reduce cost of presentations without increased hospital representations or increased rate of strokes.

Aims: This study will assess whether pregnant women at risk for mental health concerns benefit from a model of care offering continuity-of-care throughout the perinatal period. Research question: Is an enhanced model of midwife care effective and acceptable for reducing mental health symptoms in a cohort of pregnant women at low to moderate psychosocial risk in an ethnically diverse, socio-economically disadvantaged area? Objective: Implement a maternity care intervention offering continuity-of-care to pregnant women of low to moderate psychosocial and mental health risk and assess whether parental distress was lower in the group allocated to continuity-of-care.

Many patients who have bariatric surgery already have micronutrient (vitamin and mineral) deficiencies before their surgery. However, there is no standard approach to how deficiencies are corrected. This pilot study is conducted to test the feasibility of our methods before conducting a larger study. Participants will be randomised (will not be given a choice) to one of two groups. The intervention group will be referred to a medical practitioner to have their deficiencies treated via infusions and/or injections, alongside multivitamin and calcium tablets for two weeks. The comparator group will receive relevant vitamin and mineral tablets to correct their deficiencies. They will take these tablets, as well as multivitamin and calcium tablets for two weeks. We hypothesise in this pilot study, that a larger study will be feasible to be conducted in a private clinic setting.

This will be a single-centre, randomised, double-blind, placebo-controlled, and sequential cohort study to evaluate the safety, tolerability, PK and PD of single and multiple ascending doses of SIR9900 after oral administrations in healthy adult volunteers. Male and female healthy adult volunteers aged 18 to 64 years inclusive at the time of screening are eligible for recruitment. Part 1 SAD participants (except cohort 3) will have a screening period of up to 28 days and be required on-study for approximately 2 weeks post-dose. Part 1 SAD cohort 3 (FE) and Part 2 MAD participants will have a screening period of up to 28 days and be required on-study for approximately 3 weeks post-dose. SIR9900 is a potent and selective allosteric RIPK1 inhibitor being developed for the potential treatment of inflammatory, autoimmune, and degenerative diseases, particularly in the central nervous system.

The current study aims to investigate the outcomes, benefits and feasibility of a brief evidence-based eating disorder prevention program within an Australian youth mental health service (at headspace Camperdown). This program is the Body Project program, which is a well-established eating disorder (ED) prevention program. The study aims to investigate the feasibility of this program in a sample of young Australians (between ages 12-25). Specifically, this study aims to compare outcomes (including body image concerns/outcomes, eating disorder symptomatology and general psychological distress) between the those who complete the Body Project program at headspace (our Treatment Group) and those who do not complete the Body Project program but who do continue to access their standard care at headspace (Treatment-as-usual Control group), and compare outcomes pre-treatment, post-treatment and at one month follow-up. By conducting this study we hope to assess the potential utility of such a brief and low-cost program within the headspace centre setting which, if found to be effective, could be rolled out nationally (to the 150+ headspace centres around Australia) as an early intervention approach to preventing the development of eating disorders amongst Australian youth. We hypothesise that our study results will demonstrate that attending the Body Project group program embedded into the headspace youth mental health service model will effectively reduce symptoms of eating disorders, body image concerns and psychological distress for young Australians at risk of developing an eating disorder.