ANZCTR search results

To assess the clinical utility of using a non-invasive haemodynamic monitoring device (the Clearsight TM system) in the cardiac assessment of patients undergoing CRRT and IHD To evaluate the feasibility of using the Clearsight TM system on patients that are currently on CRRT To evaluate the feasibility of using the Clearsight TM system on patients that are currently on IHD To evaluate the haemodynamic changes that occur during a CRRT session and how are these changes correlated to the clinical status of the patient To evaluate the haemodynamic changes that occur during an IHD session and how are these changes correlated to the clinical status of the patient Patients rercruited would have already been receiving IHD or CRRT and were then approached to enter this study. Patients would not have their IHD or CRRT intervention altered in anyway. The ClearSight cardiac output monitoring device is a small pressure cuff that is applied the the middle phalanx of either the 2nd, 3rd or 4th finger. This allows for continuous monitoring of cardiac output

Congenital cytomegalovirus (CMV) infection can lead to lifelong disabilities in babies if passed from the mother during pregnancy. It is the leading infectious cause of newborn disability in Australia and can result in conditions such as deafness, intellectual disability, and cerebral palsy. To prevent the morbidity and mortality associated with CMV, it is important for pregnant women to receive appropriate antenatal care and support. This study aims to assess the feasibility and acceptability of routine serological screening for maternal primary CMV infection early in pregnancy. Pregnant women who test negative for CMV IgG before 10 weeks of gestation will be eligible to participate. Participation involves providing a blood sample between 10 weeks 0 days and 13 weeks and 6 days of gestation for repeated testing of CMV infection. Additionally, participants will complete three questionnaires during the study period to evaluate the effectiveness of the CMV screening protocol, including measures of anxiety, decisional conflict, and decisional regret. If the serology results are negative (indicating no infection) at 10-14 weeks of gestation, the woman will be informed over the phone, and the results will be recorded in her medical records. If a woman is found to have been infected by CMV or potentially infected, the results will be disclosed by a maternal fetal medicine specialist, and she will be referred to the Perinatal infectious diseases clinic for counseling and clinical management. The management options offered to these women follow the standard clinical care guidelines for perinatal ID clinics. In case of a confirmed infection during pregnancy (expected in up to 5% of participants), the woman will be offered management options according to usual clinical care. These options may include informing the woman about the possibility of using valaciclovir, prenatal diagnosis through amniocentesis, and, if necessary, fetal MRI. The woman's decision to participate or not in the research will not impact the clinical care provided for CMV infection. At the end of the study, we aim to report the rate of CMV testing uptake during 10-14 weeks of gestation among pregnant women who initially tested negative for CMV IgG at their first antenatal visit with their GP or obstetrician. By analyzing feedback from participants regarding their experience with CMV screening and the clinical management they received for the prevention of congenital CMV infection, we will evaluate the feasibility of implementing a CMV screening program. Furthermore, the study seeks to determine the prevalence of primary CMV infection in the first trimester of pregnancy, document the clinical pathways chosen by participants who were diagnosed with primary CMV infection during this period, and report any psychological consequences associated with antenatal serological screening for CMV infection.

PART A of the study is investigating the safety and efficay of Single ascending dose of BW-20507 in healthy volunteers in 4 dose level cohorts. Who is it for? You may be eligible for PART A this study if you are a healthy adult aged 18 to 60 years old. Study details Participants will receive either each dose of BW-20507 or placebo which will be administered as SC injection(s). The estimated total time on Part A, inclusive of screening and follow-up, for each subject is up to 8 weeks. The duration of screening is 4 weeks. The duration of treatment is a single dose based on the assigned dose level. The duration of follow-up is 4 weeks after study drug administration. It is hoped that this research will help determine the safe and well toerated dose and define the dosing regimen of BW-20507 can be safely given to patients with Chronic HBV Infection.

Part B of the study is investigating the safety and efficacy of multiple ascending doses of BW-20507 in subjects with chronic HBV infection while Part C is a long-term Study to Evaluate the Safety, Tolerability, and Efficacy of BW-20507 in Subjects with Chronic HBV Infection Who is it for? You may be eligible for PART B of the study if you are an adult with chronic Hepatitis B virus infection in the age group between 18-65 years. Subjects who participated in the Part B and completed the Week 32 visit will be automatically enrolled into Part C if his or her HBsAg is = 0.05 IU/ml at Week 32 or following visits in Part B Study details Participants will receive multiple dose of BW-20507 which will be administered as SC injection(s). The estimated total time on Part B, inclusive of screening. treatment and post-treatment follow-up. for each subject. is up to 24 weeks. For subjects consenting to extended follow-up, the estimated total time is up to 52 weeks. Estimated total time for Part C is about 124 weeks. It is hoped that this research will help determine the safe and well tolerated dose and define the dosing regimen of BW-20507 can be safely given to patients with Chronic HBV Infection.

This project will look at the impact of digitalised music therapy during hospital admission for patients living with dementia. Each patient will receive a personalised library of music that they can access throughout their stay via headphones and/or speaker. It is anticipated that patients will experience improvement in behavioural and psychological symptoms associated with dementia (BPSD), with subsequent benefits including a reduction in the use of psychotropic medication, hospital length of stay, caregiver stress and critical incidents.

This primary aim of this study is to examine the effectiveness of Measurement-Based Care (MBC session-by-session measures plus feedback to parents and clinicians) versus Measurement as Usual (MAU) for parents of children aged between 3 and 9 years 11 months of age participating in a 8-10 session BPT, delivered via telehealth. All participating families will complete measures at pre, post and three-month follow-up. Primary outcomes include reduction in severity of children's symptoms of DBDs according to both diagnostic ratings by blind clinicians and parent reports at post-intervention and three- month follow-up. Secondary outcomes include: teacher reports of severity of DBDs; parent satisfaction with treatment; clinician and parent ratings of therapeutic alliance, dysfunctional parenting; parental conflict over parenting; and parental mental health. In addition, clinically significant change in severity of DBDs rated by blind clinicians and parent reports will be calculated and compared across groups. Rates of drop-out from intervention and total time in the program will also be compared across groups. 1. At post-assessment and three-month follow-up, relative to the MAU comparison group, the MBC intervention group will have: a) significantly lower levels of child symptoms of DBDs (diagnostic ratings and parent reports) b) significantly lower levels of teacher ratings of DBDs c) significantly higher parent and clinician ratings of the therapeutic alliance d) significantly higher levels of clinician ratings of child functioning e) significantly lower levels of dysfunctional parenting, inter-parental conflict over parenting, and improved parental well-being. e) significantly higher parent ratings of satisfaction with treatment. 2. Compared to the MAU comparison group, the MBC intervention group will show: a) significantly high levels of clinically significant change in severity of DBDs (for diagnostic ratings and parent reports) at post and three-month follow-up b) significantly lower levels of drop out from the intervention c)significant less time participating in the program overall.

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.