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Labour and birth can be painful experiences. In Australia, 53% of labouring women use inhaled nitrous oxide. The widespread use of nitrous oxide is currently being reconsidered due to environmental concerns. Without nitrous oxide, there would not be a widely available self-administered, needle-free method of pharmacological labour analgesia. In this pharmacokinetic study, we will evaluate the use of nebulised fentanyl for labour analgesia, obtaining maternal and cord blood samples to measure concentrations in the mother and baby. This will be used to develop a proposed dosing schedule. We will also evaluate patient and midwife experiences. This preliminary research will lead to dosing recommendations and larger clinical evaluations, aiming to provide an additional needle-free option for labour analgesia across Australia.

Due to ongoing workforce deficits in the health sector, particularly in rural and remote regions, access to essential healthcare services including emergency care have been compromised. Challenges with attracting and retaining appropriately qualified medical and nursing staff in these areas has resulted in many health care facilities needing to deploy expensive contingency plans, including the commissioning of out-reach medical services. Emergency department nurse practitioners employed to manage patients presenting to emergency departments with non-life threatening conditions have been reported to be effective in providing timely, effective high quality care that is acceptable to patients and feasible for services to adopt. This study seeks to evaluate if a similar model implemented in four rural emergency departments in Hunter New England Local Health District is an effective, feasible, acceptable and cost-effective approach to maintaining emergency services within rural health jurisdictions.

This study aims to determine the incidence of respiratory depression in post-surgical patients who received intrathecal morphine, and whether those patients that develop respiratory depression have an increased risk of post-operative complications.

The millions of Australians seeking care in our emergency departments each year are routinely confronted by overcrowded waiting rooms, ambulance ramping, stressed clinicians and long wait times. EPIC START aims to help this situation. The Early nurse Protocol Initiated Care- Sydney Triage to Admission Risk Tool (EPIC-START) model of care will implement data analytic tools and evidence-based clinical pathways specifically designed to improve patient flow in the emergency department. The model focuses on the three D principles of patient flow: Earlier decision-making, delivery of care and detection of clinical deterioration.The EPIC-START will be tested accross 30 Emergency departments in metropolitan, regional and remote New South Wales

This study aims to compare if magnetic resonance imaging (MRI) is equivalent to a diagnostic laparoscopy as a tool for finding macroscopic (visible to the eye) ovarian cancer. Who is it for? You may be eligible to join this study if you are a woman aged 18 years or older with advanced ovarian, primary peritoneal or fallopian tube cancer. Study details All participants in this study will have MRI performed, which takes approximately one hour. This will be done either before chemotherapy, midway through chemotherapy, or both. At the time of your MRI, two radiologists (doctors who specialise in imaging) will calculate a score based on how much cancer is visible. You will then have your scheduled diagnostic laparoscopy (keyhole surgery) within two weeks of your MRI. If you are having laparoscopy only, then the surgery is likely to take approximately 30 minutes and you would be in hospital for a few hours. Based on the laparoscopy, the surgeon will calculate a cancer burden score. The MRI and laparoscopy scores will be compared for the purpose of this study. It is hoped this research will determine if MRI is able to replace laparoscopy in assessing cancer, which would allow risk and patient burden to be reduced.

This study aims to compare radiation therapy delivered directly to the prostate with or without radiotherapy to close lymph glands, to active surveillance in terms of cancer control, in a carefully selected group of men with prostate cancer. Who is it for? You may be eligible for this study if you are an adult male aged 18 or older, who has previously been treated for prostate cancer, including removal of all or part of your prostate. In particular, people who still have active prostate cancer that has low risk features and negative Prostate specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) imaging will be eligible. Study details Participants who choose to enroll in this study will be randomly allocated by chance (similar to flipping a coin) to one of the two study groups. Participants who are allocated to the first group will not undergo radiotherapy and will be seen in clinic at regular intervals by their doctor for routine check-ups and blood tests. The PSA blood test will be done every 6 months to allow surveillance of their cancer. Participants who are allocated to the second group will undergo specific radiotherapy to their prostate area with or without radiotherapy of their pelvic lymph nodes as decided by the treating clinician. Before starting the radiotherapy, participants will have a CT scan of the area where the prostate gland used to be (the prostate bed) and potentially the lymph glands related to the prostate in the pelvis to plan the radiotherapy. The radiotherapy is given over about 6 and half weeks. Participants will need to come in for treatment 5 times a week and will have a total of 32-35 treatments. Each radiotherapy treatment will take approximately 15 minutes each day. Following the radiotherapy, review appointments and investigations will be carried out every 6 months including PSA blood testing. All participants will be asked to complete a series of questionnaires to provide information on their health and wellbeing for up to 3 years after enrolment into the study. It is anticipated that completing these questionnaires will take about 20 minutes at each timepoint. It is hoped this research will determine whether additional radiotherapy directly to the prostate area after removal of the prostate is effective in controlling cancer recurrence in these low-risk patients. If the radiotherapy treatment is found to be better at controlling cancer recurrence for prostate cancer patients compared to the standard care surveillance, it may be introduced as a standard of care for all prostate cancer patients.

The purpose of this study was to examine the effect of training on BDNF levels and whether this change would be accompanied by enhanced pacing strategies in previously untrained older men. We hypothesised that chronic training would alter circulating BDNF values and accordingly there would be altered pacing strategies during a self-paced time trial performance.

The primary aims of this project are to investigate the effects of changes in the levels of perceived stress on the relationship between post-stroke fatigue and quality of life and to explore the relationship between perceived stress and post-stroke fatigue. The secondary aims of the project are to explore the relationship between post-stroke fatigue and cognitive function and profile the expression of circulating microRNAs in post-stroke fatigue. The objectives of the study are to measure the baseline and follow-up perceived stress, fatigue, cognitive function and quality of life among 65 recruited stroke survivors over a period of three months and investigate the effects of the change in the level of perceived stress on the relationship between post-stroke fatigue and quality of life. We will also explore the correlation of post-stroke fatigue and perceived stress and the correlation of post-stroke fatigue and cognitive function. From collected blood samples we will profile and identify circulating microRNAs in post-stroke fatigue. The hypothesis of this project is that: 1. The increase in the level of perceived stress significantly increases the detrimental effect of post-stroke fatigue on quality of life in stroke survivors; 2. The increase in the level of perceived stress significantly increases the level of fatigue over a period of three months.

This project will evaluate the health services impacts of the recent introduction of the Seimen's Attellica high-sensitivity troponin assay across twenty Queensland Health Hospitals. The aim of the project is to compare the emergency department length of stay, hospital length of stay, the proportion of patients admitted and the proportion of patients undergoing cardiovascular testing in the pre- and post-implementation periods. The primary outcome is the proportion of patients who were discharged from the ED within four-hours of presentation for suspected acute myocardial infarction. Consecutive adult patients who presented to an emergency department with suspected acute myocardial infarction will be included. Six-months of pre- and six-months of post-implementation non-identifiable data will be sourced from several hospital databases including AUSLAB, the Emergency Data Collection minimum data set and the Queensland Hospital Admitted Patient Data Collection database. We anticipate approximately that 120,000 patients will be included in the pre- and post- implementation periods. We hypothesis that following the introduction of the Siemens Atellica high sensitivity troponin assay more patients will be discharged within four hours of ED presentation without an increase in the proportion of patients receiving cardiac angiography.

Patient education is a critical component of healthcare delivery. However, medical information and knowledge is complex and can be difficult for patients and families to comprehend when delivered verbally, via pamphlets and/or video. This study aims to assess whether using virtual reality (VR) as an education tool for people with cancer is effective and well received. Who is it for? You may be eligible for this study if you are aged 18 years or older, you have been diagnosed with a cancer of any stage (e.g., melanoma, kidney cancer, mesothelioma, lung cancer) that will be treated with immunotherapy and you are due to start only immunotherapy agents (i.e., patients may not receive any other treatment, such as chemotherapy or radiotherapy). Study details Participants who choose to enrol in this study will be randomly allocated by chance (similar to flipping a coin) to one of three groups. Participants who are allocated to the first group will have a standard of care verbal education session with an education nurse, followed by a 5-7 minute 3D 360° virtual reality (VR) education experience during their first immunotherapy treatment session. Participants who are allocated to the second group will have a standard of care verbal education session with an education nurse, followed by a 5-7 minute 2D video education presentation during their first immunotherapy treatment session. Participants who are allocated to the third group will only receive a standard of care verbal education session with an education nurse during their first immunotherapy treatment session, and will receive educational pamphlets about immunotherapy treatment as well. Prior to their first treatment session, straight after the first treatment session and at two weeks after their first immunotherapy treatment session, all participants will be asked to complete a series of questionnaires regarding their understanding of the educational information provided to them. Participants will also be asked to complete a one-on-one 20 minute interview with a member of the research team to discuss how they found their education session and delivery method. It is hoped this research will determine whether it is feasible to provide patient education via VR and how this delivery impacts participants' understanding of their immunotherapy treatments. If this initial study is positive, the use of VR education may be expanded to a greater number of cancer patients undergoing immunotherapy treatment in the future.