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Occupational therapists conduct home assessments to establish patient safety at home and provide rehabilitation to support hospital discharge and prevent readmissions. Assessment requires visual observation of the home environment. This requires significant engagement with the patient and often a carer. In 2021, over 6000 home assessments were completed across Sir Charles Gairdner Osborne Park Healthcare Group (SCGOPHCG), with staff spending over 1,650 days per year completing home assessments at a cost of over $700,000. Virtual care has been introduced to undertake home assessments and has great potential for providing a non-inferior and cost-effective service. Some small studies have demonstrated that home assessments delivered via virtual care are feasible at assessing the home environment for risks, providing rehabilitation and potentially reducing hospital length of stay. This study will implement an occupational therapy home visiting service using virtual care to reduce therapy time. It is hypothesised that this model will be non-inferior to the traditional face-to-face model of care in regard to adverse events and patient satisfaction.

Patients with a diagnosis of high grade glioma are at risk of extended hospital stays. The lack of access to timely services is an ongoing challenge for multidisciplinary teams when planning discharge for these patients. This study aims to assess the impact of early referral (at diagnosis) to allied health services on the quality of life and health outcomes for patients with high grade glioma (HGG) and their carers. Who is it for? You may be eligible for this study if you are aged 18 years or older and you have been diagnosed with high grade glioma within the past three months. Patients with and without carers will be eligible. Study details All participants who choose to enrol in this study will be given an early referral to the allied health service at Sir Charles Gairdner Hospital. Participants will be contacted by either a senior occupational therapist or a senior social worker within 6-8 weeks of their first oncology appointment, which may occur in person or over the phone. During the initial appointment, the occupational therapist or social worker will complete an assessment with the participant (and their carer, if applicable) to determine their needs. Follow-up appointments will be scheduled for each participant dependent on their needs. The initial and subsequent appointments will either be face to face or via virtual care (remotely delivered telehealth) and will vary in length from 30-90 minutes. Standard interventions that are provided by the occupational therapist and social worker in the oncology service include provision of equipment, assessment and referral for home services, National Disability Insurance Scheme (NDIS) application support, case coordination and patient and carer education. Participants and their carers will be asked to complete a series of questionnaires during the initial assessment and again at 6 months after the initial assessment. The study period is set at 6 months, but therapy treatment will continue after this time dependent on the participant’s needs. It is hoped this research will determine whether providing early referrals for high grade glioma patients to allied health services, including occupational therapists and social workers, leads to improved quality of life and fewer unplanned hospital admissions. If this model of care is found to be more beneficial than the current as needed referral system, it may be implemented more broadly to high grade glioma patients nationwide.

Individuals living with treatment resistant depression are faced with an especially challenging road to recovery. The factors that complicate treatment include, lack of a universal definition on what treatment resistant depression is, poor doctor-patient relationship, inadequate knowledge about treatment options, patient /caregiver fatigue, and high cost associated with co-morbidities. Due to the nature of treatment resistant depression, a need to emotionally self-regulate amidst stress commonly arises in adults. This stress may range from activities of daily living (like bathing, taking medication, grocery shopping) to medical management (attending doctor’s appointment, corresponding with insurance providers etc.) and/or social engagements. Continuous exposure to such stress keeps one’s sympathetic nervous system charged and activated often resulting in a heightened state of alarm which further exasperates depressive symptoms. In this way, repeated exposure to stress is part of the lived experience in adults with treatment resistant depression. This graduate researcher believes that moving towards stability begins with an increased understanding and awareness about one’s automatic stress responses. Such knowledge can help foster and create a path where individuals living with treatment resistant depression can comfortably identify manage their stress. Current tools in depression treatment do not document the experience of learning and practicing somatic based stress management techniques after participating in group dance therapy sessions. This tool may be potentially helpful for both, adults living with TRD and their health practitioners in tracking symptoms of TRD. Based on this background, this research project is designed as to help understand if group dance therapy sessions may be helpful in alleviating stress associated with a treatment resistant depression diagnosis by fostering somatic aptitude in participants and if dance therapy helps provide any symptomatic relief associated with treatment resistant depression.

To assess the efficacy of the NurofluxTM device to continuously monitor and detect significant neurological deterioration in patients with acute ischaemic stroke due to large-vessel occlusion (LVO) in anterior cerebral circulation against the gold standard of high-intensity nursing monitoring of vital signs and neurological function, and use of routine brain imaging. Study Design: This is an investigator-initiated and conducted, multicentre, open-label, single arm, clinical evaluation feasibility (proof-of-concept) trial. After an internal pilot phase (Phase 1; registered seperately) to rehearse the main study to identify key issues to consider in the next phase of the study, as well as to optimise the device parameters, this study phase (Phase 2) will be rolled out for full assessment of the sensitivity, specificity, and predictive value of monitoring of patients in acute phase across three major teaching hospitals in Sydney under the supervision of leading stroke clinician-scientists. Phase 2 – Main phase 260 consecutive patients with AIS with LVO in the anterior circulation will be recruited and monitored using the device and followed through the course of regular treatment and management. Device metrics (sensitivity, specificity, and positive/negative predictive values) will be determined against routine clinical and brain imaging (CT/MRI) to determine thresholds for detection of: AIS (severity and location), response to treatment (successful reperfusion) and neurological deterioration (from bleeding [haemorrhagic transformation], cerebral oedema [‘brain swelling’] and/or extension/recurrent stroke). Phase 2 Primary Outcome: 1. Performance of the device (sensitivity and specificity) on detection of neurological deterioration Secondary Outcomes: 1. Positive and negative predictive values of the device 2. Detection of acute ischaemic stroke (severity and location) 3. Correlation to initial and follow-up imaging parameters 4. Response to treatment (successful or unsuccessful reperfusion) 5. Detection of recurrent stroke 6. Detection of cerebral oedema, haemorrhagic transformation, and early seizure (after study enrolment) 7. Proportion of time spent wearing the device within the intended period

Aims: To assess the efficacy of the NurofluxTM device to continuously monitor and detect significant neurological deterioration in patients with acute ischaemic stroke due to large-vessel occlusion (LVO) in anterior cerebral circulation against the gold standard of high-intensity nursing monitoring of vital signs and neurological function, and use of routine brain imaging. Study Design: This is an investigator-initiated and conducted, open-label, single arm, clinical evaluation feasibility (proof-of-concept) trial. This stage is an internal pilot phase to rehearse the main study to identify key issues to consider in the next phase of the study, as well as to optimise the device parameters within the RPAH under the supervision of leading stroke clinician-scientists. Phase 1 – Threshold estimation RPA only. Recruit 50 patients to wear the device following confirmed AIS with LVO in the anterior circulation to estimate device threshold of critical neurological deteriorations. An assessment of device utility in routine clinical practice will also be undertaken. Outcome Measures: Phase 1 Primary Outcomes: 1. Device threshold estimation on detection of neurological deterioration 2. Safety and patient acceptability profile of the device when immediately deployed Secondary Outcomes: Device threshold estimation on: 1. Acute ischaemic stroke (severity and location) 2. Response to treatment (successful or unsuccessful reperfusion) 3. Recurrent stroke 4. Cerebral oedema, haemorrhagic transformation, and early seizure (after study enrolment) Phase 2 of this study will involve a larger sample size gathered from multiple sites for more detailed assessment of device accuracy. Phase 2 will be registered separately.

This study aims to assess the effect of an intervention to reduce problematic internet usage, to be run over 21 days. The intervention is based on the results of previous studies testing different aspects of a theory of self-regulation, which showed expected effects of inducing a Commitment or Progress framework on intentions for internet usage goals. The study intervention will test the effect of investigator feedback on participant internet usage in participants who report objectively problematic levels and patterns of internet use. It will test the following hypotheses: Hypothesis 1: When experiencing a goal setback on the previous day, individuals who frame their behviour in a Progress framework will subsequently perform better than individuals who frame their behaviour in terms of self-monitoring Hypothesis 2: When experiencing a goal achievement on the previous day, individuals who frame their behaviour in terms of a Commitment framework will subsequently perform better than individuals who frame their behaviour in terms of self-monitoring In terms of personal benefit, participants may reduce problematic internet usage and may learn new methods for regulating their behaviour towards their goals.

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