ANZCTR search results

Concussion is a significant public health concern among Australian children and adolescents. A large population of children who experience a concussion (approximately 30%) will go on to experience persistence post-concussion symptoms for more than 4 weeks following their injury. These symptoms can limit their ability to attend and engage in school, extra-curricular activities and can lead to reduced quality of life. International consensus on Concussion recommends a brief period of physical rest immediately after concussion (24-48 hours) followed by a graduated return to physical activity at a level that does not provoke significant symptom exacerbation . Active rehabilitation involving sub-symptom threshold aerobic activity is a growing area of research with evidence showing reduced symptoms and improvements in recovery following concussion. There is a lack of evidence for an incremental aerobic exercise test that can safely be performed via a telehealth platform. This requires that the participant remain in view of the therapist via a computer, tablet or smart phone camera. One such method is the Modified Shuttle Test (MST). The MST is an incremental aerobic exercise test. Here, the participant to walk/run back and forth between the two markers separated by 10m as many times as possible following incrementally increasing speeds (i.e. incrementally increasing aerobic exercise) indicated by an audio recording. It has been validated in several paediatric populations with chronic health issues (Cystic Fibrosis, bronchiectasis, cerebral palsy, asthma, obesity). We propose to validate the 10m MST in children and adolescents with concussion. In phase 1 of our study, we will validate the 10m MST by comparing it to the gold-standard Buffalo Concussion Treadmill Test. The aim of the study is to validate the Incremental 10m Shuttle test for use in a paediatric population who have sustained a concussion. The objective of this study is to determine if there is a correlation between the Buffalo Concussion Treadmill Test and Modified Shuttle Test exertion test for those children who have sustained a concussion. Permission for the physiotherapist to contact the family will be provided as per QPRS Contact Consent Form. The physiotherapist will supply the participant with a graded exercise program in the next 24 hours via email if the family are interested.

TransformUs is a behavioural school-based intervention targeting reducing sedentary behaviour and increasing physical activity in students with additional needs. This is an adaption of a previously registered successful trial "Scalability of the Transform-Us! program to promote children’s physical activity and reduce prolonged sitting in Victorian primary schools" (ACTRN12617000204347), to suit children and adolescents with additional needs. In this study a sample of 6 special schools (3 with students requiring a low to medium level of support and 3 with students requiring a medium to high level of support will be invited to participate in the effectiveness trial. One nominated school leader per school (n=6) and teachers/teachers aides (n=20) from each school will be invited to deliver the program. Around n=125 students (with varying levels of support) will be assessed on physical activity, on-task behaviour and life skills. A sub-sample of students will be invited to take part in focus groups where the discussion will be around students’ perceptions regarding the physical activity strategies implemented in the trial (enjoyment, physical/mental effort, favourite activities, perceived barriers, suggestions for improvements, etc.). We believe that students may find this activity engaging and enjoyable. Focus groups will take up to 45 minutes and be in the presence of teachers and teacher's aides, or other school staff where applicable. Our findings will determine the effectiveness of the program for students will disability in Australia so that it can be rolled out nationally and become part of routine best practice.

The purpose of this study is to evaluate the effectiveness of the Moral Injury Treatment for Refugees (MIT-R) in reducing posttraumatic stress symptoms (PTS) and symptoms associated with moral injury (i.e., heightened moral emotions of anger, shame and guilt, and disconnection with others) in a group of Arabic, Dari, Farsi and English-speaking refugees. This study will use a case series design where participants are randomised to different baseline lengths (4, 6, or 8 weeks) before receiving the intervention. It is hypothesized that participants will show reductions in PTS symptoms and negative moral emotions when compared to symptoms pre-treatment. It is also hypothesized that participants will endorse greater social functioning at post-treatment completion compared to pre-treatment. Clinically, this project will represent a critical first step in trialling a novel psychological intervention for moral injury in refugees.

Biliary Cancer (BC) or Cholangiocarcinoma remains a rare but important cause of cancer related mortality worldwide. Although surgical resection can be curative, most patients present with advanced disease not suitable for surgery. Current chemotherapy has improved median survival to 1-2 years for these patients. The aim of this study is to examine the feasibility and benefit or role for integrating comprehensive molecular profiling (CMP) of advanced biliary cancer (ABC) using tissue collected during routine diagnostic tests or procedures. Who is it for? You may be eligible to join this study if you are aged 18 years or older, have suspected advanced biliary tract cancer, and are either scheduled for an endoscopy procedure or have pre-existing "biobanked" (stored) endoscopic biopsy tissue. Study Details: All participants will have been reviewed in a multi-disciplinary meeting and deemed suitable for inclusion in the trial. Those enrolled will be asked to provide a sample of their pre-existing or upcoming cancer biopsy tissue. The tissue will be collected at the time of the routine endoscopic procedure, or from the existing tissue sample stored at the hospital. Then, 6 months after providing the tissue sample, participants will be called by a member of the study team for telephone interview asking about disease progress and diagnosis. Additionally, information related to advanced biliary cancer diagnosis will be directly collected from medical records for the 12 month period after providing the tissue sample. It is hoped this research will show that comprehensive molecular profiling (CMP) on samples obtained /biopsies from routine diagnostic tests is able to perform comprehensive molecular profiling of advanced biliary tract cancer, and improve the detail on the profile and accuracy of cancer diagnosis.

Nasal continuous positive airway pressure (CPAP) is the most common method of respiratory support used in the care of preterm infants. Injury to the nose from nasal CPAP occurs frequently (25% of infants using CPAP), potentially causing permanent scarring and disfigurement. Infants most at risk, are those born < 30 weeks gestation and < 1250g. Current nasal interfaces for CPAP available in the Grantley Stable Neonatal Unit (GSNU), come in a limited number of sizes and do not fit all faces. 3D printed custom fitted CPAP masks hold promise for reducing the risk of nasal injury from CPAP in this vulnerable population. This study will gather preliminary data to determine the best 3D scanning technique, to identify facial features that predispose preterm infants to CPAP nasal injuries. This is the first step towards the development of custom fitted CPAP masks to be manufactured, in house, at Metro North’s Herston Biofabrication Institute (HBI).

The ageing profile of the Australian population is well documented. The proportion of people aged 65 and over has been predicted to rapidly rise over the next few years. There is also evidence of an epidemiological transition in oral health, moving from high rates of edentulism and tooth loss towards lower rates of edentulism in the older population. Still, dental caries is one of the most significant health problems facing older adults. This creates new challenges to the society. One of these challenges is how to maintain the oral health of that group of the population. Preventive or therapy approaches are preferred to restorations. This is particularly the case for root caries lesions. In fact, prevention of root caries is central in older adults as they frequently have exposed root surfaces and may have compromised salivary flow. Further research is required into preventing root caries lesions. This study will compare the effectiveness of two silver diamine fluoride (SDF) solutions in arresting dental root caries and to assess the colour of arrested caries lesions at 12 months after 2 applications: baseline and 6 months in follow up dentine/root caries in older adults living in a fluoridated area.

We are conducting a pilot, safety, feasibility, efficacy, crossover, open-label randomised controlled trial, of 20 adult critically ill patients, in the Departments of Intensive Care at the Austin Hospital and Bordeaux University Hospital. Continuous renal replacement therapy (CRRT), an artificial means of providing kidney function support, is often required in acutely ill patients who are admitted to the intensive care unit (ICU). The aim of CRRT is to achieve adequate blood purification from kidney failure associated toxins (typically non-protein bound small solutes). However, there are additional toxins that are related to liver failure, which should be a target for effective removal but cannot be effectively removed by (e.g. ammonia and/or bilirubin) during the current approach to CRRT. In patients experiencing liver failure that is also complicated by kidney failure, an additional form of blood purification that can be easily added to the CRRT circuit would be desirable. Such blood purification is now available in the form of hemoperfusion (HP). It consists of a biocompatible coated resin inside a cartridge, which can adsorb large amounts of multiple toxins even when they are protein bound. This new technology has now been used to treat patients with septic shock, COVID-19-related acute respiratory distress syndrome (ARDS) and hyperinflammation as well as the itch associated with end stage kidney disease and advance liver disease. The added form of hemoperfusion offers much promise as a way of detoxifying plasma in acutely ill liver patients admitted to ICU with kidney failure.

Carpal Tunnel Syndrome (CTS) is a disabling condition and treatments such as wrist bracing and carpal tunnel release surgery can improve patient symptoms and functional outcomes. Nerve conduction testing has been proven to be a good diagnostic tool (both sensitive and specific) for the diagnosis of carpal tunnel syndrome. The association between a combination of extended risk factors and clinical features of carpal tunnel syndrome and its diagnosis has never been estimated via likelihood ratios. The association between pain experienced during nerve conduction testing and pain experienced from carpal tunnel syndrome has also never been established in the past. We aim to prove that: 1. There are multiple risk factors and clinical features associated with high positive likelihood ratio for the diagnosis of carpal tunnel syndrome 2. Pain experienced during nerve conduction testing is more severe when pain related to carpal tunnel syndrome itself is more severe.

Colorectal cancer can develop in the colon (large bowel) and/or rectum. If left undetected, it can spread to lymph nodes and other organs in the body in a process called metastasis. It is thought that the immune system plays a role in preventing some cancers from growing or spreading. However, we do not fully understand why the immune system fails to prevent all cancers. New therapies called ‘immunotherapy’ have been developed that target the immune system in order to treat cancer once it is detected. Unfortunately, this type of treatment does not work well for most individuals with colorectal cancer. This project aims to investigate whether an immune system process called ‘tolerance’ may explain why the immune system fails to prevent colorectal cancer from growing and spreading. The project also aims to investigate whether ‘tolerance’ may explain why immunotherapy is not effective for most individuals with colorectal cancer. 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 stage 4 colorectal cancer and you have been scheduled to undergo surgery to remove your primary tumour, lymph nodes and other affected sites as part of your cancer treatment. Study details If you choose to enrol in this study, you agree that the study investigators may take samples from the tumour, lymph nodes, blood and other affected tissues for this study. Participants will also be asked to grant permission for the investigators to review and collect details of their medical history from their records. The investigators will then complete a series of analyses on the samples to determine whether 'tolerant' cells are present and may explain why immunotherapy does or does not work against these cancers. It is hoped that knowledge gained from this project may contribute to the development of new and better treatments for individuals with colorectal cancer in the future.

Background This study aims to investigate the effects of green-blue light therapy in combination with sleep health guidelines on sleep disturbances and quality of life in individuals with cancer receiving chemotherapy. Who is it for? You may be eligible for this study if you are an adult who has received a cancer diagnosis within the last six months and are scheduled to receive neoadjuvant or adjuvant chemotherapy with curative intent for stage 1-3 cancer, and meet the criteria for poor sleep quality and/or insomnia. Study details Participants will be randomly allocated to receive green-blue light therapy in combination with sleep health guidelines, or sleep hygiene guidelines alone. Green-blue light therapy will involve wearing light therapy glasses for 30 minutes each day for 4 weeks. Participants will be asked to complete various questionnaires on insomnia severity, fatigue and quality of life. Expected Outcomes It is hoped that information from this study will help determine if light therapy can be used to optimise sleep in individuals with cancer