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A longitudinal study to investigate the learning effect of virtual reality-based brain-computer interface training on motor imagery signals in unimpaired individuals
Rehabilitation is crucial for recovering motor functions after injuries like spinal cord injury (SCI) or stroke. Traditional methods often require a lot of manual effort from therapists, making them time-consuming and less effective for patients with limited or no motor control. Brain-computer interfaces (BCIs) offer a promising alternative by converting brain signals into commands that assist devices, enabling automated therapy without constant manual input. Our study focuses on training individuals, especially those new to BCIs, to use their imagination to control these systems in a virtual reality (VR) environment. This approach could make rehabilitation more efficient, engaging, and accessible for people with severe motor impairments.
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Safe Recovery to Prevent Hospital Falls.
The aim of this study is to deliver a new evidence-based education program in hospitals called the Safe Recovery program and to evaluate if it reduces falls and injuries. The study will also measure changes in patient and staff knowledge and motivation about falls prevention and if they are taking actions to reduce falls. Falls education is known to reduce patient falls and injuries in hospital. If effective the program will reduce falls and injuries in the wards that take part in the trial.
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A phase 2 study of the feasibility and efficacy of at home patient administered subcutaneous daratumumab in patients with relapsed multiple myeloma (Dara@Home)
PURPOSE The purpose of this study is to assess the feasibility of patient self-administration of daratumumab in patient's own home. WHO IS IT FOR? You may be eligible for this study if you are male or female aged 18 years or older, have a documented diagnosis of multiple myeloma. Have relapsed following first line therapy and require treatment with daratumumab, bortezomib and dexamethasone. STUDY DETAILS Daratumumab, bortezomib and dexamethasone is standard of care. Daratumumab is currently administered in the hospital. Bortezomib can be administered home if your hospital has programs in place for this to happen. Dexamethasone is a tablet that you can take in your own home. The Dara@home trial is to assess the feasibility of implementing a program to allow patients to self-administer daratumumab at home. In addition to standard tests used to treat and monitor your myeloma, this study will have additional questionnaires for you to report your experience with myeloma treatment. There is also an additional blood test to assess the level daratumumab in your blood to ensure that the treatment is working. It is hoped that findings from this study will give insight on the possibility of having daratumumab to be self-administered at home, which can reduce your visits to the hospital.
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Personalised Anxiety Treatment for CHildren (PATCH)
Anxiety disorders are the earliest emerging, most common and debilitating mental illnesses, yet 40-45% of anxious children do not respond to best-practice psychological treatment, cognitive behavioural therapy (CBT). For the past two decades, we have been examining fear conditioning and extinction (CON-EXT) markers of anxious children’s underlying threat sensitivity, positive valence, and cognitive control systems, and the markers that predict who will recover following CBT. We have developed a CON-EXT Profile to assess markers at the individual patient level and conducted studies of CBT enhancements that allow for personalised treatment. The next and most important step is to examine outcomes from personalised CBT relative to standard CBT. The primary aim of this project is to conduct a Phase III randomised controlled trial, in which anxious children, 7-12 years of age, are randomised to Stratified CBT, in which CBT is personalised to their CON-EXT markers (right CBT for each anxious child), compared to Standard CBT, in which anxious children receive standard CBT (one size fits all). It is hypothesised that a higher proportion of children will be in remission, and acceptability ratings and treatment completions will be higher, in Stratified CBT than Standard CBT at the post-treatment primary endpoint and 6-month follow-up.
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The design and impact of a patient educational program targeted at setting realistic expectations of the outcomes of total knee arthroplasty surgery (EXTOKA).
Unfulfilled expectations of surgical outcomes are a major factor influencing patient-reported dissatisfaction following Total Knee Arthroplasty (TKA). In Australia, approximately 60,000 TKA procedures are performed annually, with numbers expected to increase over the next decade. Despite advancements in surgical procedures, 10-20% of patients report dissatisfaction with surgical outcomes, indicating a significant number of individuals experience sub-optimal outcomes. In the EXTOKA project, we will develop an educational program for patients focusing on formulating realistic expectations of surgical outcomes following TKA in the private healthcare sector. The success of the program will be assessed by comparing patients’ expectations before and after the program, and by comparing expectations of those who participate in the program to those who receive standard clinical care alone. Additionally, the project will determine if participation is associated with a higher level of expectation fulfilment and satisfaction with surgical outcomes. Project findings will inform efforts to improve patient health literacy associated with TKA, supporting patients to make more informed choices about their recovery journey. By setting meaningful, realistic and achievable expectations of surgical outcomes, there is potential to better target rehabilitation programs to support attaining individual patient goals, thereby connecting them to the right care at the right time.
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A Randomized Controlled Trial of Digital Self-Management Support for Inhaler Device Technique and Medication Adherence in People with Chronic Obstructive Pulmonary Disease (COPD) and other Chronic Health Conditions
Chronic Obstructive Pulmonary Disease (COPD) is a common, long-term health condition that usually co-exists with other long-term conditions (comorbidities), which can lead to low health-related quality of life and death. Poor inhaler device technique and medication adherence further impact management of COPD, and can be improved by tailored, self-management support. This pragmatic randomized controlled clinical trial will test a digital self-management support intervention to improve inhaler device technique and medication adherence, based on the COM-B Model, in people with COPD and comorbidities in the community. The PRISIMA Trial will rigorously test whether this intervention is effective in improving COPD-related quality of life, inhaler device technique, medication adherence for COPD and comorbidities, patient activation, exacerbations and hospital admissions due to COPD, and overall health-related quality of life. A qualitative and health economic evaluation will also be done to determine whether the intervention can be implemented in routine practice.
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Comparing a 'wait and watch' approach vs medical treatment with misoprostol for first trimester retained products of pregnancy and using ultrasound to predict success
Study hypothesis - This study hypothesizes that non surgical management of first trimester retained products of conception has a high success rate and various ultrasound parameters can help in more accurate treatment selection with either expectant or medical management. Brief summary Retained products of conception ( RPOC) is a common occurrence after first trimester expectantly, medically or surgically managed miscarriage or termination of pregnancy. However, there is lack of evidence on the most ideal way to manage these patients, Surgical management has been the fall-back due to immediate results but comes with a high rate of complications such as intra-uterine adhesions which can lead to sub-fertility. On the other hand, non-surgical methods, not known to cause such complications, have shown promise but lack robust evidence. Hence, the purpose of our study is to determine the efficacy of non-surgical options in successfully managing RPOC. Participants aged 16-45 years presenting to the early pregnancy assessment unit and Emergency department (ED) with symptoms and ultrasound diagnosis of retained products of conception in first trimester of pregnancy will be consented, recruited and randomized to either expectant management or medical management with misoprostol. They will be followed up at 4 and 8 weeks for symptom review and progress ultrasounds to note successful management of RPOC. Success rates, ultrasound factors influencing success, short- and long-term complications will be noted.
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Sexual and Reproductive Health Screening in a Child and Youth Mental Health Service
This study aims to implement standardised sexual and reproductive health (SRH) screening into the Children’s Health Queensland (CHQ) Child and Youth Mental Health Service (CYMHS). CYMHS provides specialist outpatient mental health services to those up to 18 years of age with complex mental health needs. The intervention involves development and delivery of a brief training and education module designed to equip clinicians with the knowledge and confidence required to engage young people aged 12-17-years in consultations around their SRH and facilitate referrals for nurse-led SRH consultations where indicated, through which further SRH information, more advanced screening, and/or other care can be provided.
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Influence of the clear aligner trimline on incisor tooth movement, and patient experiences during orthodontic treatment
The intervention involves the use of clear aligners with a straight trimline, with control being aligners of a scalloped design. Participants are randomly assigned to start in aligners of either design. The predictability of the achieved tooth movement, according to each aligner design, will be assessed on a monthly basis. Tooth position data will be captured and superimposed to assess the predicted vs achieved tooth movements. The comfort and acceptability of each aligner type will be assess using a online questionnaire, using the validated tools of the OHIP-14 Questionnaide (Slade, Spencer, 1994) and the Visual Analogue scale. We hypothesise that using a straight trimline aligner may increase the predictability of orthodontic treatment with clear aligners.
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Can peer-workers help those leaving residential addiction treatment improve their recovery by planning and setting goals based on recovery strengths and weaknesses?
Most people who receive alcohol and/or other drug (AOD) treatment in Australia are not provided with continuing care; however, those who are, have improved outcomes (Manning et al., 2017). In Australia, the employment of AOD Lived Experience Workers (LEW) is growing with most jurisdictions committing to building this workforce. LEWs have their own experience in building recovery resources and are ideally placed to provide cost-effective continuing care. However, the LEW workforce is still developing and LEWs describe a lack of structure and standardisation in their roles (Eddie et al., 2019). This project will test a peer-supported recovery planning intervention to assist people leaving AOD residential inpatient treatment to receive structured peer support, identify their recovery skills and assets, improve engagement with services, and access additional care and support. The study aims to compare the effectiveness of this peer-led continuing care intervention compared to treatment as usual using a randomised trial design. It is hypothesised that those who receive this continuing care intervention will have a greater growth in recovery capital compared to those who receive treatment as usual.