ANZCTR search results

This prospective nested cohort study of Acute Kidney Injury (AKI) in a cohort of patients recruited to the ARISE FLUIDS randomised controlled trrial aims to describe the incidence of AKI with differing strategies of vasopressor use/ fluid resuscitation in patients presenting to the Emergency Department (ED) with septic shock, and to describe the relationship between these resuscitation strategies and sensitive biomarkers of AKI. As part of the ARISE FLUIDS trial, patients will be randomised to either 1. A ‘restricted fluids and early vasopressor strategy’ whereby ongoing hypotension is managed by a vasopressor infusion titrated to the desired blood pressure, or 2. A ‘larger initial intravenous fluid volume and later introduction of vasopressor strategy’ whereby an additional litre of intravenous fluid will be given for persisting hypotension, and then further, more liberal boluses of fluid as required. Patients recruited to this nested cohort will have additional granular renal data (creatinine, urine output, etc) collected through the subsequent admission, to determine the incidence and severity of AKI, and important renal outcomes. In addition, a novel sensitive biomarker (urinary insulin-like growth-factor binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases (TIMP-2) will be measured at enrolment and 24 hours. The relationship between this biomarker, resuscitation strategy, and renal outcomes will be explored.

The project is part of a national collaborative project by Australian clinicians and researchers, the National Endometriosis Clinical and Scientific Trials (NECST) Network. The NECST Registry will be a national resource of participant data that will facilitate high quality research aiming to understand the causes of endometriosis, improve diagnosis and treatment outcomes, and reduce the burden of disease for patients with endometriosis-related symptoms or diagnosed with endometriosis. Currently, there is a lack of clinical data about endometriosis. This is why there can be a delay of 7 – 12 years before a diagnosis of endometriosis is made for some people. In addition, clear care management plans are not yet available due to the lack of understanding of how endometriosis develops or changes during a woman’s lifetime. The NECST Registry will collect and securely store demographic and health related information from consenting participants, who experience and/or seek management for endometriosis and/or endometriosis-related symptoms or conditions (e,g., adenomyosis).

This study aims to determine whether behavioural activation treatment reduces symptoms of depression in adolescents with intellectual disability and depression, using a treatment called Beat-D. Behavioural activation treatment involves increasing people’s behaviours and engagement in things they enjoy doing, aiming to improve their mood and overall wellbeing. Half of the participants involved in the research study will be randomly allocated to receive the behavioural activation treatment, and the other half will be randomly allocated to continue to receive their usual care.

This study will investigate the effectiveness of Functional Imagery Training (FIT) as a motivation enhancement to self-guided attentional bias modification training (ABM) for young people seeking to reduce alcohol consumption. ABM training for alcohol is an emerging intervention designed to train individuals to disengage attention to alcohol cues in order to disrupt the cognitive elaboration process that precedes alcohol consumption as posited by Elaborated Intrusion theory (EI; Kavanagh et al., 2009). This project will extend our understanding of motivational enhancements to improve adherence to self-guided, digital health interventions. While there is promising early evidence for effects of FIT on treatment participation, this intervention has not yet been applied to improving adherence to ABM training regimens. Therefore, the results of this study will contribute to our knowledge about the potential for FIT to improve training completion rates and lead to better outcomes for ABM users and creators of self-guided applications. The aim of this study will be to determine if a self-guided, online FIT add-on, developed based on results and feedback from the earlier studies, increases adherence to multi-session ABM. The following hypotheses will be tested. Hypothesis 1: Participation in FIT will increase adherence to internet-based attentional bias modification training (intervention) for young people compared to ABM training and breath counting training (control), as measured by a significant group difference in the number of training trials completed. Hypothesis 2: Participation in FIT will be associated with improved therapeutic outcomes compared to control group, measured by a difference in self-reported number of alcoholic drinks consumed in the seven days prior to the conclusion of the trial compared to the seven days prior to commencing the trial.

The research study aims to understand if patients' attitudes towards appropriate care for their Age-related Macular Degeneration can be altered based on the type of education they receive. Two different approaches to providing patient education will be provided. This study will help us understand what type of education helps patients accept care that is best for them. If one approach to education is found to be better, we will share our educational approach with other eye health professionals so that they can help their patients make better care decisions too.

This will be a mixed-method, observational study and will be undertaken at the Royal Prince Alfred Hospital, Women and Babies Department. The study hypothesis is: Women feel more prepared for the induction of labour process when they access antenatal education, receive adequate clinical information and feel part of a shared-decision making process in the antenatal period. Women who feel prepared and satisfied with their decision to proceed with induction of labour feel more supported and greater contentment with their birth outcomes. The study will be conducted via a participant questionnaire (quantitative) and an audio-recorded interview with women at 6 to 8 weeks postpartum (qualitative). Electronic medical notes will also be reviewed to measure pregnancy and birth outcome data. The purpose of this design is to review the association between women who access antenatal education services, the reason given for induction of labour, women’s perspectives and experiences with the induction of labour process and delivery outcomes. The sample size calculation is approximately 100 participants for the survey and 15 participants for the interview, or until saturation with themes has been reached.

In this study we will be looking at the effects of vigorous intensity exercise during each trimester of pregnancy on blood pressure and blood vessels, as well as foetal heart rate. More specifically we want to see if exercising at a higher intensity may be more beneficial to vascular function during pregnancy. During pregnancy adaptations occur to the circulatory system to support the growing foetus. Sometimes these changes can result in negative health outcomes for the mother and the baby, e.g. gestational hypertension and pre-eclampsia. Exercise during pregnancy has been shown to have a range of benefits, including reducing blood pressure and the risk of pre-eclampsia. Higher intensity exercise has been shown to have more benefits on blood pressure in non-pregnant populations, however research on the effects during pregnancy is currently lacking.

Excessive near work is considered to play a role in the development of refractive errors of the eye, especially myopia (also known as short-sightedness). Studies have shown that myopia onset is associated with the education. Our modern education commonly involves reading, writing, arithmetic (problem solving etc). During near work, the pupil (aperture that allows light into the eye) normally constricts (reduces in size) and in addition, the lens inside the eye (crystalline lens) changes shape to increase in power (accommodation). These changes allow the image to focus on the retina (photosensitive layer responsible for sending signals from eye to brain). Although it is commonly considered that pupil constricts (reduces in size) while doing near work, surprisingly, performing a cognitive task at near (solving mathematical problems) dilates the pupil. In a previous study conducted as part of our research, we have demonstrated that whilst doing near tasks, the accommodative system is engaged for both reading and cognitive tasks but not for gratings. In comparison, the pupil is constricted for reading, dilated for cognitive tasks, and remains unaltered for grating tasks. A smaller pupil will improve the depth of field and improve resolution whereas a larger pupil is likely to decrease retinal image quality due to increased aberrations. This in turn may play a role in development of myopia. Optical correction such as myopia control contact lenses and spectacle lenses, which were specifically designed with desired power profiles to reduce the optical defocus and enhance the retinal image quality were found effective in slowing myopia. It is important to determine if the pupillary and accommodative responses are altered with such treatment modalities. Other than optical correction, it has been thought that exposure of the eye to short wavelength light (blue light 440nm – 480nm) may influence myopia progression. Therefore, it is of interest to determine the accommodative and pupillary responses of the eye with habitual and myopia control strategies under normal light and blue light.

Heart failure occurs when the heart muscle becomes too weak to pump blood to vital organs in the body. Common causes include prior heart attacks, cardiomyopathy (genetic or acquired), high blood pressure and diabetes. The long-term prognosis of heart failure is poor and multiple medications are required to treat it. Cardiac transplantation is a lifesaving procedure that can prolong the life of a person with heart failure. It requires lifelong immunosuppression to prevent rejection of the transplanted heart. Heart transplant survival rates have improved with modern immunosuppression medications. However, these medications can cause complications that eventuate in transplant-related illness and death. Prevention of medication-related complications, including diabetes, kidney impairment, and stiffening of the transplanted heart will improve health outcomes and financial costs associated with managing these complications. Excitingly, a new class of diabetes medications, the sodium glucose cotransporter-2 (SGLT2) inhibitors, have recently been shown, in large numbers of human subjects, to have major benefits for the heart. Not only do they reduce the risk of death from heart disease in people with type 2 diabetes, but they also improve heart function and reduce the likelihood of admission to hospital for heart failure. Interestingly, they also appear to exert this benefit in people without diabetes. In light of this evidence, it is possible that the SGLT2 inhibitors could improve the functionality of transplanted hearts. We will undertake a 12-month study of SGLT2 inhibitors in 100 patients who have undergone a heart transplant, to determine whether diabetes and other complications of immunosuppression medications can be prevented, and whether the efficacy of the transplanted heart, and the lives of the recipients, can be improved.

This study aims to evaluate the acceptability of a coach-supported, individually-tailored online parenting program for parents of adolescents who refuse school in the context of clinical-level anxiety or depression. The program aims to increase parental self-efficacy to support their teenage child by providing personalised feedback about their current parenting and equipping them with evidence-based parenting strategies to respond to school refusal, anxiety and depression. The intervention is delivered online and comprised of up to 12 parent-led, online modules covering different topics. Online modules are supplemented by up to 8 one-on-one videoconferencing sessions with a therapist-coach to support parents in making changes in their parenting. In this study we aim to understand how acceptable the program was to receive, and how the acceptability of the program could be enhanced. We also aim to gather preliminary indications of how effective the program was in improving 1) parental self-efficacy to respond to school refusal, 2) parenting behaviours to reduce teen anxiety and/or depression, 3) carer burden, and 4) teen school attendance. Due to the exploratory and mixed-methods nature of the study, no hypotheses have been specified.