ANZCTR search results

Following elective total hip or knee replacement surgery (THR/TKR), receiving care at home instead of hospital is recommended for most patients. However, care at home services such as rehabilitation-at-home are underutilised in private hospitals. Research suggests the primary reason patients spend additional time in private hospitals is driven by patient concerns with safety and value of care at home. To address patient concerns, we have designed new patient information aiming to dispel fears about safety and better inform patients about the benefits of rehabilitation-at-home. The primary aim of our trial is to investigate if new patient information helps more patients to receive rehabilitation-at-home instead of hospital. For patients scheduled for a THR or TKR at a private hospital, we will randomly select 299 patients to receive new patient information before surgery, and another 299 patients who will receive the current information only. Then we can compare the two groups to see if the new information help more patients receive rehabilitation-at-home. We will also measure patient outcomes (e.g., quality of life) and costs between the two groups. We also plan to compare outcomes between participants who receive non-inpatient rehabilitation (i.e., rehabilitation-at-home or outpatient rehabilitation) versus inpatient rehabilitation care. Alongside the trial, we will also conduct interviews with a subset of participants who received the new patient information, to explore their perspectives on the intervention based on their experiences.

Cardiovascular disease remains a leading cause of death. The burden of arterial calcifications remains an important predictor of cardiovascular disease events and deaths, however, predicting those who will eventually develop a large arterial calcification burden is difficult. Recently, lab studies have suggested that a low level of oxygen within the arterial wall, and plaque, may predispose to increasing calcification in the same region. 18F-Fluoromisonidazole (18F-FMISO) Positron Emission Tomography (PET) is a novel molecular imaging modality that can detect areas of low oxygen in the arterial wall and plaque and may be a suitable imaging tool to predict where calcification develops. In a prospective arm, we aim to determine if regions of low oxygen in the vessel wall, detected with 18F-FMISO PET, in patients undergoing lower limb amputation, is associated with other markers of hypoxia (in-vitro hypoxia inducible factor 1-alpha) and calcification (ex-vivo 18F-Sodium Flouride PET) in the same anatomical region.

This prospective cohort study will recruit consecutive clients attending the withdrawal unit and offer them rapid point-of-care testing for hepatitis C viral load by fingerstick. This will be compared to current standard-of-care hepatitis C testing through a retrospective analysis of testing and treatment over the preceding 12 month period. The study will aim to evaluate the uptake and acceptability of point-of-care testing of hepatitis C amongst individuals with substance dependence presenting to a residential withdrawal unit along with the rates of direct acting antiviral treatment initiation and adherence for individuals with confirmed hepatitis C. The study will be undertaken at Depaul House, a residential withdrawal unit attached to St Vincent's Hospital Melbourne.

Osteoarthritis is the most common form of arthritis and is a leading cause of global disability. This study will evaluate the effects of two different nutrition programs in individuals with knee OA delivered over 12 weeks. We hypothesise that the anti-inflammatory dietary intervention will result in greater improvements in pain, function, quality of life, inflammatory biomarkers and body composition after 12 and 26 weeks compared to a standard care control group.

The aim of the study is to prove that the Felix™ System is just as good as either or both the Density Gradient Centrifugation (DGC) and Swim-up (SU) methods of spermatozoa separation when using Intracytoplasmic Spermatozoa Injection (ICSI) fertilisation. This will be measured based on how many embryos could be immediately transferred, 5 or 6 days post fertilisation or retained and frozen for later transfer.

Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder with no validated biomedical treatments for the core social and behavioural symptoms. The current study is a randomised crossover trial to assess whether cannabidiol (CBD) can promote behavioural and neurophysiological improvements in 5- to 12-year-old children. Several recent studies have investigated acute CBD administration on neurophysiological processes in the adult autistic brain (Pretzsch, Freyberg, Voinescu, et al., 2019a; Pretzsch, Voinescu, Lythgoe, et al., 2019a, 2019b; Pretzsch et al., 2021a). Others have documented behavioural outcomes following chronic (long-term) administration of the compound (Aran et al., 2019, 2021; Bar-Lev Schleider et al., 2019). To date, no investigation has explored effects of long-term CBD administration on glutamate and GABA concentrations alongside social communication outcomes. With a specific focus on the Research Domain Criteria (RDoC) ‘social processes’ domain (Cuthbert & Insel, 2013), which is heavily implicated in ASD, this study will utilise electroencephalography (EEG) to measure neurophysiological changes after chronic administration of CBD over a 12-week period. EEG will be used to acquire resting-state, social task-related processing, and mismatch negativity (MMN) data. MMN is a recognised measure of glutamatergic NMDA receptor function, and thus, neuronal excitation (Kompus et al., 2015). The study is designed to address the following aims: Behavioural: to measure the effect of CBD on the RDoC social processes domain in children with autism. More specifically, to observe a change in Social Responsiveness Scale (SRS) scores from baseline to Week 12. Neurophysiological: to observe whether CBD ‘shifts’ cortical excitation/inhibition during a social task, measured using EEG.

To assess whether incorporation of a polygenic risk score (PRS) into cardiovascular disease examinations (e.g., Heart Health Check), through the PPP-CAD clinical pathway, identifies subclinical CAD in participants considered to be at low or moderate 5-year absolute cardiovascular disease (CVD) risk (Absolute CVD Risk).

Nutritional supplements are routinely ingested throughout a training period to maximise exercise-based adaptations. While the mechanisms for adaptations can be varied and can include increased energy expenditure, reduced catabolism, and increased protein synthesis, the intended outcome is an increase in the intended adaptations to training. Pycnogenol, a herbal dietary supplement extracted from French maritime pine bark, is widely marketed for its antioxidant effects. Health benefits purported for Pycnogenol include improved cognitive function, endothelial function, and blood pressure regulation. However, the effect of Pycnogenol on exercise performance, or exercise-induced oxidative stress and inflammatory responses is less clear. Consumption of Pycnogenol has been shown to increase serum NAD+ levels and more recently a study demonstrated that French maritime pine bark extract reduced markers of oxidative stress 48 hours post exercise. Substantially more investigation into the influence of Pycnogenol on exercise performance is required to confirm these results, to examine the optimal timing and dose amount of this supplement, as well as to establish the physiological mechanisms that explain the increased time to exhaustion during intense endurance exercise. Therefore, we hypothesize that Pycnogenol, could be a supplement that increases endurance and with greater adaptations when consumed in addition to training. Here we propose a study designed to establish whether Pycnogenol can improve endurance in highly trained AFL footballers.

Providing feedback to runners outside of laboratory settings may be more advantageous than traditional laboratory-based feedback due to reduced associated costs and improved accessibility. With advancements in wearable technology, it is now possible to use small wireless sensors, called inertial measurement units (IMU), to provide runners with real-time feedback on variables associated with injury in their usual running environment. This project will determine the effects of field-based gait retraining using real-time biofeedback from wearable sensors in high impact runners and assess whether any biomechanical effects are retained at 1-month post retraining. To assess our project aims we plan to recruit 30 healthy runners with high landing impacts. Participants will be randomised into an intervention group that will receive real-time feedback to lower their landing impacts or a control group that be provided with a sham IMU and not receive any feedback during field-based running sessions. Groups will be compared post-training and at 1-month post-training. The expected findings may provide an IMU-based method of running gait retraining and allow for large-scale translation of the results to field settings and reduce the reliance on laboratory-based gait retraining.

Overview: Chronic wet cough in children can be a sign of underlying lung disease such as protracted bacterial bronchitis (PBB) or bronchiectasis. In the absence of pointers to alternative diagnoses, chronic (>4 weeks duration) wet cough that responds to antibiotic treatment typically indicates a diagnosis of PBB. Timely recognition and management of PBB can potentially prevent progression of disease to irreversible bronchiectasis with lifelong consequences3. However, detection and management requires both timely health seeking by parents/families and optimal management by clinicians. Our study’s overall aim is to improve (a) parent/family health seeking for chronic wet cough in their children and (b) clinician management of chronic wet cough in First Nations children. We hypothesize that implementation of a culturally integrated strategy, which is informed by barriers and facilitators identified by parents and health care providers, will improve respiratory health of First Nations children and thereby reduce the burden of bronchiectasis by preventing the progression of protracted bacterial bronchitis to bronchiectasis in First Nations children. Methods The trial is a multi-center, pseudorandomized stepped wedge design where the implementation of the intervention (a strategy) is adapted to each site through a combined Participatory Action Research and Implementation Science approach informed by the Consolidated Framework of Implementation Research. Outcome measures will consist of three categories related to (i) health (ii) economics and (iii) implementation. Health seeking will be measured as the proportion of parents seeking help for their child in a 6-month period before and the same 6-month period after the intervention. The Cough-specific Quality of Life (PC-QoL) will be the primary health related outcome measure. Discussion We hypothesise that tailored intervention based on identified barriers and facilitators identified through engagement with parents and health service providers will result in improved health seeking for parents of children with chronic wet cough and improved clinician management of chronic wet cough. We expect this will result in improve lung health outcomes for children with chronic wet cough.