ANZCTR search results

Induction of labour (IOL) is one of the most frequent obstetric interventions, being performed in more than 100,000 pregnant women in Australia every year. The first phase of IOL consists of preparation of the cervix, which is often done with the placement of a balloon catheter through the birth canal for 12-24 hours. This procedure is effective, safe and generally performed in hospital. This study will not only investigate whether cervical ripening with a balloon catheter can be performed safely and effectively at home after insertion in hospital, but also establish a network of obstetric services in Australia. If we show that cervical ripening with a balloon catheter can be safely and effectively performed at home, this will reduce significantly the number of admissions and healthcare costs.

The purpose of the study is to evaluate a product called Tranexamic Acid (TXA) and its best use in patients who are undergoing total knee replacement. The product is currently used to reduce bleeding during and after surgical procedures. This can lessen the chance of a blood transfusion and may decrease pain, swelling and recovery time following the operation. Tranexamic Acid is already routinely used by surgeons for patients having joint replacements but there is currently no accurate information about how to dose individual patients with this medication to achieve the best results. This study will assess whether different treatment durations and doses will lead to better patient outcomes. The form of TXA that we are using in this study is one single dose in the vein-intravenously and/or an oral tablet. There are 2 treatment groups: Group 1 –Receives 1 gram of TXA intravenously 1 hour prior to surgery Group 2 – Receives 1 gram of TXA intravenously TXA 1 hour before surgery and post-operatively oral dose of 2 grams 8th hourly for a total of 6 doses.

The West Australian Heart Valves Study (WAVES) aims to improve patient outcomes in valvular heart disease. The study aims to achieve this via two separate components: 1) A registry that includes data linkage of mortality and hospital morbidity records of all patients who have had a heart valve replacement and/or repair in one of the 3 tertiary public hospitals in Western Australia since 2010 and 2) An observational cohort study of all living patients in the registry to determine health outcomes, medication use and patient reported outcomes such as quality of life, functional capacity and life disability.

The most common spinocerebellar ataxia worldwide, Machado-Joseph disease (MJD) has the highest estimated prevalence in affected Aboriginal communities of the Top End of Australia. MJD, or spinocerebellar ataxia 3 (SCA3), is a rare autosomal dominant neurodegenerative disease that leads to progressive ataxia and functional decline. The ‘Staying Strong Toolbox’ is a physical activity and lifestyle program designed by Aboriginal families living in Groote Eylandt and Ngukurr, to keep their families walking and moving around. Families with MJD in these communities who were concerned about their declining mobility partnered with the MJD Foundation and university researchers to co-design the Staying Strong Toolbox, based on their experiences and what is known from MJD research. The aim of this study was in order to determine the feasibility and impact of the Staying Strong Toolbox program on walking and moving around for Aboriginal families with MJD in the Top End of Australia. A mixed method multiple case study design was used to pilot the Staying Strong Toolbox. Eight individuals with MJD participated in the program for four weeks. Participants tailored their own program using the Toolbox workbook. Families, support workers and researchers facilitated each individual’s program. Feasibility was determined through program participation, adherence, coinciding or serious adverse events, participant acceptability and cost. Impact was determined through measures of mobility, ataxia, steps, quality of life, wellbeing and goal attainment, assessed before and after the program.

Endometriosis is a common and chronic condition. Whilst deep forms of the disease (ovarian endometriomas and deep-infiltrating endometriosis) are reliably diagnosed on ultrasound prior to surgery, superficial pelvic disease is not. This pilot study aims to assess a new ultrasound measurement to determine its accuracy in diagnosing superficial endometriosis. Patients scheduled for key-hole surgery will undergo pelvic ultrasound 1-2 months before surgery, then standardised surgical samples of the uterosacral ligaments (fibrous bands originating at the lower uterus) will be analysed. Should this ultrasound measurement be successful, it will improve diagnostics for endometriosis, and guide which patients may benefit most from surgery.

Deep brain stimulation (DBS) is an established treatment for Parkinson’s disease (PD) and has been shown to improve the symptoms and quality of life of patients with this condition. The effectiveness of DBS relies on applying DBS therapy to an ‘ideal’ location to achieve maximal symptom improvement. This ‘ideal’ location is dependent on where the DBS lead is implanted during surgery and where the doctor choses to apply DBS therapy along the lead after surgery. Electrical signals recorded in the brain during DBS surgery may help doctors in identifying: 1) the ‘ideal’ location to implant DBS leads during surgery and 2) the ‘ideal’ location to apply DBS therapy after surgery. Evoked resonant neural activity (ERNA) is a new electrical brain signal that has been recorded from DBS leads during surgery in patients with PD. ERNA holds significant promise as an electrical brain signal that could guide DBS lead implantation during surgery and assist doctors in selecting the ‘ideal’ location to apply DBS. However, the reliability of recording ERNA signals in the brains of patients with PD is unknown. Therefore, the primary purpose of this study is the establish whether the ERNA signal can be reliably and safely recorded in the brains of patients with PD during DBS surgery. The secondary purpose of this study is to determine how the ERNA signal relates to the location of the DBS leads in the brain and the response of the patient to DBS therapy.

MovingTogether is a health promotion program for socially isolated, older adults that targets modifiable risk factors including physical inactivity and balance to improve mental and physical health outcomes. The program is delivered online, through a private Facebook group. Allied health professionals e.g. exercise physiologists and a dietician provide education, individual guidance and promote social connection within the group. Topics covered include increasing physical activity, decreasing sedentary behaviour, healthy eating, goal setting and balance training. The balance training portion of the program is covered by the inclusion of NeuRA’s StandingTall app. Our previous pilot study demonstrated feasibility, acceptability and preliminary effectiveness. With the general protocol maintained and improvements made to program design since, we hypothesise that the program will be effective in comparison to a control group.

The aim of this study is to investigate the effects of daily consumption of gold kiwifruit on psychological health and wellbeing and other health related outcomes including biochemical parameters, and gut symptoms in adults aged 35-60 years with elevated (mild to moderate) stress, anxiety and depression. Gold kiwifruit contain exceptionally high levels of vitamin C. Vitamin C is recognised for its important role in mood, cognition and physical health and wellbeing. Gold kiwifruit has the potential to infer beneficial effects on the constructs of psychological wellbeing and gut health and functioning. The CSIRO will lead a 10-week trial involving daily delivery of gold kiwifruit in adults experiencing current mild to moderate levels of psychological distress and who present with sub-optimal vitamin C concentrations.

The use of cognitive training to target neuropsychological dysfunction in ‘at-risk’ patients including individuals with depression, and/or with subjective or objective cognitive impairment (including those with diagnosed mild cognitive impairment) represents a promising therapeutic option in the absence of any existing treatment. However, there remains a paucity of cognitive training programs being offered in public mental health settings, and in the context of a global pandemic, face-to-face interventions remain suspended. While our group has recently demonstrated feasibility, tolerability and acceptability for our group-based, face-to-face cognitive training program, due to the restrictions resulting from the current pandemic, we have been unable to continue to offer this valuable intervention to vulnerable older people. There is now an urgent need to evaluate whether we can deliver this intervention in a virtual mode for 'at-risk' older adults, who are now presenting in increased numbers due to the pandemic.

The aim of this study (registry) is to document diagnosis, treatment and outcomes for patients with advanced melanoma over time, in order to better understand survival and treatment efficacy in these patients. Who is it for? You may be eligible for this study if you are aged 18 years or older, and have been diagnosed with stage III or IV cutaneous or unknown primary melanoma. Study details Information regarding the multi-disciplinary management of melanoma, including surgery, radiotherapy, systemic therapy, and palliative care in the routine clinical practice setting is obtained via medical records. Information regarding the clinical outcomes of treatment, including time to disease progression and overall survival, will also be collected. Participants will be followed up for a minimum of 12 months and a maximum of 5 years, if funding for this extension can be secured. No additional tests or time commitment by participants is required. It is hoped that this study will allow a comprehensive analysis of melanoma diagnosis, treatment and outcomes, supporting much needed basic, translational and clinical research of this disease. This may help to provide insight into optimal management of advanced melanoma in light of new and emerging treatments.