ANZCTR search results

The purpose of this study is to determine whether or not instilling gentamicin, a type of antibiotic, into the bladder during urodynamic assessment, will reduce rates of post-procedural urinary tract infections (UTI). Patients with spinal cord injuries suffer from an increased rate of urinary tract infections due to a number of factors arising from the injuries to the nerves in the spine impacting on communication with the bladder. Further to this, intermittent self-catheterisation devices and indwelling catheters promote introduction and colonisation of the urinary tract. While spinal cord injured patients are frequently colonised with micro-organisms, some can lead to symptomatic infections requiring frequent courses of antibiotics, hospitalisations and urosepsis in the most severe cases. It is therefore critical that when we perform invasive procedures such as urodynamic assessment that we identify ways to reduce new bacteriuria and symptomatic urinary tract infections. Currently rates of UTIs after urodynamics in patients with spinal cord injuries is significant, ranging between 5-30%. Using gentamicin, an antibiotic, during urodynamics could be a new way in reducing rates of UTIs. Studies have shown that intravesical administration for high risk patients such as those with spinal cord injuries reduces symptomatic UTIs, oral antibiotic use and antibiotic resistance. The use of intravesical (instilled within the bladder) gentamicin irrigation for prevention and treatment of recurrent urinary tract infections was first reported by McGuide and Savastono in 1987. A systematic review of intravesical antibiotic agents (gentamicin, neomycin, polymyxin, colistin) showed a good response with a reduction in symptomatic UTI of 78.2% for both treatment and prophylaxis groups. A success rate of 71% (n=120) was seen in the prophylaxis group in the short term, with discontinuation rate of 8% (n=14). To assess the true effect of gentamicin used during urodynamics, both participants and medical staff performing the urodynamics will be ‘blinded’. This means that neither the participants or the staff will be aware of whether or not the patient will be receiving normal saline (routine solution used during urodynamics) or normal saline mixed with 240mg of gentamicin. This is what researchers refer to a randomised blinded controlled trial.

One in three strokes in Australia are repeat events. These repeat strokes are more likely to result in death and are costly, for both individuals and the healthcare system. Cardiac rehabilitation is a well-established and widely available secondary prevention program that reduces disease risk and death from heart disease and could help prevent repeat strokes as both share similar risk factors, such as physical inactivity, high blood pressure and poor diet. However, our research has found that less than 2% of Australian cardiac rehabilitation programs include people with stroke. This is despite Australian stroke health professionals and cardiac rehabilitation coordinators agreeing that cardiac rehabilitation is suitable for people after a transient ischaemic attack (TIA) or mild-stroke. Here the University of Canberra (UC) will partner with Canberra Health Services and Calvary Public Hospital, supported by the Stroke Foundation and Heart Foundation, to investigate the effectiveness of a 6-week integrated (TIA, mild-stroke, heart disease) traditional cardiac rehabilitation program (Cardiovascular rehabilitation) at the UC Health Clinics. Together we will recruit 140 Canberrans who have had a TIA or mild stroke over 2-years. These study participants will be randomly allocated to the Cardiovascular Rehabilitation program or a 6-month wait list group. We will then measure physical fitness, hospital admissions, blood pressure and other risk factors for stroke to determine the effectiveness of the program, as well as costs. Feedback from participants and health professionals will also be sought to guide the implementation of this novel program in other health services. Results will be disseminated to health professionals and the public via presentations, webinars and publications. If successful, the results will guide future research, policy and practice, potentially reducing the risk of repeat strokes locally, nationally and internationally. By reducing the risk of further strokes through the use of this existing secondary prevention program, we aim to help more Canberrans live longer after TIA and mild-stroke and avoid hospital readmissions.

Budesonide is an inhaled corticosteroid which is commonly used to treat asthma. It is inexpensive and widely available. Budesonide is a category A drug in pregnancy. There is evidence that budesonide reduces hospital admission in patients with covid-19 who are not pregnant. The physiological changes that take place in pregnancy include increased minute ventilation and upwards displacement of the diaphragm which results in a high-risk state for any kind of respiratory compromise. As such, treatments that reduce the risk of these fit young mothers suffering respiratory decompensation are pertinent to the well-being of both the baby and the mother. This study seeks to determine if budesonide improves outcomes in those hospitalised with covid-19.

This project aims to see if real-time video teledentistry can be used to look at your mouth, and give you some preventive dental advice. We want to determine whether teledentistry can be an option over traditional in person site visit.

Genetic testing has become a central focus in cancer care due to the ability to identify individuals with an inherited predisposition to cancer and inform prognosis and treatment options. This trial is investigating the effectiveness of using the Genetic Psychosocial Risk Instrument (GPRI) in genetic counselling appointments for people with an inherited predisposition to cancer (for example a family history of cancer). Who is it for? You may be eligible for this trial if you are an adult aged 18 years and above and you have an increased risk of a hereditary cancer syndrome. Patients attending the Parkville Familial Cancer Centre for genetic testing will be invited to participate. Study details Participants who choose to enrol in this study will be randomly allocated by chance (similar to flipping a coin) to either the GPRI intervention arm, or a standard care control arm. Participants in the intervention arm will complete baseline questionnaires and the GPRI online before their first appointment. During the first appointment, the clinician taking the appointment will use the results of the GPRI to inform the genetic counselling provided while discussing genetic testing. Participants will then return approximately 8 weeks later for their second genetics appointment where they will receive their genetic test results. Prior to this second appointment, participants will complete the GPRI online again. During this second appointment, the clinician will again use the results of the GPRI to inform the genetic counselling process when discussing genetic test results and personal and family implications. Participants in the control arm will also complete the baseline questionnaires but will not complete the GPRI. Instead, these participants will receive the current standard of genetic counselling which involves the clinician facilitating communication about the medical, psychological, and reproductive implications of an inherited cancer predisposition. All participants will be invited to complete three subsequent questionnaires about their experiences throughout the study period up to 6 months after the second genetics appointment. It is hoped that this study will demonstrate that the GPRI tool is useful and may help patients with an increased risk of cancer to feel more empowered about their health and future treatment options.

Accidental falls are a costly public health problem and can result in significant negative implications for the individual, particularly when resulting in injury and hospitalisation. A range of factors are known to influence one’s risk of accidental falls, including age, physical activity, quality of life, fear of falling and social interaction/isolation. In an era of rapid changes in the way we socially interact and/or isolate, this may have important implications for falls risk. Thus, the aim of this observational study is to examine the predictive effect of social interaction, physical activity levels, quality of life and fear of falling on falls incidence in older adults.

Iron deficiency (ID) is the most common worldwide nutrient deficiency, is of particular concern to athletes due to the fundamental role of iron in optimal sports performance. Exercise-induced physiologic changes may be a possible explanation for the high rates of ID in athletic cohorts. These mechanisms include iron losses via sweat, gastrointestinal bleeding, hematuria, and repeated inflammatory mediated increases in the iron regulatory hormone hepcidin. Furthermore, in female athletes, the iron losses associated with menstruation add an extra burden that may contribute to the high rates of ID seen in female compared to male athletes (~35% vs ~10%, respectively). Although these mechanisms have been examined in isolation, whether the sustained and combined effects seen in high performance athletes have a meaningful impact on iron metabolism and long-term iron balance is unknown. Therefore, the primary aim of this study is to compare iron absorption, loss and overall balance using iron isotope tracers in endurance trained athletes with recreationally active individuals at regular intervals across a 12-month training cycle. 12 months after the iron isotope tracer is administered, participants will attend the laboratory at 3 monthly intervals for a 12 month period (5 visits). Participants will have a venous blood sample collected and measured for markers of iron status and isotopic the isotopic iron composition, as well as an assessment of hemoglobin mass. Information around habitual dietary intake (specifically iron), menstrual cycle history and training volume will also be collected at each visit. Outcomes of this study will increase our understanding of iron requirements for athletes against those of the general population.

This study will collect endometrial biopsies from women who are having laparoscopic surgery. During their operation, the presence +/- severity of a condition called 'endometriosis' will be graded. We hope to see whether or not there is a correlation between 'BCL6' levels on their endometrial biopsy specimen, with the presence +/- severity of endometriosis at keyhole surgery.

A key barrier to hepatitis C (HCV) diagnosis and treatment is the multi-stage process of conventional HCV testing as patients require multiple visits to pathology services and healthcare providers to obtain a HCV antibody test, then a HCV RNA test, receive the result and finally be linked into care. This novel study aims to scale up HCV screening in the community by providing HCV point-of-care (POC) testing, liver assessment and direct referral into treatment at the priority settings of mental health, prisons and alcohol & other drugs (AOD) services. The study will investigate the benefit of providing POC HCV diagnostic testing using SD Bioline fingerstick antibody (Ab) assay and Cepheid fingerstick HCV RNA for participants who return a positive HCV Ab result. Providing same day test results and referral for treatment in one visit addresses a major barrier to HCV treatment uptake, particularly in people at high risk of HCV infection such as people who inject drugs (PWIDs).

Reduced cardiorespiratory fitness is a common secondary impairment for people who have sustained a severe traumatic brain injury (TBI). Gamification including virtual reality (VR) may be one strategy to provide a motivating environment for fitness training. A recent large randomised controlled trial (n=300; including 18 adults with severe TBI) conducted by members of the research team, provided additional rehabilitation using digital devices and demonstrated improvements in mobility and self-reported physical activity at 6-months and cognition at 3 weeks. Fitness training and virtual reality has been investigated in people after TBI by one single group study conducted over 20 years ago. In this study, 13 people with severe TBI underwent 4 weeks of fitness training on a cycle ergometer using VR. This study showed promising results in cognitive changes, but no follow up work was conducted. Given the improved knowledge in dosage and benefits of fitness training in this population, and the growing interest and access to virtual reality systems, a pilot study focused on how best to implement this type of program in practice is warranted. This study will evaluate the efficacy of gamification on outcomes from fitness training using a single-case experimental design protocol with a group of patients from the Liverpool Brain Injury Rehabilitation Unit who require physical rehabilitation after TBI.