ANZCTR search results

This study aims to close an identified research-practice gap and increase accurate cerebral palsy diagnosis (CP) under six months of age in Australia through tailored e-learning for physicians. This trial will determine whether adaptive e-learning using virtual patients, targeting CP diagnostic behaviours and skills, effectively changes physician behaviour and practice compared to non-adaptive e-learning instructional design or control. Our hypothesis is that physicians who complete adaptive e-learning will perform better on an examination of CP diagnostic skills, and self-report of real-world behaviours and practice compared to physicians that receive the non-adaptive e-learning or a control group who don’t receive an intervention. We also hypothesise that physicians who complete either type of e-learning will be more effective at clinically diagnosing and applying for National Disability Insurance Scheme funding for infants with a diagnosis of CP under six months of age compared to a control who don’t receive an intervention.

People with musculoskeletal pain and injury exhibit higher than expected cortical inhibition, which means that the brain actively inhibits the recruitment of motor units and hence impairs motor function. Specifically, following ACLR and a rehabilitation program targeting lower limb strength, decreased quadriceps strength has been associated with abnormal cortical inhibition, with higher than expected corticospinal inhibition present even at the stage athletes return to running. One intervention proposed to assist in the reduction of cortical inhibition and improve motor drive is transcranial direct current stimulation (tDCS). tDCS can be applied to the motor cortex using a direct current via electrodes placed on the head when performing exercise. tDCS has been shown to improve muscle strength and assist in motor learning making it feasible that applying tDCS to a cohort of ACLR patients may improve functional outcomes. Specifically, anodal tDCS to the primary motor cortex has been shown to reduce intracortical inhibition, potentially addressing the identified deficits following ACLR. Objectives 1. Determine if the addition of tDCS is superior to sham tDCS for improvements in knee muscle strength and motor control following ACL-R in the short and long-term. 2. Determine if the addition of tDCS results in a reduced timeline to pass a return to play testing battery compared to sham tDCS.

Our study will establish whether weight-based dosing of enoxaparin (for venous thromboembolism prevention) is feasible. Feasibility will be determined by the observation of peak levels of a biomarker outcome (anti-Xa) within the target ranges for VTE prophylaxis recommended for ICU patients. On completion of the study we expect to inform a future (larger, multi-centre) trial for one of the most common treatments in ICU, VTE prophylaxis in critically ill patients weighing greater than or equal to 100kg. We will also gain valuable insights into how the electronic medical record can be utilized for research on campus. Patients assigned to usual care (control) will receive enoxaparin 40mg subcutaneously twice daily. Patients assigned to the intervention arm will receive enoxaparin according to a personalized algorithm. We have reviewed the literature and based on existing data, a weight-based dosing regimen with dynamic adjustment (personalized approach) is recommended when the pharmacodynamics and pharmacokinetics of enoxaparin become unpredictable. Patients with increased body weight during critical illness represents the archetypal condition that would benefit from such an approach; it has the greatest potential to improve VTE prevention in this cohort.

The present study seeks to evaluate a brief online intervention, Managing Emotion, which has been developed by the present investigators for the purpose of supporting the psychological and emotional well-being of university students. Participants will be recruited for the trial through the Curtin Wellbeing Survey, a mental health screening and stepped referral care program offered to all first year students at Curtin University in Western Australia. Students identified as being at low suicide risk will be invited to participate in the Managing Emotion RCT (Students at moderate to high risk suicide risk receive safety planning or personalised referral options, and are excluded from invitation to the Managing Emotion RCT). Participants will be randomly assigned to either the Managing Emotion intervention or treatment as usual (provision of list of general mental health resources). The intervention content seeks to increase understanding of the relationship between thoughts, emotions, and behaviour, and discusses a number of evidence-based strategies for managing one’s emotions, particularly during times of stress. The intervention content is divided into five self-paced modules, to be completed over the course of one week. Each module includes a number of brief engaging videos, light reading material, and take-home activities. A set of questionnaire measures will be administered immediately before and after completion of the Managing Emotion program, and at 1 month follow-up, to provide an evaluation of the efficacy, acceptability and feasibility of this intervention. We predict that completion of the Managing Emotion program will be associated with an increase in participants' ability to regulate their own emotions, an increase in participants' perceived self-efficacy and resilience, reductions in reported depressed mood, anxiety and stress, and their overall adaptation to university.

Gastric and gastroesophageal cancers are common and carry exceedingly high mortality rates. Of those patients treated with curative intent, the majority have locally advanced disease, and require chemotherapy before and after radical surgery. Since 2017, 5-fluorouracil, leucovorin, oxaliplatin and paclitaxel (FLOT)-based chemotherapy has become the most commonly used perioperative regimen. This study aims to assess the survival patterns of patients receiving this chemotherapy regimen, and to assess whether receiving FLOT-based chemotherapy both before and after surgical management affects survival compared to those who received only pre-operative FLOT-based chemotherapy. Who is it for? You may be eligible for this study if you are aged 18 years and over, have been diagnosed with gastric or gastroesophageal cancer, and received preoperative FLOT-based chemotherapy and surgical resection between 01/01/2017 to 31/12/2021. Study details For all participants, information regarding survival and disease progression (identified clinically, biochemically, and/or radiologically) will be obtained from your electronic medical record, with no study visits or additional testing required. This data will be used to compare the survival and disease progression between those who did and did not receive post-operative FLOT-based chemotherapy. It is hoped that this research may identify whether there is any further survival benefit from providing post-operative FLOT-based chemotherapy, which may help to dictate future management of patients with gastric or gastroesophageal cancer.

Social prescribing is a relatively new way of linking patients with sources of non-medical support within the community. Studies have shown that non-medical activities are an effective way to manage psychosocial problems in the community. This pilot project aims to cooperate with existing service providers in the Huon area to increase the rate and effectiveness of social prescribing. The project will deliver a practice improvement module to GPs to highlight the benefits of social prescribing. Existing community networks ('hubs') in the Huon are used sporadically by GPs. The practice improvement module will provide a streamlined method of referring patients to hubs. The project will measure the feasibility and appropriateness of this model of referral by surveying GPs at the onset of the pilot and after 6 months. The number of referrals provided and number of "completed" social prescribing interactions will be compared. Patients' self-rated social connectedness and health literacy will be measured at the point of referral and after 6 months. Community hub leaders' receptiveness of the referral pathway will be assessed by survey at the end of the pilot study period.

We aim to investigate the efficacy of a 4-week online diet intervention for improving depression symptoms in young adults aged 18-25. We hypothesise that the fresh food group will demonstrate great change on measures assessing nutrient composition, compared to the comfort cooking condition. Our previous work has shown that diet change can reduce symptoms of depression in young adults. However, it is not known what components of the diet change are required to observe improvement in mood. Furthermore, in our previous work, the resources were provided face-to-face, and it is not yet known whether providing the same resources in an online format will result in the same degree of change in diet.

Proximal humerus fractures (fractures of the upper arm) comprise approximately 2% of all fractures in children. While recent studies in adults have demonstrated no benefit of surgery for certain proximal humerus fractures, there remains a paucity of evidence to guide the management of proximal humerus fractures in children, and there is considerable debate in the literature regarding the indications for the different management options. The aim of this project is to analyse the functional and quality-of-life outcomes for a cohort of paediatric patients with proximal humerus fractures, in attempt to inform the management of the various types of proximal humerus fracture in children. A secondary aim is to determine the clinical factors that predict a poorer clinical outcome for paediatric proximal humerus fractures, including patient demographics, fracture pattern and treatment methodology. The hypothesis is that adolescent patients treated non-operatively have a higher risk of a poor clinical outcome, especially when the initial displacement of their fracture is greater.

Research has shown that people with depression experience poorer treatment outcomes if they have had adverse childhood experiences; and that these experiences often intrude into their thinking, and at a rate similar to that of post-traumatic stress disorder (PTSD). Although cognitive behaviour therapy (CBT) has been found to be effective in the treatment of depression, a number of people treated with CBT do not recover, or relapse during follow-up. We wish to test the efficacy of an adjunct trauma-focused therapy — Imagery Rescripting (ImRs) – for the treatment of depressed patients receiving group CBT treatment. We hypothesise adjunct ImRs treatment will lead to a superior reduction in depression symptoms compared to control conditions of individual CBT and treatment as usual.

High rates of chronic disease persist in remote Indigenous communities in North East Arnhem Land. A community-developed and led nutrition and lifestyle program, Hope for Health (HfH), has been developed in Galiwin’ku, Elcho Island, with promising preliminary results. This trial seeks to evaluate the effectiveness and acceptability of this program and provides a wider platform to work with partners and the community towards structural changes in understanding about healthy nutrition, healthy food availability, school education and community initiatives around healthy lifestyle. Diet modification leading to even moderate weight loss drastically improves cardiometabolic risk in overweight and obese people. This study is a single arm pre and post study designed to develop an evidence base for an innovative community-developed and controlled, experiential learning program (HfH) that is based on the premise that traditional values and kinship are fundamental to physical health for Aboriginal Australians. Primary objective is to determine if the proportion of participants achieving weight loss following HfH at the end of the program in overweight and obese adults is at least 10%, as measured by achieving weight reduction from baseline of at least 5%. The study is performed in Galiwin'ku, Elcho Island, Northern Territory including 70 indigenous residents.