ANZCTR search results

Cognitive remediation is an evidence based therapy to address the thinking problems (e.g. trouble attending, remembering or planning) associated with schizophrenia and related disorders. The exact mechanism of benefit is unclear. This pilot study explores one potential mechanism of effect and that is reward learning ( the rewards that follow learning experiences). Reward learning will be measured before the 12 week intervention and post intervention using clinical measures, pen and paper measures as well as images of the brain that reflect reward learning.

This is a study of two different methods of providing oxygen to patients having a transcatheter aortic valve implantation (TAVI) under conscious sedation. TAVI is a type of treatment for patients who have a narrowing of the aortic valve in the heart (aortic stenosis). Traditionally treatment of aortic stenosis has required open-heart surgery but with this procedure doctors can place a new valve in the heart through one of the large blood vessels in the leg (transfemoral TAVI). Usually patients having a TAVI recover from their treatment faster and can go home sooner. Also, unlike patients having open-heart surgery, patients having a TAVI will be under conscious sedation, meaning they will have been given medication to make them relaxed and sleepy but will be awake. Sometimes during a TAVI the patient’s blood oxygen levels can become too low (known as hypoxaemia). Therefore all patients having a TAVI under conscious sedation need to be given oxygen. This study is investigating two different methods of providing oxygen to patients having a TAVI under conscious sedation. These are: Standard oxygen therapy: via nasal cannula (tube) at low flows in the nose vs High Flow Nasal Oxygen (HFNO) at much faster rates of delivery. The two devices are compared to see if either is better at preventing hypoxaemia (low oxygen levels in the blood) as well as improved patient comfort, a decreased need to go to a high dependency unit after the procedure and a reduced risk of changing to a general anaesthetic during the procedure.

Twenty percent of adults meet criteria for food addiction, with 70% reporting four or more symptoms of food addiction. Food ‘addicted’ individuals have significantly lower diet quality, higher intakes of junk foods and higher weight status. The personality characteristic of impulsivity is a common risk factor for substance use and food addiction. There are currently no evidence-based interventions run by clinicians for food addiction. Current treatment options largely stem from online self-help groups such as Food Addicts Anonymous and Overeaters Anonymous which have 10 000+ members, demonstrating the clear need for services and evidence-based programs. Interventions targeting personality risk factors and motivational interviewing for other addictions, such as alcohol use, are effective. This project builds on an existing pilot study (ACTRN12619001540101) utilising a personality-based intervention for the targeted treatment of addictive overeating in individuals with food addiction. The current study will determine the effectiveness of a personality-based intervention targeting addictive overeating to improve individuals’ symptoms of food addiction and associated dietary behaviours, when compared to active and passive control groups. The primary intervention will be delivered by phone/ telehealth. It is hypothesised the intervention group will have reduced food addiction symptoms and better/improved dietary behaviours than both the active and passive control groups at 3 and 6 months follow up. If successful, this project will provide an evidence-based treatment for those individuals with food addiction and addictive overeating behaviours in the community and clinical services.

The objective of this investigator-initiated study is to determine whether an Australian treatment team can safely and effectively deliver 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy to patients with treatment-refractory posttraumatic stress disorder (PTSD) through training and ongoing mentoring from the Multidisciplinary Association for Psychedelic Studies (MAPS). MAPS is a non-profit research and educational organisation working to obtain approval for the prescription use of 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct to psychotherapy in patients with posttraumatic stress disorder (PTSD). It uses an open-label design to assess the feasibility of safely and effectively providing MDMA-assisted psychotherapy in Australia by treating four Western Australian adults with chronic treatment-resistant PTSD.

This is a randomized, double-blind, placebo-controlled, single-ascending dose (SAD, Part 1) and multiple-ascending dose study (MAD, Part 2) of KER-012 in healthy postmenopausal women. The study will evaluate the safety, tolerability and PK of KER-012. In addition, this study will explore the effects of KER-012 on muscle, bone, and adipose tissues, and determine the pharmacokinetic/pharmacodynamic (PD) relationship of those effects.

Bronchial Thermoplasty (BT) is an approved radiofrequency treatment for patients with severe asthma. In this study we evaluate whether the treatment is likely to be useful in patients with moderately severe COPD. We explore whether BT leads to airway dilatation after treatment in the same way as it does in asthma, and whether this is accompanied by an improvement in patient symptoms.

Hypothesis: The use of HOFA on patients with facial medical devices will decrease the incidence of facial pressure injuries in the adult ICU population. One in four patients admitted to the ICU will sustain a pressure injury from a medical device (Barakat-Johnson et al., 2017). Pressure injuries (PI) are painful and when sustained to the face can result in permanent disfigurement. Pressure injuries are also very expensive in economic terms representing approximately 1.9% of all public hospital expenditure (Nguyen et al., 2015). This diverts resources from other areas within health care (Slawomirski et al., 2018). Research has established that the cost of prevention for PI in patients at risk is dwarfed by the costs to treat them (Demarré et al., 2015). And, as PI are largely preventable (Slawomirski et al., 2018), medical device-related pressure injuries (MDRPIs) have become a key indicator of patient safety and nursing quality in acute care settings (Jackson et al., 2019). Medical devices pose an increased risk for PI development because the pressure of the device on the skin may cause friction, excessive moisture and increase temperature, which impairs the microclimate. The increased pressure and shearing load are accepted as the causal pathway to the development of pressure injuries (Otero et al., 2017). This project has two primary aims: (1) To assess the effectiveness of HOFAs to prevent facial pressure injuries (FPI) from medical devices in the adult ICU setting; and (2) Assess the implementation and dissemination of the intervention, in particular the acceptability, feasibility, and sustainability among clinical nursing staff.

In Australia, approximately one third of community-dwelling older people aged 65 years and older fall each year and the risk of falling increases with age. The consequences of falling can be fatal including fractures, institutionalising and loss of independence. The sport of judo includes a number of techniques and strategies that can be amended to teach older adults aged 65 years and older how to prevent falls, how to fall safely, and how to stand up once on the ground. The aims of this project are to (a) examine the safety and feasibility of an 8-week judo-based exercise program designed for community-dwelling older people aged 65 years and older, and to (b) determine the impact of the judo-based exercise program on fear of falling, quality of life, balance and physical performance. The hypothesis is that a suitably designed and delivered judo-based exercise program is feasible and safe in older community-dwelling adults and that it has the potential to reduce fear of falling, improve balance and physical performance, minimize harm from a fall, thus improving older adults’ quality of life.

Background Stroke is a cardiovascular disease that is estimated to affect 1.7% of all Australians. Due to stroke-related disabilities, 40% of patients experience limitations with walking, upper limb function and other activities, causing reduced participation in society. High intensity rehabilitation is required to optimise recovery however, this is not being achieved using current approaches to therapy. There are limited strategies for maximising intensity of stroke rehabilitation that have proven benefit and do not involve additional resources. Counting and recording repetitions is a possible solution, however, this strategy is yet to be evaluated. This study will quantify the effect of counting and recording repetitions and discussing target numbers of repetitions on the intensity of practice achieved in stroke rehabilitation. During therapy sessions for the intervention group exercise repetitions will be counted and recorded and participants will be encouraged to reach target numbers based on their previous performance. The control group will continue with usual therapy. Significance of Research If this study demonstrates that counting and recording repetitions increases the intensity of practice done in rehabilitation, it could lead to changes within stroke rehabilitation that will make therapy more efficient and effective. It will provide a strategy that incrases the intensity of stroke rehabilitation with no additional resources, time or cost for the therapist or the patient. Aim Therefore, the aim of this study is to determine the impact of counting and recording repetitions on the intensity of rehabilitation (rate of repetitions) completed. It is hypothesised that this intervention will lead to a statistically and clinically relevant increase in the intensity of stroke rehabilitation. Objectives • To determine the percentage difference in the rate of repetitions between the start and end of study for both the intervention and control group. • To compare the percentage difference between the intervention and control group • To determine if counting and recording repetitions has any statistical or clinical significance in increasing the intensity of stroke rehabilitation

Project Summary In the majority of cases coronavirus disease (COVID-19) people present with signs and symptoms of respiratory tract infection including fever, cough, fatigue, dyspnoea, and sputum production. Although the majority of COVID-19 cases have mild to moderate disease, approximately 15% will develop severe or critical disease that requires intensive medical management or admission to an intensive care unit (ICU). Medical management in ICU often includes use of sedation, neuromuscular blocking agents and prolonged mechanical ventilation. Given the nature of the disease process and the treatment required, those affected by severe COVID-19 infection are at risk of long-term sequelae that can potential to affect long-term health and wellbeing. These sequelae include symptoms such as fatigue and shortness of breath, ongoing weakness and reduced physical function due to ICU-acquired weakness (ICUAW) and impaired psychological function. It is essential to provide an in-depth multidimensional description of recovery trajectories during and following the acute phase of the disease from a symptom, physical and psychological perspective. The main aim of this study will be to provide a multidimensional analysis of recovery in people with severe (or critical) COVID-19 during the first 12 months following diagnosis. Specific objectives are to: (i) document recovery trajectories during and following the acute phase of the disease from a symptom, physical and psychological perspective; and (ii) identify factors associated with prolonged recovery.