ANZCTR search results

This research project compares two different absorbable nasal dressings applied directly after functional endoscopic sinus surgery for the treatment of chronic rhinosinusitis. One is chitosan-dextran (Chitodex) gel mixed with a topical steroid added and the other is the current standard of care PureRegen gel. Post-operative adhesion formation to sinus openings and wound-healing will be assessed as well as the participant's subjective and objective symptoms scores.

RECORD-AF study will enroll participants with a clinical diagnosis of atrial fibrillation (AF). This study will assess development of stroke and cognitive decline overtime, as well as record mortality rate among patients with AF. The primary objectives of this study are: 1. Assess the interaction of baseline AF health literacy, social determinants of health and biological aging the incidence of long-term outcomes such as: a) heart failure (HF) (HF preserved ejection fraction (EF), HF midrange EF, and HF reduced EF); b) mortality; c) stroke; d) cognitive decline and e) progression of AF Secondary objectives of this study are: 1. Determine the impact of blood pressure variability on long-term outcomes, in particular cognitive impairment, in patients with paroxysmal and non-paroxysmal AF. 2. Determine factors associated with development of tachycardia induced cardiomyopathy in AF patients.

During radiation therapy treatment, some treatment machines have the ability to monitor a patients breathing patterns during treatment using a monitoring camera. A particular benefit of this treatment technique is for left sided breast patients as a deep breath (and hold) allows us to treat the breast cancer with reduced radiation dose to the heart. In this study, we are looking at whether the patient monitoring camera on the end of the Varian Halcyon treatment machine couch (called a Live View System (LVS)) can be used to monitor patients breathing during treatment. This will be compared to the currently used breathing motion camera called the Real-time Position Management (RPM) System. Who is it for? You may be eligible for this study if you are an adult receiving radiation therapy treatment at an Icon Cancer Centre. Study details We are aiming to recruit at least 16 patients (32 patients in total) at each participating site in order to determine the effectiveness of the new camera based system. Data will be collected from patients that are already being treated using the RPM system as well as other patients who are receiving radiation therapy treatment. This study will not impact the patients treatment in any way. For those patients where the RPM system is already being used in their treatment, data will be collected on both the RPM and LVS system during their treatment. The breath-hold-gating devices will collect the data during one daily treatment only and will not take any additional time for the patient. If breath-hold-gating is not required as a part of the patients treatment, they will be asked to participate, in a session separate from their treatment where their breathing can be monitored over a short period of time, providing data from both systems that can then be compared. It is intended that this research will contribute to the outcomes of patients by allowing motion management to be utilised on the Halcyon Linear Accelerator.

To reduce the occurrence of autoimmune adverse events from the treatment of multiple sclerosis (MS) with alemtuzumab through the subsequent targeted use of rituximab. The hypothesis to be tested is that rituximab therapy following alemtuzumab treatment for MS will reduce the frequency of autoimmune adverse events. If this strategy proves to be safe and is effective in preventing or significantly reducing the frequency of autoimmune adverse events in the treatment of MS with alemtuzumab, then this approach could be adopted immediately in a large number of pwMS with an immediate reduction in co-morbidity.

The primary purpose of this project is to examine the changes in muscle strength with different prescriptions of RT volume and intensities while equating the overall resistance training ‘dose’ in healthy untrained adults. Resistance training dose is calculated as the number of sets × repetitions × intensity × number of exercises. This investigation will also examine how muscle strength is impacted when an intervention group is prescribed roughly half the dose of RT. In addition, this study looks to determine if RT dose influences changes in health and well-being. Lastly, this study will examine the relationship between objectively determined intensity and perceived intensity of training over multiple sets and exercises. The researchers hypothesize that no significant difference in muscle strength will be observed between the two equated RT dose interventions, with the reduced dose intervention producing significant increases in muscle strength but lower when compared to the other intervention groups.

This study builds on pilot work testing 2-5 session perfectionism programmes with children (ACTRN12616000981426) and early adolescents (ACTRN12618000444280; ACTRN12621000457842) which found improvements in emotional problems, self-imposed perfectionistic standards (sustained at 4-week follow-up), and well-being, sustained at 3-month follow-up (Vekas & Wade, 2017). The modified programme for the current research expands the pilot programme (ACTRN12618000444280) and subsequent 5-lesson perfectionism intervention (ACTRN12621000457842) to be led by trained psychologists which include an emphasis on the difference in pursuing excellence and pursuing perfection to high school students across Year 7 to Year 12 universally. Research objectives 1. To examine the impact of the Pobody's Nerfect curriculum on primary (perfectionism) and secondary (anxiety, depression, wellbeing, self-compassion) outcomes. 2. To test whether improvements in certain outcome factors (anxiety, depression, well-being, self-compassion) are moderated by the following outcome factors: level of perfectionism, self-compassion and sex. We hypothesize that the intervention group will experience significantly greater decreases in perfectionism, anxiety, and depression, and significantly greater increases in wellbeing and self-compassion at follow-up. We also hypothesize that decreases in perfectionism and increases in self-compassion between baseline and end of treatment will moderate the association between group and follow-up changes in anxiety, depression, and well-being.

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal system that mainly comprises ulcerative colitis (UC) and Crohn’s disease (CD). Treatment modalities include anti-tumour necrosis factor (TNF) biological agents such as intravenous (IV) infliximab infusions given regularly every 8 weeks, subcutaneous (SC) adalimumab given every 2 weeks and golimumab given every 4 weeks. Anti-TNF drugs are now available as biosimilars, which are identical copies of the originator drug. Remsima® is prescribed for adults 18 years or older at a dose of 120mg infliximab solution SC via pre-filled syringe or pen every 2 weeks. The efficacy of SC infliximab is similar to IV infliximab at one year in an initial open-label study. Another study demonstrated non-inferiority of SC infliximab compared with IV infliximab in terms of pharmacokinetic, efficacy and safety in patients with active Crohn’s disease and ulcerative colitis. Efficacy analysis found no statistically significant differences between both routes of administration. Safety profile was also comparable between both groups. The aim of our study is to determine whether SC infliximab is non-inferior to IV infliximab in the maintenance of clinical and biochemical remission in patients in IBD within Australia.. This study differs from prior studies as we will examine patients in remission (and not those with active disease). We also aim to determine the patient satisfaction of switching from IV infliximab to SC infliximab as determined by a self-administered questionnaire. The hypothesis of this study is that there is no difference in clinical outcomes between the two groups and that patients will be more satisfied with SC infliximab.

Our preliminary work demonstrates a strong need for a DIVA identification process which accurately highlights those patients who have DIVA; and links to an insertion escalation pathway, incorporating the use of ultrasound if needed, so that DIVA patients have a better chance of having a PIVC successfully inserted on the first attempt. The three-phased project will develop, implement and evaluate the clinical and cost-effectiveness of DIVA identification and escalation pathways. The Difficult Access Requires Thought, Training and Technology (DART3) project aims: (1) To understand and describe the budget and funding mechanisms for PIVC insertion procedures in Australian hospitals; (2) To develop and pilot test sustainable DIVA identification and escalation pathways and associated implementation strategies suitable for the Australian care context; and, (3) To test the effect of the DIVA identification and escalation pathways on clinical, cost and implementation outcomes

We seek to determine whether the use of a multimedia video can enhance consent for patients undergoing a total laparoscopic hysterectomy. In the era of increasingly complex surgical procedures and focus on patient-centred decision-making, the responsibility on clinicians to provide quality informed consent has never been more critical. In the current surgical climate, the Coronavirus pandemic has meant less face-to-face appointments and further delays from the initial booking appointment to surgery. Various media sources are often informally accessed by patients but these risk misinformation and further confusion. The addition of multimedia videos to routine consent has been shown to increase patient understanding and recall which optimizes informed consent and healthcare outcomes. This is a randomised controlled trial. Participants will be patients currently on the waitlist for a total laparoscopic hysterectomy at the Mercy Hospital for Women who have already received routine consent with their doctor. Participants will be assessed on their baseline understanding of the procedure, baseline anxiety levels and health literacy. They will be randomised into two groups. Group 1 will receive additional routine verbal consent. Group 2 will receive additional routine verbal consent and then watch an 11 minute multimedia video. Both groups will complete a questionnaire afterwards to evaluate their understanding of their procedure, anxiety and satisfaction levels which is repeated at 4 weeks. The multimedia video uses animations and text to describe the procedure of a total laparoscopic hysterectomy as well as complications and post-operative recovery. Our hypothesis is that patients who watch the multimedia video will have a better understanding of their procedure which will be reflected in a higher score in the questionnaire, without a negative impact on their anxiety level.

People who live in rural areas of Australia have higher rates of heart disease. Nutrition impacts on many of the risk factors for heart disease, making it a key lifestyle factor to focus on. However, access to qualified health professionals with the skills and knowledge assist with this can be limited in these areas. This randomised controlled trial will test the effectiveness of five telehealth consultations with a specially trained Accredited Practising Dietitian (APD) for rural people who are at moderate to high risk of heart disease. The study participants will also get the usual care they would normally receive from their General Practitioner (GP). The control group in this instance will receive usual care, as offered by their GP. Both groups will also receive personalised feedback on their nutrition via the Australian Eating Survey - Heart Version. Study participants must be categorised as living in an area classed as 3-7 by the Modified Monash Model, a measure of rurality, and receive a letter of invitation from their GP. Our study will look at the changes in blood cholesterol over 12 months, and will compare the results of those who had consultations with APDs against those who did not. We shall also investigate blood pressure, weight and waist circumference. We believe that the series of five consultations with health professionals with specialised training in nutrition will be cost effective in reducing the risk of heart disease in rural adults.