ANZCTR search results

The key objective of this study is to define the strengths and limitations of telemedicine and virtual care from the perspective of key stakeholders in care, specifically patients, carers, clinicians, and administrators in hospital ambulatory (outpatient) settings.

Laser peripheral iridotomy is used to treat narrow and closed-angle glaucoma and eyes with narrow anterior chamber angle to prevent progression to glaucoma. The laser peripheral iritodomy can be done in any location in the peripheral iris, however traditionally, it has been performed in the superior 12 o’clock position. The superior and temporal (3 o’clock for left eye, 9 o’clock for right eye) sites are the most common sites for laser peripheral iridotomy. Rarely, some patients may experience visual disturbances after laser peripheral iridotomy. These are known as dysphotopsia symptoms and typically described as grey or blue horizontal or slightly curved line. The purpose of this study is to assess the whether superior or temporal placement the iridotomy hole is associated with incidence of dysphotopsia symptoms. The hypothesis is that superiorly placed laser peripheral iridotomies are associated with reduced incidence of dysphotopsia symptoms.

Mental health (e.g., anxiety, depression) and functional difficulties (e.g., cognitive problems) are highly comorbid in people with Multiple Sclerosis (MS). However, access to effective psychological treatments are limited. People with MS face many barriers (e.g., costs, limited trained clinicians, mobility issues) accessing effective psychological care. The Wellbeing Neuro Course offers an innovative solution to these barriers and aims to improve access to effective psychological care for adults with MS within the Australian healthcare system. The Course uses the principles of both cognitive behaviour therapy and compensatory cognitive rehabilitation to target several domains of mental health and functional disability. The purpose of this project is to assess the acceptability, feasibility and effectiveness of an established internet-delivered psychological treatment, the Wellbeing Neuro Course, in reducing symptoms of depression, anxiety and disability in patients with Multiple Sclerosis, The study also aims to gather critical data of the characteristics of patient’s response to treatment. it is hypothesised that: (1) the program will be highly acceptable and that high levels of engagement will be observed; (2) the program will require relatively little clinician time to administer; and (3) preliminary evidence of improvements in disability, anxiety, and depression will be observed at post-treatment and maintained at 3-month and 12-month follow-up in patients with MS.

The aim of the study is to assess the effect of a bitter compound, quinine, on gastric emptying and intragastric distribution of a mixed solid-liquid meal, using the ‘gold standard’, scintigraphy, secretion of glucoregulatory hormones and postprandial blood glucose. We have recently established that quinine, when allowed to sufficiently interact with small intestinal bitter receptors, reduces postprandial blood glucose by stimulating glucoregulatory functions, including slowing of gastric emptying and stimulating glucoregulatory hormones. Gastric emptying was measured by 13C-acetate breath test, a non-radioactive, non-invasive test that provides a broad indication of the relative effect on gastric emptying, but does not allow quantification of gastric content over time, or examination of intragastric meal distribution. However, scintigraphy is the ‘gold standard’ for the measurement of both liquid and solid gastric emptying. Moreover, this technique allows quantification of intragastric meal distribution, i.e. both proximal and distal gastric contents.

Sexual dysfunction is a significant personal and social problem for people living with a spinal cord injury (SCI). The capacity for penile erection and vaginal lubrication is preserved to some extent, either through psychogenic or reflexogenic sexual response to stimulation. However, the ability to achieve orgasm is impaired and in turn, this can negatively impact personal relationships, quality of life, sexual satisfaction, and male fertility. An understanding of the altered neural circuitry contributing to sexual dysfunction in the context of SCI is therefore necessary in order to meet an unmet need for viable therapeutics. This project will assemble evidence about spinal cord and brain involvement in the initiation and maintenance of reflexogenic and psychogenic sexual responses using functional magnetic resonance imaging (fMRI). It is important to try to understand the relative contribution of signalling in spinal cord and brain circuits and pathways to sexual arousal in males and females and to relate this to the pathophysiology of sexual dysfunction in SCI.

The aim of this study is to evaluate the effectiveness of context-specific physical activity recommendations and activity plans for increasing physical activity in adults with a previous diagnosis of coronary heart disease. (A) The investigators hypothesise that: Primary hypothesis: 1. Participants will show a greater improvement in steps walked within 180 minutes of receiving motivational messages compared to not receiving the motivational messages. Secondary hypotheses: 2. Participants will show a greater improvement in physical activity duration and heart rate within 180 minutes of receiving motivational messages compared to not receiving the motivational messages. 3. Certain times of the day will be more effective in the proximal outcomes in those randomized to the intervention compared to those who are randomized to not receive the intervention. 4. There will be no difference in distal outcomes in Phase 1 of the study compared to Phase 2. (B) Physical activity can be tracked via Fitbit devices, which our participants will wear 24/7 during the intervention period which will be 90 continuous days at time points 4-6 and 10-12 months. (C) Baseline data will be collected for a full one month prior to initiating the intervention for the initial 4-6 months, and at month 9 (natural baseline) for the 10-12m study period. (D) Our intervention will be sent as messages (seen as notifications via the app) according to a random schedule to participants who will be randomised (to either receive or not receive the messages) at each time-point per day during the intervention period. (E) We will have a smartphone app adapted for this research and we will implement this MRT through it. (F) Data from this MRT will allow us to further design just-in-time interventions for future digital interventions. Just-in-time interventions are simply providing the right support (messages) at the right time. (G) The purpose is to provide behavioural support directly corresponding to real-time needs when participants can participate in positive behaviours. (H) Our hypothesis suggests those participants receiving the intervention messages will show an improvement in physical activity compliance, improvement in heart rate variability, and improvement in heart rate, with an overall improvement in cardiometabolic health at the 12-month time point. (I) 58 participants will be randomised for 90 days at two time points (4-6m and 10-12m).

Intestinal barrier perturbation is a central mechanism to a multitude of diseases but its function has proven elusive to measure. Clearer experimental models of barrier dysfunction induction and reliable non-invasive markers are required. Currently we do not have a good way to intestinal permeability or 'leaky gut' The aim of this study is to help develop blood tests which will help with this measurement. We hypothesise that both the high fat, high carbohydrate meal as well as the injection of corticotropin releasing hormone will cause a significant disruption to the intestinal barrier function that will be measurable with the blood tests that we are testing.

Pressure injuries, also commonly known as pressure ulcers or bedsores, are wounds considered adverse events when acquired in care. Pressure injuries are a burden to patients and their carers, due to pain and distress and can decrease the quality of life. This study aims to determine the usefulness and cost-efficiency of two different silicone dressings compared to usual care for the prevention of pressure injuries in cancer patients who are in palliative care. Who is it for? You may be eligible for this study if you are aged 18 years or older, you have a primary diagnosis of any cancer, and you score three or over on the Resource Utilisation Groups – Activities of Daily Living (RUG-ADL) questionnaire. Study details All participants who choose to enrol in this study will be randomly allocated by chance (similar to flipping a coin) to one of three groups. All three groups will receive standard care for the prevention of pressure injuries, which includes risk assessment, skin inspection and the implementation of appropriate support surfaces (bed and chair seating devices) and repositioning equipment (hoist or slide sheet). It also involves the provision of patient and caregiver/family prevention education, including equipment use and maintenance, the need for regular repositioning, skincare and advice to optimise nutrition for the hospice patient. Participants allocated to group 1 will also have multilayer silicone dressing Brand 1 applied to the sacrum (lower back near buttocks). The dressing will be changed three times a week during the usual nurse visit schedule for at-risk palliative care patients or sooner if the dressing becomes dislodged. Participants allocated to group 2 will also have multilayer silicone dressing Brand 2 applied to the sacrum (lower back near buttocks). The dressing will be changed three times a week during the usual nurse visit schedule for at-risk palliative care patients or sooner if the dressing becomes dislodged. Participants allocated to group 3 will not receive any additional dressings and will be managed via standard care practices only. All participants will receive this care for up to 4 weeks following enrolment, unless they deteriorate, develop a pressure injury or need to be transferred to a hospital or other care facility. It is hoped this research will determine whether the use of silicone dressings is practical and has any impact on the prevention of pressure injuries compared to usual care practices. If the silicone dressings are more effective than usual care, they may be implemented across other care facilities to improve the quality of life for future cancer patients.

We hypothesised that pain generated by tourniquet after exsanguination of lower limb with Esmarch is significantly lower comparing with pain from elevated lower limb for one minute and applied same type of tourniquet. We intend to record pain score generated by these two methods of exsanguination every 2 minutes for 20 minutes of tourniquet type and for 10 minutes after tourniquet is released. Pain curve will be the primary parameters where the pain in each point of time and time of full recovery will be the second paremetres. We will use one leg of participant for Esmarch group and the second leg for elevation group. Sides of interventions will be randomly chosen.

Overseas-born gay, bisexual men and other men who have sex with men (Ob-GBM) populations are at an increased risk of HIV in Australia. Despite the availability of Pre-Exposure Prophylaxis (PrEP), they experience socio-cultural, and systemic barriers to accessing PrEP as an effective HIV prevention biomedical tool. Behavioural economics is a relatively new field, that is being applied by governments in policies and interventions to alter an individual’s behaviour in a predictable and cost-effective manner. It can be a powerful approach that blends psychological insights with economic decision-making processes of individuals, through ‘nudges’. A nudge is any aspect of the choice architecture that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives, such as using the default option, or social norms. For example, in health, nudges have been applied to improve the rate of organ donations, and to increase the rate of attendance at hospital consultations. In the field of HIV, the application of behavioural economics is also novel, and this study aims to contribute to the evidence of applications of nudges in HIV-related interventions. This study aims to run an online (social media) nudge campaign to improve PrEP awareness and access through an ad campaign on social media platforms that target particularly among (overseas-born gay, bisexual men, and men who have sex with men (Ob-GBM) populations in Australia.