ANZCTR search results

Peripheral artery disease (PAD) involves blockages in the leg arteries, leading to exertional lower-limb pain and reduced physical capacity and quality of life. This research aims to improve the management of PAD through investigating the effectiveness of a holistic management program (PAD-medical) in improving PAD management, assessed through a new validated scoring system. Participants in this research will be Australian adults aged at least 18 with diagnosed PAD and have sub-optimal management of their PAD as indicated by a PAD-medical score of less than the maximum of 6. This research is a 2-year prospective, randomized, multicenter trial which will assign participants to the PAD-medical program, or usual care by their general practitioner and vascular surgeon. The PAD-medical program will run for the first 6 months and include: risk factor monitoring, optimisation of risk factors for PAD through medical management (prescribed medications and smoking cessation), an exercise program, and smoking cessation support. This program will be delivered entirely through telehealth. It is expected that this program will improve the management of PAD in participants assigned to the PAD-medical program, assessed through an improvement in their PAD-medical score. The final follow-up phone call for all participants will occur at 2 years after randomisation.

In Australia, 2.8% of children are diagnosed on the autism spectrum. Autism Spectrum Disorder is a lifelong neurodevelopmental condition which impacts social communication and is often characterised by restricted / repetitive behaviours. Additionally, 88% of autistic people are also reported as having additional co-occurring disabilities. For up to 70% of children and adolescents on the autism spectrum this can include mental health conditions including anxiety and depression. In addition to the impact of Autism, the mental health conditions they suffer from are of at least the same severity as that of their disability. However, unlike Autism, mental health conditions are reversible and preventable. While approximately half of autistic adolescents also have an Intellectual Disability, there is very little research or evidence-based programs aimed at this vulnerable population that aim to promote mental health, emotional development and social skills. For autistic adolescents with co-occurring ID there is no targeted intervention supporting the development of emotion-based skills. Previous implementation research on the Westmead Feeling Program, developed and researched by psychologists at the Children’s Hospital at Westmead, has established the effectiveness of emotion-based learning for primary school-aged children on the autism spectrum, with and without an intellectual disability, and adolescents without an intellectual disability, both in school and clinical settings, in improving emotional competence and reducing symptoms of mental disorder. Recently the Westmead Feeling Program authors conducted a pilot study to investigate the feasibility and experience of an adolescent adaptation of the Westmead Feelings Program, called The Feelings Program Adolescent Version (TFP-A; HREC/17/SCHN/386). The small pilot study found that adolescent participants, their parents and teachers all found the program, when delivered by the researchers, to be feasible and enjoyable. These positive results provide support for further research to investigate the impact of the intervention. In this study we aim to further address the current research gap in intervention by implementing a larger trial of the adapted program for autistic adolescents with mild ID, to be delivered in an Aspect school-based setting, delivered by teachers and psychologists. This study aims to assess the feasibility and efficacy of TFP-A that will inform a large scale evaluation of the program. This study aim to exploring the impact of the intervention on emotional competence, problem behaviours, and mental health. TFP-A involves adolescent participants attending intervention sessions held across a school year and a 1 hour booster session six months later. Parents are also invited to attend group emotion coaching sessions and access online content . Questionnaires and assessments completed by adolescents, their parents and teachers will provide data on outcomes.

Schwartz Rounds are a unique, organisation-wide interdisciplinary intervention aimed at enhancing staff wellbeing, compassionate care, teamwork, and organisational culture in healthcare settings. They provide a safe space wherein both clinical and non-clinical health staff can connect and share their experiences about the social and emotional aspects of health care. Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated Australian healthcare settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff wellbeing, compassionate care and organisational culture, in a tertiary metropolitan hospital in Brisbane, Australia. Methods and Analysis This mixed methods repeated measures pilot study will recruit 24 participants in two groups from two departments, the Intensive Care Unit (ICU) and the gastroenterology department. Participants from each group will take part in three unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures while secondary outcomes will include Maslach Burnout inventory, the Schwartz Centre Compassionate Care Scale, and Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, post-round, and three-month follow-up. Two focus-groups will be held approximately two months after completion of the Schwartz Rounds. Descriptive statistics, t-tests, chi-square tests, and analysis of variance (ANOVA) will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analysed using an inductive thematic analysis approach. This study was approved by the Mater Misericordiae Ltd. Human Research Ethics Committee (HREC), reference number: HREC/MML/71868, and the Griffith University HREC, reference number: 2021/025.

Children with critical illnesses are at high risk (> 20%) of developing seizures and brain injury. Each year, over 10,000 children in Australasia require paediatric critical care unit (PICU) admission. Significant advances in PICU mean more severely ill and injured children now survive, and subsequently go home to the community. However, these children remain at high risk of seizure. Therefore, it is essential that continuous improvements are made that address survivorship and morbidity, especially recognition of patients at risk and preventing further brain injury by monitoring appropriately to save brain function. The measuring of brain activity (electroencephalography/EEG) is the only available form of monitoring brain currents in patients with suspected seizures. Seizures are often invisible otherwise, as children often show no visible signs. Despite improvements in the field, recognising these seizures at the bedside in a timely way is not possible for the treating team. This can have serious effects (high risk of brain dysfunction), and potentially add to long term poor outcome or even death. We will perform a worldwide first cohort study to show that EEG monitoring using automated seizure detection software can lead to accurate and timely seizure detections by bedside clinicians..

The ReActiv8 Observational Registry is a multi-center, data collection registry in patients who are being considered for a ReActiv8 implant. At the time of implant, patients must meet the indications and not be contraindicated for ReActiv8. If it is determined that a patient will not be implanted, the patient will be exited from the Registry. Implanted patients will be followed for two years post-activation, at which point they will be exited from the Registry. The ReActiv8 device is approved by the TGA for use in Australia for the indications above and its implantation in participating centres is standard of care.

This study will explore the perspectives of patients with a chronic disease on the COVID-19 vaccination. Who is this study for? You may be eligible to take part if you meet all of the following criteria: • Aged 18 and above • Diagnosed with any of the following chronic diseases: a) cancer; b) diabetes and; c) multiple sclerosis • Receiving care or services for the chronic disease from one of the participating health services. Note: Some health services are only conducting the survey for one of the chronic diseases, please speak with your healthcare team for more information. Study details Participants in this study will be invited to complete a short anonymous online survey. The survey asks participants about their views towards the COVID-19 vaccination and how their chronic illness diagnosis may be affect these views. Participants will also be asked about basic non-identifiable information such as age, gender and chronic disease diagnosis. Upon survey completion, participants can register their interest to be randomly selected for a one-on-one interview. The interview will explore the views towards the COVID-19 vaccination in more detail, including where participants have received information about the COVID-19 vaccination. The data collected from the surveys and interview will provide knowledge of COVID-19 vaccine perspectives in Australian patients diagnosed with a chronic disease. The findings can help health services better understand how to support patients better with various COVID-19 vaccination needs.

Atrial fibrillation (AF) is a global epidemic associated with significant morbidity and mortality and growing health care burden. Hospitalisations due to AF are the most common cause for cardiovascular hospitalisation in Australia, many of which are preventable. Redesigning care delivery could result in fewer unnecessary hospitalisations and complications related to this condition, such as stroke, the most devastating yet often preventable complication of AF. Whilst effective medications can be used to reduce the risk of stroke, these are frequently under or overused, resulting in suboptimal care delivery. The use of protocols in the emergency department (ED) to guide clinicians in the acute management of AF has resulted in a marked reduction of hospitalisations related to AF in other countries, yet has never been tested in an Australian setting. This study seeks to evaluate an innovative model of care for the acute management of AF, combining an emergency department protocol with early outpatient follow up in a nurse led rapid access AF clinic. This will ensure standardised and guideline adherent care delivery to reduce the risk of preventable hospitalisations and complications in the AF population. We believe that this model of care will help to reduce unnecessary hospital admissions for AF, in addition to reducing complications associated with the condition and empowering individuals to learn how to self manage their AF.

The RIVASTIM trials aim to identify strategies to improve immunological responses to a 3rd booster dose of the mRNA Pfizer Comirnaty COVID-19 vaccine in a cohort of kidney transplant patients who have failed to achieve an adequate immune response to a standard two-dose COVID-19 vaccine course. Kidney transplant patients are a highly vulnerable group of immunosuppressed patients who suffer from disproportionately high COVID-19-related morbidity and mortality. The dietary fibre supplement inulin shows promise in enhancing immune responses to vaccination. In this study kidney transplant patients will be randomised to either take inulin supplements or placebo. Four weeks after randomisation, participants will receive a 3rd COVID-19 vaccine dose, and immunological responses will be assessed 4-6 weeks later.

This project will investigate how biceps femoris long head muscle and aponeurosis morphology are influenced after undertaking either a chronic concentric- or eccentric-only resistance training intervention in healthy, recreationally active males. A secondary aim is to determine the impact of these contraction mode specific interventions on biceps femoris long head muscle architecture, diffusion parameters, knee flexor strength, three-dimensional (3D) biomechanics and the musculotendinous demands experienced during running. We hypothesise this muscle-aponeurotic adaptation will be the major driving factor that influences the intrinsic tissue demands during gait (such as musculotendinous strain or fibre strain) instead of due to changes in joint kinematics or kinetics.

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain an ongoing and preventable cause of heart disease affecting Aboriginal Australians and/or Torres Strait Islander people (hereafter referred to as Indigenous Australians). The diagnosis of ARF is based on the presence of signs or symptoms rather than a definitive investigation. This can lead to instances where the diagnosis is uncertain and diagnostic categories of possible, probable and definite are used. Failure to diagnose ARF accurately is of particular concern given secondary antibiotic prophylaxis is important in the prevention of further ARF as well as progression to RHD-related valvular heart disease. This multi-site research will use cardiac MRI in Alice Springs, Darwin, and Cairns to identify and quantify cardiac inflammation in patients with confirmed or suspected ARF. A score of extent of inflammation will be developed to aid in the diagnosis of ARF, such that more confidence can be placed in the accuracy of diagnosis and therefore the need for ongoing secondary antibiotic prophylaxis. This score will be compared to that of healthy controls and participants with non-ARF inflammatory conditions such as pneumonia. ARF cohort participants will be followed-up at two years to determine if they have subsequently developed RHD (per echocardiogram result). This is to determine whether baseline CMR predicts the future development of RHD (or whether this is dependent on number of antibiotic doses received).