ANZCTR search results

This study will explore the impact that a sigh breath will have on ventilator weaning in post cardiac-bypass patients. Cardiac -bypass (a form of extra-corporeal support ) is utilised to allow Cardiothoracic surgeons to operate on the heart for a variety of procedures. Due to the complexity of the case and the impact of bypass on patients, these patients remain intubated at completion of the operation. Weaning from the ventilator occurs in ICU. Patients are required to be haemodynamically stable, with minimal respiratory support before being extubated. A sigh breath (a type of recruitment manoeuvre characterised by a high volume inspiration) has been shown to improve respiratory mechanics. It is hypothesised that patients who take a sigh breath as part of their assisted mode of ventilation will be able to be weaned off of a ventilator quicker. This study will introduce a sigh breath to a randomised sample of elective Cardiothoracic patients in order to demonstrate improvement in the primary outcome “Time to Weaning from mechanical ventilation”. It will examine for secondary outcomes like adverse effects, re-intubation rates and other physiological parameters. Mechanical ventilation is instituted in a variety of patients for respiratory support, to allow for certain procedures, for airway protection (e.g. in Traumatic brain injury). Mechanical ventilation is not without its dangers with longer periods of ventilation associated with increased risks. Clinicians routinely aim to extubate patients as soon as safely possible to mitigate these adverse effects. If Sigh ventilation can be shown to aid in a shorter duration of ventilation in this subset of patients , it may allow for further study into Sigh ventilation’s efficacy in other ventilated patient groups.;

The objective of this Pharmacy-based Screening and Quality Use of Medicine in Kidney Disease Trial is to screen for people with or at risk of kidney disease and subsequently optimise the use of medications. The primary hypothesis is that the addition of a Point of Care Testing for kidney function markers to an online CKD risk assessment tool (POCT + QKidney® Risk Assessment; Intervention Group) will result in (i) a significantly increased proportion of newly diagnosed CKD cases and (ii) reduced inappropriate medication use (higher than recommended dose as per kidney function and/ contraindicated medications) when compared to the use of CKD risk assessment alone (QKidney® Risk Assessment; Control Group). Additionally, we hypothesise that there will be a long-term economic benefit resulting from the addition of POCT to CKD risk assessment alone.

Group One: Freestyle Libre blood glucose sensors and consults using telehealth Group Two: Freestyle Libre PRO combined with Freestyle Optium Neo blood glucose finger prick monitoring and face to face study visits. Aim: To compare Flash Libre glucose monitoring paired with Telehealth consultations versus standard SMBG monitoring with face-to-face clinic visits in people with diabetes who are undergoing discharge from hospital. Hypothesis: That, in at least 60 people with type 1 and type 2 diabetes who are being discharged from Royal Prince Alfred Hospital (RPAH) on insulin treatment, those randomised to the Freestyle Libre (Flash) will have favourable effect on glucose levels (time in range (TIR), estimated HbA1c (eHbA1c), hypoglycaemia frequency and glucose variability) compared to the traditional finger prick BGL group over a seven week period after discharge.

Tonsillectomy, with or without adenoidectomy, is one of the most commonly performed otolaryngological procedures, occurring in 75 per 10,000 Australian children. The evolution of different techniques and devices throughout the years, along with the contradictory outcome measures, has resulted in there being no international consensus regarding the optimal technique for tonsillectomies and the decision on which technique is used often comes down to the surgeon’s experience and the perceived benefits of the different techniques. In this study, we aim to perform a prospective, randomized, blinded study to compare post-operative pain in patients undergoing BiZact tonsillectomy compared to bipolar tonsillectomy. We hypothesis less pain will be experienced post-operatively in patients undergoing BiZact tonsillectomy.

MAPS is an online program which combines music/song writing and psychological therapies with a closed social networking group, for people living with younger-onset dementia (PLWYOD) and their spousal care-partners. The goals of the program are to improve well-being, social connections and coping, with a secondary goal of investigating whether non-cognitive symptoms related to dementia, called neuropsychiatric symptoms (NPS) might improve as part of the program.

This is an observational study investigating the use of the ResApp SleepCheck algorithms to determine the presence and severity of OSA in adult patients in a home setting. Breathing and snoring sounds recorded using a smartphone are analysed by the ResApp SleepCheck algorithms and compared to clinical diagnosis made via at-home polysomnography.

The study will assess the safety, antiviral activity, and immunogenicity of AB-729 followed by VTP-300 in virologically suppressed CHB participants. The study will enroll 62 stably NA-suppressed participants to receive AB-729 in addition to their NA for 24 weeks to lower HBsAg. Participants will then be randomized into one of two groups. Group A will receive active VTP-300 and Group B will receive VTP-300 placebo in addition to their NA. Participants will remain on their NA and be followed every 2-12 weeks for safety and efficacy assessments through Week 48. Group C an additional arm will assess if the addition of low dose nivolumab (0.3 mg/kg) to the MVA-HBV boost component of VTP-300 will further stimulate reduction of HBsAg after initial treatment with AB-729 followed by the ChAdOx1-HBV prime. If participants meet certain criteria (low ALT, low HBV-specific viral markers) at Week 48, they will stop their NA and be followed every 2-4 weeks for an additional 48 weeks to evaluate for functional cure. If participants do not meet these criteria they will stay on their NA and be followed every 12 weeks for 24 weeks. Participation will be for approximately 79-103 weeks, depending on whether NA discontinuation criteria are met. It is hoped that this study may lead to better understanding of host immune responses against HBV, and potentially facilitate immune control of HBV (functional cure).

Current national yearly data estimates 59,100 people aged 25 and over have a heart attack; around 162 events every day, including death. Despite advances in treatment, 15% of heart attack survivors have another heart attack, stroke or die within 12 months and 8.9% are unexpectedly readmitted to hospital within a year. The Secondary Prevention for All in Need (SPAN) trial will address the established evidence-practice gap that 7/10 heart attack survivors in Australia are not accessing guideline-advocated secondary prevention measures. Barriers to improving reach, completion and outcomes are complex and well-documented but can be addressed by studying more personalised ways of delivering prevention. This trial, where patients have an equal chance of receiving preventive treatment options, will evaluate the implementation of a published and flexible framework for improving secondary prevention amongst heart attack survivors; developed by three of the investigators. The SPAN trial involves comparing personalised rehabilitation with standard outpatient, group-based rehabilitation (or usual care). The SPAN framework offers a flexible, targeted and sustainable approach for risk factor control through shared decision-making and goal attainment. The trial will report on the differences between the two rehabilitation strategies in terms of completion defined as participation in greater than or equal to 80% of scheduled contacts as established at the initial engagement, and subsequently all admissions to hospital and death identified from administrative records at 1-year. We will determine if there is an absolute increase of at least 15% in the proportion of heart attack survivors that complete SPAN versus usual care; i.e. 65% vs 50% at medium three months, respectively. If successful this personalised rehabilitation strategy could be rapidly and widely implemented and would be expected to reduce the risk of recurrent cardiovascular events and unplanned readmissions to hospital nation-wide.

This project aims to undertake a multi-centre randomised controlled trial to evaluate the addition of the web-based health behaviour tool (FESS) to existing exercise physiology and exercise science services with the intention of improving health behaviours. The project is a 12-month, two-arm, randomised control trial with participants randomised into either the FESS intervention group or a control group. It is hypothesised that the FESS group will improve their health behaviours (as measured by the FESS questionnaire) in comparison to the control group. The FESS intervention group will have access to the online FESS Questionnaire for 12 months, which is completed daily (2-3 minutes in duration) in participants' own time. During the first three months of the intervention, participants in the FESS group will have adherence support from the research team. The control group will be simply directed to web-based government health behaviour information. The research team will then independently complete the eligibility screening and explain the study to participants at each location. Mixed evaluation methods will assess outcome measures at baseline, 3-month, 6-month and 12-month in both groups. FESS questionnaire adherence to the questionnaire will be evaluated in the FESS intervention group. Furthermore, accelerometers and questionnaires will be used in a sub-group of participants to validate the FESS survey against commonly accepted criterion measures.

The aim of this project is to examine the implementation of a new model of care. This model of care will involve giving intravenous therapy (IVT) to women with nausea and vomiting of pregnancy in their home. We aim to assess if the number of times women present to emergency departments is reduced by receiving IVT at home and to explore the acceptability, sustainability and feasibility of this model of care with both women who participate in the project and with clinicians and managers involved in delivery of hospital in the home care, midwifery and obstetrics.