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Evaluation of healthy adults' views on the value of different educational tools for skin cancer early detection
The aim of the study is to undertake a qualitative investigation on how well people understand each of the various education tools for skin self-examination, whether they find one more intuitively appealing or acceptable than another, Who is it for? You may be eligible for this study if you are aged over 18 years or over and speak sufficient English. Study details All participants will take part in a 60 minute audio-recorded focus group at the Translational Research Institute, Woolloongabba, Brisbane. Participants will be asked to complete a demographic survey at the start of the focus group. Discussion includes self-examination practices and the use of educational tools for skin self-examination. This research will be used to determine how well people understand each of the various mnemonics used in Australia and influence future design and implementation of skin cancer early detection support for people.
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A study in children undergoing laparoscopic appendectomy to track changes in oscillatory mechanics measured by forced oscillation technique (FOT).
Laparoscopy is the preferred surgical approach in several abdominal procedures as it provides several advantages compared to open surgery, including: minimal incision, shorter hospital stay, less pain after the operation, and early mobilization . However, gas insufflation into the abdomen increases abdominal pressure with consequent changes in respiratory mechanics and lung volume de-recruitment. During an operation an anaesthetist will typically use what are called recruitment manoeuvres, e.g. sustained inflation or multiple manual breaths, to re-open collapsed lung areas. Patients undergoing laparoscopic surgery are normally anaesthetised, muscle paralysed, receive a breathing tube and will need to be on a ventilator. The ventilator must generate (positive) pressure to blow oxygen into the lung and inflate them. Prolonged positive pressure ventilation, particularly requiring higher pressures, is damaging to the delicate lining of the lung. The continual opening and closing and/or over-distention of the alveoli caused by the ventilator seem to be the most important trigger for damage. The younger and smaller the children the more susceptible the airway, but also the lower safety margin with the pressures that are safe to use. The forced oscillation technique (FOT) is a non-invasive method for the assessment of lung mechanics, which has been successfully applied in patients with breathing tubes in. Briefly, it applies small pressure waves down into the airway and detects the reflected/returning waves allowing assessment of the airway. While intermittent assessments have been performed in the past, our study proposes a novel continuous technique not previously used in the anaesthetic setting. he aim of this study is therefore to assess the feasibility of this novel continuous assessment of respiratory mechanics in theatre and to track their changes, as measured by FOT, in children undergoing laparoscopic appendectomy. If this study demonstrates the feasibility of this new technique of tracking lung function during laparoscopic surgery, it will allow paediatric anaesthetists to use real time data to continually optimise the ventilator settings required for a child. It could then allow formulation of new evidence-based ventilation guidelines and policies to optimize and personalize the ventilation strategy in children undergoing laparoscopic surgery.
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Effectiveness of providing online information to parents of children with communication difficulties.
The Promoting Early Communication workshop provides parents with information and strategies, to support their child's language development during everyday activities. An online version of the Promoting Early Communication workshop has been developed as an option for parents who find it difficult to attend a face-to-face workshop in person, or those who would prefer an online version. The aims of this research are to find out whether: • parents who use the online Promoting Early Communication workshop, find it as useful as parents who attend the face-to-face Promoting Early Communication workshop. • online service delivery has comparable costs with those of a face-to-face workshop • parent engagement with online service delivery is comparable with parent engagement with face-to-face workshops. We hypothesise that that parents who complete the online workshop will find it as useful as parents who participate in the face-to-face workshop. It is also hypothesised that provision of the online parent education package will prove to be a cost effective service delivery option that also has additional non-financial operational benefits for the service. It is hypothesised that parent engagement with the online parent education package will be equivalent to or better than engagement with face-to-face workshops.
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Acceptability of a bronchiectasis clinic
To evaluate whether an interdisciplinary bronchiectasis clinic will be acceptable to patients in a regional area.
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INHALE: Investigation of Health outcomes in Australian Lung cancer
The purpose of this study is to collect and analyse how lung cancer is managed in Australia, and examine patient outcomes. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have been diagnosed with lung cancer. Study details: Participants in this study will continue to receive routine clinical care, which will not be impacted by involvement in this study. All enrolled patients will have clinical data collected for up to 5 years. Data captured will include presentation of the disease, surgical interventions, prescription of system therapies, and information regarding multidisciplinary management and outcomes of lung cancer in the routine clinical practice setting. This registry will be used to help to describe the current practice patterns so that we can continue to improve the health outcomes of patients diagnosed with lung cancer in Australia.
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Re-imagining Stroke Environments with Virtual Reality
We will recruit 60 people with stroke from 1-month post-hospital discharge to an exploratory study of patient responses to a novel virtual reality immersive experience. This VR experience is designed to compare stroke survivors’ responses to single- versus multi-patient room types according to 4 main factors i.e. social connectivity, access to nature/ greenery via window view, noise, and room size/expanse. We will gauge people’s responses using preference and emotional ratings. We will also track stroke survivors’ physical responses using a pulse probe and a wearable motion sensor. Following the 1 hour VR experience we will gather further insights into how people think and feel about patient room design. This study will run for 2 years. On conclusion of this study, we plan to be able to show the feasibility of a VR environment testing suite in the design of physical environments for the recovery of people with stroke. We also will have identified the significance of patient room type, social connectivity, nature exposure, and room size/expanse to people with stroke. This information can then be used to inform design guidelines in Australia for new and renovated health environments in hospital and rehabilitation settings.
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Sleeping Sound in Adolescence: A research project aiming to improve sleep in adolescents with ADHD.
ADHD is an impairing neurobiological disorder affecting over 300,000 young people in Australia. Up to 70% of children with ADHD experience sleep problems which contribute to substantially worse functioning. A number of studies have now demonstrated that sleep problems are amenable to intervention in young children with ADHD, with large improvements in sleep and child and family wellbeing. This study will extend this program to adolescents with ADHD given that sleep problems continue to be prevalent in adolescents are associated with poorer wellbeing. We recently completed a small pilot randomised controlled trial (DUHREC 2018-135) of a sleep intervention for adolescents (N=11) which demonstrated that the intervention is feasible to deliver to adolescents and their parents. We will now conduct a novel RCT to efficacy of the adapted Sleeping Sound intervention in adolescents aged 13-16 years with ADHD. It is hypothesised that compared to families in the usual care group, adolescents and parents in the intervention group will experience improved outcomes at 3 months post-randomisation for the following: 1. Adolescent sleep problems and sleep hygiene 2. ADHD symptom severity in adolescents 3. Adolescent wellbeing (i.e., mental health and quality of life) 4. Parent mental health
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A study to test the effectiveness of the I-DECIDED device assessment tool in improving care and prompt removal of invasive devices in adult hospital patients.
SUMMARY: Every day, many invasive devices are left in hospital patients after they are no longer needed for acute treatment, simply because they ‘might’ be needed or because staff forget to remove them. This places patients at unnecessary risk of hospital-acquired infections and other complications. This study will test the effectiveness of the I-DECIDED® device assessment and decision tool for improving the assessment, care, and timely removal of temporary invasive medical devices in acute adult hospital patients. AIM: To test the effectiveness of a decision-making tool (I-DECIDED®) in improving invasive medical devices assessment, care, and timely removal in acute hospital patients. SIGNIFICANCE: Each year in Australia, almost 10 million patients are admitted to hospital. Most patients receive at least one invasive device during admission, with many patients requiring multiple devices throughout their hospital stay. Many invasive devices are left in situ when no longer medically indicated, placing the patient at risk of healthcare-associated complications (HAC), increased morbidity and mortality, increased hospital length of stay and financial burden for the healthcare system, and personal and economic consequences for the patient. Regular daily assessment of all invasive devices for continued need and early detection of complications can prevent or mitigate many HACs. The proposed study will test the utility of the I-DECIDED® tool in guiding assessment, care and timely removal of all temporary invasive medical devices in acute adult hospital patients. The predicted outcome of implementing this simple but comprehensive tool is early detection of device complications, and fewer idle invasive devices and healthcare-associated infections. Success of this study will have positive consequences for hospital patients, healthcare providers, and healthcare systems.
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A randomised trial of an intervention to sustain primary schools’ implementation of a state-wide physical activity policy
The aim of this randomised controlled trial is to provide sustainability support to schools to sustain classroom teacher’s scheduling of daily Energisers (i.e., short 5–10 minute bouts of physical activity that occur during class-time) across the school week from baseline to 12 and 24-month follow-up. Schools will be provided a series of support strategies including, obtaining executive support, prompts and support to school champions, and provision of resources. Approximately 40 primary schools in Hunter New England, Illawarra Shoalhaven, Murrumbidgee and Northern New South Wales Local Health Districts will be randomly allocated to either an intervention group or a control group. The final trial endpoint is 24 months post baseline.
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A trial of a new pillow to prevent sleeping on the back during pregnancy
The aim of this study is to test the effectiveness of a new pillow designed to decrease the amount of time pregnant women spend sleeping on their back. This study will involve two conditions for each woman: one week using the new pillow and one week without the pillow, each ending with a night of overnight sleep monitoring. The sleep monitoring will (i) measure body position throughout the night to establish whether the new pillow is preventing back sleeping, and (ii) to determine if the pillow is comfortable and encourages better sleep. Importantly, we will (iii) perform fetal heart rate monitoring during the night to compare whether there are measurable differences in the baby's heart rate between these two settings. This study will help us to determine the impact of sleeping on your back during pregnancy, and whether we can encourage a safer sleeping position.