ANZCTR search results

Chronic rhinosinusitis (CRS) is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen for at least 12 weeks, despite treatment attempts. This then causes mucous build up. According to the Australian National Health Survey, in 2007-2008, 9.2% of the Australian population reported to suffer from this condition. Symptoms include difficulty breathing through the nose, the area around the eyes and face may feel swollen and the patient may have facial pain or tenderness. Patients also frequently suffer from depression, poor sleep and fatigue leading to significant direct and indirect costs to the health system. Even though this condition is common in the community, there is an ongoing search for an efficient and practical method to deliver ongoing treatment that decreases the financial and physical burdens of CRS. The most recent accepted standard treatment of CRS include nasal saline irrigation (washing the nasal passages with a mild salt water solution) and intranasal corticosteroid sprays/drops (applying medicine directly into the nose through drops or spray). Corticosteroids are medicines that assist in treating inflammation in the body. Current practice of adding a corticosteroid to the saline wash solution means the medication does not stay in the nose for very long and this then requires daily treatment. Applying the corticosteroid directly to the inside of the nose (nasal mucosa) offers the benefits of treating CRS directly with high local concentrations without the systemic (whole body) side effects. There has been recent interest in the use of soluble gels, that gradually dissolve, which are applied directly to the inside of the nose to deliver these medicines. These soluble gels slowly release the medication into the surrounding tissue. These gels have the potential to change the way medications are delivered to the nasal mucosa and thus the treatment of CRS. The aims of this trial is to ascertain: 1. how long the soluble gel takes to dissolve once applied to the nasal mucosa 2. if the addition of a corticosteroid medication to the soluble gel affects the time it takes to dissolve.

Peripheral intravenous catheters (PIVCs) are small hollow tubes inserted into veins for medical therapy in most children admitted to a Paediatric Intensive Care Unit (PICU). However, extravasation or ‘leaking’ of fluid into surrounding tissues remains a harmful complication. Nursing surveillance and assessment of PIVCs assists in detection of extravasation. However, demanding clinician workloads and the inability of some patients to communicate symptoms during critical illness has proved early detection challenging. In order to improve early detection of extravasation injuries, ivWatch® was developed as continuous and non-invasive monitor of PIVCs. It consists of a patient monitor, an optical sensor cable, and a sterile, disposable receptacle for attaching the sensor to the patient’s skin, near the PIVC site. Using infrared light, ivWatch® manufacturers claim the device can detect early signs of extravasation. However, there are few clinical data regarding the effectiveness, acceptability and value of ivWatch®. We are undertaking an efficacy trial to test the feasibility of a larger trial to evaluate the effectiveness of ivWatch®, versus surveillance by clinicians, to identify extravasations within the PICU. We believe this technology has the potential to significantly improve treatment provision and increase patient safety within all critical care settings.

The purpose of this study is to assess the effect of early intervention exercise after surgery on mood and post-operative outcomes. Who is it for? You may be eligible for this study if you are aged 18 or over, and undergoing major foregut cancer surgery. Study details Participants in this study will be randomised by blocking, into two groups. Participants in one group will receive standard care which includes, enhanced recovery after surgery protocol. The other group will start exercise from the first post-operative day until discharge from hospital. The exercises will involve two sessions daily, one resistance training and one cardio training. The resistance training will involve chest press, knee extension, bicep curl, shoulder press, lateral raise, calf raises and sit to stand. The cardio training will involve walking, arm cycling, leg cycling, and step ups. The sessions will last approximately 10-45 minutes. As a part of this study, all participants will answer questionnaires and undergo simple fitness tests prior to surgery, when leaving the hospital, and at 1 month and 3 months after discharge from hospital. It is hoped this research will demonstrate starting exercise sooner will results in improved mood and physical outcomes.

Iron infusions are a commonly used therapy to correct iron deficiency anaemia (low blood haemoglobin). They are used with increasing frequency in surgical patients with the aim being to optimise a patient’s own blood stores prior to surgery and improve post-surgical outcomes. International guidelines recommend the pre-operative administration of iron to surgical patients who are not anaemic, but have iron stores considered sub-optimal, when substantial blood loss that would result in depletion postoperatively is anticipated. However, this is based on limited evidence, and with uncertain outcomes. This pilot study will examine the feasibility and tolerability of a research protocol to compare outcomes (including recovery of iron stores, exposure to blood transfusion and quality of recovery after surgery) in a group of hospital patients having major surgery. Non-anaemic patients with suboptimal iron will either receive an iron infusion pre-operatively or placebo. Patients will be examined by questionnaire, physiological testing and blood tests post-operatively and at one month after their operation to quantify and qualify outcomes for comparison between these groups.

Chinese immigrants are at increased risk for obesity and non-communicable disease (e.g diabetes, cardiovascular disease) after migration due to an interacting set of factors, including dietary change, cultural barriers, and genetic predisposition. To better understand the increased risk among immigrants, it is important to consider the dietary shift that occurs when Chinese immigrants move to Australia. The goal of our research study is to understand how and why Chinese immigrants change their dietary habits after migration and what impact these dietary changes have on risk factors for diabetes and cardiovascular disease. We hypothesise that over the two-year observation period there will be 1) evidence of dietary acculturation in Chinese immigrants to Australia; and 2) changes in risk factors for cardiovascular disease and diabetes.

This application is for the purpose of conducting a randomised controlled trial (RCT) of a smartphone-based intervention (Anchored) aimed at reducing depression and promoting mental health and wellbeing within Australian workers. The app has previously undergone pilot testing for feasibility, usability and acceptability. Participants will be randomised to one of two conditions: (1) the Anchored app (a CBT, mindfulness, and behavioral activation-based smartphone app) and (2) a psycho-educational online resource. Post-intervention assessment will occur 30 days after baseline, and follow-up assessment will occur 3 and 6 months after baseline. All assessment will be completed online. Key outcomes include: depression symptoms, anxiety symptoms, stress, wellbeing, resilience, function, burnout, work productivity, and lifestyle elements.

This project aims evaluate a way of delivering care that allows people with cystic fibrosis to receive approximately half of their outpatient care in their own home. The study will use telehealth, a system where the hospital staff and the patient each log into a video call and all questions and assessments are performed online. By using telehealth, patients will not need to travel, which may lead to increased satisfaction as well as cost savings for individuals and the healthcare system. The study aims to measure how satisfied patients are with receiving care in their own home. The study will also determine the costs to the patient and how much of a burden it is on patients to have their appointments at home compared to travelling to the hospital. This is an important study because, as technology improves and the healthcare system has the ability to provide more care without seeing patients in person, there is a responsibility to carefully study if using technology is beneficial to the patient or if this may be detrimental to the patient. Patients that choose to be part of the study will be randomly divided into two groups. One group, named the ‘usual care group’ will continue to attend the hospital for all of their appointments, this represents no change to their usual care. The second group, named the ‘telehealth group), will attend the hospital for approximately half of their appointments only and will remain home for approximately half of their appointments with the hospital staff conducting the appointment via telehealth.

This study is a prospective randomised controlled trial investigating whether the use of cooled radiofrequency ablation in total knee arthroplasty improves postoperative pain and postoperative function.

The study aims to evaluate a pain psychology therapy delivered by virtual reality to cancer patients with chronic pain. In addition, to confirm the feasibility and acceptability of VR use in a cancer population. Who is it for? You may be eligible for this study if you are 18 years or older with cancer. Study details Patients will be randomly allocated (50/50 chance) to either the intervention group or the control group. The intervention group will receive 3 x 30min sessions of VR-pain psychology therapy, as timed by a researcher. Each session will allow one module of the VR-pain therapy to be provided. The VR session will occur after the patient has seen their oncologist. The software program will incorporate three pain psychological modules: (1) Patient education on the nature and type of pain, and methods to control pain; (2) Teaching progressive muscle relaxation as a form of arousal reduction therapy; and (3) Guided pain visualisation technique to reduce pain catastrophising, reduce maladaptive response to pain, and improve functional outcomes Participants will be required to answer questionnaires about their quality of life and cancer symptoms at several time points, including, 1 month, 3 months, and 6 months after recruitment. It is hoped this trial will provide greater insight into the clinical effectiveness of the Virtual reality intervention on pain scores and can possibly offer cancer patients an alternative non-pharmacological analgesia.

The Alfred and Emergency and Trauma centre sees in excess of 65,000 patients per annum which includes approximately 8,000 trauma presentations. Close to 40% of these presentations will be admitted to hospital, with a substantial number requiring spinal immobilisation for a period of time prior to spinal clearance. Of these, 20%, (approx. 1500 patients per year ) are admitted to the Alfred emergency short stay unit (SSU). Such patients are often required to lie flat in bed, with direct visual contact with the ceiling of the Emergency Department. These is often no visual stimulation for this group of patients which can lead to agitation, aggression, fear and anxiety, which often results in reduced compliance with spinal immobilisation. This study aims to demonstrate improved emotion comfort among spinally immobilised patients in the emergency department short stay unit by providing sensory mindfulness content using a customised mobile integrated patient controlled immersive audio visual device as a therapeutic tool to facilitate relaxation which has been specifically designed for immobilised trauma patients.