ANZCTR search results

We propose a randomised control trial to explore whether pacemaker programming, specifically an increased atrial pacing rate, can improve atrial fibrillation (AF) outcomes for older patients with concurrent sinus node disease. Participants will be randomised to either an increased atrial pacing rate, or atrial back-up pacing. The primary outcome will be AF burden.

Our research team developed a prevention and treatment program (RESP-ACT) based on internationally agreed recommendations for preventing and managing respiratory disease in children with cerebral palsy (CP) and then tested its feasibility (ACTRN12620000114943). The aims of this study are to reduce respiratory health service usage (hospital days and presentations to emergency department) and to increase the reach, adoption, implementation, and maintenance of RESP-ACT. The objectives are to implement RESP-ACT at Perth Children’s Hospital for all children with CP who are at risk of respiratory disease. Implementation will involve clinician training, a collaborative environment, strategies tailored to address referral barriers, team facilitation, audit, and feedback, and to assess its feasibility, utility, and effectiveness.

The primary purpose of the DALI-2 study is to describe the achievement of therapeutic antibiotic exposures (concentrations) in critically ill patients. Our HYPOTHESIS is that failing to achieve therapeutic antibiotic exposures (concentrations) in critically ill patients is an independent determinant of clinical outcomes, including clinical failure, mortality, ICU-free days, and the emergence of antimicrobial resistance, across diverse patient populations. Our VISION for DALI-2 is to pioneer a new era in the management of severe infections by providing definitive evidence that will reshape antibiotic dosing strategies for critically ill patients globally, irrespective of age. We aim to set a new benchmark for treatment efficacy and safety.

The primary purpose of this 12-week randomised controlled trial is to assess the impact of digital health technologies on physical activity, offering valuable insights into the effectiveness of digital health tools in promoting physical activity among health insured members in real-world settings. We hypothesise that responsive prompting strategies will positively influence physical activity behaviour as measured through daily step counts and perceptions of quality of life. The findings will contribute to the broader understanding of how digital interventions can support long-term health behaviour change and inform future health promotion strategies.

Vascular ultrasounds are a limited resource and not always available in Emergency Departments. Similarly, current clinical decision rules are either too subjective or burdensome to result in high compliance in the Emergency Department. This study aims to derive a simple clinical decision rule to safely exclude the diagnosis of DVT and reduce the amount of vascular ultrasounds performed in the ED.

Current international guideline suggest that physicians should consider cath-lab based (eg. Intravascular imaging and vasoreactivity testing) and non-invasive investigations (eg. Echocardiography and cardiac MRI) for patients with myocardial infarction with non-obstructive arteries. However, there is no consensus as to which investigations should be performed and in what order. The aim of this study is to determine if using additional intravascular imaging in up to all 3 major coronary arteries would improve the diagnostic yield and reduce length of hospital stay in patients compared to inpatient cardiac MRI

Project Summary: Aim: The aim of this study is to design and measure the effect of a PICU bereavement service to follow-up families of children who died unexpectedly. Background: Despite most inpatient paediatric deaths in developed countries occurring in a paediatric intensive care unit (PICU), there is a gap in literature and services on the topic of unexpected bereavement. Unlike patients who have life-limiting conditions and those who die expected deaths, children who present acutely to PICU and subsequently die generally do not fall under the remit of traditional palliative care services, and therefore their families often do not receive structured bereavement follow-up. Due to the rapid and traumatic nature of their child’s death these families have unique and significant grief factors equating to high risk of post-traumatic stress, complicated grief, and poor family functioning. Examining the experience of these families provides an opportunity to design bereavement care targeted to their needs and improve family-centred outcomes including family coping, functioning, well-being, and the family experience of bereavement. Methodology: A two-phase project consisting of a design phase followed by an interventional study. Phase One will consist of: 1) an integrative review of the literature on the topic of unexpected death in PICU and practice recommendations for bereavement care, 2) focus groups and interviews with bereaved families to understand what they consider important in a PICU bereavement service, 3) a scoping survey of current bereavement practices in Australian PICUs, and 4) Informed design of a PICU bereavement service (FOOTPRINTS) in collaboration with industry stakeholders and health consumers. Phase Two will be a type 2 hybrid effectiveness-implementation design. Effect of the FOOTPRINTS Service will be measured in a mixed-methods interventional trial, utilising a sequential pre and post design to assess grief severity in bereaved family members as the primary outcome. Implementation measures will assess feasibility, fidelity, and translatability of the FOOTPRINTS Service. Significance: The findings of this project will increase knowledge about unexpected death in PICU, family bereavement care needs, components of a bereavement service and feasibility of intervention delivery. Findings will contribute to establishment of a business case for a PICU bereavement service.

The aim of this study is to compare the views of the larynx or voice box obtained by two different commonly used laryngoscopes. A laryngoscope is a device designed to visualize a voice box to place a breathing tube into the trachea for airway support and safety during surgery. The two laryngoscopes are a Macintosh laryngoscope and a GlideScope Spectrum DirectView MAC™ video laryngoscope which are both commonly used throughout Australia and internationally in current practice. Video laryngoscopes, such as the GlideScope Spectrum DirectView MAC™, are commonly used for teaching medical professionals how to place breathing tubes. However, there is no evidence to confirm that the view of the voice box obtained with the GlideScope Spectrum DirectView MAC™ is the same as the standard Macintosh laryngoscope and this may have implications for quality of training.

Community members and clinicians anecdotally report that many individuals living with ME/CFS identify as, or are thought to be, neurodivergent. However, there are no published prevalence estimates of autism and ADHD in ME/CFS across the lifespan. This study seeks to estimate the prevalence of autism and ADHD in adolescents aged 10-19 years who have been diagnosed with ME/CFS and who have attended the outpatient ME/CFS clinics at either the Royal Children's Hospital or Monash Children's Hospital in Melbourne, Australia.

Approximately 240 PICCs are inserted at the Toowoomba Base Hospital (TBH) Medical Imaging department every year, with many of these patients receiving care at TBH but geographically located throughout DDH. Current migration or partial dislodgement rates are recorded locally as being as high as 60%. This is a significant proportion of patients who may be experiencing unnecessary complications requiring additional care and treatment. To our knowledge, there are no RCTs looking at the efficacy of SASS in adult patients requiring a PICC. The aim of our study is to determine if the securement of PICCs with SASS decreases the risk of catheter dislodgement (partial or total) compared to securement with SSD in adult patients. To investigate this at Darling Downs Health, the study team will undertake a randomised controlled trial in adults requiring the insertion of a PICC comparing the use of SASS compared to standard care