ANZCTR search results

Central venous catheters (CVCs) are used in most intensive care units (ICU) patients to deliver intravenous treatment and monitor central venous pressures. Whilst integral to patient treatment, CVCs are associated with significant risk, the most serious being infection. Polyhecamethylene buguanide (PHMB)-impregnated foam discs around the CVC insertion site may work to reduce the incidence of CVC infection, but have so far not been tested in a critical care environment. The aim of this pilot study is to assess feasibility of study protocol and processes to inform budget, sample size calculations and protocol development of a larger, definitive trial. The outcome measures for this pilot study are feasibility (eligibility, recruitment, retention, protocol fidelity, missing data, patient/staff satisfaction), central line-associated bloodstream infection (CLABSI), other BSIs, venous/arterial infection, skin complications, device/dressing functional dwell time, SAEs and cost-effectiveness.

Twenty-two French ICUs published in 2017 found worse outcomes in bereaved relatives that received a condolence letter compared to no follow up. By comparing three communication strategies: a condolence letter, a telephone call and no contact, our pilot study aims to determine which of these interventions administered four weeks after death is associated with the lowest rate of anxiety, depression, complicated grief and PTSD when assessed at six months.

High blood pressure, or hypertension, is a highly prevalent chronic disease, affecting 1 in 3 people in Australia. Our diet has been long known to influence the levels of blood pressure. New evidence from our laboratory has emerged that this may be due to the tiny microorganisms that live in our gut, called gut microbes. While our bodies are incapable of digesting some types of fibre, they are fermented in gut, where they feed the community of ‘good’ microbes (especially bacteria), resulting in the release of substances that can be detected in our blood and might be beneficial in lowering our blood pressure. The present study will test if a modified high fibre food supplement that copies the release of gut substances that could be used to lower blood pressure,

Approximately 10-30% of young children are at high-risk of experiencing posttraumatic stress disorder (PTSD), anxiety, mood and/or behavioural disorders following a traumatic injury. We have developed and found support for the efficacy of the Coping with Accident Reactions (CARE) early intervention at accelerating the recovery from PTSD symptoms for young injured children (1-6 years). The aim of this pragmatic trial is demonstrate the effectiveness of the screen-and-treat CARE intervention program when delivered by hospital staff as part of routine clinical care.

Lipids(such as resolvins) have been shown to play an important role in resolution of inflammation. The research aims to assess the lipid variations present saliva and gingival fluid of patients with no gum disease and healthy gums, compared with those with inflamed gums but no gum disease, and those with gum disease. It is expected that through the research analysis and treatment of gum disease we will identify lipid profiles amongst gum disease and health as well as certain lipid profiles that respond to treatment better than others.

This study seeks to evaluate the effect of a one-day resilience workshop on the burnout levels and occupational resilience in general practice registrars.

IBD is a global disease challenge and common cause of chronic ill-health among young people in Australia, for which there is currently no cure. It affects approximately 1 in 250 Australians aged 5 – 40 years, with almost 75,000 Australians having CD or UC, with this number projected to rise to 100,000 within the next 5 years. Being able to identify people at risk of disease onset, prior to symptomatology, or by preventing symptom progression would yield significant global social impact and economic benefit and plays to the heart of IBD healthcare, namely to improve patient health. Two recently published studies have highlighted the strengths of utilising longitudinal assessment of the IBD gut microbiome. There is an existing knowledge gap in terms of defining microbiota changes in IBD in Australia. Different populations have differing genetic risk loci and disease prevalence rates in terms of IBD, they also harbour different gut microbes, in part due to varying environmental exposures and dietary habits. We believe it is timely to initiate such a study to contribute information on the natural history of gut microbiota changes in IBD in Australia. We will adopt state-of-the-art clinical data and sample collection in a large case-controlled cohort to elucidate microbial changes associated with onset of IBD symptomatology, the identification of an ‘at risk’ microbial signature to allow targeted intervention and the generation of novel predictive models of direct translational utility.

Motor imagery is the imagining of an action without its physical execution and motor imagery elicits activity in brain regions that are normally activated during actual task performance. Motor imagery has been shown to increase strength, improve mobility and promote motor learning in older adults. The primary aim of this research project is to identify whether the addition of six weeks of motor imagery training to standard physiotherapy care promotes improved outcomes compared to standard physiotherapy care alone in older adults following discharge form rehabilitation. Specifically, the project aims to determine whether the addition of motor imagery training promotes greater improvements in leg strength and mobility in older adults. Participants will undergo baseline testing two to three days prior to discharge from the facility, then again six weeks after discharge from the facility. Testing will involve assessments of leg strength, walking speed, imagined walking, and questionnaires relating to balance confidence and fear of falling. After baseline testing, participants will be randomly assigned to either standard care or standard care plus motor imagery. Upon discharge, participants in both groups will receive standard care as determined the community health care team (independent of research project). Those in the motor imagery group will also undertake 15 minutes of motor imagery training per day, 5 days per week for 6 weeks. The motor imagery training will be guided by audio tapes uploaded onto an electronic device (ie. phone, tablet). The motor imagery tracks guide participants to imagine doing lower limb strengthening activities and walking tasks.

Acute kidney injury (AKI) is a medical term that defines a condition when kidneys fail to make enough urine output or dispose of waste products leading to increased level of toxins in blood. AKI effects close to one-third of patients admitted to the intensive care unit (ICU). AKI is problematic as it makes patient care more difficult and exposes such patients to extra risks. This is because patients cannot remove drugs and toxins effectively and cannot control fluids, potassium, and blood acidity in a normal way. AKI, therefore, increases risk of death, and prolongs ICU and hospital length of stay. Unfortunately, despite numerous efforts, no effective treatment to prevent AKI has been developed. One of the reasons for this is that it is difficult to find out which patients are going to develop AKI early enough to intervene. However, there has been recent progressed in this area. A new urine test has been developed called NephroCheck, which measures proteins in the urine that are released when the kidneys are under stress. If such protein levels are high, then these patients are very likely to develop AKI in the next 24 hours. This means that early treatments to can be applied. Recently, there has been much research regarding the possibility that, in ICU patients, high dose vitamin C, given into through a vein, can protect organs (including the kidney) from malfunctioning in the setting of stress, as occurs in critically ill ICU patients. Such treatment is very safe and has not been reported to cause any side effects so far. It is unknown whether intervening early, in response to the findings of positive NephroCheck test, can prevent the development of AKI. However, the consensus view of the Austin hospital ICU treating team is that, in light of the available evidence, the introduction of such vitamin C therapy is both safe and desirable in ICU and should be studied. In response, we plan to perform a study to test whether giving high dose vitamin C to patients who have a high risk of developing AKI as identified by positive NephroCheck test can decrease the occurrence and/or intensity of AKI.

The purpose of this study is to evaluate the safety, Tolerability Pharmacokinetics and Pharmacodynamics of AR882. There will be up to 4 cohorts with 10 subjects per cohort randomized to receive treatment with AR882 (8 subjects) or placebo (2 subjects). Dosing: Subjects will ingest IP after an overnight fast and will remain fasted until at least 4 hours post-dose. Subjects may ingest water ad libitum during the period of fasting before and after IP administration. Planned cohorts; Cohort 1: Subjects will be dosed (50mg) AR882 or placebo once daily for 10 days Cohort 2: Subjects will be dosed (75mg) AR882 or placebo once daily for 10 days Cohort 3: Subjects will be dosed (100mg) AR882 or placebo once daily for 10 days Cohort 4(Optional): Subjects will be dosed with a lower or intermediate dose (less than or equal to 100mg) of AR882 or placebo once daily for 10 days