ANZCTR search results

The overall aim of this study is to improve methods of temperature monitoring for patients undergoing surgery. There are concerns about how accurate the most commonly used, non- invasive methods of temperature monitoring are. The most accurate methods of measuring core temperature are very invasive, and therefore not routinely used for all patients undergoing surgery. Accurate and consistent measurement of temperature is important when patients are undergoing surgery to detect abnormal temperatures including fever, and perioperative hypothermia – that is, a very low temperature related to undergoing surgery and anaesthesia. Perioperative hypothermia is linked with range of adverse side effects. Therefore, it is very important that health care staff monitor temperature using the most effective, yet practical and safe mode of measurement. This study specifically seeks to test the zero-heat-flux temperature monitoring device (Bair HuggerTM). The device will be tested in comparison to oesophageal temperature monitoring, which involves the insertion of a temperature monitoring probe into the oesophagus. This is often undertaken as part of routine care, as this method is considered an accurate method of core temperature measurement. The zero-heat- flux device is completely non-invasive, yet existing research suggests that it may offer greater accuracy in monitoring core temperature than other non-invasive devices in use. This study will assess the accuracy of the device, ability to detect hypothermia, as well as assessing the feasibility of a larger trial of the clinical application of the device. This device will be compared with the standard of care (oesophageal) device and all participants will receive both forms of monitoring.

This randomised control trial will evaluate the immediate and long terms impacts of a 12 week exercise program in pediatric survivors of childhood posterior fossa brain tumours (PFBTs) Who is it for? The study is for children aged between 5 to 17 years with a diagnosis of a PFBT that required surgery at least 12 months earlier. Study details Participants will be randomly assigned to either the intervention or the control group. All participants in the intervention group will be required to attend a research facility once a week for a 30-60 minute individualized, goal-directed exercise session for 12 weeks. The study will also involve a parent-led, home exercise program to be completed for 30 minutes, 3 times per week. The control will receive standard care. Participants will be assessed on immediate (at 12 weeks) and long-term (at 6 month and 12 month follow-up) effects on their cardiorespiratory fitness, goal attainment, muscular strength, habitual physical activity, and quality of life. If found to be effective, the therapeutic exercise program may improve the quality of survivorship, and will have strong potential for translation to clinical practice and paediatric rehabilitation services.

This project will aim to determine the feasibility of using smart phone based applications in a clinical population with severe mental illness, and to determine whether the information gathered from mobile devices can detect and predict deteriorating mental health. Two groups of participants will be recruited from mental health services across South Australia; primary healthcare professionals, and patients. Primary healthcare professionals (clinicians) will be recruited for the purposes of overseeing patient recruitment, and determining eligibility. Patients will be asked to download a smartphone app called Mindtick, and will be asked to use the app for the duration of the study. Through the app, they will be prompted (via push notification) a number of times in a week to answer 8 questions relating to a number of variables; (mood, sleep, cravings, level of functioning, and disruptions to life events). Additionally, the app will collect sensor data (GPS, call/text logs, etc.) from sensors already built into the smartphone. In addition to the mobile application, an online clinician dashboard has been developed for the purposes of clinician review to monitor and improve engagement with the intervention. The dashboard summarises patient app data, and presents this information in a graphical format for monitoring mental health patient’s symptoms and functioning. We will investigate whether fortnightly responses and statistics in mobile sensor data can predict early the change in the routinely collected traditional assessment measures observed at baseline, 3, and 6 months.

We are recruiting participants aged over 18 years old to participate in a 2-year internet based study, called the Actionable Intime Insights (AI2) Study . The study aims to explore whether the use of patients Medicare Benefit Scheme (MBS) and Pharmaceutical Benefit Scheme (PBS) claims data held in My Health Record, can unveil more sufficient ways for clinicians and other healthcare professionals to provide optimal health care to patients with a chronic mental illness. Specifically, when people go to visit their doctors, they typically lodge a MBS or PBS claim to subsidise some of the payment costs. However, to date, there has not been a successful way of monitoring and managing the MBS and PBS data. We hope that we can be the first to provide a long-term sustainable solution to this problem, with the implementation of our novel digital application called the Actionable Intime Insights (AI2) application. We believe the AI2 application will help transform the way clinicians and patients interact with each other and ultimately improve patient’s well-being and outcomes.

Introduction & aims Tranexamic acid (TXA) is an anti-fibrinolytic historically been used to reduce haemorrhage during trauma. Its benefits in reducing the blood loss and subsequent blood transfusions after elective total joint replacements (TJR) have been widely accepted. Despite this, tranexamic acid has yet to be routinely used in all patients – mostly due to the theoretical concern of an increased incidence of venous thromboembolism. This study aims to determine whether the use of TXA in TJR increases the risk of venous thromboembolism. Method A retrospective audit of consecutive patients undergoing a TJR between July 2016 and June 2018 was performed at TQEH. Patient demographics, history of thromboembolic events and American Society of Anaesthesiologists (ASA) scores were identified. This was then analysed against the incidence of a post-operative thromboembolic event. Patients who did not receive TXA were further investigated as to the reason for withholding

In Tasmania, bowel cancer is the second most commonly diagnosed type of cancer. Appropriately prescribed exercise during cancer treatment is recommended as an important component of cancer care, but few people take up exercise during their treatment. Often the reasons given for not exercising during cancer treatment are access to exercise experts and affordability. This study will explore the effectiveness of exercise counselling and prescription delivered by an Accredited Exercise Physiologist using app-based technology in people with bowel cancer Who is it for? The study is adults over 18 years who are in primary or adjuvant therapy for localised (non-metastasised) bowel cancer (chemo, radiation or post colostomy surgery). Inclusion criteria includes people who are a maximum of 6 months post treatment for stage I to III colorectal cancer. Study details: Participants will volunteer for the Home Exercise (intervention) group or the Usual Care (control) group. The Usual Care group will receive standard care as directed by their general practitioner and/ or oncologist.. The Home Exercise group will be involved in an unsupervised home exercise program with 4 x fortnightly education sessions around positive lifestyle changes during treatment for bowel cancer. The program will be delivered via an app using a video conferencing feature. It will cover exercising and eating recommendations for bowel cancer as well as managing stress. The intervention will run for 8 weeks and involve questionnaires and vital sign measurements (heart rate, oxygen saturation, BMI). What do we expect will happen? We expect that participants in the Home Exercise group will improve their understanding of the importance of regular exercise in managing the ongoing health effects of cancer and its’ treatments. After 8 weeks of structured and individualised exercise, we expect participants in the Home Exercise group will have improved quality of life, increased strength and aerobic fitness and be more confident in the ongoing self-management of their health, compared to the Usual Care group.

Currently, dietary supplements are widely used by patients with osteoarthritis. Some commonly used supplements such as glucosamine and chondroitin have been proven to be ineffective in reducing the symptoms of osteoarthritis. However, some lesser-known supplements such as: Boswellia serrata extract, Pine bark extract, Curcumin, and Methylsulfonylmethane have demonstrated promising results in clinical trials, but further research is needed. We have developed a new product combining the four supplements above to test its efficacy on people with hand osteoarthritis. We hypothesise that 12 weeks of active supplement combination is superior to its placebo in improving pain intensity in people with symptomatic hand osteoarthritis.

The Birth Course: Evidence based childbirth education program to reduce rates of caesarean section in first time mothers. Maternal and child health are priority public health areas listed by the World Health Organisation (WHO). Successive reviews of maternity services for more than four decades, both in Australia and internationally, have called for a decrease in medical interventions, particularly caesarean section (CS), due to it associated morbidity and mortality. It is well established in the literature that medical interventions in labour significantly increase the risk of caesarean section (CS). In 2014, only 56% of women experienced a normal vaginal birth, with more than half receiving an epidural, and more than a third giving birth by caesarean section. However, there is a major practice gap in how to address the rising rates of intervention in childbirth, and strategies to provide effective and cost-effective methods to support women and reduce medical interventions are required. The Birth Course is a complementary medicine (CM) package of antenatal care combining education about normal physiology and pain dynamics in labour, with five different evidence-based CM techniques for the management of pain in normal labour and birth. The Birth Course education program is an intervention which introduces the concepts of: Physiology and hormones of birth, the Fear-Pain-Tension cycle, working with pain, the relaxation response, and uses the five techniques of: upright positions/yoga and movement for birth, acupressure techniques, guided visualisation, breathing techniques and massage. We hypothesise that this study will provide an effective antenatal education program to reduce rates of medical intervention in labour and birth, and provide women with non-pharmacological pain management options.

This multicentre pilot pragmatic open label randomized controlled Trial (RCT) compares early metabolic resuscitation treatment with Hydrocortisone, Vitamin C, and Thiamine in comparison to standard care defined as no treatment with Hydrocortisone, Vitamin C, and Thiamine. We hypothesize that in children presenting with sepsis and septic shock early intravenous administration of Vitamin C (30mg/kg iv q6h), Thiamine (4mg/kg q12h) and Hydrocortisone (1mg/kg q6h) delivered early during resuscitation is feasible. We hypothesize that these interventions will lead to a more rapid resolution of shock, reduced duration of organ dysfunction, leading to reduced intensive care resource utilisation. The study can provide the urgently needed evidence on currently used sepsis resuscitation bundles.

In view of the potential harm related to high volume fluid administration in septic shock, fluid-sparing algorithms using early intravenous inotropes to treat shock have been proposed as an alternative strategy. This multicentre pilot pragmatic open label randomized controlled Trial (RCT) compares early inotropes started after 20ml/kg fluid resuscitation with standard care defined as providing up to 40-60ml/kg fluid resuscitation prior to initiation of inotropes as per the American College of Critical Care Medicine recommendations. We hypothesize that in children presenting with sepsis and septic shock, a fluid-sparing algorithm using early inotropes delivered early during resuscitation is feasible and will lead to a more rapid resolution of shock and reduced duration of organ dysfunction.