ANZCTR search results

This project aims to evaluate the impact of an intervention designed to improve activation on patient outcomes and investigate whether activation levels of patients on haemodialysis change overtime. This study will involve adult participants 18 years and over who are new to haemodialysis and commence at Monash Medical Centre. It will be a single centre, prospective participant blinded randomised controlled trial with 18 months follow up. Participants will be randomly distributed into a control and an intervention group.

Trauma focused cognitive behavioural therapy has long been the standard approach for the treatment of posttraumatic stress disorder (PTSD). Cognitive Processing Therapy (CPT) is a manualised treatment protocol based on a cognitive behavioural therapy approach, typically delivered over 12 sessions. Whilst CBT approaches have good efficacy in the treatment of PTSD, the non-response to treatment and dropout rates remain substantial. In military clients, between 20-30% will drop out of treatment prematurely and 40-64% will fail to lose their PTSD diagnosis by the end of treatment (Forbes et al., 2012; Resick et al., 2015, 2017). This research utilises a flexible adaptation of CPT which individualises therapy based on the needs of the client and allows for deviation from the standard treatment protocol. It is hypothesised that this approach will result in less dropout and better good end-state functioning.

The National Comprehensive Cancer Network guidelines now suggest testing all men with metastatic prostate cancer for germline mutations predisposing to cancer, the purpose of this study is to determine whether this kind of testing is acceptable to patients with prostate cancer. Who is it for? You may be eligible for this study if you are an adult who has been diagnosed with prostate cancer. Study details: The study involves having a discussion with a member of your treating oncology team about genetic testing for an inherited gene that may have predisposed to developing prostate cancer. If you agree to the testing, we will collect a saliva sample and send it for testing. The results will be available in about 4 weeks. If your result shows a change in one of the genes that we are testing for, that may have contributed to your development of prostate cancer, then we will refer you for a consultation with the Familial Cancer Service. After your oncologist provides you with the test result, we will provide you with a questionnaire, asking you about your opinion on the testing process. It is hoped that this study will help determine if the testing process is acceptable to patients with prostate cancer.

Good sleep is essential for normal daytime functioning and health and effects of sleep disorders and sensory disturbances such as traffic noise on sleep quality and health outcomes are well known. Expansion of wind farm facilities in Australia has been associated with widespread community complaints regarding sleep disturbance and adverse health effects potentially attributable to wind farms operating in a normally quiet rural environment. Wind farm noise exposure, including audible and potentially inaudible low frequency components, clearly has the potential to adversely affect sleep, health and well-being through two main plausible and inter-related mechanisms; chronic sleep fragmentation from frequent physiological activation responses to sensory disturbances in sleep, and chronic insomnia which could potentially develop more gradually over time in sensitised individuals. However, as outlined in the NHMRC rapid review of the evidence, data from well-designed studies using objective measures of sleep and sound are remarkably lacking and are clearly now needed to definitively establish the sleep disruption characteristics of wind farm noise compared to other noise disturbances in sleep. This project will, for the first time, use direct electroencephalographic (EEG) and cardiovascular measurements to systematically evaluate the sleep disruption and physiological activation response characteristics of wind farm noise during sleep. Groups of individuals with and without prior wind farm noise exposure will be studied in carefully controlled laboratory conditions using pre-recorded and accurately-reproduced wind-farm noise, including and excluding low frequency components and infrasound. Dose-response characteristics will also be evaluated against more ubiquitous traffic noise in sleep. Potential predictors of sleep disturbance responses such as sensory acuity, annoyance and physiological activation response to noise presented during wakefulness will also be evaluated.

Research focusing on frailty in residential aged care services (RACS) is sparse. A better understanding of the relationship between frailty progression, residents’ use of life space and their perspectives on quality of care, combined with residents’ health data will help to better determine the progression of frailty, its associated health outcomes and costs, and assist in developing interventions that could improve the health circumstances of residential aged care residents in the long term. The aims of this study are: 1. To confirm the validity of the FRAIL-AC in comparison to the FRAIL-NH and 66-Item FI 2. To describe the trajectory of frailty and its relationship with factors such as malnutrition, mobility, qualify of life, quality of care, dementia, sleep, activities of daily living, strength and pain 3. To investigate the association between frailty, hospitalisation, emergency department presentations and mortality via data linkage Hypothesis: We have recently investigated the frailty trajectory of older people living in the community and have demonstrated that frailty levels are dynamic with improvement and stability possible. Through this study, we aim to investigate if similar findings are present within RACS. We hypothesise that frailty and its trajectory may be associated with characteristics of the care provided in RACS to older adults.

Central sensitisation is when normal sensation from an everyday experience such as light touch is increased to produce an abnormally painful response. This project aims to look at how common (the prevalence) central sensitisation is in women who have pelvic pain. It will also explore other factors that may be associated with a higher risk of central sensitisation, for example, a longer duration of pain, anxiety/depression or a history of other pain conditions e.g. fibromyalgia. The findings will improve the medical knowledge about the role of central sensitisation in the development and experience of pelvic pain. Participation in this project will involve the following: - completion of the consent form below - completion of the questionnaire which will ask about age, demographics, pain history and risk factors, including questions about sensitive issues such as pregnancy loss and abuse. The questionnaire will take about 14 minutes to complete and some of the questions may seem repetitive.

This study is designed to evaluate the effects of 8 weeks treatment with the glucagon-like peptide-1 agonist, exenatide (once weekly (QW)), on the rate of stomach emptying, glucose absorption and blood glucose and plasma insulin concentrations in type 2 diabetes. This is a randomised parallel designed study. Subjects recruited into the study who pass screening criteria will be randomised to receive exenatide QW or matching placebo. They will have a gastric emptying study performed using the gold standard technique (scintigraphy) at baseline and at 8 weeks. Immediately following the first gastric emptying study they will commence treatment with exenatide QW or Placebo, administered subcutaneously at weekly intervals. Glucose absorption, blood pressure, blood glucose and plasma insulin will be assessed during each of the gastric emptying measurements.

Sunrrise Australia is the Australian arm of the Sunrrise Trial (Single Use Negative pRessure dressing for Reduction In Surgical site infection following Emergency laparotomy), a randomised controlled trial funded by the Research for Patient Benefit Program of the National Institute of Health Research UK. The UK trial is led by the Trainee Research Collaboratives in the West Midlands and North West Regions of England. Sunrrise Australia has full support from NIHR RfPB board, the UK trial leaders and the Clinical Trials Network Australia and New Zealand (CTANZ) This study tests whether a new type of active wound dressing can reduce rates of wound infection (surgical site infection, ‘SSI’) after emergency surgery on the abdomen. These dressings are Single Use Negative Pressure Dressings (SUNPD). They combine a sealed pad and suction to remove fluid from in and around the wound. Emergency abdominal operations are performed for a variety of life-threatening reasons, including bowel blockages, perforations, traumatic injuries and infections. At least 1 in 4 patients will be affected by an SSI after these procedures. These SSIs are painful, take longer to heal, extend hospital stays, incur significant extra costs, and can lead to ongoing wound care in the community. In an already unwell patient, development of an SSI can contribute to other major complications, including death. The trial is currently recruiting patients at 5 sites in the UK. It is expected that a further 25 UK sites will be opened by December 2019. With support from this grant, Australian sites will start recruiting in October 2019 The Australian study increases the power from 80% to 90%, reinforces the links in Surgical Research that have developed between the Research Collaboratives in the UK and Australia, and enhances surgical clinical research capacity in Australia by training a new generation of surgical trainees in trial methodology and conduct.

Traditionally ETT is used for the nose surgery for maintenance and protection of the airway during anaesthesia and recovery. There are only a few studies comparing reinforced laryngeal mask airway to ETT and these have shown similar efficacy in achieving the above functions. Reinforced laryngeal mask( RLMA) have been shown however to have a lower incidence of hoarseness, coughing during recovery in the post-anaesthesia care unit (PACU) and oxygen desaturation than patients treated with ETT . There is a paucity of literature on the use of RLMA and emergence characteristics. There are no trials examining the emergence characteristics of patients ventilated with ETT vs RLMA using remifentanil and Propofol. . We wanted to assess the RLMA for the suitability of its use in intranasal surgery (INS) and assess its safety during the surgery and emergence characteristics at the end of surgery.

Intermittent infusions utilising lidocaine, magnesium or ketamine are routinely used in the management of neuropathic pain and fibromyalgia. These three treatments are utilised for treatment of the same condition without any current evidence to compare efficacy or to guide clinicians in the most appropriate therapy for a given patient. The current paradigm in the management of pain utilises multimodal analgesia, in which analgesics with different mechanisms of action are used in combination to harness presumed additive (and hopefully synergistic) effects and limit dose related adverse effects. However studies of analgesics are only infrequently examined in combination, which leads to a lack of information regarding the additive nature of any effects (positive or negative). Within the Sir Charles Gairdner Hospital (SCGH) Pain Management Department, patients are admitted as day stay patients for brief (1-2 hour) infusions of either lidocaine or ketamine, usually repeated on a weekly basis for a series of three infusions. The aim of this pilot study is to assess the efficacy and tolerability of an infusion utilising a combination of lidocaine, magnesium sulphate and ketamine in the treatment of neuropathic pain, CRPS and fibromyalgia. Data will be used to identify appropriate doses and guide the creation of a later comparative study. This study will be an open label pilot study. 30 patients with peripheral neuropathic pain, CRPS or fibromyalgia will be recruited from the Pain Management Department at SCGH. Patients will receive four intermittent infusions utilising a combination of lidocaine, magnesium sulphate and ketamine. Patients will be assessed for intra-infusion adverse effects and on a fortnightly basis for 6 weeks and then at 3 months following the final infusion. Data will be collected via phone interview as well as utilising the ePPOC questionnaire which includes multiple pain measures (BPI, DASS21, PSEQ,PCS, GRoC and medication usage) and is routinely used in the Pain Management Department at SCGH to assess efficacy of therapy. Following completion of the study, data obtained along with data from a prior audits of lidocaine and ketamine infusions for the treatment of neuropathic pain will be used to design a double blind comparative study.