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A study that evaluates the effectiveness of oral combined THC/CBD for people with advanced cancer experiencing a range of symptoms.
The purpose of this study is to assess whether delta-9-tetrahydrocannabinol (THC) and cannabidoil (CBD) can be used to reduce total symptoms in patients with advanced cancer in palliative care. Who is it for? You may be eligible for this study if you are over 25 years of age and have been diagnosed with advanced cancer. Study details Participants will be randomly assigned to one of two treatment groups; either THC/CBD or a placebo medication. Participants will be asked to take increasing doses of the study medication for 14 days, with the dose increasing until participants are satisfied with the symptom improvement and are experiencing no unacceptable side effects. After these 14 days, participants will be asked to take a steady dose of the medication for another set of 14 days. During the 28 days of the study you will be required to have routine bloods and urine test which will be used as part of the eligibility and post trial analysis It is hoped that this research will show a positive effect of THC/CBD on symptoms for patients suffering with advanced cancer and thus provide an option in helping manage symptoms.
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Integrated motivational interviewing and cognitive behaviour treatment to increase physical activity in non-admitted patients from a tertiary hospital in regional Australia: the Healthy 4U-2 randomised controlled trial
Chronic are the leading cause of illness, disability and death in Australia. Hospitals, as a result, need to broaden their role from disease treatment towards a position of more preventive care. This study will examine if telephone coaching can increase physical activity and health outcomes from non-admitted hospital patients coming to see a surgeon. Telephone coaching can support and motivate participants through a range of strategies for health-related behaviour change. This office based intervention may also create linkages between hospital patient’s and programs available in the community. It is hypothesised that by the end of the intervention, compared to the minimal intervention group, the participants in the intervention group will show significant improvements in physical activity, and in physical activity self-efficacy, quality of life, and anthropometric values.
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Melatonin for Delirium Reduction, Resolution And Mitigation of Abnormal Arousal (MelaDRRAMAA)
Delirium is the sudden onset of confusion or hallucinations, due to an illness or medication. It affects the elderly particularly, and is both distressing to the sufferer and their carers, as well as causing death, disability and institutionalisation. Melatonin is a naturally occurring hormone in the human brain important in sleep. Sleep is disturbed in delirium, and studies have shown melatonin can prevent delirium. This study aims to determine whether Melatonin 5mg in oral capsules given nightly for 5 nights can treat and cure delirium that has developed in older patients in hospital.
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Effectiveness of Balint Groups in Junior Doctors
Balint groups are a type of facilitated support group that has evidence for improving medical student empathy for patients and each other, and subsequently preventing burnout. The project would be aimed at establishing an initial Balint Group with local psychiatrists who are trained in this area, while simultaneously training co-facilitators who can continue the groups on a wider scale. The study is aimed at determining whether Balint Groups can help junior doctors maintain empathy and prevent burnout.
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Stop for the Op and stop for life; Can smoking cessation be increased before elective-surgery by an offer of free mailed nicotine replacement therapy (NRT) and Quitline counselling to smokers waiting for surgery?
Over 20,000 Australians die each year from smoking. Such deaths are cardiovascular related in almost 40%. Even having a few cigarettes a day doubles risks of a heart attack. Quitting sharply reduces risks within a year or two, and is the best thing you can do for your heart. Each year, large numbers of smokers have planned (elective) surgery for both vascular and non-vascular reasons. Promising evidence shows that offers of quit-help are particularly effective at this time in encouraging permanent quitting. This will be the first study to evaluate the effect of a tailored quit intervention for all smokers (light and heavy) having elective surgery. The intervention will be offered weeks/months before surgery when the smoker is first put on the waiting list, as this gives more time for quitting and gets hearts and lungs in better shape for surgery. The intervention will be fast-acting Nicotine Replacement Therapy (NRT) lozengers, plus patches (for heavier smokers), and the tailored supply will be posted to acceptors of the offer. The telephone Quitline will provide extra support while quitting. According to our existing data, relapse to daily smoking after hospitalisation for surgery occurs in 50% of newly abstinent smokers. This will also be the first study to evaluate a relapse prevention strategy for new quitters after having surgery. The relapse kit “Open in case of smoking emergency” will contain advice, phone numbers and fast-acting NRT. The use and effectiveness of the kit in protecting new abstinence will be studied 3-months after surgery. This study builds on previous work by us that mailed NRT before planned surgery is feasible and increases quitting. By including all smokers, tailored NRT dosing, and a relapse kit, we hope to offer an effective low-cost intervention that any health service could adopt for the many smokers who have surgery. If more Australians give up smoking for good, heart attacks, blocked blood vessels and strokes will be prevented.
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Trial of My Vital Cycles (a school-based Whole Person ovulatory-menstrual health literacy program for 13-16 year old females) in Perth Western Australia
This study aims to develop and trial an intervention to facilitate ovulatory menstrual (OM) health literacy among 13-16 year old adolescent girls. Based on a whole person framework, the intervention will integrate the spiritual, intellectual, social and emotional dimensions with the physical changes of the OM cycle. The intervention will be trialled with a convenience sample of 120-150 Year 9 female adolescents from a single-sex school. The study hypothesis is that the intervention will facilitate positive attitudes towards OM health and skills to monitor and self-report OM health for confident communication of the common OM disturbances.
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Safely Preventing Errors and Complications due to Inappropriate Allergy Labelling: The SPECIAL Study - The Adult Arm.
Antibiotics are often implicated as the cause of drug allergy and many patients admitted to hospital will have a self-reported antibiotic allergy documented in their medical record during admission, and subsequently, the section of their inpatient medication chart specific to allergies and adverse drug reactions. This process has become known as ‘labelling’ and the patient is said to have an antibiotic allergy label. Documentation of allergy should protect the patient by alerting providers to avoid prescribing a drug that will result in a serious or life threatening reaction, however studies have shown that up to 90% of patients who report an allergy to penicillin, the most commonly reported antibiotic allergy, can tolerate the drug. This mistaken attribution of allergy by way of labelling has been shown to be harmful for patients directly, by limiting the selection of antibiotics for any given infection; and indirectly by increasing costs associated with alternative antibiotic choices; and increased hospital admissions. Clinicians have now recognised that a health strategy to verify or remove an antibiotic allergy label has an important role to play in increasing patient safety and reducing antibiotic resistance. The SPECIAL (Adult) study is supported by the WA Health Department. This study will allocate inpatients who report an antibiotic allergy, to either receive allergy assessment and an antibiotic challenge or an allergy assessment and usual medical care (control group). The allocation will be random so that participants have an equal chance of being in the intervention group or the control group. The intervention will be a medically supervised ‘drug challenge’. Participants will be given small doses of antibiotic in stages and their reactions will be monitored. Some participants will have skin testing first. Participants will be told the outcome of the challenge and whether they can safely take the antibiotic or that they are genuinely allergic and must completely avoid it. Documentation supporting this outcome will be provided to the participant and their GP. There will be one year of scheduled follow-up for all participants every three months by phone or email during which time participants will be asked about their health, specifically infections, and use of medical services, for example, GP visits and hospitalisations. At the end of one year participants in the control group will be offered an appointment in the allergy clinic to receive the antibiotic allergy provocation testing in line with the participants in the intervention group who received their challenge at the beginning of the study.
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Does bilateral superficial cervical plexus block improve the quality of recovery after anterior cervical spine surgery?
The anterior approach to the cervical spine is a common procedure in spine surgery. There is increased interest in decreasing the length of stay in hospital after this procedure. In addition, there is increased focus on improving the patients experience after surgery. Ultrasound guided bilateral superficial cervical plexus block has been shown to be beneficial in thryoid surgery, but there is a paucity of data related to anterior cervical spine surgery. Therefore, we designed a placebo controlled trial to assess the benefits of this procedure in regards to improving the patients recovery from surgery and decreasing their length of hospital stay.
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Assessing the health effects of six months of simulated wind farm infrasound: A community-based randomised controlled trial.
The study hypothesis is that exposure to infrasound, compared with the sham exposure, is associated with impaired sleep quality. We will randomly allocate participants to one of two groups. One group will receive speakers that generate wind farm simulated infrasound and the other group will receive speakers that generate no sound (sham). The speakers will be installed in the bedroom, will operate continuously and remain in place for 6 months. In addition, to impairment of sleep quality we will assess whether six months exposure to wind farm simulated infrasound is associated with other health effects such as annoyance, impaired neurobehavioural and neurocognitive performance, impaired vestibular function, increased arterial stiffness, increased blood pressure, mood, anxiety and stress. Secondly, to investigate whether experiencing an excess of symptoms that have been attributed to Wind Turbine Syndrome is related to baseline levels of stress and anxiety.
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SECUREment bundles for Peripheral IntraVenous Catheters in general medical and surgical patients: a feasibility trial.
Despite the importance of PIVCs to the delivery of patient care, failure and complication rates are unacceptably high. Rates of failure and unscheduled reinsertions due to complications are reported to be between 30 and 69%. Factors responsible for early failure include phlebitis, occlusion, infiltration, extravasation, dislodgement and infection. PIVC failure is a significant cost to both patients and the health care system. Effective securement of PIVC is paramount to preventing failure and complications however, to date, an optimal dressing and securement combination is yet to be identified and more innovative solutions are required. An evidence gap exists regarding the use of medical adhesive tapes and supplementary securement products in PIVC care. We will conduct a single centre pilot randomised controlled trial (RCT) to assess the feasibility of conducting a large scale RCT testing PIVC securement bundles against standard care to prevent PIVC failure and complications. The primary aim of this study is to establish feasibility of the protocol and the planned processes. This will help to budget and plan correctly for the larger definitive trial. We will collect data on the success of screening and recruitment strategies; test our data collection processes and technology; cost the Research Nurse time required for the trial; and finalise sample size requirements for the larger trial. Participants will be eligible for inclusion in this trial if they are a medical or surgical patient over the age of 18 and are having a peripheral intravenous catheter inserted as part of their therapy (which is expected to remain in place for at least 24 hours). All participants enrolled in this trial will be randomly allocated (by chance) to have their PVC dressed and secured with either standard care (control) or one of two securement bundles (intervention). Daily follow ups will then be carried out by a Research Nurse until the time of device removal.