ANZCTR search results

Aims: To improve identification and management of patients with ACS within rural hospitals in a Local Health District by implementing a hub and spoke ACS management system. MORACS clinicians will receive notification of patients presenting to intervention Hospitals with ACS symptoms, review ECG, troponin, clinical information and contact the site to provide advice on evidence based treatment. Research Question: In patients admitted to a rural hospital with suspected Acute Coronary Syndrome (ACS), does a centralised management system improve identification of STEMI and subsequent clinical outcomes in all ACS patients?

High dose magnesium administered intravenously is often utilized in the management of atrial fibrillation with a fast heart rate. Randomised controlled trials have shown conflicting results in regards to its efficacy. We aim to further examine the relationship between the heart rate and magnesium therapy in patients presenting to a Melbourne based Emergency Department with 'fast' atrial fibrillation. We are primarily interested in finding out whether Magnesium therapy aids the reduction of heart rate and our secondary endpoints include; reversion to sinus (normal) rhythm, time to achieve target heart rate, number of additional treatments required to achieve heart rate target, length of stay in emergency department, rate of inpatient hospital admission and 30 day mortality and readmission rates.

Dexmedetomidine is a drug that is commonly used on Intensive Care Units across the world in patients requiring sedation as part of their medical treatment. This research aims to see if this drug is protecting or causing harm to the kidneys. We will do this by using very sensitive techniques that detect kidney function, which are not used in routine clinical practice. There have been a few studies looking at this drug in the past, mainly with people undergoing heart operations. There have also been some studies looking at animals being given this drug for sedation. The results of these have been mixed, meaning that it is unclear what the true effect is of dexmedetomidine on the kidneys. This study hopes to look at a small number of patients who are already receiving this drug as part of their treatment and see what happens to their kidney function after they start receiving it.

Evaluating the effectiveness of the coach education program for sporting coaches. The program centers around positive coaching to create engaging learning environments for players whilst increasing the active playing time for participants

This study will evaluate the feasibility and acceptability of implementing a nurse-led screening assessment for older adults with cancer Who is it for? You may be eligible to join this study if you are aged 65 years or older, have been diagnosed with cancer and attend one of the cancer clinics who are implementing the screening assessments into routine practice. Study details All cancer clinics will start in the control arm and transition to intervention arm, but the order in which they transition will be allocated randomly (i.e. by chance). During the control arm period older people with cancer attending the clinic will have clinical assessments as decided by the multidisciplinary cancer treatment team. The intervention arm will receive a screening assessment administered by the cancer nurse to assess for mobility, self-rated health, appetite or weight changes and psychological concerns, Further comprehensive geriatric assessment may also be administered if needed to assess physical function, weight, nutritional status, cognition, other medical conditions, medication, and psychosocial wellbeing.

The aim of this controlled clinical trial was to test whether implant supported restorations have similar biological and technical outcomes when placed into previously augmented maxillary sinuses via the lateral wall approach using stabilized anorganic bovine bone mineral, as used in defined clinical scenarios (i.e. reduced local autogenous bone availability and/or sinus membrane perforation), when compared to those placed into a composite graft of anorganic bovine bone mineral and autogenous bone.

NF1 is a common genetic condition with a prevalence rate of at least 1 in 2,700 live births. While not diagnostic of the condition, cognitive and behavioural impairments are the most commonly cited childhood complications of NF1. NF1 is also highly comorbid with ADHD (40%) and autism spectrum disorders (ASD; 25%). Auditory Processing Disorder (APD) is characterised by abnormal auditory nerve function in the presence of normal functioning cochlear sensory hair cells. Common impairments include a reduced ability to perceive rapid changes in auditory signals (e.g., brief gaps or amplitude fluctuations) and speech perception difficulties in the presence of background noise, even at signal to noise ratios that would be expected in everyday listening environments (e.g., classrooms; playgrounds). Our recent phenotyping study of 36 NF1 individuals indicated that a significant proportion presented with convincing evidence of APD, compared to age matched healthy control participants. The children in our study who demonstrated clinically impaired performances on two or more tests of auditory processing, on average, also scored within the clinical range on parental questionnaires of inattentive ADHD symptoms. The clinical question that remains is whether auditory processing deficits in NF1 children can be treated. Intervention research suggests that assistive listening devices (ALD) attenuate speech processing deficits associated with APD in the general population. While there is evidence that ALD can improve listening and educational outcomes in other hearing-impaired populations, these systems have not yet been explored as an intervention option for children with NF1. The current clinical trial is a pilot study assessing all elements of the study design (recruitment strategy, tolerability of the study product, study duration, study procedures and outcome measures) to assess whether ALDs are acceptable and feasible for the conduct of a full-scale randomized clinical trial to treat auditory processing deficits in NF1 children. Eligible participants will have their hearing assessed under two conditions (with and without ALD) and testing order will be randomised. They will then be randomised to one of two treatment sequences: 1) being fitted with an inactive ALD for two weeks, followed by active ALD use for two weeks or 2) being fitted with an activated ALD for two weeks, followed by a period of two weeks of use with an inactivated ALD. We hypothesise that children will exhibit improved hearing outcomes while wearing the active ALD, as measured by an objective audiology assessment, and by questionnaire ratings from children, their parents and teachers.

Sleep disorders, particularly obstructive sleep apnoea (OSA) are common conditions amongst the Australian adult population. Improving the patients’ understanding of OSA and the treatment with CPAP therapy is vital for properly treating the condition. Previous patients in our clinic have informed us that they would like health information regarding their sleep disorder to be made available in an online video format. We have developed five educational health information videos related to OSA. The main aim of this research is to determine how effective these videos are at improving patients’ understanding of OSA, uptake of CPAP therapy and usage of CPAP therapy. A randomised controlled trial will be conducted. A total of 208 eligible patients will be randomised to either Group 1 “Standard of care” or Group 2 “audio-visual clips”. For patients in Group 1 (standard of care) education will be provided at night by the sleep scientists according to standard laboratory policy and procedures. For patients in Group 2 (audio-visual clips), five videos will be shown well as the standard education. The primary outcome of this study is to determine CPAP adherence (hrs) in both standard of care and audio-visual arms at 2-months and 12-months.

Lateral ankle sprains are the most prevalent musculoskeletal injury sustained by individuals who participate in sports. They also have the highest recurrence rate of all musculoskeletal injuries; between 32% to 74% of individuals will experience a re-injury and/or report persistent injury-associated symptoms. The high prevalence (40%) of re-injury and persistent injury-associated symptoms experienced within the 1-year time period following first-time acute lateral ankle sprain injury suggests that current management practices may be insufficient. A study of US high school athletes identified that 71% to 75% of athletes return to sport (RTS) within 3 days of incurring an acute lateral ankle sprain injury, whilst 95% of athletes RTS within 10 days of injury. Based on these timeframes, it is not surprising that sensorimotor impairments associated with acute lateral ankle sprains are still present when athletes RTS. Early, and symptomatic, RTS after an acute lateral ankle sprain injury could heighten the risk of persistent injury-associated symptoms, future injury risk and the development of secondary problems, such as ankle joint osteoarthritis. There are a number of likely reasons why sportspersons RTS early, and with impairments, after incurring an acute lateral ankle sprain injury. First, lateral ankle sprains are often assumed to be minor injuries and consequently over half of individuals do not seek formal medical treatment. Thus, in these individuals, injury-associated sensorimotor impairments are never addressed with specific targeted rehabilitation. Second, there are currently no criteria-based guidelines to guide RTS decision making for individuals with an acute lateral ankle sprain injury. In light of the lack of evidence for RTS criteria following acute lateral ankle sprain injury, and lack of literature addressing this question, there is need to determine and collate expert opinion to inform RTS practice. The Delphi process is one method that can be used to collate and refine expert opinion. This approach has been undertaken to inform the development of RTS criteria for hamstring injuries. Information gained by this process can be used to inform the development of RTS criteria for acute lateral ankle sprains and provide the basis for prospective cohort studies to test the use of the proposed criteria for successful RTS. The aim of this study is to use a Delphi approach to develop consensus for RTS criteria for individuals who have sustained an acute lateral ankle sprain injury.

There is a need to support individuals to maximise their potential for return to employment following major trauma. The current study will evaluate an early vocational intervention service provided to individuals experiencing major trauma to determine whether it positively impacts employment outcome one year post-injury as well as study, community and social participation, and quality of life, as compared with delivery of 'usual care' access to vocational rehabilitation. It is hypothesizes that participants receiving the early vocational intervention will show better employment outcomes and social participation at one year post-injury than control participants receiving usual care. Qualitative interviews with injured individuals, their employers and the therapists involved will also be conducted to identify the factors associated with successful RTW, as well as barriers, and satisfaction and quality ratings will be completed with participants, their employers, therapists and insurance claims coordinators to identify key learnings from the early vocational intervention program