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Autologous Haematopoietic Stem Cell Transplantation for highly active treatment resistant multiple sclerosis.
Expand descriptionWe propose to study the benefits and risks of Autologous Haematopoetic Stem Cell Transplant (AHSCT) in people who have an aggressive form of MS not controlled by conventional treatment. Participants will have AHSCT at The Alfred hospital, and they will be closely monitored for 5 years post the transplant to ensure their safety, and also level of Multiple Sclerosis disease activity.
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Patients' perception of qualitative and quantitative risk in preanaesthetic consent
Expand descriptionAim: To determine the relationship between quantitative and qualitative risk perceived by patients presenting for anaesthesia. Participants will be recruited before their preanaesthetic consultation in the preadmission clinic and will be above 18yrs old. Methods: Participants randomised as to the order in how anaesthesia risk is presented. Group A will be asked to correlate verbal descriptions of risk with numerical descriptions and then be asked to correlate numerical descriptions with verbal ones and Group B will do it the other way round. All participants will be asked general demographic information and which method of describing risks they prefer and whether they would like a discussion of risks to be included in the preanaesthetic consultation. Expected Outcomes: to be able to correlate verbal descriptions of risk with numerical descriptions in order to develop a useful set of words that can be used to communicate risk more clearly.
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The health implications of malnutrition in Northern New South Wales
Expand descriptionThe purpose of the study is to report malnutrition prevalence from the nutrition audit conducted in 2014 and whether certain outcomes demonstrate an association to the determined nutrition status. Understanding whether malnutrition is linked to outcomes including length of stay in hospital, readmission, infections and falls can help identify where improvements in medical care is required. Based on previous findings in the literature, the hypothesis is that malnourished and severely malnourished patients experience longer number of days in hospital, are at an increased risk of having falls, infections and in-hospital mortality.
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Optimisation of the use of tranexamic acid, a medication used to treat or prevent excessive blood loss during total knee replacement surgery
Expand descriptionTotal knee replacement (TKR) is a major surgical operation that will be conducted in increasing numbers in Australia over the next 10 years. The patient’s post-operative course is typically painful and can have significant associated morbidity. The recovery process is also expensive due to the intensive nursing and physiotherapy that are required for rehabilitation. Optimising and streamlining this clinical pathway is vital for improved patient outcomes and the overall health budget. Whilst there is evidence to support the early mobilisation of patients post TKR (to reduce venous thromboembolism (VTE)), respiratory complications and bowel dysfunction), this may cause bleeding in and around the joint. This blood creates swelling, pain, reduced mobility, decreased knee flexion and an increased potential for infection. The primary goal of this study is to decrease surgical site bleeding as the patient mobilises in the early post-operative period. We aim to assess this by a number of clinical outcome measures. The study will use oral tranexamic acid (TXA) to reduce post-operative bleeding. It is already accepted that TXA is effective in reducing blood loss for TKR, whether it is used in the intravenous, topical or oral route. Current literature shows that there have been no attempts in individualising oral dosing of TXA for a patient, based on their weight and renal function. Additionally, evidence is sparse regards to identifying the benefits of achieving acceptable therapeutic target TXA exposure in plasma over a longer period while the potential for bleeding at the surgical site to occur is still high. We aim to show that therapeutic exposure of TXA can be used safely over a prolonged period and that this will improve outcomes.
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LifeSpan Trial of Youth Aware of Mental Health (YAM) Program in NSW Schools.
Expand descriptionThis study aims to investigate the effectiveness of a universal, mental health promotion and suicide prevention program – Youth Aware of Mental Health (YAM) – for reducing suicidal ideation and attempts, and increasing help-seeking in young people. The primary hypothesis is that after completing the YAM program, P1) students will report decreased severity of suicidal ideation.. Secondary hypotheses are, after completing the YAM program, students will self-report S1) no new incidents of suicide attempt, S2) increased help-seeking intentions and behaviours for suicide, and an associated increase in suicide literacy, and S3) decreased depressive symptoms.
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Transdiagnostic Cognitive Behavioral Therapy for the Treatment of Emotional Disorders
Expand descriptionThe purpose of the proposed research is to develop an ongoing empirical evaluation of the effectiveness of transdiagnostic cognitive-behavioural treatments (tCBT) for emotional disorders.
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A prospective observational study exploring association between Fractured Neck of Femur (#NOFF) patient's cardiovascular state and postoperative brain oxygen levels and mental state
Expand descriptionThis study primarily aims to see how patients having surgery for a common type of hip fracture have the oxygen levels in their brains affected after the operation by changes in their heart strength during the operation. We also want to see how other factors during the operation (blood pressure, and related factors) affect these same patients’ thinking after the operation; as well as seeing how common and how severe abnormally low readings in these factors (and other related heart factors) occur during the operation. We believe that intraoperative reduction in heart strength is related to reduced postoperative brain oxygen levels.
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mi.spot (supportive, preventative, online and targeted): a moderated online intervention for young adults who have a parent with a mental illness and/or substance use concern: A study protocol for a randomised controlled trial
Expand descriptionThe transition to adulthood can be a vulnerable period for emerging adults who have a parent with mental illness or substance use concern. Compared to their same aged peers, this group of youth face increased risks to their own mental health and commonly do not engage with traditional face-to-face health services or have access to age-appropriate, targeted interventions. Increased engagement may result through providing an online intervention. This controlled trial examines the utility of mi.spot (mental illness: supportive, preventative, online, targeted) online intervention for emerging adults aged 18 to 25 years who have a parent with a mental illness or substance use concern. The research will investigate the impact of the mi. spot intervention on the mental health and wellbeing of an intervention group compared to a control group waiting to participate in the intervention. The two groups will be compared pre, post and 6 weeks follow-up after the intervention period.
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Parent and Child Cognitive Behavioural Therapy for Anxiety Disorders
Expand descriptionThe purpose of this study is to determine the acceptability and effectiveness of a newly developed parent-child cognitive behaviour therapy protocol for parents and their children who both have an anxiety disorder diagnosis. Ten separate parent and child group treatment sessions will be delivered. Treatment sessions will include relevant psychological education and the development of skills to best treat anxiety symptoms. It is anticipated that parent and child participants will find the treatment acceptable and show improvement in symptoms from pre-treatment to post-treatment. Findings from this study are expected to advance current understanding of effective treatment for parents and children with anxiety.
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Evaluating the update of acupressure in the management of post-operative nausea and vomiting through auditing
Expand descriptionAbout one in two to three surgical patients suffer from nausea and vomiting after operation (PONV) and PONV greatly impacts on patient surgical experience and can prolong the hospital stay. Acupressure, a form of non-invasive acupuncture, can safely and effectively reduce the incidence of PONV by up to 30%. The current project aims to assess if acupressure could be incorporated into the routine management of PONV in a public hospital in Victoria to provide a non-drug option for surgical patients; what factors may impact on the adoption of acupressure; and if this non-drug option could reduce PONV and / or the use of medications. The acupressure tested is a wristband, called Seaband, and is applied to Nei Guan, an acupuncture point on the wrist of patient, about 30 min prior to surgery. The band can be in place for 24 hours. The band can be easily removed by patient if it becomes uncomfortable and can be applied later. We expect to see that this band can be easily integrated into the standard PONV management plan, and acupressure may reduce PONV or the use of anti-emetics post-operatively. Both staff and patients would be happy to have a non-drug option to complement the existing PONV management plan.