ANZCTR search results

We will recruit 120 women with singleton pregnancies without cardiac abnormalities from 28 weeks gestation to term. Each participant will undergo a NI-FECG recording session with concurrently recorded CTG and tocodynamometer to ascertain a gold standard for the fetal heart activity and uterine activity.

D-mannose is a carbohydrate and important in the metabolism of some proteins within the human body. It has been shown to prevent the adherence of E-coli bacteria to the uroepithelial lining found in the bladder. This is important because E coli is the most common pathogen responsible for urinary tract infections. D-mannose has also been shown to be useful in reducing the bacteriuria (bacteria in the urine) in animal studies and is used in equine veterinarian practices for this purpose. Previous studies using D-mannose as a preventative measure against UTI have been promising. However, none have examined the effect in patients with diabetes mellitus or the elderly patient, who frequently have recurrent and resistant strains of E-coli in their urine. Therefore the aim of this study is to measure the effectiveness of D-Mannose in reducing the development of full urinary tract infection in those high risk patients who experience recurrent urinary tract infection. The study will be a double blind randomised trial with the primary outcome examining the percentage of patients developing a UTI during the study period. It will be conducted over a 24 week period.

There are many factors which are thought to contribute to the ability to maintain good brain health, including genetics, psychosocial and environmental factors. In addition, recent research has indicated that it may be possible to induce, or promote, brain health using non-invasive brain stimulation - namely transcranial Alternating Current Stimulation (tACS). Therefore, the purpose of this project is to investigate brain activity that is related to cognitive performance (i.e. thinking skills) in people with mild cognitive impairment. We will conduct these investigations a number of times over a three-year period to allow us to look at any changes that may occur in brain activity and cognitive performance. We will also be looking at any psychosocial and environmental factors that might contribute to changes in brain activity and cognitive performance. Finally, we will also investigate the effects of tACS on brain activity and cognition over the same period of time. Overall, this project aims to help provide a better understanding of the reasons why some people with MCI go on to develop Alzheimer’s, whilst others do not, and ultimately help in the development of early intervention treatments for Alzheimer’s disease. It is hypothesised that participants receiving active treatment will improve cognitive function, enhance brain activity, and strengthen functional brain connectivity after each yearly treatment course compared to those who undergo sham treatment. It is also hypothesised that there will be a lower conversion from MCI to Alzheimer’s disease in individuals receiving the active treatment over the three-year period, compared to those receiving the sham treatment. Finally, it is hypothesised that biopsychosocial factors will influence pathophysiological changes in people with MCI over time.

Disturbances of sleep occur frequently in the critically ill. Much less is known as to whether sleep disturbance is acute and resolves as patients recover, or is an issue that persists after hospital discharge and continues to adversely affect patients. Studies using patient subjective assessment suggest that sleep disturbances persist. However, only 28 patients in total (3 studies) have used objective measures (e.g. polysomnography) in ICU survivors to measure sleep, and in none of these three studies were measurements taken in ICU or hospital. This study will provide novel data as it will be the first comprehensive and objective longitudinal assessment of sleep disturbances in patients admitted to ICU. This inception cohort study will determine feasibility of objectively and subjectively measuring sleep, provide estimates of the proportion of long-stay ICU patients who have a new sleep disorder and evaluate whether sleep changes over time during critical illness and recovery.

This project is designed to determine if specific genetic sub-groups associated with metabolic disease risk benefit from a Mediterranean diet. This research may lead to personalised nutrition recommendations using genomic information to promote health. The aims of the proposed project are to: (i) Determine the influence of an 8-week Mediterranean dietary intervention on gut bacteria, levels of metabolites (involved in glucose, fat and protein metabolism) present in blood, and gene modifiers (whether genes are turned on or off) in blood. This will be compared to a person’s habitual diet (baseline results) and a general healthy eating diet following The Australian Guide to Healthy Eating (control diet). (ii) Determine the potential of key genetic variants related to metabolic disease (including the Fat Mass and Obesity-Associated (FTO) gene, Transcription Factor 7-Like 2 (TCF7L2) gene, and Apolipoprotein E (APOE) gene) to influence gut bacteria, blood metabolite and gene modifying outcomes in response to the dietary interventions. (iii) Determine whether differences between genetic variants exist for body composition, key hormones (ghrelin and insulin), glucose tolerance, and dietary intake (food frequency and nutrient composition) in response to the dietary interventions. It is hypothesized that variations in key genes associated with metabolic disease impacts on gut bacteria, blood metabolites and gene modifiers following an 8-week Mediterranean dietary intervention.

Acute adenoviral conjunctivitis is a highly contagious, widespread endemic disease associated with frequent outbreaks, significant patient discomfort, lost productivity, and in some cases permanent visual compromise from long-term immune mediated sequelae. OKG-0301 is a novel ophthalmic solution with a potent ribonuclease that has broad-spectrum antiviral properties relevant for the treatment of acute adenoviral conjunctivitis. This randomized, double masked, multi-center Phase 2 study is being conducted entirely within Australia and is designed to support the safety and efficacy of OKG-0301 for the treatment of acute adenoviral conjunctivitis. The study intends to show superiority of OKG-0301 Ophthalmic Solution compared to vehicle for the primary efficacy endpoint of mean change from baseline in viral titre in patients with acute adenoviral conjunctivitis. Secondary efficacy endpoints including adenoviral eradication, clinical cure of acute adenoviral conjunctivitis, subepithelial infiltrates, other clinical signs and symptoms, and rate of cross-over infection to the other eye will also be assessed. Safety will also be evaluated.

Although impaired cardiac function initiates the syndrome, subsequent skeletal muscle and vascular abnormalities are major determinant of functional capacity and quality of life in the heart failure (HF) syndrome. Exercise based rehabilitation is a cornerstone of HF therapy. Improvements in functional capacity resulting from exercise training predict prognosis, enhance quality of life, and reduces frailty and hospitalizations. An impediment to exercise rehabilitation for heart failure patients is the early physical deconditioning which is a trademark characteristic of this patient group which can limit classical aerobic and concentric strengthening exercise prescription. The current project aims to trial a new form of exercise, utilising eccentric muscular contractions, which have unique characteristics that allows for peripheral (muscular) gains at lower oxygen consumption and promisingly suggests enhanced functional benefits at lower cardiovascular risk.

This study aims to conduct a single-blind randomised controlled trial to evaluate health outcomes of the Virgin Pulse Global Challenge (VPGC) programme across several Australian organisations. A comparison of the VPGC programme with a control treatment in terms of physical activity, sleep, psychological well-being, cognition and overall health outcomes will be assessed. It is hypothesised that the VPGC will improve both physical and mental health of participants. The project will contribute to filling a gap in the literature (rigorous evaluation of the health benefits of programmes similar to the VPGC and the development of a heart age measure that quickly responds to behavioural change) while providing Virgin Pulse with tools, insights, models and recommendations for improving the Global Challenge programme.

Physician-performed focused cardiac ultrasound (FCU) is established in anaesthesia and critical practice and is increasingly taught in undergraduate medicine curricula. The most important barrier to adoption, reported by Conlin (Conlin et al., Anesth Analg 2017;125:1878–82) was lack of training opportunity, and identifies a strong need for a scalable teaching process that provides acceptable learning outcomes The traditional training model for FCU is a combination of didactic learning followed by proctored practical teaching of ultrasound image acquisition with FCU trainers (eg. iHeartScan, University of Melbourne), who are in short supply. Reliability on trainers restricts training to participants who can access the limited number of courses. Ultrasound simulators are increasingly adopted by medical institutions to teach FCU. We have developed an FCU course that reduces the requirement for trainers from one and a half days to only three hours (FCU TTE Course) using a cloud-based platform that provides eLearning of knowledge base and instruction to participants on their personal device on how to teach themselves image acquisition using an ultrasound simulator. We have demonstrated that the simulator course was more effective in teaching FCU image acquisition (Canty et al. J Crit Care 2019;49:38–44). This reduction in trainer time required to teach FCU increases the capacity for training FCU, however is still significantly restricted by the 3-hour proctored session. We have recently eliminated the requirement for trainers by replacing the 3-hour proctored learning session with an eLearning package and on-line automated assessment. The aim of this study is to determine whether the learning of image acquisition skills by medical students who complete the self-directed simulator course is non-inferior to students not exposed to the course, and to determine if the learning of cardiovascular clinical examination of patients with cardiac disease is improved. Justification and expected benefits There is increasing demand for FCU training and for this to begin in medical school. An entirely self-directed FCU teaching course that also course improves the learning of cardiovascular clinical examination would be a significant step to answering this demand.

Project summary - This project is a pilot study to examine whether the difference in psychosocial and physical measures are associated with gaze behaviour in individuals with OA and their younger healthier counterparts. The purpose of this research is to examine motor, cognitive and perceptual behaviours in individuals with OA; and, investigate whether the manifestation of these behaviours are associated with an increased risk of previous or future falls. Hypothesis - The hypothesis of this project is that individuals with osteoarthritis will demonstrate compromised gait patterns, adverse gaze behaviour and poorer walking automaticity (normally found in healthy adults). The adverse gait patterns, gaze behaviour and inability to complete dual tasks while walking is also hypothesized to be linked with greater falls prevalence.