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Cardiovascular disease (CVD) is the leading cause of death and disability. Ageing is associated with a number of traditional CVD risk factors, including high blood pressure and high cholesterol, as well as changes to the structure of our heart and blood vessels, which over time contribute to an increased risk of cardiovascular events. Statins are common cholesterol-lowering drugs that have been shown to reduce the risk of developing heart disease. Nutraceuticals are food components or active ingredients in food that may be used as therapeutic agents to help lower cholesterol and modify risk of heart disease. This project will investigate the effect of statins and nutraceuticals, either alone or in combination, on markers of heart and blood vessel function in people at moderate risk of heart disease. We hypothesise that statin therapy will delay the cardiovascular ageing process, as evidenced by improvements in structural and functional outcomes. These improvements will be further enhanced with adjunct nutraceutical therapy. In addition to the beneficial effects on risk factors for heart disease, nutraceutical compounds will offer additional benefit through changes to the gut microbiome, including improvements in bacterial diversity and composition, as well as alterations in the production of important short chain fatty acids and bile acids.

Research indicates that people living with HIV have higher risk of heart disease. This is partly due to the effects of anti-HIV drugs, and partly due to the effects of HIV itself, however it is not understood how HIV might cause heart disease. We intend to collect information from participants to help compare the changes in the structure and function of 'good cholesterol' or high density lipoprotein (HDL) which are known to be affected by HIV and treatment for HIV. In addition, we intend to study traditional risk factors of heart disease such as cholesterol levels and artery health to understand how they change with HIV disease indicators such as viral load and CD4 cell count. To do this, we will recruit three groups of participants. a) HIV-positive participants who are not on anti-HIV treatment, b) HIV-positive participants who are about to commence their anti-HIV treatment and c) healthy matched controls. At baseline, participants will be asked to complete a lifestyle and clinical observation survey and blood will be collected for laboratory analysis. Bloods will provide us with information on their HDL, lipid profile, heart disease markers as well as HIV progression. Participants will also have the wall of their carotid artery assessed by ultrasound, a measurement known as carotid intima-media thickness (cIMT) as an indicator of artery health. Participants will be followed-up once a year for three years (four visits in total). At each visit, anthropometric, bloods and cIMT measurements are collected. This information may lead to the development of new markers of heart disease for physicians to better monitor and treat heart disease in people living with HIV.

Preeclampsia is a common, serious complication of pregnancy, affecting 5-8% of pregnancies. It is responsible for 70,000 maternal and 500,000 infant deaths globally every year, with this burden largely shouldered by lower-middle income populations. Currently there is no medical treatment for preeclampsia and the only way to stop disease progression is delivery of the pregnancy. When this occurs at early gestations, the serious potential complications of prematurity are inflicted on the newborn. The establishment of a safe preventative treatment for preeclampsia would therefore be a major advance in the clinical care of pregnant women and their babies. Laboratory work undertaken by the Translational Obstetrics Group at the University of Melbourne has shown that Proton Pump Inhibitor (PPI) drugs may play an important role in preventing or treating preeclampsia. Esomeprazole, was shown to be particularly effective at reducing high blood pressure associated with preeclampsia in animal studies and when tested on donated human placental tissues. The drugs were also observed to reduce and partially reverse damage to the blood vessel linings (endothelium) caused by preeclampsia. Another study has shown that women who have a high risk of developing preeclampsia and are coincidentally taking PPIs have lower levels of preeclampsia biomarkers present in their bloodstream than other high-risk women who are not taking PPIs. In large studies of >1,000,000 pregnant women, PPIs (commonly prescribed in pregnancy to treat symptoms of acid reflux) have been shown to be safe to take, with no increase in the risk of fetal malformation (structural damage to the baby), premature birth, or miscarriage. Given these promising early results, coupled with esomeprazole’s established low-risk harm profile in pregnancy, we propose to progress this concept by undertaking a clinical trial to evaluate esomeprazole as a preventative therapy for preeclampsia. We plan to recruit a total of 5,500 women with a Body Mass Index (BMI) =>30kg/m² at the time of their first hospital visit, from a number of different hospital sites in Australia, Chile and the UK, leading up to the birth of their first baby. This group of women has been chosen because they have a higher risk of developing preeclampsia than other pregnant women. We will randomly allocate these women to either receive 40mg oral esomeprazole, or an inert placebo (sugar pill), each day from recruitment until the birth of their baby. We will monitor for the diagnosis of preeclampsia in these two groups, as well as collecting information about the outcomes of the women and their babies. We will also monitor key biochemical features of preeclampsia in a subset of women who are recruited at the Mercy Hospital for Women. At the completion of this study, we hope to have sufficient evidence to justify recommending routine esomeprazole therapy as a preventative treatment for preeclampsia in pregnant women with a BMI =>30kg/m².

This study aims to evaluate the effectiveness of a 6- week comprehensive supervised pre-surgical exercise program in prostate cancer patients scheduled for prostatectomy. Who is it for? You may be eligible to join this study if you are a male aged between 45 and 80 years of age and have been diagnosed with localised prostate cancer with at least seven weeks to until scheduled surgery date. Study details Study participants will be allocated by chance to one of the two groups. The first group will receive a 6- week comprehensive supervised pre-surgical exercise program consisting of progressive resistance and aerobic exercise. The second group will receive usual care during the pre-surgery period along with information on performing exercises on the trunk stabilising muscles similar to the exercise intervention. This group will be provided with an option to partake in the home-exercise intervention of 6 weeks prior to surgery. Testing will be conducted at baseline, pre-surgery and 6 weeks post- surgery (6PS). Testing will involve, strength and aerobic tests, a body scan, questionnaires and a 24-hr pad test. In addition, a 24-hr pad test will be undertaken after discharge from hospital and at the 12 weeks after surgery. This research is a critical step in a series of studies required to determine the most effective and efficient ways to maximize prostate cancer patient health and therefore lay the foundation for future research.

Many people are terrified of and avoid needles. This fear often stems from bad experiences with receiving needles as a child. For many children getting a needle can be a painful, distressing experience. This fear can have devastating consequences, leading to vaccine hesitancy and outbreaks of preventable diseases. Our research aims to reduce the negative impact of needle procedures in children. We aim to test 2 different strategies – using attention and using positive language to reframe memory – for their ability to reduce needle pain and fear in children aged 8-12 years of age undergoing flu vaccination in South Australia. Importantly, we will also test if these strategies, when combined together, have even greater effects. Children’s memories of needle-related pain are a powerful predictor of future pain experiences. Memory of pain can be distorted (recalling higher levels of pain than initial pain reports) and this is associated with higher subsequent pain, distress and worse medical compliance. Children’s memories for pain can be changed through use of positive language to reframe memory of past painful experiences. These interventions involve talking to children for a few minutes to emphasise the positive aspects of a past painful experience, correct exaggerations in recall, and increase their self-efficacy in their pain coping. We want to test the effect of such an intervention for flu vaccination related pain intensity and pain-related fear. We can also reduce the pain and fear associated with needles by reducing how much the needle hurts. Attention and expectation can impact how much something hurts. Recent work has shown that even small shifts in attention can reduce pain. For example, when you expect to feel something in one of two locations on your skin (so you have to pay attention to both locations), a stimulus provided between those two locations hurts less than when your attention is not divided. Because you feel needle pain in one small area of skin, dividing attention may be useful to reduce the pain felt from a needle merely by taking advantage of the way our nervous system works. We will recruit a minimum of 40 children that have consented to undergo flu vaccination. They will be randomly assigned to 1 of 4 groups – using positive language, dividing attention, both, or neither (usual standard care). An experienced paediatric nurse will provide the flu vaccinations and we will measure how much pain (intensity) and fear (pain-related) that children expect at baseline, how much pain/fear they experienced during the vaccination, how much pain/fear they remember experiencing (measured 2 weeks after the vaccination), and how much pain/fear they expect for a future vaccination. We will also explore feasibility in terms of : recruitment rate, retention rate, feasibility/acceptability of the interventions (based upon parent, child, nurse experiences) and fidelity of the intervention provision.

Study purpose The purpose of this study is to test new combinations of drugs for ovarian cancer that has come back after first-line treatment. The new combinations of treatment include olaparib given by itself, olaparib given with an antibody (durvalumab), or olaparib given with chemotherapy (cyclophosphamide) and then with an antibody (durvalumab). These new combinations may slow the progression of the cancer and delay the time until chemotherapy treatment is needed. Who is it for? You may be eligible for this study if you are a female aged over 18 years and have a histologically proven diagnosis of high-grade serous or carcinoma of the ovary, fallopian tube or peritoneum, at first asymptomatic CA125 progression which responded to platinum-based chemotherapy. Study details Participants will be randomly assigned (by chance) to one of three treatment groups. One group will receive two medications, olaparib taken by mouth twice a day, followed by durvalumab given into a vein and at the same time olaparib, then olaparib only. The second group will receive three medications, olaparib taken by mouth twice a day and at the same time cyclophosphamide taken by mouth once daily for 5 days of every week, followed by durvalumab given into a vein and at the same time olaparib, then olaparib only. The third group will receive one medication, olaparib taken by mouth twice a day. Participants will attend a number of hospital visits to give blood and answer questionnaires about their quality of life. It is hoped that this research may help people in the future who have the same kind of cancer as you have.

This study aims to establish a simple, safe, bedside test to better determine which patients are most suitable for organ donation following circulatory death. The DCD 10-10 test is a 10 minute spontaneous breathing trial which aims to determine respiratory drive in these patients, it is hypothesised that this test will be predictive of which patients will die within 90 minutes post withdrawal of cardiorespiratory support. This 90 minute time frame is essential for ensuring organ viability for donation. The DCD 10-10 Pilot Study is a safety and feasibility trial on a small sample of patients, it aims to ensure the DCD 10-10 test is safe and can be easily performed in the organ donation setting. It will also test software used for data collection and gather some early descriptive statistics on the sensitivity and specificity of the test and patient factors that correlate to time of death.

This study is evaluating a Centralised Specialist Cancer SurvivOrship (CISCO) Assessment Unit for people who have completed curative therapy. Who is it for? You may be eligible for this study if you have a histologically confirmed diagnosis of early breast cancer or ductal carcinoma and are completing or have recently completed chemotherapy and/or radiotherapy. Study details All participants will complete a series of questionnaires and have a consultation with a survivorship specialist team, who will provide information for ongoing cancer care and symptom management. Participants and their general practitioner will receive a care plan (called a survivorship care plan (SCP)) to easily manage their follow up care together. Supportive resources will be reviewed and pathways for contacting the oncology service will be established. Participants will be followed-up 6-12 months later and complete some questionnaires to evaluate the CISCO assessment unit. It is hoped this study will establish the feasibility and acceptability of the CISCO model and improve the transition from cancer care to primary care for patients who have completed treatment.

The purpose of this research study is to investigate the changes in cardiovascular function and contents of sweat and urine in healthy young adults after a single session of Finnish-style sauna, far infrared sauna and exercise in comparison to a control resting activity.

Individuals experiencing psychosis are 2-3 times more likely to have comorbid cardiometabolic illness, and die 10-25 years prematurely compared to the general population. Despite this, consumers receive rates of cardiometabolic care as low as 3%. There remains a critical implementation gap around delivering a high standard of cardiometabolic care within Australia’s current health service and policy landscape. Based on the best available evidence and preliminary studies, our team developed the Physical Health Nurse Consultant (PHNC) service that is offered alongside usual mental health care. The PHNC service offers cardiometabolic assessment, risk management and care coordination, and overcomes barriers including stigma, consumer disempowerment and lack of specialist health knowledge. The objective of this project is to evaluate whether the PHNC role alongside usual care (compared to usual care alone) results in improvements in Burden of Disease risk factors, consumer experience of care, and cost-effectiveness in an 24 month, 2 group RCT. Evaluating consumer experience is a key innovative feature of the methodology that addresses a critical knowledge gap around the influence of consumer experience and participation in care on Burden of Disease risk factors. Outcomes are expected to result in a significant advance in knowledge on implementing and delivering physical health care within mental health services. Outcomes will also have a substantial impact on health policy given the National Mental Health Commission is seeking solutions for this priority issue. Our experienced project team includes highly influential senior members and an outstanding early career researcher with a depth and breadth of expertise that includes mental health nursing, psychiatry, consumer participation, health economics, statistics, health services and physical health research.