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Postoperative nausea and vomiting in children is a common phenomenon, particularly after ear nose and throat (ENT) surgery. While it affects up to 80% of patients who do not receive preventative medication during their operation, more than 1 in 5 children still suffer from postoperative nausea and vomiting after tonsillectomy even when given 2 medications to prevent it (internal audit data). Nausea and vomiting after an operation (postoperatively) particularly following tonsillectomy can be very painful and distressing for the child and their carer. Vomiting may also increase the risk of postoperative bleeding, a serious complication after the surgery. Postoperative nausea and vomiting is not only one of the main reasons for prolonged hospital stay or re-admission in children; it is also one of the main reasons for dissatisfaction with anaesthesia in children and their families. In adults, a pilot study has found that chewing gum postoperatively can significantly reduce postoperative nausea and vomiting. Chewing and swallowing, results in increased activity in the gut and lessens the effects of medications given under anaesthesia that tend to slow the gut. However, for young children particularly following anaesthesia, chewing gum may not be a safe option. Therefore in this pilot study we will investigate if chewing a large jelly confectionary snake after the anaesthetic will help to reduce nausea and vomiting. The children who are enrolled in the study will be randomised to receive a jelly snake or no jelly snake to chew once awake after the surgery. There will be no other changes to the standard management which will be in accordance to institutional guidelines. We will then compare the rates of vomiting between the children who did and did not receive a jelly snake to chew. We will also monitor other oral and food intake and requirements for painkillers, as well as for other potential problems (e.g. delayed discharge) after surgery. The advantage of using a jelly snake is that it is a simple, inexpensive, non-drug treatment. Parents are very keen to avoid the use of drugs for their children and so would be open to the use of this new approach. For children the jelly snake offers something familiar and an enjoyable solution to their discomfort. The use of jelly snakes could also be a simple intervention that parents could do at home following day case surgery for other procedures. While the jelly snakes are high in sugar, they are comparable to the sugar content of a glass of fruit juice, flavoured milk or soft drinks. Generally, in our experience, the willingness of parents to allow their children to receive treats in the postoperative period is very high, particularly since all children have a significant time of fasting (at least 6 hours, often longer) for solid foods prior to surgery.

Influenza vaccination coverage in children with chronic lung conditions has been poor in Australia. This study aims to find out whether text message reminder system is effective in improving influenza vaccination uptake in these children. Parents of children with chronic lung diseases who attended the Sydney Children's Hospital Randwick during 2010-16 will be recruited to participate in this study, which will be carried out between May and October 2018. Participants will be randomised into 3 groups i.e. one control and 2 intervention groups. For those in the intervention groups, they will receive an education flyer with information about influenza vaccination via postal mail at the beginning of the flu season. In addition,one of the intervention groups will receive vaccination reminder text message twice a month during the study period. No education flyer or text message will be sent to participants in the control arm. At the end of the study period, a link to an online survey will be delivered to all participants via text messages. Differences in influenza vaccination rate will be compared among the three groups using chi square exact tests and attitudes toward influenza vaccine and reminder system will be examined.

Depression is an exceedingly common and debilitating disorder among older adults living in Residential Aged Care Facility (RACF). To date, attempts to decrease its prevalence have relied largely on assertive case-finding (directly or through the training of care staff) and treatment of those affected with antidepressants or psychological interventions, although the benefits for residents seem to have been limited and difficult to sustain over time. Existing data have shown that up-skilling RACF staff to assess and diagnose depression is helpful, as is the use of structured behavioural interventions. There is also evidence, from community studies, that Behaviour Activation (BA) is a simple, inexpensive and effective intervention to treat and prevent depression in later life, particularly when delivered in a collaborative care context. In addition, RACF interventions focused on older adults with dementia have shown the importance of supported local leadership (“Dementia Champions”) to promote and sustain the acquisition of practical knowledge about dementia assessment and care. In other words, it is possible that the absence of supported local leadership could have contributed to limit the benefits of interventions designed to decrease the prevalence of depression in RACF. The present study will build on the beyondblue e-learning Professional Education to Aged Care (PEAC) package. PEAC increases knowledge about depression and enhances the self-efficacy of staff working in RACF. We will test if the systematic training and supervision of a nominated ‘Mental Health Champion’ (MHC) on the principles and delivery of a BA program can contribute to enhance and improve the sustainability of the reported benefits associated with PEAC. Specific aim of trial: To determine whether training a local staff member in the use of a structured BA program enhances the benefits of the beyondblue e-learning PEAC program and decreases the prevalence of depression among older adults living in RACF.

This study is evaluating a group therapy, Experiential Awareness Therapy, for people experiencing disordered eating. Experiential Awareness Therapy is an evidenced based therapy aimed at enhancing psychological functioning for eating disorder recovery. Benefits of participating This therapy will aim to: • Increase participants ability to regulate their emotions • Increase participants sense of self-worth and support a realistic and functional understanding of others • Enhance participants ability to identify and understand their emotions and feelings and also identify others intentions, emotions and feelings. • To facilitate an understanding of how these areas of psychological functioning impact eating disordered symptomology. Enhancing these abilities has been shown to be supportive of recovery from disorder eating and also enhance quality of life.

The purpose of the study is to compare two Hepatitis B vaccination (HBV) schedules of 40 µg at 0, 1, 2 and 6 months with schedule of 20 µg at 0, 1, 2 and 6 months in patients with stage 4 or 5 Chronic Kidney Disease (CKD), and the response to routine vaccination against influenza. The study will also examine responses to booster HBV in CKD patients who are receiving haemodialysis. This will enable us to determine the best way to vaccinate people with CKD against hepatitis B, and will provide us with information about changes that occur in the immune system in people with CKD.

Amphetamine-type substances, especially d-methamphetamine, are second only to alcohol for incurred personal, economic and societal burden. Both alcohol and methamphetamine produce impairments in many areas of cognitive/neurobehavioural functioning which are also observed under complex driving conditions, and these two drugs are detected in as many as one-third of drivers injured and killed in road traffic accidents. No controlled experimental research is available which assesses performance on these tasks when alcohol and methamphetamine are used in combination, and importantly, how these deficits may translate into increased crash risk. This trial aims to assess the direct effect of combined usage of low (legal) doses of alcohol combined with d-methamphetamine in measures of higher-order cognitive and neurobehavioural functioning, driving performance and ocular activity. This will be achieved through a within-subjects, double-blind, placebo-controlled design comprising four experimental sessions [alcohol (placebo: 0.00% BAC; active: 0.04% BAC) and d-methamphetamine (0.42mg/kg, placebo; active). This project will provide vital information of how several behavioural, cognitive, neurobehavioural and physiological indices are affected following combined alcohol and methamphetamine use, and will show the effect of these combined drugs on driving performance and accident risk.

Sleep disordered breathing is common with obstructive sleep apnoea (OSA) being the predominant type. OSA is the repetitive complete obstruction (apnoea) or partial obstruction (hypopnoea) of the collapsible part of the upper airway during sleep. Symptoms include excessive daytime sleepiness, unrefreshing sleep and fatigue. Numerous studies have shown that OSA is associated with depression, hypertension, stroke, motor vehicle accidents, and other cardiovascular disorders. Obstructive sleep apnoea (OSA) is diagnosed with polysomnography. Respiratory events, either apnoeas or hypopnoeas, frequently worsen when lying in the supine position. Previous data have shown that 60% of patients with OSA have supine predominant OSA (OSA that occurs at least twice as frequently in the supine position) and 25% of patients have OSA that is solely present when lying supine (Joosten et al, 2012). In this context, knowledge of OSA severity in different body positions is crucial to informing patient management. Polysomnography involves sleeping while attached to a significant number of sensors and electrodes to measure sleep quality and breathing and cardiac parameters. Because of the inconvenience of the test, patients commonly report that the position they sleep in during polysomnography does not represent what they usually do at home, with patients most commonly reporting that they sleep more in the supine position that they would normally do. However, patient reports of habitual body position during sleep may not necessarily be accurate and whether body position in polysomnography reflects habitual body position at home has never been systematically addressed in a research study. Therefore, our project aims to look at the body position of patients during polysomnography in comparison with the habitual body position of patients at home. We intend to enrol patients having sleep studies in our tertiary academic sleep unit, and provide them with a small, unobtrusive body position sensor to detect their habitual body position in their home over the subsequent week. We hypothesise that there will be a discordance between polysomnography determined body position and habitual sleeping body position, with less time spent supine when at home that during polysomnography, given multiple factors. These could include less restriction due to leads, changes in bedroom environment and bed size.

The National Dermatology Radiation Oncology Registry (NDROR) is a human research Registry that collects and collates information from patients referred for radiotherapy for the management of non-melanoma and melanoma skin cancer and difficult to manage inflammatory skin diseases. Who is it for? Patients aged 18 years or above will be recruited based on referral from their current treating dermatologist to a Genesis Cancer Care (GCC) Radiation Oncologist once diagnosed with a lesion or condition deemed treatable with radiotherapy. Study details Data may be collected from eligible patients retrospectively regarding their previous relevant medical history, and prospectively, including treatment schedule and treatment outcomes of their radiotherapy treatment. Upon agreeing to participate in the NDROR, the referring dermatologist (RD) will send information to the Treating Radiation Oncologist (TRO). Previous relevant medical history as well as current treatment plans will be imported by both RD and TROs into the data Registry called the Skin and Radiotherapy Online Secure Platform (OSP). The intended outcome of this Registry is to ultimately assess the safety, tolerability and outcomes of treatment. Although treatment of skin cancer and inflammatory skin conditions with radiotherapy is currently used, limited practical evidence into the safety, tolerability and outcomes based evidence has been established in Australia. This Registry will be the first of its kind in Australia and will provide a basis for a number of research publications assessing these outcomes.

Each year in Australia 300-400 new cases of Spinal Cord Injury (SCI) are reported with prevalence predicted to continue to increase with population growth and improved medical care. The most obvious consequence of SCI is paralysis however it also has an impact on many other body functions as well, including social, financial and psychological implications. Most long-term wheelchair users adopt a sedentary lifestyle with prolonged sitting and limited opportunities to engage in physical activities. As a result, many people with SCI experience progressive physical deconditioning and its associated multifactorial health consequences such as diabetes and hyperlipidaemia. This contributes to loss of functional ability and the increased risk of cardiovascular morbidity and mortality. Physiotherapy during rehabilitation focuses on goals related to improving functional ability such as walking, transferring, propelling a wheelchair, balance and upper limb usage. This involves the management of weakness, reduced range of movement, decreased fitness, pain, and respiratory compromise. For those patients with paralysis there is often great difficulty in assisting them to stand and support their body weight. It places a substantial burden on therapists who must assist the patient into standing whilst trying to facilitate exercise and prevent falls. Therefore, these patients are often denied opportunity for the intense, functional therapy this is required to produce positive outcomes. The development of robotic exoskeletons has the potential to overcome the current limitations to therapy. These overground exoskeletons provide motorised assistance at the hips, knees and ankles via motors and coordinate movements at these joints to produce or assist with standing, upright exercises, and walking. They can be used to make gait training, transfer training, and balance training, easier and provide a safe opportunity for intensive practice related to standing and strenuous exercise. There are many different types of robotic exoskeletons currently available but there is no published evidence investigating the patient benefits of using the REX Bionics exoskeleton (HELLEN) as a rehabilitation tool. We aim to examine the potential benefits of using this device as an adjunct tool for rehabilitation in people with SCI. This data will be compared to data being collected in adjacent trials in Stroke and Multiple Sclerosis, currently being conducted by this research team.

Obesity is a major contributing factor in chronic disease burden within our community. While there are already established intervention management strategies for obesity, results on conventional primary care, non-invasive and/or drug-free approaches appear to be inconclusive. The planned study focuses on evaluating the efficacy of an already existing, peer-supported, behavioural change obesity intervention program, the “My Health for Life” (MH4L) program. The MH4L program is based around scheduled peer support sessions facilitated by a trained health or allied health professional. Participants in the intervention group also receive a MH4L workbook and printed material to assist with the behaviour change process. This is all in addition to their usual general practice care for weight management. This group will be compared with an active control where participants receive regular GP led management for obesity (6 month management plan designed by the participant’s regular GP which includes 5 visits to appropriate allied health services and 5 visits to chronic disease nurses as well as regular GP consultations as appropriate). All participants are tracked for 2 years after randomisation with measurements significant to obesity taken every 6 months. The study is a single blinded, randomised controlled trial. This means that there are two different treatment groups. One group is called the control group and they will receive currently established management for obesity. Another group is called the treatment group who will receive the new management program for obesity. Participants are not told what group they are assigned to (single blind) and group assignment is random. There is a 2 in 1 chance of being placed in the new treatment group. It is hoped that all participants in this study will, at a minimum, receive the best and most current medical management for obesity. However, the study will reveal the efficacy of a peer-supported obesity management program.