ANZCTR search results

Delirium is an acute neurocognitive disorder that is characterised by a fluctuating level of consciousness with impaired attention and cognition. Delirium has been estimated to occur in approximately 30% of adults admitted the intensive care. Delirium is associated with poor outcomes which include longer stay in intensive care unit, longer stay in hospital by 10 days and experience a prolonged duration of mechanical ventilation. The longer-term outcomes include long-term cognitive impairment, dependency in activities of daily living and 2-3 times higher mortality rates. The restlessness and agitation experienced by patients leads to increasing workload of ICU nurses who need to stay continually by the bedside to ensure the patients safety, thereby requiring one-to-one nursing care. This increases the financial burden of delirium on the Intensive Care unit as well as the hospital. This study will evaluate the impact of a nursing-led delirium-prevention protocol (‘the intervention’) that is aimed at reducing the incidence, severity, and duration of delirium among adults admitted to ICU. The Delirium Prevention Nursing Protocol targets the risk factors for delirium which includes visual and hearing impairment, to prevent or treat sensory deprivation and ultimately the loss of orientation; sleep deprivation, cognitive impairment to (re)orientate patients with regard to time, place and person to prevent or minimize decline; and immobility, to improve patients’ functional mobility in the ICU and to stimulate patients’ cognition.

The study aims to establish whether the amino acid, glycine, is absorbed from the stomach in patients who are critically ill. It also aims to assess the effect of glycine supplementation on the structure and function of muscle. It is proposed that glycine will be absorbed from the stomach and cause an increase in glycine concentration in the blood. It is also thought that administering glycine to critically ill patients will have a protective effect on muscle, prevent muscle wasting and preserve physical function.

This pragmatic, open-label randomised partial cross-over trial aims to evaluate if adding a nicotine maintenance intervention (a nicotine vaporiser, 3 months of refill fluid at no cost and additional refill fluid at cost until final follow-up at 24 months) to standard quit support intervention (a 3 month course of cessation pharmacotherapy at no cost, self-help materials and active referral to Quitline) improves quit rates for people with priority medical conditions and whether offering both interventions concurrently (Condition A: both interventions used started at the same time) is more effective and cost-effective than offering the interventions sequentially (Condition B: only standard quit support offered at baseline and nicotine maintenance intervention only offered to those who are not abstinent at 6 months). Hypotheses: Condition A will have a higher rate of 3 months continuous abstinence compared to Condition B at 6 months (H1) and 12 months (H2) and lower relapse rates at 6, 12 and 24 months (H3). Condition A will be more cost-effective than Condition B at 6 months (H4) and 12 months (H5). Outcomes/significance: Smoking is a leading cause of preventable death for people with priority medical conditions due to their high smoking prevalence, greater vulnerability to tobacco-related disease and low quit rates with current cessation therapies. Our study will provide evidence on the effectiveness, safety and cost-effectiveness of offering nicotine maintenance in addition to standard cessation treatment to people living with comorbidities.

The purpose of this study is to determine whether a new psychological intervention for cancer-related anxiety is feasible and acceptable. Who is it for? You may be eligible for this study if you are attending the Kinghorn Cancer Centre, are aged over 18, have been diagnosed with a metastatic, recurrent or progressive cancer, and have clinically significant anxiety. Study details All participants will need to take part in 9 sessions, lasting 60-90 minutes of behaviour therapy with clinical psychologist. These 9 sessions will be weekly and will involve cognitive behaviour therapy, metacognitive therapy and acceptance and commitment therapy. This therapy program takes into account the specific concerns of patients with cancer, such as dealing with ongoing uncertainty and worries about the future. Participants will also be required to complete questionnaires at the beginning of the study, after each therapy session and 2 months after therapy has finished. It is hoped that this research will help determine whether this type of therapy is effective in reducing anxiety for participants and whether the content of the sessions is deemed by the participants to be essential and effective

A three-arm randomised controlled trial will be conducted to examine the effectiveness of each of the two intervention programs for improving older drivers’ safety, relative to receiving no intervention. The interventions will involve either on-road skills training, (two tailored driving lessons with a qualified instructor) or a home-based computerised cognitive training (training of speed of processing and cognitive-motor reaction time) for 1-2 hours per week over the 12 week intervention period. Driver safety will be assessed in on-road driving tests conducted pre- and post-intervention, and with off-road lab-based and paper and pencil measures of driver safety, driving self-efficacy, and cognitive functioning, also collected pre- and post-intervention. Diary data collected monthly for twelve months following baseline assessment will provide a self-report, secondary measure of driving incidents.

The primary purpose of this study is to set up a registry of patients with recurrent and advanced colorectal cancer to evaluate patterns in the presentation, treatment and outcomes of the disease. It is for patients over the age of 18. Researchers will collect information relating to the presentation and characteristics of each participant's disease and information on treatments received and response to treatment by reviewing medical records. It is hoped that the findings from the registry will enhance our understanding of how treatments received and the timings of these treatments affect disease outcomes, and how these relate to the presentation and characteristics of colorectal cancers.

Aortic stenosis is the commonest valve pathology requiring medical intervention. Aortic stenosis causes restriction and alterations in blood flow to the rest of the body including the coronary arteries which can cause symptoms of fatigue, breathlessness, chest pain and dizziness. Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure where a new valve is inserted inside the old narrowed valve using a balloon catheter. This can relieve the symptoms as blood can once again be pumped freely to the rest of the body without the additional effort. Existing data suggests that this procedure allows partial restoration of normal blood flow to the coronary arteries. However, it remains unclear what the longer term effects of this procedure are. This an important consideration as it will enable us to have a better understanding of this treatment. We aim to conduct assessment in 30 patients undergoing TAVR using cardiac CT, echocardiography and coronary flow measurements around the index procedure and at 6-9 months follow up. We expect to see that there is further restoration of normal coronary physiology at follow up after TAVR.

The OHS population have higher cardiovascular morbidity and mortality than the OSA population despite correcting for age and weight. This study aims to elucidate some of the factors contributing to the discrepancy in cardiovascular health between the two studied populations.

Strong evidence published in 2016 showed that routine collection of Patient Reported Outcomes (PROs) significantly improves the survival and quality of life of medical oncology patients in the US and Europe (Basch, 2016). Despite these findings, PROs are not routinely used in Australian oncology care. The purpose of this translational research project is to understand how PROs can be implemented in a medical oncology setting to improve personalized care.The purpose of this project is to explore the feasibility, acceptance and effectiveness of implementing Patient Reported Outcomes (PRO) measurement in routine medical oncology outpatient care. Who is it for? You may be eligible for this study if you are over the age of 18 and are a patient attending for medical review in a medical oncology clinic enrolled in the study. Study details All patients attending the enrolled clinics will be approached to report their symptoms on a touchscreen, which will generate a report. A copy of the report will be given to participants, and a copy put in the patients medical record. This information will be available to all clinicians in the multidisciplinary team. The study will be facilitated and evaluated using an implementation science approach throughout. It is hope that results from this study will provide evidence and guide future research into the implementation of this complex intervention into the clinical setting. There are significant benefits in the clinical trials to date, and it is hoped that this project can better inform the translation of this into clinical practice.

The aim of this study is to investigate the effect of a home-based lingual strength training program using the Iowa Oral Performance Instrument (IOPI) on the lingual strength of patients who experience chronic swallowing problems. Previous studies have found that lingual strength improves following training and therefore it is hypothesized that lingual strength will increase following an at-home IOPI training program. Additionally, the effects of this lingual training on self-reported swallowing, speech, saliva control and quality of life will be assessed, as well as reductions in the burden of cost for the healthcare system.