ANZCTR search results

Dementia is the leading cause of disability among Australians aged 65 or older and also the second leading cause of mortality. Nearly 400,000 Australians are currently living with dementia and, without a cure, this number is projected to reach 1.1 million over the next 30 years, with an estimated cost to the Australian community of more than $36.8 billion. Developing effective strategies to prevent dementia has become a global health priority, with projections suggesting that the total number of people living with dementia could be reduced by 13% (or about 400,000 people) if the onset of symptoms could be delayed by 10 years or more. The Lancet Dementia Taskforce concluded that hearing loss could account for 9% of all cases of dementia. Age-related hearing loss (ARHL) is a highly prevalent form of sensory impairment in later life, affecting 40% to 45% of people aged 65 years and 83% of those aged 70 years or above. At present, it is unclear if the reported association between hearing loss and dementia is causal and if the clinical remediation of sensory impairment could reduce the rate of cognitive decline among older adults at risk of dementia. The study will also explore the cost- effectiveness of the intervention compared to the control arm.

The primary purpose of this study is to Investigate consumer opinions and preferences on screening and surveillance type and frequency. Who is it for? Participants for this study will be people who are part of the SCOOP program who are between 18 and 75 years old, who are at mild to moderate risk for colorectal cancer and who undergo regular surveillance and screening with colonoscopy and FOBT. Study details: All study invitees will be sent via mail a study invitation letter and a questionnaire. The questionnaire contains questions about their previous experiences with colonoscopy and FOBT, attitudes toward managing health, fear of cancer, levels of anxiety, trust in the healthcare system, and basic demographic questions (including age, education level, country of birth). A four week period will be allowed following the mail out of letters for return of completed questionnaires. If the questionnaire has not been returned during this time, then a reminder letter will be sent. The findings of this trial will determine consumer preference for colorectal cancer surveillance. This information will help to guide the clinicians in any policy changes related to surveillance programs, such as with plans to extend surveillance colonoscopy frequency.

Diabetic foot ulcers (DFUs) are common, costly and take a toll on patients, families and communities. In Australia, the annual estimated expenditure exceeds $1.6 billion. Despite improved clinical management, effective treatment also relies on self-care away from the clinic. Unfortunately, adherence to self-care is typically low. To address this challenge, the research team developed a mobile phone application (MyFootCare) designed to motivate and engage people with DFUs in their self-care. This project aims to determine the feasibility, usability and perceived value of using MyFootCare to engage patients in the self-care of their DFUs. Participants will include patients with a DFU, their carers and the treating clinicians. All patient participants will use MyFootCare in addition to receiving standard evidence-based care. This project is a predominantly qualitative study using interviews and direct observation, whilst collecting some quantitative measures via application usage log data. The expected outcome is a novel mobile application that seeks to engage patients with DFUs through goal-setting, progress monitoring and reminders to enact self-care.

Heart Failure (HF), often accompanied by comorbidities, is characterised by high rates of death and hospital readmissions. Hospital readmissions consume beds and resources. There has been a lot of effort in the USA (less to date in Australia) to reduce them. This seems to vary from >30% at one month in Victoria and Tasmania, to 20% in South Australia. (CSANZ 2017). The disease management program (DMP) is one of the variables most associated with readmissions following index admission for HF. DMPs are expensive making their availability difficult, hence if applied uniformly to all patients, they may prove wasteful in low-risk, and insufficient, in high-risk patients. Data from the TasHELP study have shown that such readmissions can be predicted (JAMA Cardiol 2016;1:362-4) and possibly prevented, opening the possibility of risk-based targeting of DMP. This proposed PhD project, that will follow a prospective randomised controlled trial, will apply TAS-HELP risk algorithm focusing on intensities of HF DMPs to investigate its effectiveness in reducing 30-day readmission following HF diagnosis and lowering costs. Consecutive patients admitted for HF from July 2019 will be screened for eligibility and asked to participate following their informed consent. Enrolled patients will undergo evaluation of readmission risk and those 50% or more risk will be randomnised to usual care or intervention arm. The Victorian hospitals participating will include The Alfred Hospital and Western Health Footscray and Sunshine Hospitals. The impact of comorbidities on readmission will also be evaluated. A secondary outcome of this RCT will focus on quality of life (QoL) measures and fluid status. Patients in the control arm will receive hospital's usual care while those in the intervention arm will receive hospital care plus the following: DMP intensity adjusted for risk, based on five steps: i) adequate pre-discharge review of fluid status, ii) continuity of transitional care to the community, iii) a nurse-based home DMP lead by independent HF- Nurse, iv) surveillance and v) home-based pre-crisis management. In addition, the intervention group will be offered our HF app. This app is designed to deliver education for HF patients. It also measures QoL, HF Knowledge and self-care behaviors. Throughout the duration of the program which is 52 days, the patient records daily weight and is being given tasks and goals to achieve. The HF app is designed based on Heart Foundation guidelines. This proposed RCT will provide the strongest possible evidence for a home based nursing follow up base on risk for hospital readmission. The novelty of this study is the intervention delivered by an independent health practitioner, ensuring external validity and the application of both an avatar style patient education program, as well as the addition of a portable echo assessment in patient’s home.

This research is being conducted to investigate the impact of 3 different interventions on the stress hormone cortisol. Dr Stapleton is leading the study in her role within the Faculty Society and Design, Bond University. What you will be asked to do If you have responded to a call for participants and meet the inclusion criteria, you will be randomly allocated to one of three conditions designed to impact stress levels. Firstly, you will be sent an online link for the pre-questionnaire survey. You will then attend Bond University at a set time on a set day for a 1-hour stress intervention. You will be asked to attend 30 minutes prior to your session for the salivary cortisol testing to be done. You will then immediately attend your 1-hour intervention, and 30 minutes after it concludes, you will be asked to provide a salivary cortisol sample again and complete your post questionnaire (same as pre-questionnaire). You will be expected to attend Bond University for a total of 2 hours maximum. What are the 3 interventions being offered? 1. Emotional Freedom Techniques is a type of exposure therapy which includes a somatic and cognitive component. Likened to a version of psychological acupuncture but without the use of fine needles, EFT uses a statement you say out loud while you tap on acupressure points on the face and upper body. The session will teach how to use EFT for stress reduction. 2. Another condition will be a psychotherapy group who will receive information about how to reduce stress. 3. The third group will be asked to enjoy reading as a way of reducing stress for the hour. Participants will be randomly allocated to these different 1-hour treatment conditions. There will be no choice in this aspect. What will happen to my test sample? Saliva samples will be used immediately or stored for future analysis. All data processing will occur by use of a unique code number and not your name. You can withdraw from the study at any time and your sample and personal information will be destroyed. Data collected will remain in a coded format. How participants will be selected or screened Participants will be called for through community advertising, and will have to be over 18 years (for consent issues), You CANNOT participate if: You are taking any of these medications: • Antidepressants (e.g. for depression) • Steroids (e.g. for asthma) • Hormonal medication (eg for Menopause) • Thyroid medication • Diabetes medication (including insulin) • Contraceptives (e.g Pill) You cannot participate if you are pregnant, undergoing menopause currently or have Cushing’s disease, a history of major depressive disorder, PTSD (post traumatic stress disorder), or chronic diseases characterized by abnormal cortisol levels (e.g. osteoporosis, hypertension or high blood pressure, diabetes). The expected benefits of the research The benefits of this study will include determining the most effective brief treatment for stress.. When this is established it will form an invaluable component of future stress programs where time is limited.

To explore the effect of sensory awareness practice program in patients following stroke to see if a greater focus on quality of movement improves body awareness, quality of life and somatosensory function. It is hypothesised a greater emphasis on quality of movement during awareness practice will improve patient outcomes following stroke.

Reading is an important leisure activity with multiple health benefits, and the elderly are known to spend more time reading than any other age group. People living with dementia may find book reading difficult to access and enjoy. This study asks whether participating in a shared reading group, using dementia-friendly books, at an aged care facility provides psychosocial benefits. This single-blinded, randomized controlled trial tests the hypothesis that participation in a book club for fourteen sessions improves quality of life (as measured by Resident QoL –AD, self and proxy). Secondary outcome measures are effects on thriving (TOPAS, self and proxy), Theory of Mind (Adapted RMET), cognition (ACE-III), mood (GDS), and behaviour (NPI). The control participants will engage in activities as usual at the facility. The study will include participants with moderate dementia and their family carer.

This pilot study aims to determine the feasibility, acceptability and preliminary effectiveness of using an online platform to deliver a group-based physical activity intervention for first responders (police, fire and ambulance workers) and their partners/carers. By nature of their occupation which involves repeated exposure to potentially traumatic events, first responders are at a significantly increased risk of experiencing poor mental and physical health, including developing depression, anxiety and post-traumatic stress disorder, as well as premature cardiovascular disease. These health conditions are also associated with lower levels of physical activity and higher levels of sedentary behaviour. The low levels of physical activity among this underserviced population and the potential physical and mental health benefits justifies the importance of exploring innovative and effective ways to promote physical activity in first responders. It is expected that our online intervention will be both feasible and acceptable. We also expect that physical activity levels will increase which may have beneficial flow on effects on mental health outcomes . Sedentary first responders and their chosen support partner will be recruited to a 10-week, group based physical activity promotion intervention delivered online through a secret Facebook group. The group will allow members to receive information and contribute to weekly conversations on pre-specified topics related to physical activity. The purpose of the Facebook group is to facilitate social support and provide participants with a platform to exchange personal experiences including barriers and facilitators to commencing and maintaining a physical activity program. All participants will also be provided with a Fitbit and encouraged to set goals and track their physical activity levels as a way to support self-monitoring. The iterative development of this intervention has occurred through collaboration with project advisors with lived experience of working as a first responder, and of living with mental illness related to occupational trauma. By closely involving carers and consumers in the development and implementation of the online intervention we aim to gain a better understanding of how to adopt and translate these online strategies into real world settings. These advisors will also act as peer support members within the Facebook group.

The overall aim of this research is to evaluate whether group education and individual monitoring of recovery delivered by telehealth improves follow-up attendance rates compared with usual face to face care for breast cancer patients who have undergone axillary dissection. Who is it for? You may be eligible to join this study if you are a male or female aged 18 years or over and have undergone breast wide local excision or mastectomy and axillary lymph node dissection for breast cancer at Royal Brisbane and Women’s Hospital. To be eligible to receive the telehealth service, patients must be able to access an Internet-enabled computer device within their own home. Study details Four to six weeks after axillary dissection at Royal Brisbane and Women’s Hospital, all patients will receive group lymphoedema education and individual review by a physiotherapist. There will be two groups in this study. One group will be reviewed face-to-face at Royal Brisbane and Women's Hospital (as is standard practice). The other group will be reviewed in their home remotely using telehealth. Attendance rates will be compared between groups, and all participants will be asked to complete a number of questionnaires at 3, 5 and 8 months post breast surgery in order to evaluate lymphoedema symptoms, shoulder function, scar appearance, satisfaction and costs. It is hoped that telehealth can help to address high nonattendance rates at lymphoedema education and review sessions post surgery.

The aim of the study is to examine the effect of lifestyle-focused program delivered by text message on function in people with non-persistent low back pain. 304 people will be recruited to the study and randomly assigned to receive either the text message intervention or minimal intervention. Those assigned to receive the text messages will receive semi-personalised text messages providing advice, motivation and information to improve education, physical activity, sleep, mood, use or care and medication. Participants will receive 4 text messages every week for 12 weeks. Messages will be sent on randomly selected days and at one of 4 randomly selected time slots. Participants will be eligible to receive certain messages depending on whether they have acute low back pain, sleep issues, are more than moderately active, report taking medication for their low back pain at baseline and have a sedentary job. Health related data will be collected from all participants via online surveys following recruitment, 3 months, 6 months and 12 months after recruitment. The health data collected will be those that are recommended by the key groups in this field of research: The Outcome Measures in Rheumatology Clinical Trials group (OMERACT) The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). These will include measures of pain, functional status, patient reported impression of change, generic quality of life, levels of activity, health literacy and health care use and costs.