ANZCTR search results

This project is a point prevalence study of ECMO-related infection and cannula dressing and securement practices in both adult and paediatric populations across Australia and New Zealand. The aims of this project are to identify the following: (1) Prevalence of ECMO cannulation site infection (local infection) (2) Prevalence of ECMO-related bloodstream infection and other nosocomial infections (3) ECMO cannula dressing and securement practices, and adherence to local dressing/securement guidelines Data will be collected on each eligible patient on one day during the pre-specified data collection week. There will be one data collection week per month for 12 months. It is hypothesised that this data will give an accurate snapshot of the prevalence of nosocomial infections and of cannula dressing and securement practices across Australia and New Zealand in patients receiving ECMO.

Stroke survivors often have difficulty walking quickly and this can limit their ability to walk at home and in the community. Exercises to train power in the leg muscles, plyometric exercises, have been shown to improve the speed of walking in younger and healthy older people. These exercises can be undertaken on land or in the pool, but stroke survivors may find the exercises easier in the pool. This pilot trial will therefore investigate whether aquatic plyometric exercises are as effective as land-based plyometric exercises to improving walking speed, endurance and leg power in stroke survivors. Hypotheses: • It is hypothesised that aquatic plyometric exercise will be equally effective as land-based plyometric exercise in improving gait speed, endurance and plantar flexor power in people with chronic stroke. • It is hypothesised that land-based plyometric exercise will result in greater heart rate and blood pressure changes than aquatic plyometric exercise The trial will aim to recruit twenty stroke survivors who have suffered a stroke more than three months ago, are living at home and can walk at least 10m independently or only need a walking stick. The trial will be a cross-over design, with participants randomly assigned into one of two groups. One group will start with twice a week aquatic exercise for two weeks, while the other group will start with twice a week land-based exercises. After two weeks, the groups will swap over with the aquatic group completing the land exercises and the second group completing the exercises in the pool. A range of functional assessments will be completed. Walking speed will be measured on a ten metre walking track. Endurance will be measured by the distance participants can walk in six minutes. Lower leg power and strength will be recorded using a small, hand-held device which measures how much force is used to push into the device's force plate. Leg power will also be measured by seeing how high participants can reach when jumping from a standing position. In addition, measures of heart rate, blood pressure and muscle soreness will be recorded before and after each of the exercise sessions. Functional assessments will be completed before starting the exercise programs, after two weeks before swapping to the other exercise modality, after finishing the final exercise program and four weeks after completing the exercise protocols. Statistical analysis will be used to compare differences between the two exercise programs and groups of participants to see whether the exercise programs increased walking speed, endurance and leg power in stroke survivors.

Young cannabis users (16-25 years) will be recruited from the general community and substance use services to complete an online survey exploring the relationship between cannabis use and psychosis. They will be asked to repeat the online survey at 6 and 12-month follow ups. Eligible participants (past month cannabis use + at least 3 Psychotic Experiences (PLEs) ‘sometimes’ or 1 PLE ‘nearly always’ in the past 3 months; who express interest in trialling a website for PLEs during the baseline survey will then be invited to participate in a randomised controlled trial (RCT) comparing the efficacy and usability of the Keep it Real website versus a minimal web-based Information Control Website (ICW). Four followup online surveys will be completed at 3, 6, 9 and 12 months post baseline.

Patients are reported to be largely non-adherent to their medication, with medication non-adherence rates ranging from 30-70% among patients with chronic conditions. The Medication Adherence Service aims to develop, implement and evaluate a professional pharmacy service that is focused on increasing patient adherence whilst simultaneously examining the corresponding economic, clinical and humanistic implications the intervention poses. The research project proposes that a brief complex intervention tailored to the patient’s requirements performed on a regular basis during the dispensing process will improve patients’ adherence. The research project will be conducted in conjunction with GuildLink Pty. Ltd. a wholly owned subsidiary of the Pharmacy Guild of Australia, through use of their GuildCare software. A cluster randomised control trial will be conducted utilising a mixed method approach combining quantitative and qualitative data. The study aims to assess the impact that an enhanced intervention has on medication adherence when compared with usual care and the current adherence intervention provided through utilisation of GuildCare software.

The purpose of this study is to evaluate the impact of an evidence-based, cancer pain assessment mobile health clinician education program, on patient reported pain outcomes. Who is it for? You may be eligible for this study if you are a medical/nursing staff member routinely caring for cancer or palliative care patients Study details Participants in this study will be randomly assigned (by chance) to one of two groups. One group will receive the intervention, which is a pain assessment performance feedback program delivered using the Qstream platform on their mobile phone or via email. The other group will receive their standard in-service and be offered the intervention after 16 weeks. Participants will complete an online survey at two points in the study. It is hoped this research will prove this mobile-health education program will be found efficacious and cost-effective.

The loss of a pregnancy, whether spontaneous or induced for medical reasons, is a very traumatic event for the parents. In many cases, the reasons for a fetal abnormality or miscarriage are not clear, but can be very important for future pregnancies and patient counselling. Fetal autopsy is performed (with parental consent) as often as possible, but some parents cannot consider autopsy at a very stressful time in their lives, and others cannot consent for cultural or religious reasons. Some of these parents will allow an external examination and x-rays which provide only limited information. The use of multi-detector computed tomography (MDCT) is well established in forensic science units around the world. To date, there has been very little research into the value of MDCT in fetal deaths. A recent article by O’Donoghue et al. used MDCT as an adjunct to autopsy in the investigation of 3rd trimester stillbirths, finding good correlation between measurements obtained in both settings, although only half their cases underwent formal autopsy.1 We aim to investigate the value of MDCT as part of the investigation into fetal abnormalities and pregnancy losses in the 2nd and 3rd trimesters, and early neonatal period. While we do not propose to replace conventional autopsy, we hope to show a good correlation between radiological and pathological findings, so that we can offer a non-invasive alternative to autopsy where the parents cannot consent to dissection. 1. O'Donoghue K, O'Regan KN, Sheridan CP, O'Connor OJ, Benson J, McWilliams S, Moore N, Murphy MJ, Chopra R, Higgins JR, Maher MM. Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth. Eur J Radiol. 2011 Apr 29. [Epub ahead of print].

Introduction: Osteoradionecrosis (ORN) of the mandible is a painful and debilitating condition frequently occurring after radiotherapy to the head and neck to treat cancer. For decades Hyperbaric oxygen (HBO) has formed the mainstay of non-surgical management of ORN. Literature about the efficacy of HBO is contentious. Recently a combination of medications known as PENTOCLO has shown promising results in treating ORN. The purpose of this pilot study is to generate a hypothesis that can be tested in larger multi-centre controlled trials. Who is it for? You may be eligible for this study if you are an adult who has been diagnosed with osteoradionecrosis by an Oral and Maxillofacial surgeon. Study details For this pilot study, we will recruit 16 participants. These participants will be randomly allocated to up to 18 months of either Hyperbaric Oxygen or PENTOCLO treatment after completing 4 weeks of ‘pre-treatment’. Pre-treatment involves taking daily medications (Amoxicillin + Clavulanic acid, Fluconazole, and Prednisolone) for 4 weeks, with the overall goal of reducing inflammation, infection and pain. Participants will have an initial appointment to take some measurements and record their medical history as well as having X-rays of their jaw taken. They will then be followed up at two weeks, four weeks, six weeks, eight weeks, twelve weeks, six months, nine months, twelve months and eighteen months and have photographs and a further assessment at each visit. Further X-rays will be taken throughout the follow-up period according to when they are needed such as if a participants condition improves or worsens. No other tests need to be performed during the study. It is hoped that this research will help us to conduct much larger studies in the future about whether each treatment is suitable for use in Australia as well as providing international doctors and patients with meaningful information about which treatment for ORN is better. This will help to improve the lives of patients currently suffering with ORN and those who may develop the condition in the future by limiting their pain and suffering. Ethics and dissemination: This study will be registered with the clinical trials database of the TGA in Australia as well as the Australian New Zealand Clinical Trials Registry of the NHMRC. Data generated by conducting this study will be uploaded to an open access repository in a de-identified form. Results from this study will be disseminated at national and international conferences as well as peer reviewed medical publications.

Bowel cancer is the second most common form of cancer in Australia, and screening can substantially reduce both mortality and health care costs. However, participation in the Australian National Bowel Cancer Screening Program (NBCSP) is quite low, with only around 39% of invitees taking up screening. This research investigated how screening rates might be increased by asking participants to think about the regret they would anticipate in the future if they chose not to screen. Earlier studies have shown that just thinking about this anticipated regret can increase the likelihood of participation in a range of protective behaviours like screening.

A common but likely erroneous belief is that using exercise as a treatment for knee osteoarthritis will cause damage to an already worn joint. We propose to perform the first RCT to examine the effect walking has on knee structure, objectively assessed using MRI. Participants will be randomised to either community walking plus usual care or usual care alone for 6 months. Participants randomised to walking will walk 3 days/week for one hour (2 days/week supervised group sessions and 1 day/week unsupervised). Group sessions will be tailored to individual fitness levels and led by a physiotherapist or exercise physiologist with experience in prescribing exercise for OA patients. The aim of this study is to generate pilot data for a proposed larger study (which aims to enrol a total of 186 participants, funding applications currently under consideration) to demonstrate feasibility of the study design, recruitment, screening, adherence, safety and retention. This pilot study will enrol 48 participants (24 randomised to walking plus usual care and 24 to usual care). It will be conducted in line with the recent CONSORT statement for pilot and feasibility trials.

We hypothesise that a minimal, mobile shoe design will increase foot and lower limb muscle strength and performance outcomes in children compared to standard school shoes, over time. To test this, we are measuring the change in children after ten months of wearing two very different shoes to school; one group in the common school shoe and the other in a very mobile shoe. We hope that this will scientifically inform future shoe design, which is currently not well understood for children.