ANZCTR search results

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.

The objective of this study is to determine if the ULG hull-less barley developed by CSIRO is safe for consumption by participants with coeliac disease (CD). The secondary objective is to determine if the fibre-containing characteristics of the ULG barley improves the bowel health of participants. In addition there is limited published information about the effects of barley gluten on coeliac participants as most relates to wheat. This study will add to the barley-related literature.

How clinicians describe a health problem influences the health decisions of patients. A recent systematic review (Nickel, et al., 2017) identified seven studies that provided participants with hypothetical scenarios that described health conditions. Each condition was described using two or more differing terminologies (medicalised or descriptive). For example, when a participant read a hypothetical scenario about polycystic ovary syndrome (PCOS), when the participant was given the name of the health condition (PCOS) compared with the description of a ‘hormonal imbalance’, they were more likely to have an ultrasound (Copp et al., 2017), or when told in the scenario their child had Gastro-oesophageal reflux compared with only a description of symptoms, participants had greater intention to treat the condition with medication (Scherer et al., 2013). These studies share several characteristics: subjects were young women, scenarios were hypothetical, and both investigated a single illness potentially prone to overdiagnosis. But they can only speculate on possible cognitive processes driving subjects’ decisions because they lack mechanisms to formally test possible psychological factors driving the changes in intentions. Using four hypothetical health conditions (each with a diagnostic labelled version and a description only version) we will analyse between group differences of participants intentions to undertake further tests. We will also report differences in satisfaction and confidence in decision making and explore the effects of participant characteristics (personality, health locus of control, regulatory focus, medical minimiser/maximiser), risk orientation, risk perceptions and stigma on intention to undertake further tests. Drawing from the extensive body of research on ‘perceptions of risk’ (Slovic 2000) and stigma (Brakel 2006), we will also explore differences in perceptions of risk between labelled and description only scenarios for each of four illnesses. Finally, we will conduct exploratory analysis of whether intentions to pursue follow on tests (as well as satisfaction and confidence in decision) differ by illness condition as well as by label versus description only. References: Nickel B, Barratt A, Copp T, Mynihan R, McCaffery K. Words do matter: a systematic review on how different terminologies for the same condition influences management preferences. BMJ Open 2017 Copp T, McCaffery K, Azizi L, Doust J, Mol BWJ, Jansen J. Influence of the disease label ‘polycystic ovary syndrome’ on intention to have an ultrasound and psychosocial outcomes: a randomised online study in young women. Human Reproduction 2017 Scherer LD, Zikmund-Fisher BJ, Fagerlin A, Tarini BA. Influence of “GERD” label on parents’ decision to medicate infants. Pediatrics 2013 Slovic P. (2000) The Perception of Risk. Brakel WH. Measuring health-related stigma – A review of the literature.

To determine the pharmacokinetics and safety of ECs315 wafer in healthy volunteers.

Background: Royal Freemasons has developed an enhanced care program that emphasises the ‘transitions’ that residents experience in their journey in residential aged care. This program is called ‘For You For Life Tapestry’ (or just ‘Tapestry’). Elements of this program were evaluated in a pilot case-control study (Melb Health Negligible Risk Research Approved Project QA2014215), with positive outcomes. Royal Freemasons is now expanding this project by integrating the Tapestry program into existing routine care at multiple Royal Freemasons aged care facilities in Victoria, as part of a quality improvement service. Royal Freemasons has partnered with the National Ageing Research Institute (NARI) to assist with the quality assurance and research evaluation of this Tapestry program. Rationale for the study: Elements of the Tapestry program have been successfully piloted and evaluated. However a number of limitations warrant a larger more comprehensive evaluation. The pilot was short in length and small in sample size. Residents in the pilot were not systematically followed at regular time points over a sufficiently long time frame. The pilot also did not evaluate how the program impacted the families of residents. This two year project (ending June 2019) will address the limitations of the pilot by implementing and evaluating the Tapestry program in seven urban and regional Victorian residential aged care facilities. The implementation of the program includes the Transition Map scale (developed for the Tapestry program), Cumulative Illness Rating Scale Geriatrics (CIRS-G, an existing scale), and a resident goal care plan (developed for the Tapestry program), as well as systems and policies to support the integration of the Tapestry program with existing care. NARI will evaluate outcome measures of the Tapestry program integration that is being implemented by Royal Freemasons. This research study will evaluate the Tapestry program at seven Royal Freemasons residential aged care facilities. This program aims to better equip RESIDENTS and RELATIVES to make informed choices and timely plans, realistic resident goals, and accept that some treatments may be non-beneficial and should be avoided. Participating RESIDENTS will be regularly evaluated on a number of outcome measures for one year. Outcomes include quality of life, functional status, health and medical outcomes (including number of hospital admissions and number of potentially non-beneficial treatments), resident goal plans, and RELATIVE satisfaction with care and communication. After the implementation of the program, the primary hypotheses are: (1) improved RESIDENT quality of life, and appropriate and achievable goals at 12 months, (2) decreased RESIDENT hospital admissions and reduced non-beneficial treatments at 12 months, (3) RELATIVES report improved satisfaction with care and better communication

Effective postoperative pain management continues to be an issue in laparoscopic surgery including gastric bypass. The aim of this study is to evaluate the efficacy of intraperitoneal nebulisation of ropivacaine to reduce post-operative pain in patients undergoing gastric bypass surgery.

This project investigates the effectiveness of the evidence-based driving cessation intervention for people with dementia and their family members who are retiring from driving, through a cluster randomised controlled trial. Stopping driving impacts health and quality of life for people with dementia and their care partners, and poses considerable challenges to health professionals who monitor driving issues. Although a diagnosis of dementia does not immediately disqualify someone from safe driving, eventually they will need to stop. Without intensive practical and emotional support to plan for, and eventually, cease driving, people with dementia are at high risk for depression, anxiety, grief, social isolation, unsafe and unlicensed driving and injury. We have developed a comprehensive support- and education-based intervention targeted at people with dementia and their care partners and family members to manage the transition from driving to non-driving status. The intervention is a translation of a proven driving cessation intervention for people without cognitive decline (CarFreeMe, formerly UQDrive) and is based on what people who have experienced driving cessation said that they needed to adjust, and stay active and engaged. The intervention is unique in that it is focused on both the practical and emotional issues that are experienced as a result of driving cessation. The intervention includes seven modules that cover education and practical support, delivered by an experienced health professional who is trained in CarFreeMe delivery. It is anticipated that trained health professionals will deliver the intervention to people with dementia and their families in their homes and/or community settings. The intervention is individualised according to geographic location and the particular needs and preferences of participants and is intended to be flexible. The individualised program involves a combination of one-to-one sessions, groups, practical outings and activities with a local experienced health professional, as well as home-based independent written and verbal activities.