Naunhof, Germany

The Communicate Study Partnership

The goal of "The Communicate Study: partnership across the Top End to improve Aboriginal patients' experience and outcomes of healthcare" is to achieve sustainable organisational change to provide excellence in cultural and clinical safety for Aboriginal people utilising NT Health facilities. Aim 1: Transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples - Develop, implement and evaluate anti-racism training using 'Ask the specialist-Plus'. This comprises moderated discussion and reflection on 'Ask the Specialist' podcast episodes held during in-service and clinical teaching timeslots for healthcare providers Aim 2: Strengthen the tools and strategies required underpinning culturally safe practice 1. Improve demand for Aboriginal interpreters and Aboriginal health practitioners through improved cultural understanding and recognition of patient needs 2. Improve supply of interpreters and Aboriginal health practitioners willing to work in the hospital environment by creating a culturally safe workplace and supporting career pathways 3. Effectiveness strategies tailored to participating sites such as - positioning interpreters at points of need and embedding them in medical and surgical teams - Optimising workflow to facilitate efficiency and availability across hospital departments Aim 3: Evaluate outcomes using comprehensive qualitative and quantitative measures 1. Qualitative enquiry to assess cultural safety from patient perspectives, and understand experiences of Aboriginal and Non-Aboriginal healthcare providers and interpreters 2. Quantitative outcomes including - performance across key indicators: changes in documentation of language; Interpreter bookings made; Interpreter bookings completed; % Aboriginal patients in need getting access to an interpreter - Impact of intervention: proportion of admissions with and without interpreters ending in self-discharge; unplanned re-admissions and changes in hospital length of stay - economic analysis of the costs and cost benefits of interpreter use to decrease self-discharge and re-admission rates.

Predictors of Probabilistic Selection Task Performance

The aim of this study is to investigate the effect of a non-invasive, low intensity and risk, brain stimulation technique known as transcranial direct current stimulation (tDCS) on the way people learn in a computer administered cognitive task. This will be achieved by comparing participants' performance on this task after receiving placebo 'sham' tDCS in one experimental session, and real 'treatment' tDCS in another experimental session. Neither the researcher administering the session or the participant will be aware of which form of tDCS is being used. Previous research indicates that tDCS of the left dorsolateral prefrontal cortex brain region stimulates the release of a chemical neurotransmitter, dopamine, that is linked to reward and punishment processing, and implicated in conditions such as addiction and Parkinson's disease. The computerized cognitive learning task presents participants with pairs of six different symbols and asks them to choose one of these. In the first half of the task, participants receive visual feedback (correct or incorrect; +$0.10 or -$0.10) and the symbols are preprogrammed to be rewarded or punished for. In the second part of the task, participants are tested on the same task but do not receive feedback. Further, the effect of participants' personality characteristics (specifically extraversion and impulsivity), as well as eye-blink-rate, on cognitive learning performance will be investigated, as this is known to be influenced by tDCS. Past research suggests that people may respond differently to tDCS based on individual differences in these personality traits, that are linked at a brain circuits level. Participants will be assessed on extraversion and impulsivity personality traits using pen and paper, self-report questionnaires. Similarly, eye-blink-rate is linked to the aforementioned brain neurotransmitter, dopamine, and will be assessed by manually counting of blinks in a video recording of the participant focusing on a stationary point.

Brentuximab Vedotin in Early Stage Hodgkin Lymphoma

Eligible patients will be randomised to receive either ABVD chemotherapy (doxorubicin, bleomycin, vinblastine and dacarbazine) or A2VD chemotherapy (doxorubicin, brentuximab vedotin, vinblastine and dacarbazine, with growth factor support). If patients agree, they will have a PET-CT scan after 1 cycle (PET1). The result of this scan will be blinded and used for exploratory endpoints only. Treatment will not be influenced by the result of this scan. All patients will have a PET-CT scan after 2 cycles of treatment (PET2) which will be centrally reviewed. The Deauville score from central review will be used to risk adapt subsequent therapy as follows: - Patients with Deauville score 1-3 will have one further cycle of their randomised chemotherapy and then enter follow up. - Patients with Deauville score 4 will have two further cycles of their randomised chemotherapy followed by involved site radiotherapy - Patients with Deauville score 5 will be withdrawn from trial treatment. They will have further treatment at their treating clinician's discretion and will enter follow up for the trial. Patients with Deauville score 4 on PET2 will have a final PET-CT scan to confirm adequate treatment response. Patients will be followed up for a minimum of 5 years after completing treatment.

Real World Assessment of People Living With Chronic Hepatitis B in Australia

Participants presenting to participating clinics for HBV care within the previous 12 months will be identified and enrolment data will be collected including demographics, laboratory parameters, liver disease assessment, treatment history and clinical management. Follow-up data on HBV treatment and clinical management, liver disease stage and laboratory parameters will be collected at each subsequent visit or at minimum every 12 months.

BonE and Joint Infections - Simplifying Treatment in Children Trial

Children with acute onset BJIs who present to the participating sites will be enrolled into the trial if eligible (see eligibility criteria) and randomly allocated into two groups. Children in the 'standard treatment group' will receive standard treatment for BJIs, which consists of IV antibiotics for 1-7 days followed by 3 weeks of oral antibiotics. Children in the 'entirely oral treatment group' will receive high dose oral antibiotics, followed by the standard dose of oral antibiotics for 3 weeks. The outcomes of children in each of the two groups will be compared to determine whether BJIs can be treated without needing a course of IV antibiotics.

An Implementation Trial to Improve Access to Pulmonary Rehabilitation in People With COPD

Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia

Community-acquired pneumonia (CAP) that is of sufficient severity to require admission to an intensive care unit (ICU) is associated with substantial mortality. Patients with pneumonia who are being treated in an ICU will receive therapy that consists of many different treatments, as many as 20 or 30. These treatments act together to treat both the infection and its effects on the body. When treating a patient, doctors choose from many different treatments, most of which are known or believed to be safe and effective. However, doctors don't always know which treatment option is the better one, as individuals or groups of individuals may respond differently. This study aims to help doctors understand which treatments work best. This clinical study has been designed in a way that allows the information from patients already in the study to help new patients joining the study. Most studies aren't able to do that. REMAP-CAP has been designed to: - Evaluate multiple treatment strategies, at the same time, in the same patient. - Reach platform conclusions when sufficient data is accrued, rather than when a pre-specified sample size is reached - Utilise data that is already accrued to increase the likelihood that patients within the trial are randomised to treatments that are more likely to be beneficial - New questions can be substituted into the trial as initial questions are answered, meaning that the trial can be perpetual or open-ended - Interactions between interventions in different domains can be evaluated It is reasonable to presume that any pandemic respiratory infection of major significance to public health will manifest as life-threatening respiratory infection including Severe Acute Respiratory illness and severe Community Acquired Pneumonia (CAP) with concomitant admission to hospital, and for some patients, admission to an Intensive Care Unit (ICU). Previous pandemics and more localized outbreaks of respiratory emerging infections have resulted in severe CAP and ICU admission. Previous pandemics and outbreaks of emerging infectious diseases have outlined the urgent need for evidence, preferably from Randomized Controlled Trials (RCTs), to guide best treatment. However, there are substantial challenges associated with being able to organize such trials when the time of onset of a pandemic and its exact nature are unpredictable. As an adaptive platform trial that enrolls patients during the interpandemic period, REMAP-CAP is ideally positioned to adapt, in the event of a respiratory pandemic, to evaluate existing treatments as well as novel approaches.