Stirling

This research aims to evaluate a new online group program called the CAREFREE Carer's Programme, designed for carers of adults with moderate to severe Anorexia Nervosa. The study focuses on improving quality of life and relationships among those with Anorexia Nervosa and their carers, while also enhancing motivation to recover for adults with the condition. The program emphasizes understanding Anorexia from a biopsychosocial and schema-compassion focused framework, addressing biological, psychological, social, and environmental factors, as well as carer burnout and family communication. The CAREFREE Carer's Programme consists of 12 sessions delivered online, targeting carers across Scotland. It provides psychoeducation about Anorexia Nervosa and carer burnout and promotes emotional fluency, family communication skills, and self-other compassion. The study is conducted in two phases: an initial feasibility trial assessing recruitment, retention, and acceptability, followed by a second phase that will build on these findings to evaluate the intervention's effectiveness ahead of a larger trial. Participants will be assessed using various questionnaires and rating scales before, during, and after the program, including follow-up at three months. These assessments measure quality of life, family functioning, emotional and psychological symptoms, and other factors related to carer and patient wellbeing. The study will analyze outcomes such as carer and patient quality of life, family communication, and patient motivation to change over a 24-month period, with results published upon completion.

Researchers are investigating treatments for bloodstream infections caused by the bacterium Staphylococcus aureus, which can be deadly within three months of infection. This international, multi-center Phase 4 adaptive platform trial evaluates multiple treatment options simultaneously to identify those that reduce death rates within 90 days of infection. The trial adapts over time by assigning more patients to better-performing treatments, removing less effective ones, and adding new options, aiming to find the best combination of therapies for patients with this serious infection. Participants receive various antibiotic treatments such as Cefazolin, Penicillin, Clindamycin, Vancomycin or Daptomycin, as well as strategies like early switching to oral antibiotics. The trial also includes whole body FDG PET/CT imaging using standardized protocols to support diagnosis and treatment decisions. Patients are randomly assigned to different concurrent treatment options currently used in routine care, with ongoing adjustments based on accumulating results. During the study, participants undergo regular evaluations including blood culture monitoring to confirm infection clearance, clinical assessments, and imaging when applicable. Researchers track all-cause mortality up to 90 days after enrollment as the primary outcome. The trial infrastructure supports additional sub-studies, with patient safety and treatment effectiveness closely monitored throughout the trial period.

Aortic stenosis (AS) affects a significant portion of the elderly population, with approximately 5% of those over 65 years old and around 3% of those over 75 years having moderate to severe AS. The number of people with AS is increasing rapidly due to an aging population, creating challenges for clinicians in managing mostly elderly patients who are often symptom-free but have severe AS diagnosed incidentally. While symptomatic severe AS requires aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), the best approach for asymptomatic patients remains unclear. This trial aims to compare early AVR or TAVI with standard expectant management in these patients to provide evidence on clinical outcomes and cost-effectiveness. The study is a large, multi-center randomized controlled trial conducted in the UK, Australia, and New Zealand, with plans to expand internationally. It includes two phases: a vanguard phase and a main phase, with an internal pilot to ensure adequate recruitment over two years. Eligible participants with severe asymptomatic AS will be randomly assigned to either early AVR or ongoing surveillance (expectant management). Those in the early AVR group will undergo surgery within about three months, which may include additional procedures like coronary angiography and possible coronary interventions if needed. The trial uses intention-to-treat analysis to compare outcomes between groups. Participants will be closely monitored throughout the study, with evaluations including routine tests and assessments as part of their care. The primary outcome measured is a combination of cardiovascular death and hospitalization for heart failure over a minimum of three years. The study also collaborates with another trial, EVoLVeD, offering participants additional research opportunities. Overall, the study seeks to provide important data on whether early valve replacement before symptoms develop can improve outcomes for people with severe asymptomatic AS.