Stirling

This research aims to evaluate a new online group program called CAREFREE for carers of adults with moderate to severe Anorexia Nervosa. The program focuses on enhancing carers understanding of Anorexia through a Biopsychosocial and Schema-Compassion Focused framework, addressing biological, psychological, and social factors affecting the disorder. It also targets carer burnout and aims to improve emotional communication, family interactions, and compassion among carers. The study includes two phases an initial feasibility trial followed by a more detailed feasibility study to determine the interventions effectiveness before a larger trial. The CAREFREE program consists of 12 sessions delivered online to carers across Scotland. It provides psychoeducation about Anorexia Nervosa and carer burnout, focusing on improving emotional fluency, family communication skills, and self-other compassion. The study does not have comparator groups but tracks various outcomes before, during, and after the program, including a 3-month follow-up. This cross-regional NHS project aims to support carers and indirectly improve patient motivation and quality of life. Participants will complete multiple assessments including weekly rating scales during the program and questionnaires before, immediately after, and three months post-intervention. These assessments measure family functioning, quality of life, emotional stress, attachment experiences, schema modes, eating disorder impact, and parenting. Qualitative interviews with patients also take place after the intervention. The study will analyze outcomes related to carer and patient quality of life, family communication, and patient motivation to change over a 24-month period, with safety monitored throughout.

The trial investigates treatments for bloodstream infection caused by Staphylococcus aureus SAB, which can be life-threatening with a 15-30% death rate within three months. This international, multi-center randomized adaptive platform trial aims to find the best treatment options to reduce mortality within 90 days of infection. The trial adapts over time by assigning more patients to treatments that show better outcomes and removing less effective options. Participants receive various antibiotic treatments depending on their group. These include intravenous vancomycin or daptomycin, flucloxacillin or cloxacillin, cefazolin, or benzylpenicillin, with dosages adjusted for kidney function or illness severity. Some receive adjunctive drugs like clindamycin, and others may switch from intravenous to oral antibiotics if eligible after 7 or 14 days. Additionally, some participants undergo PETCT scans as part of the study. During the study, participants are monitored closely with blood cultures, temperature checks, and clinical assessments to track infection clearance and complications. Researchers measure all-cause mortality at 90 days as the primary outcome, along with other outcomes such as survival at earlier time points, hospital stay length, microbiological treatment failure, serious reactions, and antibiotic use. Safety and health economic data are also collected to evaluate treatments comprehensively throughout the trial.

Aortic stenosis AS affects many older adults, with a rising number of people over 65 and 75 years old experiencing moderate to severe disease. This study aims to compare the benefits of early aortic valve replacement AVR versus expectant management in patients with severe asymptomatic AS. It addresses a significant gap, as no randomized controlled trials have yet compared these approaches to determine which leads to better outcomes and cost-effectiveness. Participants will be randomly assigned to either early AVR, where surgery or transcatheter AVR TAVI is planned within six months, or to expectant management, involving regular monitoring according to standard hospital practice. The study will be conducted across multiple centers in the UK, Australia, and New Zealand, with an internal pilot phase to confirm recruitment feasibility. Those in the AVR group may undergo additional tests such as coronary angiography, with further treatment decisions made by their care team. During the study, participants will be followed for a median of 5.5 years, with assessments including cardiovascular events, hospitalizations, quality of life questionnaires, and health economics evaluations. Researchers will measure a combined outcome of cardiovascular death, heart failure hospitalization, and stroke, along with other health and disability measures. The study will use intention-to-treat analysis, ensuring participants are evaluated in their assigned groups regardless of treatment received.