ANZCTR search results

We aim to conduct an international prospective observational before and after study on naturopathic approaches to IBS. This will allow us to better describe naturopathic approaches to this disorder, establish the feasibility of building an international consortium of academic naturopathic clinics as well as the feasibility of recruiting participants. Our ultimate goal is to follow this observational study with a randomized active controlled trial using the same consortium and benefiting from lessons learned during this study. Our primary aims are descriptive. We aim to describe naturopathic approaches to IBS as well as establish pilot data on before and after changes in validated IBS instruments. Secondary aims include the feasibility of recruitment and operations across more than 9 sites in 4 countries; the establishment of an international research network of naturopathic teaching clinics; qualitative data gathering around the experience of patients seeking naturopathic care for IBS; and comparing the consensus results of our delphi panel of naturopathic IBS experts to the care received at the teaching clinics.

Eating Disorders Victoria (EDV), the Austin Hospital and St Vincent’s Hospital are partnering to develop, pilot and evaluate a peer mentoring program for people with eating disorders exiting hospital programs. This program is intended to address a service gap for people who require additional support to sustain recovery while living independently. It uses a peer support model, harnessing the experience of people who have recovered from eating disorders, with regular de-briefing and supervision. The aims of this research are to evaluate the outcomes of the pilot program on both mentees and mentors. Patients leaving the Austin Hospital or Melbourne Clinic, or tranisitioning to/from BETRS day program will be linked with an EDV peer mentor who has recovered from an eating disorder. They will participate in a semi-structured mentoring program with regular activities and one-on-one mentoring (3-hour, fortnightly sessions). These sessions will run over 6 months. In addition, participants (mentees and mentors) will undertake feedback and de-briefing sessions throughout the program.

This study will investigate the effect of an aquatic or water-based exercise program on exercise capacity and quality of life in people with chronic heart failure and/or a chronic respiratory disease. People will be recruited to the study after their initial assessment with the Chronic Disease Community Rehabilitation Service at Royal North Shore, Ryde and Hornsby Ku-rin-gai Hospitals. The participants will attend a 45-60 minute exercise session in the hydrotherapy pool at the Graythwaite rehabilitation centre twice/weekly for eight weeks that focuses on endurance, lower limb and upper limb strengthening in a similar manner to traditional pulmonary and heart failure gym classes. Outcome measures including six-minute walk distance, leg strength (measured by five sit to stand test), quality of life and levels of anxiety and depression will be retrieved from participants medical record after completion of the program as these measures are routinely performed as part of the CDCRS service. An additional qualitative satisfaction survey will be completed by all participants at the end of the program to evaluate the new program. All staff involved in the program will also complete a qualitative survey at the end of their involvement with the study.

Gait disorders in children can result from a number of conditions including cerebral palsy (CP), myelomeningocoele and traumatic brain injury. Such disorders can have a profound effect on the components of walking, as well as the functional participation of children in their home, school and other natural environments. Robotic-Assisted Gait Training (RAGT) is an emerging option in physical rehabilitation for adults and children with disorders impairing their ability to walk. RAGT devices such as the Lokomat®Pro support an individual on a treadmill while the robotic exoskeleton moves the lower limbs to simulate walking. There have been positive results from the use of RAGT in adult spinal cord injury and stroke populations for improvement in gait speed and endurance; however, the outcomes were not always better than traditional physiotherapy. Currently, there is weak and inconsistent evidence that RAGT may benefit children with CP with recommendations that higher level research investigates the role and potential of RAGT in this population. Additionally, many studies have failed to consider the impact of RAGT on participation outcomes. A limitation of the current literature is that no study has investigated different training schedules (frequency and intensity) of RAGT in children with CP and there is no consensus on the best schedule to promote functional improvement. Therefore, this study aims to investigate how RAGT should be prescribed and its impacts on body structure and function, activity and participation domains of the ICF. This research has the potential to aid in the development of clinical practice guidelines for the use of RAGT in children with CP. Aims of research This project will pilot test robotically-assisted gait training (RAGT) in children with cerebral palsy to: 1. Establish the most effective dosage for RAGT in terms of a) frequency and b) intensity of session, to induce clinically meaningful improvement in lower limb functioning, (as measured by the outcome measure listed in 'procedures and measurement') 2. Establish the measurements of outcome that demonstrate the most improvement from baseline after treatment to capture relative effectiveness across the ICF domains. Hypotheses: 1. In children with CP, we hypothesise that a relationship exists between increased intensity and/or frequency of RAGT sessions and clinically meaningful improvement in lower limb performance (on ICF outcome measures). 2. We hypothesise that the greatest change in outcome measures will occur in the group with the higher dosage of RAGT therapy.

This study aims to determine whether changes in REM sleep stability (during treatment for insomnia) can account for reductions in anxiety in primary school-aged children. Compared to children in the control group, we expect children in the treatment group to show improvements in sleep, anxiety and REM sleep stability..

The chemotherapy medications used for breast cancer treatment are important for achieving a cure but a potential side effect is that they can affect heart function. Current tools used to assess your heart function during and following breast cancer treatment cannot accurately predict those who will go on to develop heart problems. Aerobic fitness is an important predictor of outcomes in people with certain forms of heart disease, and having a particularly low level of aerobic fitness (termed functional disability) appears very closely linked with the risk of developing heart failure. Importantly, functional disability also reflects an exercise capacity that would limit your ability to perform basic activities of daily living such as walking briskly, climbing stairs or gardening. We are conducting a study which aims to identify how anthracycline chemotherapy affects your exercise capacity and risk of functional disability. We would also like to assess how the standard test used to measure your heart function at rest compares to state of the art MRI imaging of the heart in being able to predict your risk of becoming functionally disabled. Furthermore, we are testing whether exercise training during and following your chemotherapy is helpful in protecting against functional disability. Who is it for? You may be eligible to join this study if you are between the ages 40 and 75 years old, have been diagnosed with breast cancer and are scheduled for Anthracycline-based chemotherapy. What is involved? You will be participating in a randomised controlled research project. You will be randomly assigned to one of two groups (just like a coin toss); the control group which receives usual care for your breast cancer, or the exercise group which participates in a 12 month supervised exercise intervention plus usual care. You will have an equal chance of being randomised into either the exercise or usual care group. You will then undergo a series of assessments at the Baker Heart and Diabetes Institute within two weeks of starting your chemotherapy (Baseline), after finishing chemotherapy (4 months) and again at 12 months after starting chemotherapy. Each round of testing will be split across two days, and last between 1.5-3.5 hours each. This means you will visit the Baker Heart and Diabetes Institute on 6 occasions, totalling approximately 15 hours. The testing sessions will include assessment of your heart function, exercise capacity, body composition, muscle strength/function, cognitive function and quality of life. The exercise program will consist of three to four sessions 60-minute exercise sessions per week of moderate-high intensity endurance (i.e cycling, walking, jogging) and resistance exercise aimed at improving your heart and muscle function. The training program will be prescribed by an Accredited Exercise Physiologist (AEP) who is experienced in prescribing exercise for individuals undergoing cancer treatment.

The aim of this study is to evaluate the feasibility of MRI only planning for rectal, anal canal and gynaecological cancer radiation therapy.  Who is it for? You may be eligible to join this study if you are aged 18 years or over and have a histological diagnosis of a malignancy of the rectum, anal canal, cervix or endometrium and are about to be treated definitively with radical Radiotherapy at Calvary Mater Newcastle.  Study details All participants enrolled into this study will receive an additional MRI scan at the Diagnostic Imaging Department, Calvary Mater Newcastle, scheduled on the same day as the participants planning CT scan. There will be no change to the participant’s treatment in this study – they will receive the gold standard of care and treatment as per departmental protocols. The MRI scan will be used for comparative purposes only. The MRI will be used to create a "synthetic CT scan" which will be used prospectively to compare to the participants previously acquired CT scan. The use of MRI alone for radiotherapy planning will eliminate the potential inaccuracies in the current fusion process between the MRI and CT scan. This method has the potential to improve radiotherapy planning techniques by better utilising the superior soft tissue contrast that MRI affords.

This trial will investigate the effect of using a Fitbit device to facilitate a walking intervention in addition to usual care provided by a physiotherapist. We will be able to determine the effect of progressive walking in management LBP. We have developed the Fitbit facilitated walking intervention program to improve the patients’ adherence to the graded walking program and then increasing the physical activity level. Results from this study will inform clinical practice by providing evidence about the effectiveness of this program in reducing disability and pain, increasing physical activity levels, and improving functional and psychological status in participants with LBP.

Heart failure (HF) is a large public health burden. Heart failure is a debilitating illness especially among older people and is a major cause of mortality, morbidity and poor quality of life worldwide. Despite advances in medical, pharmacological, and surgical treatment, the outcomes of heart failure remain poor with high rates of death and hospitalisation. Self-care is the core for health programs to prevent acute decompensation in heart failure. Studies have shown that optimal outcomes in heart failure can be achieved through effective self-care. Limited health literacy is associated with high system cost, and it is a challenge to the healthcare system globally. In 2011 the Australian Bureau of Statistics reported that 47% of Australians are functionally illiterate. This means they cannot read the instruction on a medicine bottle, read a map, or a recipe. Self-care is pivotal in heart failure management. Lack of knowledge in self-care is associated with non-adherence to medication and lifestyle recommendations; as well as failure to detect deterioration that eventually leads to potentially preventable hospitalization. An avatar is an icon or figure representing a particular person in a computer game, internet forum, etc. An avatar-based application will enhance patient learning by using modern computerized tools such as animation (heart and anatomy, links to videos (demonstrating how to self-care), voice (no need to read) and touch screen response. The use of an avatar will make the teaching, more engaging and relevant to patients, therefore achieve greatest impact on patients' outcomes and make significant contribution to nursing practice in clinical setting as well as in primary care. The benefit of technology in education has already been demonstrated in a small number of conditions. Avatar based technology has been used as an aid in chronic diseases patient education such as cancer, diabetes, and depression for improving knowledge, self-care behaviors, and quality of life. Findings from these studies demonstrate positive outcomes in clinical practice. For example, an avatar-based intervention embedded into an online self-management program improved over-active bladder health-related quality of life (HRQoL) and symptoms in women. In another study, an avatar-based interactive application improved knowledge and stoma care self-efficacy in hospitalized patients with a new ileostomy. Avatar technology also reduced depressive symptoms over time in a group of young adults and prevented relapse in smoking in hospitalized cancer patients. This study is a pragmatic randomised controlled trial. There are two parallel groups, the usual care group, and the intervention group. The intervention group will be received usual care plus the avatar-based education application during the study period of six months. Both groups will be followed-up at one-month and six-month post discharge from heart failure clinic.

To investigate cytokine Response in the blood and pleural fluid in laparoscopic versus open esophagectomy in esophageal cancer. Prospective non randomised Trial.