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Active Wear for Everyone (AWE): The effect of wearing the school sports uniform on children’s physical activity
Expand descriptionThe aim of this randomised control trial is to evaluate whether students, in particular girls, are more active during the school day if they are wearing their sports uniform as opposed to their normal formal uniform. Sixty primary schools in the Hunter Region and Mid North Coast will be randomly allocated to an intervention or control group.
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A randomised trial of an intervention to facilitate the implementation of scheduled physical activity in NSW primary schools.
Expand descriptionThe aim of this randomised control trial is to assist teachers to increase the amount of scheduled physical activity time they provide across a school week. Schools will be provided professional development, resources, time and access to a support officer to make these changes. Sixty primary schools in HNE and Mid north coast LHD’s will be randomly allocated to either an intervention group or a control group. The final trial endpoint is 18 months.
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The effects of external counterpulsation on blood glucose control in participants with type 2 diabetes
Expand descriptionA three-group, randomised, placebo-controlled trial will be performed. Forty five participants with type 2 diabetes will be assigned to either 1) ECP30: ECP therapy for 30 mins/session or 2) ECP45: ECP therapy for 45 mins/session or 3) placebo (sham). Each participant will have 3 ECP/sham sessions/week for 7 weeks. To assess the effectiveness of the ECP therapy before and after the 7-week intervention participants will undergo tests of cardiorespiratory fitness, exercise capacity, blood markers (HOMA values and basal disposition index using fasting glucose and insulin), HbA1c, nitrate, nitrite, F2-isoprostanes, protein carbonyls, C reactive protein, IL-6, IL-10, IL-ra and thrombospondin-2) and vascular structure and function.
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Magnesium after cardiac surgery practice change audit
Expand descriptionAtrial fibrillation (AF) is the most common complication after cardiac surgery, with an incidence ranging from 20 to 50%. It represents a potential cause of thromboembolic events, hemodynamic instability and prolonged Intensive Care Unit (ICU) stay. Maintaining a normal blood magnesium concentration may help prevent the onset of atrial fibrillation after cardiac surgery. Previously we performed an assessment of the pharmacokinetics of magnesium administration after cardiothoracic surgery from August, 2016 to April, 2017: “Assessment of Blood and Urine Magnesium Levels in Patients Admitted to the Intensive Care Unit” (HREC: LNR/15/Austin/306). We included 60 patients: 30 patients in the before period who received a bolus of 20 mmol of magnesium sulphate over 1 hour; and 30 patients in the after period who received a bolus of 10 mmol of magnesium sulphate followed by a continuous infusion at 3 mmol/h over 12 hours. In the before period, we found that the loading dose of 20 mmol increased both serum and urinary magnesium concentrations, however the serum concentration returned to pre-intervention levels within 12 hours of observation and the urinary excretion remained elevated. In the after period, the intervention of a loading dose of 10 mmol of magnesium sulphate followed by a continuous infusion was associated with an increase of both the serum and urinary concentrations of magnesium over time. The after-period protocol allowed us to achieve a sustained, safe, and moderately elevated serum magnesium concentration at twice to three times the lowest total magnesium concentration in our laboratory (1.4 to 2.0 mmol/L), which might be expected to deliver a greater chance of AF prevention. As such the management practices associated with magnesium administration in our intensive care unit has changed. The purpose of this project is to evaluate the effect of the new protocol on the incidence of atrial fibrillation in patients who undergo cardiac surgery and are admitted to the intensive care unit. Using a medical record audit design we will evaluate patients treated with the new magnesium protocol with that of a historical control.
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Clinical and economic outcomes of the Reducing the Use of Sedatives (RedUSe) project in Australian residential aged care facilities
Expand descriptionA multifaceted program (the Reducing the Use of Sedatives; RedUSe project) was implemented across 150 Australian residential aged care facilities (RACFs). The RedUSe project consisted of educational sessions supported by auditing and benchmarking of sedative prescribing. There was also a sedative review component where pharmacists, nurses and doctors work together in consultation with the resident and/or relatives to review regularly used sedative medications (predominantly antipsychotics and benzodiazepines). We aimed to review the clinical outcomes of the residents and nursing home staff, and economic outcomes for the health care system resulting from this intervention. We hypothesised that reduced use of antipsychotics and/or benzodiazepines, as a result of this project, will: - Not negatively affect behavioural and psychological symptoms - Improve resident quality of life - Decrease the rate of resident falls - Increase activities of daily living - Decrease general practitioner visits - Decrease hospitalisations - Decrease caregiver burden - Increase the job satisfaction of nursing staff - Be associated with lower costs to the health care system than 'usual' practice. Nursing staff were interviewed with validated questionnaires to assess behavioural and psychological symptoms, social engagement, activities of daily living, and caregiver burden at the start and four months of RedUSe. Additionally, nursing staff were required to record the number of falls, challenging episodes, hospitalisations, and general practitioner consultations the residents had each month for the same four month period (a minor addendum to their existing recording activities). To asses job satisfaction, an anonymous survey was made available at the start and four months of RedUSe.
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A novel intervention to promote engagement in physical activity for individuals with whiplash associated disorder
Expand descriptionSix participants aged 18-60 years will be recruited for this study. Inclusion criteria includes: grade II whiplash of at least 3 months duration; living in a community setting; a neck disability index score >32% [1]; deemed medically safe to participate in moderate intensity PA; and currently insufficiently physically active for good health. Exclusion criteria includes: known or suspected serious spinal pathology; confirmed fracture or dislocation at time of injury – WAD Grade IV; nerve root compromise; and spinal surgery in the past 12 months. This study will utilise Multiple Baseline Single Subject Experimental Design with three phases: a 5, 8 or 11 week baseline period; a 16-week intervention comprised of 12 one hour sessions; and a 5-week no intervention withdraw. Primary outcome measures will be collected weekly during the baseline data collection period, fortnightly during the intervention period, and weekly during the follow-up period. Secondary outcome measures will be collected at the following time-points: week 1 of the baseline period; at the conclusion of the baseline period; at the midpoint of the intervention; at the end point of the intervention; and at the end of the follow-up period. Data collection will be completed by a researcher independent of the intervention delivery. 1. Vernon & Moir. The neck disability index: a study of reliability and validity. J Manip Physiol Ther, 1991. 14(7), 409-415.
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LIFE Study: Liver transplant recipient Initiative: Feasibility study to Enhance cardio-metabolic health
Expand descriptionWe are studying ways to improve the health of people after their liver transplant. We want to develop better ways to improve the cardio-metabolic health after liver transplant so that patients can avoid developing common conditions like obesity, diabetes and heart problems. The aim of this study is to find out if using telehealth technology (web-based appointments and educational videos) is useful to support patients in healthy eating and exercising in a way that can improve overall cardio-metabolic health after liver transplant. The information gathered from this study will be used to improve liver transplant services, and assist in developing better long term access to services that can be made available through technology.
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An imaging study of 64Cu-SARTATE using positron emission tomography in paediatric patients with high-risk neuroblastoma.
Expand descriptionThe aim of this project is to investigate if a novel tracer called 64Cu-SARTATE can be used to help accurately image neuroblastoma on PET/CT in pediatric patients. Who is it for? Paediatric patients aged 16 years or less diagnosed with high-risk neuroblastoma and life expectancy of 12 weeks or more are eligible for this study. Study details Eligible patients will be administered a single dose of 64Cu-SARTATE and undergo whole body PET scans at 4hrs & 24hrs. Complete safety evaluations will occur during visit 2 (day 2) & the visit 3 (day 8). Three blinded assessors will compare the new scans to the standard of care imaging to determine if they are superior. We hope that by testing this investigational product in paediatric patients, we can confirm that the biodistribution of 64Cu-SARTATE will facilitate specific and more sensitive identification of malignant tissues using PET/CT scanning. It is hoped that this method can then be translated into everyday clinical care.
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A Single-Center, Open-Label Pharmacokinetic (PK) Study to Assess the PK Profile of Nicotine Delivered by the Chrono Quit Smoking Solution (CQSS2)
Expand descriptionThis study is a Phase 2, open-label, PK study to assess the PK profile of nicotine over a 30 hour period in healthy Caucasian male volunteers who are smokers, using the Chrono Quit Smoking Solution (CQSS2) system. All subjects will receive the CQSS2. A strap (i.e., Comfort Band) will be the primary method used to attach the CQSS2 to the body. Subjects will be randomized in a 1:1 ratio to wear the CQSS2 in one of two application site locations, the upper arm (n = 5) or mid thigh (n = 5), for approximately 30 hours. Application site location, safety, and tolerability will be evaluated.
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Reducing the Use of Sedative medication in aged care facilities: Implementation of the ‘RedUSe’ project into everyday practice.
Expand descriptionFor over thirty years research has consistently shown that the use of sedatives (predominantly antipsychotic and benzodiazepine medication) in many residential aged care facilities (RACFs) is excessively high. These agents only offer modest effects, yet are associated with significant adverse effects such as falls, confusion and daytime drowsiness, and they increase the risk of stroke and death. Many strategies have been adopted to reduce sedative prescribing in aged care. The most effective interventions involve audit and feedback, health practitioner training and medication review. Combinations of these strategies appear to offer the most success. The strategies of audit cycles, nursing staff training and ACF medication review are currently promoted and funded by the Australian government; however, there has been limited training for pharmacists to effectively deliver them. Further, there are no coordinated audit/training/medication review packages that specifically target sedative prescribing. The initial ‘Reducing the Use of Sedatives’ (RedUSe) project was a 6-month controlled trial conducted in 25 Tasmanian ACFs during 2008/2009. RedUSe was pharmacy-led and involved a computerised clinical audit of sedative use. This information was then presented to each facility alongside an educational session on the appropriate use of these medications. The final component of the RedUSe project was a dedicated sedative review process which involved nursing staff, the GP and the reviewing pharmacist. The initial RedUSe project resulted in a significant decrease in the utilisation of sedative medication, an overall reduction in sedative doses used and the project was well received by participants. This study involves a significant expansion of the RedUSe project to a national sample of 150 RACFs, and is funded by the Australian Government as part of the second round of the ‘the Aged Care Service Improvement and Healthy Ageing’ grants fund. In this expanded RedUSe project the same format of sedative audit and feedback, an educational program for ACF nurses and carers, and a dedicated interdisciplinary sedative review will be followed. The overall RedUSe program will be enhanced by the involvement of collaborators; the National Prescribing Service MedicineWise, and the Pharmaceutical Society of Australia. The ultimate benefits for residents in ACFs following successful reduction in rates of sedative use should include increased mobility and alertness, decreased fall rate and an enhanced quality of life. Other interventions have also shown an increase in the level of staff satisfaction when sedative use is minimalised and we aim to evaluate these outcomes in the expanded RedUSe project.