ANZCTR search results

Peripheral neuropathy is one of the most common complications associated with type 2 diabetes and its effects can have major impact on pain, daily activities and quality of life. The primary aim of the project is to non-invasively evaluate nerve function and detect any changes over a one-year period among a group of people who are at high risk of developing diabetes (women with previous gestational diabetes mellitus) or at high risk of developing early and severe nerve complications from diabetes mellitus (people with early-onset type 2 diabetes mellitus). Women with previous gestational diabetes are at least a 7-fold higher risk of developing type 2 diabetes; and people with early onset type 2 diabetes are more likely to develop severe complications of diabetes (e.g. cardiovascular disease) some 15-30 years earlier than those with typical late onset type 2 diabetes. The sensitive nerve tests we propose to use will likely detect any changes in nerve function before they are apparent clinically. Early identification of nerve dysfunction will allow clinicians to proactively initiate early intervention and management in an effort to slow progression of nerve complications. Our proposed study has both quantitative and qualitative aspects. The quantitative aspect of the study will entail a prospective longitudinal evaluation of nerve conduction using established nerve excitability tests . This will comprise motor and sensory nerve excitability tests of the median nerve in the hand and a nerve conduction tests of the peroneal and sural nerves in the lower limb. The participants will be followed up at 6 months and 12 months and all tests will be repeated. We will also obtain information about participants' level of physical activity (using a questionnaire and a lightweight accelerometer), obtain HbA1c and fasting glucose. The qualitative part of the study will involve a 45-minute semi-structured interview, which will focus on the following topics: beliefs and understanding of nerve function in diabetes and what influences nerve complications; knowledge about signs and symptoms of nerve impairment; and knowledge of current exercise recommendations for health.

Current practice guidelines universally recommend ‘reassurance’ as an important component of low back pain (LBP) management. However, despite the recognition that clinicians are able to effectively reassure LBP patients (and with lasting effect), how best to reassure – and its impact on pragmatic outcomes – is poorly understood. Approximately 2000 adults with spinal pain are referred by medical practitioners (annually) for surgical opinion in the spinal outpatient clinics at the Royal Adelaide Hospital (RAH). Surgery, however, is likely to benefit less than 10% of these patients. It has been suggested that the communication of imaging reports may increase fear of re-injury and reduce the likelihood of a good outcome. Indeed, the highly prevalent ‘abnormalities’ detailed in radiology reports are rarely reassuring. Recent evidence suggests that many ‘degenerative’ changes found on spinal imaging are not abnormal and highly likely to be found in asymptomatic individuals. It is also understood that spinal imaging findings are not well associated with pain or prognosis. Our intervention involves a new and standardised method of communicating radiological findings in a manner designed to reassure patients, and promote engagement in an active recovery. This study is a feasibility trial which will be conducted in the spinal outpatient setting at the RAH. It is the crucial first step towards definitive testing of GLITtER (Green Light Imaging Intervention to Enhance Recovery). Aim The aim of this study is to inform feasibility of definitive testing of the GLITtER intervention in a quasi-randomised controlled trial. This trial would ultimately address the question of whether the proposed intervention – integrated into routine practice in a spinal outpatient clinic setting - is a cost-effective strategy for reducing chronic LBP and disability.

The aim of this study is to examine the effectiveness of EMDR when used to treat Indigenous Australian peoples (aged 18+) suffering from trauma related symptoms consistent with PTSD. The efficacy of EMDR for PTSD has been established, therefore this study will examine its cultural acceptability and clinical effectiveness in a remote, Aboriginal Australian community sample. The aim is to treat 20 individuals suffering from PTSD symptoms using a maximum of 10 EMDR sessions provided on alternate days. A second aim is to develop the cultural acceptability of EMDR with Indigenous Australian clients. Findings of effectiveness will be discussed with reference to the utility and cultural appropriateness of EMDR. Implications for clinical practice with Indigenous Australian clients and directions for future research will also be discussed.

The purpose of Queensland Health's Targeted Risk Modification Kids (TRIM Kids) program was to contribute to the reduction of the prevalence of overweight and obesity in Queensland children in two ways. Firstly, it sought to increase the capacity of the families who participate in it to adopt healthy lifestyles related to healthy eating and physical activity in the future. Secondly, it intended to promote healthy weight and weight management through sustainable behaviour change. The intervention delivered by the program was the PEACH program, a six-month parent-focussed positive parenting and healthy lifestyle group program that has demonstrated effectiveness in reducing the degree of overweight in primary school aged children and maintaining this reduction for more than two years after the program ended. The PEACH program is based on the recognised cornerstones of child weight management, namely diet and activity changes through behaviour modification with parental involvement and support. The delivery through parent-only groups (ie parents as the exclusive agents of change) is based on the work of Golan and colleagues who demonstrated better outcomes when parents alone were targeted and children not included in intervention sessions.

Recent evaluation of the FRAT at Peninsula Health identified that use of prompted clinical judgement had higher sensitivity for when to provide falls interventions than the stratification of risk and allocation of score. This led to the development of a new FRAT with just interventions prompts. This stepped wedge cluster randomised control trial seeks to analyse this new method of falls intervention. The design aims to roll out the introduction of the new forms to each cluster over a 9 month period. All inpatient sites and wards of Peninsula Health will be involved in this roll out excluding Women’s Health, Emergency and Paediatrics, due to different documentation requirements. The primary outcome of interest will be falls rates, secondary outcomes will also include rates of change in completions in FRATs, difference in time taken to complete new and old documentation with a potential economic evaluation of the cost of interventions. This research will provide important information about the way in which we both implement falls interventions but also seek to prevent these within the inpatient setting.

Sports Stars is a group physiotherapy program for school-aged children with Cerebral Palsy. It aims to introduce children to a range of sports specific drills, training activities and modified game scenarios to improve fundamental movement skills and provide an avenue to go on to participate in mainstream junior entry level sports programs. This study aims to investigate the feasibility, effectiveness and efficiency of group-based, sports-oriented, movement therapy for school-aged, ambulant children with CP with outcomes anticipated and measured in body structure and function, activity and participation dimensions of the ICF.

UP-STEP ACS is a prospective single-blinded, two-arm, parallel, randomized control trial with an aim to enrol 200 patients assessing the affect that personal activity monitors have on exercise capacity in patients post acute coronary syndromes primarily measured by a six minute walk test. Secondary end points will be the change in cardiovascular risk factors, namely; blood lipid and glucose levels, weight, waist circumference, medication adherence, mood and quality of life and cardiac rehabilitation adherence. Patients will be randomized to either receive a personal activity tracker or not after initial baseline assessment has been completed while inpatients during their index event. At 8 weeks patients will return for a clinical review and repeat of baseline assessments.

K inder for Children and Families O verweight: for overcoming and becoming OK A ctivity: for an active body and mind L ifestyle: for a living life-giving diet A ctions: for looking ahead together Up to 30% of children in our society are overweight or obese. This is national health crisis as 50% of such individuals will go on to develop diabetes mellitus, liver and cardiovascular disease as adolescents or young adults. We hypothesise that a "Holistic Approach" incorporating an effective proven behavioural strategy (Lifestyle Triple P) and exercise lifestyle program for children and their families will be effective at proving sustainable improvements in lifestyle and general health in children who are overweight or obese and their families. The KOALA research program aims to improve the quality of lives for children with obesity and their families for sustainable health improvements into adulthood. The KOALA research program links a tertiary based clinic at the Mater Children's Hospital (MCH) with a Community Based sustainable support network involving Triple P (Positive Parenting Program) Scouts Qld Active camps, General Practitioners (GP's) and researchers at the University of Qld to improve the quality of lives of children with obesity and their families for sustainable health improvements into adulthood. We will enrol 100-150 children into a randomised control study that compares "Care as Usual" with an "Enhanced Care Program". All participants will receive a medical, nutritional, physical activity and psychosocial assessment at baseline, 6 and 12 months at the MCH KOALA clinic, and receive standard nutritional advice, “Eat Well be Active” – Qld Health Tip sheets, and be encouraged to attend weekly physical activity sessions through programs such as Active After Schools (AASC) program or Scouts or UQ “Motor Active” programs. The “Enhanced Care” program in Arm B will be complimented by family involvement in a 20 week Lifestyle Triple P and a Scouts Active Program, including attendance at 3 weekend camps. The GP will also be supported by a GP Liaison officer with access to training and workshops. Clinical research outcomes will include 1) assessments of body mass index and body composition, 2) Metabolic and Cardiovascular health, 3) Family and Quality of Life (QOL) and Self-Esteem 4) Physical Aerobic fitness and 5)Understanding of Healthy Lifestyle changes. If successful KOALA could be implemented nationally through well-established Scouts, Triple P and GP networks to improve child and family health and lifestyle.

The primary purpose of this study is to evaluate a new questionnaire, the EORTC QLQ-MEL-38, in comparison to two existing questionnaires assessing quality of life in participants with melanoma, to ensure that the questions accurately capture how a patient with melanoma feels when they are going through treatment and follow-up care, and how this affects mood, relationships, daily living activities, work life and the experience of being a patient in hospital. Who is it for? You may be eligible to enroll in this study if you are aged 18 or over and have been diagnosed with melanoma within the previous 5 years. Study details All participants enrolled in this study will be asked to complete a brief survey which includes personal information such as living circumstances, work status and information relating to their melanoma and treatment. They will then complete five paper-based questionnaires which ask questions about quality of life, one of which is the new questionnaire being evaluated. Participants will also be asked for feedback on the new questionnaire. This whole process should take about 40 minutes and can be completed during the time spent in the clinic. It is hoped that the findings from this study will lead to validation of the new questionnaire as an accurate quality of life assessment specific to patients with melanoma.

The perinatal period has been identified as a period of increased risk for obsessive compulsive disorder (OCD) onset and worsening, for both mothers and fathers. Preliminary research suggests that metacognitive therapy (MCT) may be an effective treatment for OCD. MCT focuses on correcting misinterpretations about the meaning and importance of intrusive thoughts, and the need to control these. MCT does not involve the use of traditional exposure and response prevention exercises for OCD, often experienced as aversive by participants. Small trials to date have noted low drop out rates for MCT, so it proposed to be well tolerated by participants. Preliminary research also indicates that MCT may be an effective transdiagnostic treatment approach, meaning that it may be able to treat multiple psychological problems by targeting shared underlying maintaining factors. In clinically diverse populations, significant improvements were noted in depression, anxiety, worry, rumination and metacognition following a MCT intervention, with treatment gains sustained over 6 month follow-up. In populations with a primary OCD diagnosis MCT was found to be effective with a range of comorbid mental health conditions reflecting transdiagnostic efficacy of the treatment. To date, no studies have evaluated the use of MCT for OCD that has onset or worsened in the perinatal period. The aim of the present study is to investigate the efficacy of an 8-week group MCT program for perinatal OCD. It is hypothesised that: 1. Participants will show a categorical improvement in OCD symptoms following MCT, demonstrated by no longer meeting the diagnostic criteria for OCD at post-treatment, and maintained at 3-month follow-up. 2. Participants will show a reduction in symptom severity and intensity of OCD following MCT, demonstrated by meeting clinically significant and reliable change criteria, at post-treatment and maintained at follow-up. 3. Participants will show a reduction in co-morbid depressive symptoms following MCT, demonstrated by decreased scores on measures of depressive symptoms. 4. Participants will show decreases in scores of unhelpful metacognitive and cognitive beliefs following MCT