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Effect of reducing sitting time on cognitive function in frail and inactive older adults..
Expand descriptionIn a novel approach we propose a randomised controlled trial to investigate the cognitive benefits of reducing prolonged sitting in adults aged 60 years and older with two risk factors for cognitive decline: being frail and not meeting physical activity guidelines. The 16-week theory-informed sitting reduction program will include one face-to-face session and five telephone calls. Participants will receive normative feedback on their objectively measured sitting time, work through a series of activities in a workbook and set goals which they will integrate incrementally. 144 older adults will be randomised to receive either the sitting reduction program or a control condition. Participants will be assessed at baseline, at end of intervention at 16 weeks and at 32 weeks to assess maintenance. Primary outcome is cognitive function assessed with the California Verbal Learning Test with secondary outcomes of objectively measured sitting time, executive function, mental wellbeing (anxiety and depressive symptoms, and quality of life), and body composition (waist circumference, weight, and % body fat) and sleep (duration and quality).
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Feasibility of an online mindfulness-based program for patients with melanoma
Expand descriptionThis study will explore the feasibility of delivering an online 6-week mindfulness-based intervention (MBI) to patients with increased risk of melanoma recurrence. Who is it for? You may be eligible to join this study if you are aged 18 years or above, and have a melanoma diagnosis of stage 2c, 3a, 3b, or 3c, for which you have completed your last treatment within the past five years. You will also require access to the internet. Study details Participants in this study will be randomly allocated (by chance) to the 6-week online mindfulness based intervention (MBI) or usual care group. The MBI is designed to: (1) help patients understand the potential benefits of using mindfulness in their day to day life; and (2) support the establishment of daily meditation practice. Each week of the program explores a different topic, which builds on the topic explored the week before. The program includes three main components: (1) educational component – weekly themes related to the application of mindfulness; (2) informal practice; and (3) formal meditation practice. Participants allocated to the usual care group will continue to receive their usual care for the first 6 weeks of the study, after which they will be offered the MBI. All participants will be asked to complete questionnaires assessing fear of cancer recurrence, worry, rumination, stress and mindfulness before and after the 6-week study period. Intervention adherence, meditation quality and home tasks will also be assessed weekly. If this intervention proves to be feasible, and trends for changes in outcome measures are observed, a larger randomised-controlled study will be planned to assess intervention efficacy and cost-effectiveness.
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Integrating specialist palliative care into residential care for older people: a stepped wedge trial (INSPIRED trial)
Expand descriptionThis project aims to address core goals of the National Palliative Care Strategy, by integrating specialist palliative care into aged care. The intervention is a new model of care: whereby specialist palliative care nurses will help facilities prioritise residents who have palliative care needs. The prioritisation will occur through ‘needs rounds’ which are staff-only meetings to discuss residents who may die in the next six months. Education to staff will also be provided. Following pilot work in 2014-5, this stepped wedge trial will seek to establish whether a new model of care will: 1. reduce length of stay in hospital, leading to significant cost savings 2. improve residents’ ability to die in their preferred place 3. improve care staff understanding of death and dying, and staff capacity 4. reduce symptom burden at end of life 5. reduces relatives' distress.
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South Australian Meningococcal B Vaccine Herd Immunity Study in Adolescents
Expand descriptionTo estimate the effect on carriage, all year 10, 11, and 12 students will be offered 4CMenB vaccination in South Australia through schools over the study period with 50% of the students enrolled receiving the vaccine in 2017 and 50% in 2018. In year 10 and 11 students, posterior pharyngeal swabs will be obtained at baseline and 12 months post baseline to estimate the difference in carriage prevalence of all genogroups of N. meningitidis between vaccinated and unvaccinated participants.
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Perampanel for the control of glioma associated seizures – efficacy and safety
Expand descriptionThe aim of this study is to examine effectiveness of perampanel in the control of tumour associated epilepsy (TAE) in patients with grade II-III gliomas. Who is it for? You may be eligible to join this study if you are aged 18-65 years and have a diagnosis of World Health Organisation grade II-III supratentorial glioma and have experienced a pre-operative seizure. Study details Patients will be randomized (allocated by chance) to receive perampanel, or levetiracetam for 52 weeks. Doses will be escalated over the first four week before patients enter an assessment phase for the remainder of the trial. The primary outcomes are i) proportion of patients seizure free for 6 or more months in the assessment phase and ii) time to first post-operative seizure in the assessment phase. Secondary endpoints include measures of drug safety, tolerability and quality of life. Glutamate concentrations will be measured before drug treatment is commenced to assess whether it can be utilized to predict both post-operative seizure and response to perampanel. This will be the first monotherapy epilepsy RCT utilizing perampanel. A positive study would support a larger randomized phase III trial examining perampanel monotherapy in tumour associated seizures. The novel use of 7T MRI to quantify glutamate offers the opportunity to assess if a non-invasive biomarker can help stratify seizure risk and perampanel response. This can pave the way for individualised and targeted epilepsy treatment.
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Perampanel for the prevention of glioma associated seizures – efficacy and safety
Expand descriptionThe aim of this study is to examine effectiveness of perampanel in the prevention of tumour associated epilepsy (TAE) in patients with grade II-III gliomas. Who is it for? You may be eligible to join this study if you are aged 18-65 years and have a diagnosis of World Health Organisation grade II-III supratentorial glioma and have not experienced a pre-operative seizure. Study details Patients will be randomized (allocated by chance) to receive perampanel, or or placebo for 16 week. Doses will be escalated over the first four week before patients enter an assessment phase for the remainder of the trial. Patients will be followed up for 52 weeks. The primary outcomes are i) time to first seizure after escalation phase (weeks 5-52) and ii) proportion of patients seizure free during 12 week assessment phase. Secondary endpoints include measures of drug safety, tolerability and quality of life. Glutamate concentrations will be measured before drug treatment is commenced to assess whether it can be utilized to predict both post-operative seizure and response to perampanel. This will be the first monotherapy epilepsy RCT utilizing perampanel. A positive study would support a larger randomized phase III trial examining perampanel monotherapy in tumour associated seizures prophylaxis. The novel use of 7T MRI to quantify glutamate offers the opportunity to assess if a non-invasive biomarker can help stratify seizure risk and perampanel response. This can pave the way for individualised and targeted epilepsy treatment and prevention.
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The effect of chitosan-dextran (Chitodex) gel with budesonide and mupirocin in chronic rhinosinusitis patients post endoscopic sinonasal surgery
Expand descriptionThis research is aimed at improving outcomes for patients with chronic rhinosinusitis post endoscopic sinus surgery. A dissolvable dressing Chitodex (CD) gel has already been known to be beneficial to postoperative bleeding and healing after endoscopic sinus surgery. We aim to further improve its effects by combining the current formulation with budesonide (a steroid solution) and mupirocin (an antibacterial agent). We have specifically targeted patients in the immediate post endoscopic sinus surgery setting because in previous studies, we have found that biofilm-positive patients compared to biofilm-negative patients have worse outcome post surgery in both symptoms and nasoendoscopy scores, requiring repeated courses of antibiotic treatment and extra postoperative visits (Singhal et al 2008). Therefore in this study we hope to investigate if the eradication of biofilms combined with the improved wound healing properties of using Chitodex gel incorporated with mupirocin and budesonide (CBM gel) could prevent patients from progressing to the subset of recalcitrant disease. The specific aims of this study is to 1. To investigate the effects of Chitodex + Budesonide + Mupirocin (CBM) gel in post sinonasal surgery patients with chronic rhinosinusitis (CRS) 2. Compare the change in nasal microbiome post endoscopic sinus surgery The primary end point is measured by: 1) Eradication of bacteria confirmed with microbiological swab 2) Independently scored video endoscopic examination of sinuses pre and post treatment 3) Patient's symptoms score pre and post treatment The secondary end point is to: 1. Compare the change in nasal microbiome post endoscopic sinus surgery
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Treatment information needs of individuals diagnosed with early stage non-small cell lung cancer and their support people
Expand descriptionThe primary purpose of this study is to evaluate the treatment information needs for people with non-small cell lung cancer (NSCLC). Who is it for? You may be eligible to participate in this study if you are aged 18 to 80 years, and have been diagnosed with, or are the support person for somebody who has been diagnosed with NSCLC for which surgical or radiotherapy treatment finished between three and twenty months previously. Study details All participants enrolled in this study will participate in an 30-60 minute interview (either face-to-face or over the telephone). It is hoped that the findings from this study will provide information on the views of NSCLC patients and their support people on participation in treatment decision making, understanding treatment options and confidence in communication with clinicians.
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Antimicrobial Resistance Patterns of Paediatric Urinary Tract Infections in South Australia
Expand descriptionThis study is aimed at collating and analysing data of paediatric urinary tract infections, identifying antibiotic resistance patterns in different groups of children by age, gender, presence of renal tract abnormalities. It will also assessed the level of bacteraemia in younger children. The data will be used to evaluate whether current empiric antibiotics guidelines are adequate and suitable for all groups of patients and whether there is a need for new guidelines for high risk patients and younger patients.
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An ethnographic study of the new graduate nurse’s experience when encountering the culture of acute mental health services
Expand descriptionThe aim of this study is to explore the experiences of graduate nurses during their first year of mental health nursing. Research questions Superordinate question: 1.What are the experiences of graduate nurses when encountering the culture of mental health nursing? Secondary questions: 2.Are there links between the experiences of graduate nurses and their intention to remain in the field of mental health nursing? 3.What are the processes of assimilating new nurses into the workplace? 4.Where does the new graduate fit into the organisations hierarchy, and how is this perceived by the new graduate? The research design is an ethnographic study utilising non-participant field observation; semi-structured interviews; analysis of cultural artefacts; and analysis of reflexive researcher notes as data collection methods. Data will be analysed using thematic analysis via NViVO software. The theoretical lens guiding this research is ‘viewing mental health services through the eyes of the new graduate nurse’. It is based on the organisational of mental health services and the impact of the culture on those early experiences of new nurses.