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Prader-Willi syndrome (PWS) is a rare genetic disorder that causes individuals with the disease to have an insatiable appetite, which often leads to the development of morbid obesity. The only way that this appetite can be controlled is through constant vigilance, behavioural restraints and environmental modifications; there is currently no pharmacological treatment for excessive appetite in PWS. A single injection of exenatide, a GLP-1 hormone agonist, has been shown to increase feelings of fullness after a meal in adults with PWS. The effects of the long term administration of a GLP-1 agonist on appetite and weight management in PWS, however, have not been studied. The proposed study aims to redress this by assessing changes in gastric emptying rate, fullness, hunger, food-related behaviours, appetite hormones, cognitive function and body weight in a cohort of 20 adults with PWS treated for 12 weeks with the GLP-1 agonist Bydureon. Study participants will undergo a meal study prior to beginning Bydureon treatment to assess their response of hormones and appetite to food intake. As there have been some studies demonstrating that Bydureon slows gastric emptying, participants’ gastric emptying rate will be also be assessed by scintigraphy so that changes in gastric motility can be monitored for tolerance, with a normal gastric emptying range established from 10 lean control individuals and 10 obese control individuals. If PWS particpants’ gastric emptying rate falls within the normal range, they will begin a 12-week Bydureon treatment period with weekly injections of the drug. After 4 weeks of Bydureon treatment, gastric emptying rate will be measured again. If it has slowed below the normal range, treatment will be discontinued. Otherwise, treatment will be continued up to 12 weeks, after which PWS participants will undergo a further meal/scintigraphy study to determine the effect that Bydureon treatment has had on appetite, weight, behaviour and cognitive function. Body weight will be measured again 12 weeks after completion of the treatment period.

The application of allogeneic haematopoietic stem cell transplantation (HSCT) is hampered by procedure-related morbidity and mortality, including transplant-associated thrombotic microangiopathy (TA-TMA), sinusoidal obstructive syndrome of the liver (SOS), idiopathic pneumonia syndrome (IPS) and acute graft vs host disease (aGVHD). While the aetiology of many of these conditions is not known, it has been postulated that endothelial toxicity related to the chemotherapy conditioning is an early event common to all of them. We hypothesise that endothelial toxicity is associated with complement dysregulation, and leads to a prothrombotic state with impaired fibrinolysis, which manifest as the clinical complications listed above. In this study, we aim to document laboratory evidence of changes in coagulation and fibrinolytic potential occurring after allogeneic HSCT, and to correlate this with prospectively identified clinical and laboratory manifestations of endothelial toxicity. A total of 30 participants will be recruited, of which a minimum of 15 will have received the busulfan / cyclophosphamide regimen. Blood samples will be taken from recipients immediately prior to commencement of the conditioning regimen, on the day of transplantation, and on post-transplant days 7, 14 and 21. Additional blood samples will be taken for therapeutic dose monitoring from recipients of busulfan conditioning. Diagnoses of TA-TMA, SOS, IPS and aGVHD occurring up to post-transplant day 28 will be made according to specified criteria using diagnostic information collected as part of standard care.

The anterior cruciate ligament (ACL) is an important stabilizing ligament of the knee. It is also the most common knee ligament injury requiring surgery, with an annual incidence of approximately 1 in 3500 in the general population. Numerous technological advances have been made in recent times in the surgical techniques for ACL reconstruction but, in spite of this, the failure rate remains approximately 7-15% and many people do not return to full function in their knee after ACL reconstruction. The anterolateral ligament (ALL), a structure located in the anterolateral part of the knee, has recently been identified as an important contributor to rotational stability of the knee in addition to the ACL. Loss of ALL integrity may be responsible for some cases of failure post-operatively. Although intra-articular ACL reconstruction remains the current gold standard for operative management, it does not address the extra-articular ALL deficiency and therefore does not restore normal knee kinematics. The aim of this study is to compare the return to function and re-rupture rates following combined ACL reconstruction with lateral extra-articular tenodesis versus an isolated intra-articular ACL reconstruction. Participants will be randomly allocated to one of two treatment arms by opening a sealed envelope. They will then undergo either i) ACL reconstruction using a 4-strand hamstring ACL graft and iliotibial band (ITB) lateral extra-articular tenodesis, or ii) isolated intra-articular ACL reconstruction with a 4-strand hamstring graft. Following surgery, clinical reviews will be conducted at 6 weeks, 3 months, 6 months, 12 months and 2 years post-operatively during which the physiotherapist will make an assessment using a variety of objective knee scoring systems and a patient satisfaction survey. Any post-operative complications will also be recorded. Comparison will then be made to determine which technique has better functional outcome and lower re-rupture rate.

Our research team has recently been awarded an Australian Mental Health Award by Beyondblue and the Movember Foundation, that will fund a program of research aimed at developing and evaluating a range of new e-health interventions for working men, termed ‘Men@Work’. One of the first parts of this program is the development of a new smart-phone application that will allow men to screen themselves for both symptoms and risk factors for common mental health problems. The working title for this new smartphone application is ‘Mindgauge’. This registration covers one part of the development process; the testing of the relative appeal of different feedback texts, language, measurement tools, and content style with an early prototype of the ‘Mindguage’ application. The testing of different features and content styles within an early prototype or minimum viable product (MVP) is considered a usual early stage in the development of complex new smartphone applications. The specific questions that this research project (and registration application) will aim to answer are: a) What feedback texts are most persuasive for convincing participants to follow links to recommended interventions? b) What mood widget measurement is most appropriate? And does it map onto other standardised tools? c) Are app notifications acceptable to users? d) How interested are people in finding out about their risk? Does it impact engagement? Data collection Participants will complete quizzes pertaining to: Mood and anxiety symptoms (K6 questionnaire) and Wellbeing (WHO 5 Well-being Index) and sliding scales measuring alcohol use quantity; hours slept; perceived stress; physical and social activity. Participants who are deemed at-risk of mental health problems on the quizzes will be randomly allocated to receiving one of the following feedback types: normative positive, normative negative, theory-driven, humour-driven. The outcome measure is number of clicks to external interventions. They will be reassured that techniques are available to help improve these factors and immediately following their feedback will be provided information and a link to a variety of online self help or information sites. Participants then use the app to monitor mood and alcohol quantity, sleep quality, stress, and physical and social activity. They have the option of finding out their current risk of mental health problems. In a subsequent randomisation participants will receive one of five different mood measurement gauges, outcomes will include engagement (quantity and frequency of check-ins with app) and Signal quality (correlation of signal to weekly k6 scores and accuracy of a baseline linear classifier trained to predict k6 score from mood signal.

It has become routine for any adult who had undergone abdominal surgery to have physiotherapy treatments such as deep breathing, incentive spirometry, encouraging mobilisation (getting out of bed) and other specific chest physiotherapy techniques manual techniques. It is thought that this physiotherapy will prevent post-operative pulmonary complications. The research in adults has shown that of these techniques, early upright mobilisation is most effective in reducing length of stay in hospital for adults who have undergone abdominal surgery (Browning et al 2007). There is very little published evidence to support the use of physiotherapy to prevent post-operative complications in children who have undergone abdominal surgery. Current medical, physiotherapy and nursing care after abdominal surgery at Princess Margaret Hospital (PMH) advocates for early mobilisation. These recommendations for children are based on findings on adult patients. As a result, there are no clear guidelines of how much, how often, and how best to encourage mobilisation in children after they have had abdominal surgery. This uncertainty leaves clinicians working in this clinical area partly dependant on their own clinical experience when making decisions regarding individual patient management and results in variation in clinical care (Morris et al 2003). This uncertainty and variation in clinical practice is one of the driving forces behind the development and evaluation of the Up and Go Goodie Bag. AIM: We wish to evaluate whether patients supplied with a self-directed early mobilization and deep breathing incentive goodie bag (Up, and Go Goodie Bag ) after abdominal surgery facilitates early mobilisation, early discharge and prevents post op pulmonary complications. This information will be used to develop mobilisation guidelines for children who have undergone abdominal surgery.

This is a single-subject research design involving three participants. Recruitment will occur through Dreamfit and Ability Centre (which are affiliated) via dissemination of information to families. Screening of potential participants by a physiotherapist will occur to determine their suitability. Weekly assessment of outcome measures will occur during a 5-week baseline and 12-week intervention period, and at 4-week follow-up. These assessments will include lower limb range of movement (ROM), lower limb muscle strength, timed up and go assessment (TUG), heart rate during exercise, enjoyment (using a 5-point Smiley Scale) and a 2-minute walk test (2MWT). Probes (at the beginning and end of each phase) will include: the Canadian Occupational Performance Measure (COPM), and the Cerebral Palsy Quality of Life Questionnaire (CP-QOL). The trampoline intervention will involve twice weekly sessions at Dreamfit, where the bungee trampoline is located. The sessions will be run by the student (AG, one session a week) and a physiotherapist (one session a week), with an individualised programme suitable for each participants abilities and goals. At the conclusion of the program, an additional ‘exit’ interview will help to establish the usability of the adaptive bungee trampoline.

Despite mental disorders being the leading cause of sickness, absenteeism and work incapacity in most developed countries, mental health has not been given due attention by most employer organisations. Recent evidence suggests that many mental health problems are preventable with adverse psychosocial work environments known to be a risk factor for mental disorders. Most of these adverse stressors are experienced initially through the development of “work stress” with some later deteriorating into frank mental disorder. There is a key issues in this context. Whilst the use of pen and paper technology based questionnaires is commonplace to screen for stress there are concerns over their false positive rate and predictive ability. Measures of Heart rate variability (HRV), the beat-to-beat temporal changes in the heart rate (HR), may provide an alternative measure for stress assessment. These beat-to-beat changes are commonly used as a quantitative marker depicting the activity of the autonomic nervous system (ANS), and thus related to mental stress. It has been suggested that changes in heart rate over 24 hours, or circadian heart rate (CHR) changes, may present adjunct information for stress assessment as circadian dysregulation is present in varying degrees in all psychiatric illnesses. As such, it has been proposed that HR profiling algorithms might provide an objective and predictive measure of stress becoming a clinical illness. This study aims to assess whether measures of CHR can provide objective indications of stress and distress in the workplace. CHR and self-report measures will be collected at baseline and 8 week follow-up.

Anecdotally, survivors of critical illness reported reduced appetite that persists after discharge from ICU, however this has not been quantified, Given critical illness is associated with an increased prevalence of malnutrition, and functional deficits occur well after ICU discharge, factors that may influence recovery of nutritional status and hence function require exploration. This study is a sub-study to 'The significance of hyperglycaemia in survivors of critical illness and potential mechanisms underlying development of type 2 diabetes (ACTRN12614000449639) that will recruit ICU survivors and a healthy cohort.

Children with spastic hemiplegic cerebral palsy (CP) often have ankle control issues in one leg, with weakness and spasticity that causes trips and/or falls due to poor foot clearance when moving quickly. Many wear an ankle brace to stop their foot dragging. However, this blocks ankle motion and affects speed and performance during physical activity. The WalkAide is a device worn around a child’s calf, just under their knee, to stimulate the weak muscles that pull the foot up. Early research shows WalkAide use promotes better walking and can increase muscle size in this population. This study will determine the impact of a WalkAide and motor-learning, gait focused physiotherapy intervention on advanced motor skills and priority goal accomplishment for children aged 6-17 years old with hemiplegic CP. We know that the WalkAide is not suitable for all children and young people in this group. Results will also determine the clinical utility of the device and inform best practice prescription to maximise the benefits for children and families.

APL-2 is an experimental drug being developed by Apellis Pharmaceuticals Inc for potential use as a treatment for people with ischemia-reperfusion injuries. In this study, single doses of APL-2 will be assessed in healthy volunteers. Assessments of safety, tolerability, pharmacokinetics, and pharmacodynamics parameters following administration of single doses of APL-2 will guide decisions to further develop the drug.