ANZCTR search results

This pilot randomised controlled trial aims to develop and evaluate an innovative intervention to reduce sitting and improve activity in cancer survivors participating in clinical exercise rehabilitation. In addition to participating in the 4-week exercise clinic (1 1h session per week), half of the participants will be randomly allocated to also receive a text messaging intervention to support behaviour change outside of the face to face clinic. The 3-month intervention will consist of a suite of text messages tailored through coaching sessions conducted at baseline and 4-weeks. The primary outcome is overall sitting time (h/day) measured y the activPAL3 activity monitor. Secondary outcomes include standing time and stepping time, use of time and key clinical outcomes measured using the activPAL3, the Multimedia Activity Recall for Children and Adults (MARCA), and a clinical assessment battery, respectively. All outcomes will be measured at baseline, 4-weeks and 12-weeks. Feasibility and acceptability will also be assessed. It is hypothesised that the intervention will reduce sitting time in intervention participants compared to those that receive the exercise clinic only.

Malaria is one of the most common causes of fever in Australian travellers, with approximately 400 cases reported each year in Australia. In addition, some travellers develop malaria and seek treatment while overseas, and are not included in these reported numbers. Most travellers who develop malaria did not take anti-malarial medications, or did not take the medications properly (e.g. forgot to take tablets). Malaria is a serious illness, and could potentially be life-threatening if not treated promptly. Antimalarial medications reduce the risk of malaria by about 90%, and the most commonly used options in Australia are Malarone, Doxycycline, and Mefloquine (Lariam). This research project aims to reduce the risk of malaria in travellers by improving compliance with anti-malarial medications. We propose to test the acceptability and tolerability of a 3-day schedule of a malaria medication called Malarone. Currently, travellers are required to take Malarone daily, starting 2 days before travel to a malaria risk area and continuing until 7 days after leaving the area. With the 3-day schedule, travellers will only need to take medications for 3 days and be protected for 4 weeks. The schedule will likely improve compliance and therefore reduce the risk of malaria. For trips that are of 4 weeks duration or less, travellers will be able to complete their antimalarial medications before leaving home, and not worry about carrying or taking tablets during their trip.

Presently there is a large push in the non-scientific nutrition-diet community towards a high-fat diet for improving any disease state, with very little scientific evidence. In fact, research in animals (rats) has shown the negative effects of the high-fat, low carbohydrate diet to glucose regulation and weight management. In line with this research, much of the circadian rhythm and metabolomics literature published to date has been using animal models and no human data exists in this area. Establishing the circadian profile in a healthy middle aged population will act to inform future diet and exercise training studies. Currently, there are no dietary studies of circadian clock genes in humans and with increasing rates of type 2 diabetes and obesity, dietary alterations are common within today’s society that the consequences of such changes are not well understood.

All patients with upper gastrointestinal bleeding (UGIB) undergo a gastroscopy urgently. However, in a significant proportion of these patients a source is not identified. Small bowel bleeding is highly likely to be the source in a large number of these patients. This may be identified by capsule endoscopy. Proximal colonic bleeding is also likely in patients with melaena and is identifiable by colonoscopy. As per current standard practice, patients will undergo a colonoscopy frequently or a capsule endoscopy (CE) less often, in an attempt to find the cause of bleeding. Capsule endoscopy is noninvasive, better tolerated and preferred by patients as bowel prep and anaesthesia are not required. However,it is uncertain who will benefit most by having a capsule endoscopy as the second test. The focus of our study is to look at the subgroup of patients who will benefit most by having early Capsule Endoscopy in this context. The study aims to compare two groups of patients, one having capsule endoscopy VS the other having colonoscopy as the second test following a negative gastroscopy to determine differences in ability to detect bleeding source and therefore change patient outcome. All patients with UGIB with a negative gastroscopy will be considered for the study. This is a prospective randomised control trial. Primary endpoint measured will be identification of the source of bleeding. Secondary endpoints measured will be reduced blood transfusions, reduced length of stay, reduced number of investigations and reduced hospital admissions.

Benign Focal Epilepsy of Childhood (BFEC) is the most common type of partial motor epilepsy in the school aged child. BFEC is diagnosed based on clinical features and characteristic abnormalities on their Electroencephalogram (EEG). The frequency of seizures in BFEC is quite low and long term prognosis is generally good. Most children may not require anti-epileptic drugs (AEDs) to treat seizures. However the course may be complicated by language and cognitive impairment, by frequent or severe seizures, Todd's paresis and even status epilepticus. Inspite of being one of the most frequent epilepsies, the underlying brain abnormalities remain poorly understood. Transcranial magnetic stimulation (TMS) evaluates brain excitability in a safe, non-invasive manner. TMS may help predict the clinical severity, requirement and response to AEDs, and identify those likely to have language and cognitive impairment. BFEC is postulated to be a genetic epilepsy with possible multifactorial influence. Identical epileptiform features on EEG may be found in siblings and first degree relatives of affected children. It is not clear why some children in the family have seizures and others do not - study of brain excitability may help answer these questions. Epileptiform abnormalities similar to that in BFEC are also sometimes noted incidentally in EEGs of normal children. In this project we plan to use TMS to study children with BFEC, their unaffected siblings and parents using TMS and EEG. Abnormalities in brain excitability will be correlated with clinical features (including frequency and severity of seizures), requirement and response to AEDs, and abnormality in neurological development. This may allow us to use TMS to prognosticate whether asymptomatic children will develop seizures, which children will require treatment, which AEDs to use, and those likely to need monitoring of brain function (e.g. language).

Primary aim: - To determine whether the performance and satisfaction within meaningful occupations for adults with Chronic Pain improves in response to a Leaned Pacing intervention in comparison to Waitlist Control conditions. Hypotheses: - The Learned Pacing intervention group will have greater occupational performance and satisfaction in comparison to the Waitlist Control group Proposal research design: - Pilot Randomised Controlled Trial Two Group Pretest- Posttest Design. Methods: - Potential participants will be identified from a Community Based Rehabilitation Centre Multidisciplinary Pain Service waitlist and potential participants who consent to participating in the research project will be screened for eligibility based on inclusion/ exclusion criteria, - Eligible participants will be randomly assigned to either the Learned Pacing intervention or Waitlist Control - The experimental group intervention is a Learned Pacing intervention and will be provided over three separate sessions lasting between 60- 90 minutes, which will be provided over three consecutive weeks by a qualified Occupational Therapist. Participants allocated to this group will receive usual care subsequently with a current wait list time of approximately 3 months. - The Waitlist Control group will not receive the experimental intervention, however participants allocated to this group will receive usual care subsequently with a current wait list time of approximately 3 months. - The Canadian Occupational Performance Measure and the Brief Pain Inventory will be used as the outcome measures to record data, pre and post intervention, according to participant's occupational performance and satisfaction, as well as pain severity and interference.

Background: Familial hypercholesterolaemia (FH) is a generally unrecognised, inherited condition (prevalence 1:500-1:200) resulting in excessively high cholesterol levels in the bloodstream from birth, increasing the risk of heart attacks and angina by age 40 or earlier if left untreated. Affected individuals have a 50% chance of passing the condition onto their offspring. Only 15% of affected patients are diagnosed with 85% remaining at high risk of progressing to heart attacks and cardiovascular complications. Early diagnosis and treatment are very effective in preventing heart disease developing. Until recently FH has been managed mainly through hospital clinics. This WA-led national study trials an innovative primary care-based approach using clinical diagnostic criteria as per the Dutch Lipid Clinic Network Criteria (DLCNC) score rather than more expensive genetic testing. This new method of care will allow the condition to be managed predominantly by the patient’s General Practitioner (GP) and primary care team with support from the hospital specialist for more complex cases. Working with the GP, patient records are electronically screened to identify patients with possible FH before clinical examination to provide a definitive diagnosis. Once the first member of a family with the condition (index) is identified, the primary care team undertake family tracing/cascade testing of first-degree relatives to identify related FH patients. Primary Aims: 1) Increase in number of index cases clinically identified 2) Reduction in LDL-c of treated cases Secondary Aims: 1) Increase in the number of family cases detected/contacted (including children) 2) Evaluation of sustainability of method of care 3) Development of registry of FH patients Hypothesis: General practitioner (GP) - practice nurse (PN) led model of care improves the detection and management of FH in the community. Significance: Under a current model of care (MoC) for FH in Australia FH is diagnosed through a number of different routes and managed mainly through hospital-based lipid clinics undertaking genetic testing particularly if the clinical features (phenotype) are highly suggestive of FH. State and Federal Government policy is proposing to increase primary care management of most chronic conditions and the WA Health Department has initiated moves to re-locate the diagnosis and management of FH from the tertiary hospital sector to primary care. In Australia, over 81% of the population consult a GP annually. GP consultations therefore, offer a unique opportunity to help detect unknown index cases of FH in the community. Most of this work will be undertaken in the less expensive community setting of general practice using an electronic data extraction tool to retrospectively review patient records for FH.

The Department of Orthopaedics and Traumatic Surgery at Royal North Shore Hospital is conducting research to test a new treatment for frozen shoulder and tendinopathy. The treatment being investigated is a drug called Metformin. Metformin is currently approved to treat Type 2 diabetes. It is not currently approved to treat frozen shoulder or tendinopathy. The aim of the study is to determine whether Metformin is effective in reducing pain and loss of movement, and speeding up recovery in patients suffering from a frozen shoulder or tendinopathy. Our investigations in the Department of Orthopaedics and Traumatic Surgery's laboratory at Royal North Shore Hospital have shown that this drug acts on the cause of the stiffness in these shoulder conditions and may be effective in reducing the pain and its duration. Results of research undertaken in our laboratory, also suggest that blood tests may help diagnose these conditions and indicate if a patient is recovering well. Current treatments for these conditions have limited success. It is therefore important that more research is done into new treatments, including drug treatments. Frozen shoulder and tendinopathy cause enormous pain, which can lead to loss of sleep, difficulty in dressing and toileting, and participating in occupational and recreational activities. This drug may enable patients to return to their usual activities more quickly. This research has been initiated by the study doctor, Professor Sonnabend, who is an orthopaedic surgeon at Royal North Shore Hospital. Patients are eligible for this study if they: * Are aged between 40 and 70; * Have shoulder pain in only one shoulder, which may or may not be following an injury; * Have pain at the ends of the range of movement of their shoulder in all directions; * Have a loss of movement in the shoulder; * Have had symptoms for less than 3 months; * Have an x-ray that is normal; * Are non-diabetic. Participants will be given either metformin or a placebo to take twice daily for 3 months. The one taken will be chosen randomly. Participants and the study doctor will not know which treatment a participant is receiving. Participation in the study will involve 4 medical appointments at Royal North Shore Hospital, which would be at least the usual number of visits that would be made to a specialist, but in addition to the consultations, questionnaires will be completed and blood samples will be taken. Participation in any research project is voluntary. This study will not cost participants anything.

The primary purpose of this study is to pilot test the feasibility and potential efficacy of a parent-focused program to reduce sedentary behaviour in 2 to 4 year old children. The program will include a short group session with parents in their existing playgroups, followed by personalised text messages for parents for the next 6 weeks.

MEDIS-Australia is an observational study with cross-sectional design conducted by La Trobe University, Melbourne, Australia. Convenience sampling of a non-probability sample of participants will be used. Older Greek Australians (>65 years of age) originally from Cyprus and Greek islands such as Crete will be invited to participate, predominantly from elderly Greek community groups in Melbourne. Adjunct strategies to reach the target cohort include provision of study information and the researcher's contact details to Greek print media, radio, Greek language schools, Greek Orthodox Church community groups and the Australian Greek Welfare Society. Information will be provided to each group and recruitment sessions will be arranged with community group support. The primary aim is to assess the impact of migration on adherence to a Greek Mediterranean dietary pattern. Secondly, to evaluate the relationships between socio-cultural characteristics and behaviours with adherence to traditional Greek Mediterranean dietary pattern and cuisine and the presence of CVD risk factors and risk of MetS. A comparison of the study cohort of elderly Greek Australian migrants from islands to their counterparts living on these islands will be conducted. Data collection is underway. The impact of migration upon health and nutrition status of older Greek Australians originally from islands and the retention of culturally-specific behaviours which may be associated with diet adherence provide greater insight into the Australian Greek migrant paradox.