ANZCTR search results

Background: Poorly controlled asthma during pregnancy may harm both the baby and the mother, causing an increased risk of pre-eclampsia, prematurity, low birth weight and perinatal mortality . More than half of pregnant women do not take their preventer medications on a regular basis before and during pregnancy leading to asthma exacerbations. Evidence shows that better asthma control will be achieved if patients are involved in self-management, including regular self-monitoring of symptoms and/or lung function. This study will examine the potential for enhanced telehealth support for asthma in pregnancy. Telehealth may provide an attractive alternative to standard medical care for pregnant women with asthma. As well as providing accessibility and flexibility for patients, other potential benefits include reduced time to access healthcare services, reduced travel costs, earlier detection of worsening asthma such as exacerbations and reduced healthcare visits/hospitalisations. However, there are only a few well conducted studies in Australia providing evidence on the applications of telehealth for any condition. Aims: To develop a telehealth program for asthma management and to trial its effectiveness in pregnant women with asthma. We hypothesise that telehealth for supporting management of asthma during pregnancy will result in better asthma control, better quality of life, better maternal and better neonatal outcomes compared to the usual care Methods: A mobile phone application (Breathe-easy [copyright]) will be developed to facilitate communication between patients and their health professionals. Patient lung function data (measured using the COPD-6[copyright] device) will be transmitted daily via a mobile phone to a central server. Patients will receive automatic feedback on their mobile phones according to an individualised algorithm. The GP/Obstetrician will be notified when an unscheduled visit and/or change in medication is needed.

The aim of this study is to investigate whether Mindfulness-based stress reduction (MBSR) can be used as an effective treatment option for people with restless legs syndrome (RLS). Specifically, the aim is to evaluate the effectiveness of the six-week MBSR group program in enhancing measures of RLS-specific quality of life, general health, sleep, RLS-specific symptom severity, depression and anxiety symptoms, and mindfulness skills. It is hypothesised that there will be a significant improvement in subjective measures of RLS symptom severity, RLS-related quality of life, general health, symptoms of psychopathology, including anxiety and depression, and subjective and objective measures of sleep, directly following the MBSR program and at three months post-intervention.

Despite higher levels of activity being associated with better stroke recovery, stroke patients on most rehabilitation units spend the majority of their day inactive and alone. In animal models, Environmental Enrichment (EE) involves organisation of the environment and provision of equipment to facilitate physical, cognitive and social activity. EE promotes rewiring of the brain after stroke and has been found to significantly enhance functional recovery. Preliminary work on the use of a human model of EE using individual (eg. iPods, & word puzzles) and communal (eg. access to interactive gaming, computer, books/newspapers & jigsaws) enrichment in a rehabilitation unit indicates it encourages stroke patients to be more active. Greater activity during rehabilitation has numerous benefits, the most important of which is achieving better functional recovery and subsequently, greater independence. Altering the Rehabilitation Environment to Improve Stroke Survivor Activity (AREISSA) is a Phase II Trial involving four rehabilitation units which seeks to determine the safety, efficacy, feasibility and patient and staff acceptability of this model of EE during stroke rehabilitation. We hypothisize that compared to stroke patients undergoing rehabilitation in non-enriched environments, patients recovering in EE will: (i) be more active at 10 days (+/- 2) post admission, and that the guidelines which accompany the EE will: (ii) be adhered to by staff, and (iii) not result in a significant increase in falls or other adverse events. Results from AREISSA will be used to inform future larger trials required to determine the effect of EE on stroke recovery and stroke survivor quality of life.

What is the study about? Anorexia nervosa is a serious mental illness that is associated with much distress and difficulties for those living with the illness. There is still a lot we do not know about how to effectively treat anorexia nervosa. A new clinical resource has been developed for those with anorexia nervosa and subclinical anorexia. This resource contains the stories of recovery of former sufferers of the illness who have now been successfully recovered for five or more years. Adults who are eighteen years or over with anorexia nervosa or subclinical anorexia (i.e., Body Mass Index (BMI) of less than 20) are invited to take part in a study that is investigating the effectiveness of this new resource. What does the study involve? This study involves firstly completing a brief questionnaire online to assess your eligibility for the study. If eligible, the study involves completing questionnaires online, which will ask you about your current eating habits, attitudes towards eating, shape, and weight, motivational issues, and your beliefs and attitudes about recovery. You will be asked to complete these questionnaires on either two or three occasions, two weeks apart. You will also be asked to read the resource, which contains five stories of recovery from anorexia. This will be emailed to your nominated email address. After reading the materials you are then invited to give feedback on the resource.

The incidence of type 1 diabetes has increased worldwide, particularly in younger children and those with lower genetic susceptibility. These observations are consistent with environmental effects that promote pancreatic islet autoimmunity and destruction of insulin-producing beta cells. The Environmental Determinants of Islet Autoimmunity (ENDIA) Study is investigating candidate environmental exposures and gene-environment interactions that may contribute to the development of islet autoimmunity and type 1 diabetes.

TEXTMEDS is a randomised controlled trial of 1400 patients with acute coronary syndrome (ACS) that will evaluate an innovative secondary prevention support program delivered via mobile phone text message. TEXTMEDS aims to improve medication adherence and control of cardiovascular risk factors in patients with ACS.

Infantile colic is estimated to affect 25% of infants and occurs equally in breast-fed and formula-fed infants. Infantile colic increases the risk of post-natal depression, shaken baby syndrome and the cessation of breastfeeding. Therapeutic approaches have included changing infant formulae or the diet of nursing mohters however scientific evidence to support advice is lacking. Infantile colic presents with similar symptoms to adults with IBS. The low FODMAP diet is the only dietary approach with a high level of evidence for efficacy in adults (75%-80%) and hence this study hypothesizes that a low FODMAP diet (short-chain CHO's) in the diet of breast-feeding mothers of infants with colic will reduce the no. & duration of crying episodes.

Metal ion release is common following total hip arthroplasty, yet postoperative levels have not been defined for most stems currently used in clinical practice. The Exeter stem is the most commonly used cemented stem in Australia. The aim of this study is to assess metal ion release in the serum of patients with well functioning unilateral Exeter V40 primary total hip arthroplasties one year after surgery.

Allied Health professionals working in rehabilitation frequently prescribe home exercise programs for clients to complete independently between therapy sessions. Written notes or pictures are commonly provided as reminders to clients when prescribing home exercises. These paper based programs are sometimes difficult to follow, and growing collections of paper over the course of a rehabilitation program can become confusing and overwhelming for patients. Many new forms of technology are becoming increasingly accessible to people within the community. Smart technology applications for smart phones and touch-screen tablets are being adopted in rehabilitation settings for such things as: cognitive rehabilitation; cognitive compensatory strategies (such as memory aids); assisting with communication (using picture boards, for example); and improving fine motor skills. However, these devices also provide easy access to other tools such as reminder functions and video recording that could be used to enhance rehabilitation programs. This project aims to explore the feasibility and effectiveness of using the video and reminder functions on touch-screen tablets as a support to prescribed home exercise programs for patients with upper limb deficits following stroke. Specifically, we aim to determine whether patients receiving rehabilitation after stroke using this technology demonstrate greater adherence to prescribed home exercise programs and better functional outcomes when compared to traditional paper based exercise prescription.

This project is a prospective observational study, which aims to investigate the use of intraoperative iron infusion, initiated by anaesthetists, during surgical procedures at Fremantle Hospital over a three month period. The use of intraoperative iron transfusions is highly variable among anaesthetists, and the study aims to investigate the logistical and other practical reasons for this. It will identify the indications for intra-operative iron transfusion and note any adverse effects in the perioperative period. A secondary aim is to investigate postoperative haemoglobin values and need for transfusion postoperatively in patients who have received an intraoperative iron transfusion. Iron infusions have been shown to be a valuable therapy for anaemia, and this study investigates the effectiveness, safety and efficiency of providing that therapy intraoperatively.