ANZCTR search results

This study aims to test faecal transplant as a potential new therapy for active ulcerative colitis. Patients with ulcerative colitis have a restricted diversity of bacteria in the bowel and faecal transplant aims to replenish the diversiy of the bowel bacteria. Faecal transplant involves the delivery of stool from a faecal donor into the bowel of a patient with the aim of improving symptoms and reducing mucosal inflammation.

Adolescence is a high-risk time for the development of mental health and substance use problems. Evidence shows that young people who experience these issues typically turn to their peers for support rather than seeking professional help. While there are numerous programs that endeavour to improve student knowledge about mental health and substance use, there are few programs that provide students with the practical skills required to encourage their friends to seek help. MAKINGtheLINK is a school based education program that equips young people with correct information and the opportunity to practice assisting a friend at risk. The program teaches students practical skills regarding: signs of problematic substance use and emotional issues, what to say to a friend that you are concerned about to encourage them to seek help, the types of helpers that exists and how to access them. By comparing the knowledge and behaviours of Victorian year 9 students who receive the program with those that do not receive the program, we will be able to measure whether there are improved rates of help seeking and confidence to assist a friend to seek help amongst the group that receive the program.

The project will focus on older adults living independently in the community, and who are on the cusp of Functional Declune (FD). We will conduct a nested RCT within a 13 month longitudinal observational study. In the observational study we will apply a simple, previously untested quality of life screen to detect incipient Functional Decline, one month following an Emergency Dept presentation that did not result in an inpatient admission. Those individuals with low scores at the point of screening will enter the RCT, which will test the effectiveness of a novel, early, home-based, personalised program (compared with ‘usual care’) in arresting or slowing Functional Decline.

Poor core stability is associated with dysfunction and weakness of muscles of the trunk, pelvis and hip (core muscles) and the development of lower limb pathology and low back pain. Core strengthening programs aim to prevent injury and increase stability through improved strength and co-ordination of core muscle activity (Faries & Greenwood, 2007). However, the delivery method of training programs is highly variable and despite widespread use, the evidence for injury treatment and prevention with core strengthening programs is inconclusive. This may be due to the heterogeneity of delivery methods of programs used as the intervention. Investigation of the most effective delivery method of core strengthening programs is required to enable accurate evaluation of efficacy core strengthening interventions. The aim of this project is to compare the effect of supervised core strengthening classes, a home-based core strengthening program and no intervention on specific measures of core stability. It is hypothesised that supervised classes will 1) result in a greater improvement in performance in tests assessing core strength, and 2) increased transversus abdominus (TrA) hypertrophy when compared to a home-based program and no intervention.

Previous studies have shown mixed results on the ability of dietary interventions to improve iron status in women with iron deficiency. Given the popularity of email and mobile phones, communicating through email and text messages may be a promising means to encourage iron-friendly eating habits throughout the day. The aim of this study is to investigate whether email and text messages can improve knowledge, iron intake, and iron stores in women with low iron stores.

The Australian population is ageing, with a disproportionately large burden of disease incurred in older people. Retirement, as a major life transition, may offer an important opportunity for intervening on health behaviours. The primary aim of the Life After Work study is to comprehensively measure changes in activity patterns, health and well-being across the retirement transition, using a use-of-time approach, with the view to inform further health behaviour interventions for this population. A target sample of 120 participants aged 50 years and over who are about to retire will be recruited in two major Australian cities, Adelaide and Brisbane. Participants will undertake a battery of assessments approximately 3 months prior to retirement, and 3, 6 and 12 months post-retirement. Assessments will include self-reported use of time (using the Multimedia Activity Recall for Children and Adults), objective physical activity and sedentary behaviour (using Actigraph GT3X+ accelerometers), self-reported health status and well-being (using a battery of surveys, including the Short-Form Health Survey (SF-36) , the Australian Unity Personal Well-being Index (AUPWI), the Depression Anxiety Stress Scales, the Short Warwick-Edinburgh Mental Well-being Scale, the UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale), retirement circumstances and socio-demographic items, objective anthropometric measures (height, weight and waist circumference), and resting blood pressure. The results will allow a robust examination of the changes in use of time, health and well-being across retirement. The results will provide important new information that will inform the development of lifestyle and policy interventions to address and improve health and well-being in retirement.

Falls and fracture rates are highest in elderly in low-level aged-care than those in nursing homes or in the community, so this is the highest risk group and most likely to benefit from interventions. Drugs cannot be given to large numbers of people so non-drug approaches are needed to reduce the burden of fractures, but must be effective, safe, easily administered, readily available and low cost. Low protein and calcium intakes increase falls and fracture risk because muscles weaken, balance worsens and bone breaks down more quickly making them more susceptible to fractures. On average low-level aged-care residents consume two or less serves of dairy foods per day with more than 75% of residents below the recommended intakes levels for protein and calcium. Dairy foods are a good source of protein and calcium, and fulfill the requirements of safe, accessible, easy to administer and low cost. We aim to determine if two additional serves of dairy food per day will corrected these deficiencies and reduce the rate of falls and fractures in low-level aged-care residents by maintaining muscle mass and function and slowing bone loss. We will study this over 2 years by ensuring that residents consume 4 serves of dairy foods per day. Food service staff with be trained and supported to modify the menus to improve dairy food intake. We will recruit 3000 residents in 60 aged care facilities; 30 facilities will be randomized to intervention and 30 serving as controls. Residents will be transported under supervision to the Heidelberg Repatriation Hospital for bone, balance and body composition measures. Fractures will be monitored in residents from incident reports and verified using hospital medical records. Bone turnover will be measured using serum bone metabolic markers, bone structure measured using high resolution peripheral quantitative computed tomography (HR-pQCT) and bone density and body composition measured using densitometry (DXA). Strength and physical function and questionnaires will be assessed at facilities. All tests are performed before the intervention begins, bloods and strength re-assessed at 3 months and bone structure, density and body composition measured again at 12 months. This study will be the first to assess the anti-fracture efficacy of dairy foods, and the mechanisms and structural basis for this reduction in fracture risk. If anti-fracture efficacy is demonstrated it will provide evidence for a safe, low cost, widely available approach to reduce the burden of fractures in the community.

Alcohol Use Disorder’s (AUD’s) are a growing burden on Australia’s health care system due to associated cardiovascular and gastrointestinal disease, cognitive deficits, insomnia, suicide and other drug abuse, and have illustrated significant co-morbidity with anxiety. Additionally, anxiety is a strong motive for self-medication with further alcohol use, especially during initial detoxification. A major obstacle in AUD treatment is the significant delay in access to treatment, and motivating patients to continue treatment throughout alcohol detoxification and its associated anxiety. The effectiveness of a self directed cognitive behavioural therapy booklet allowing immediate access to treatment to manage anxiety during AUD treatment will be tested in the current study.

Background Patent foramen ovale (PFO) is a communication or “hole” between 2 chambers of the heart – the right and left atria. A PFO is present in approximately 25% of the population. PFOs can cause strokes, decompression illness in divers, and migraine headaches. Doctors sometimes recommend that a PFO should be closed if these problems occur. The usual technique for closing a PFO is to implant a metal and fabric “plug” known as a “closure device” to seal or plug the PFO. In general this is a safe and effective technique (with a success rate > 95%) but there are some risks and disadvantages with the use of the closure device. Some of the disadvantages and risks include leaving a foreign object in the body forever, a risk of the device eroding into surrounding tissue occurring in about 1 in 1000 cases (e.g. into a blood vessel or heart valve), a risk of the device dislodging in about 1-3 in 100 cases (which may require urgent open heart surgery), risk of the heart beating very slowly in 1-5 in 100 cases (which may require a pacemaker), risk of clot forming around the closure device in 1-2 in 100 cases (which may lead to stroke), and risk of infection. In addition, the closure device prevents subsequent trans-septal puncture which might be required for treatment of arrhythmias or mitral valve disease should these develop in later life. We aim to test new technique to close PFOs. This technique aims to close the PFO without the use of a closure device, and may be safer and cheaper. The technique involves the use of electrical current to “glue” the edges of the PFO together. Recent studies report that this new technique is safe and has success rates of up to ~90% of cases in carefully selected patients with PFO tunnel diameter < 4mm (Sievert et al. Circulation 2007; Walpoth et al. Swiss Med Wkly 2008; Sievert et al. Cath Cardiovasc Interv 2009; Di Biase et al. ACC 2010 Abstract). The total number of patients recruited from these 4 studies totalled 200, with only 2 patients suffering from significant blood loss (and only 1 requiring blood transfusion) as a result of this new technique. There were no other serious adverse complications such as stroke or heart perforation reported. The mean procedure time reported in these studies was between 30-50 mins, which is comparable to PFO closure using the standard technique. 3 of these studies (involving 190 patients in total) used a proprietary radiofrequency ablation catheter with vacuum suction, and 1 study (involving 10 patients) used a standard radiofrequency ablation catheter. In addition, because of similar procedure times, the radiation exposure is not anticipated to be higher as a result of the research study. In fact, we anticipate that the calculated X-ray exposure is likely to be less than the current technique for PFO closure. Aim We aim to test this new technique for closing the PFO without the use of a closure device. Potential Significance This new technique may be safer than PFO closure using the closure device. In addition, it will also be considerably cheaper (approximately $2500-$3000 vs $7500-$9000).

Diabetes is common after renal transplant and gliclazide is often used as a first line treatment. The objective of the trial is to show that Vildagliptin can be safely used to control hyperglycaemia, with less hypoglycaemic episodes than its comparator of Gliclazide. 48 participants will be randomly allocated to either the intervention arm of oral tablets of 50mg once daily or twice daily of vildalgliptin or to the comparator arm of oral tablet 60mg Gliclazide modified release once daily. The patients will be followed for 16 weeks to assess for hypoglyacaemic episodes and safety.