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Healthy lifestyle intervention for cardiovascular disease risk reduction among smokers with psychotic disorders
Expand descriptionThis study will be a multi-site randomised control (RCT) of treatment to enhance healthy living among people with psychotic disorders, specifically targeting smoking, diet and physical activity. These issues are highly prevalent, associated with premature death and reduced quality of life amongst this group. It is expected that the present study will result in the development if an effective treatment program for people with psychotic disorders who have a range of CVD risk factors. We further hypothesise that the Healthy Lifestyles intervention offered to participants in the study will produce greater, more sustainable improvements on CVD risk and smoking status relative to the controls at follow up. The results will better inform the treatment choices of clinicians and will potentially improve the match between treatment and client, improving the health and wellbeing of the group.
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Health-related quality of life in survivors of H1N1 (swine) influenza admitted to intensive care
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Improving communication about treatment options for asymptomatic ovarian cancer patients with rising cancer antigen 125 (CA-125): A randomised controlled trial of a Decision Aid
Expand descriptionThe purpose of this study is to investigate the efficacy of a decision aid (DA) for women with asymptomatic ovarian cancer and rising CA-125 levels after successful first-line treatment. Participants will be randomised to receive either the DA or a control booklet called "Understanding Ovarian Cancer”. All participants will complete an initial questionnaire when they first make their treatment decision, and a follow-up questionnaire 4 months later. It is anticipated that the DA will improve understanding of the treatment options, reduce decisional conflict, increase satisfaction with decision-making, and not increase anxiety, compared to the control booklet.
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Dose Adjustment with Food Insulin Index: the DAFII study, comparing carbohydrate counting versus DAFII algorithm for estimating insulin dosage on measures of glycemic control in adults with type 1 diabetes consuming two different breakfast meals
Expand descriptionIn this within-subject crossover study in individuals with type 1 diabetes, we will compare two methods of adjusting the dose of insulin to match the nutrients in a meal. One method, known as carbohydrate counting, uses an algorithm (= formula) that matches the dose of insulin to the carbohydrate content of the meal. The second method uses a novel algorithm based on the food’s normal insulin response in healthy subjects (the Food Insulin Index or FII). Participants who are experienced users of insulin pumps will consume three breakfast meals and apply different insulin to food algorithms on 3 consecutive test days. Their blood glucose levels will be monitored using a continuous glucose monitoring system (CGMS) and finger-prick blood testings with a blood monitor over the next 3 hours. We hypothesize that using the novel FII to adjust mealtime insulin dose will improve blood glucose readings (ie reduce hyperglycaemia) without increasing the risk of hypoglycaemia, compared with carbohydrate counting.
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Health care communication in general and specialist practice
Expand descriptionThe aim of this study is to evaluate the effect of consumers asking targeted questions to prompt evidence-based, shared decision making on the frequency and nature of evidence-based, shared decision making behaviours. Asking these three questions improved information given by family physicians and increased physician facilitation of patient involvement. Practice implications. These questions can drive evidence-based practice, strengthen patient–physician communication, and improve safety and quality. Heather L. Shepherd, Alexandra Barratt, Lyndal J. Trevena et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial Patient Education and Counseling, 2011 84(3) 379-385
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Online cognitive behaviour therapy for the prevention of postnatal depression in at-risk mothers: a randomised controlled trial
Expand descriptionThe current project is a randomised controlled trial of online cognitive behaviour therapy (MoodGYM) to prevent postnatal depression in at-risk women. To date, there have not been broad scale, cost-effective prevention programs for postnatal depression that have been effective. While the MoodGYM is effective in the wider community, it has never been used in a postnatal population. Although women will need an internet connection to access MoodGYM, major barriers, such as childcare, lack of time, stigma and low clinician availability are all overcome with this intervention. The prevention of postnatal depression in a way that is acceptable to mothers could have the potential to reduce the burden of the most common complication of the perinatal period. Prevention of this illness will result in better outcomes, not just for mothers, but for their infants and families as well.
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A prospective, observational case series to assess the clinical utility of improved methods of functional hip navigation for total hip replacement
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The effect of chitosan spray on bleeding and wound healing following tear duct surgery.
Expand descriptionThis study is been carried out to investigate the effect of a new drug (Chitosan) on bleeding and wound healing following tear duct surgery that is performed through the nose (endoscopic dacryocystorhinostomy-endoDCR). If this new drug reduces scarring, it may have an effect on the successful outcome of the tear duct surgery (endoDCR). You have presented to the clinic because you have been troubled by a watering eye. The doctor has diagnosed that you have a blockage of your tear duct, which is the passage that links the eyelids to the inside of the nose and allows your tears to drain. The doctor will examine the inside of your nose and providing that there is adequate space, may offer to perform the surgery through the nose. This surgery is called an endonasal dacryocystorhinostomy (endoDCR). If there is not adequate space in the nose, then an external dacryocystorhinostomy (extDCR) may be offered to you. The dacryocystorhinostomy (DCR) operation attempts to create a new route for the drainage of tears between the tear sac and the lining of the nose. The operation can be performed either externally by cutting into the skin on the side of the nose or through the nose as in endonasal DCR. Failure in DCR surgery often results when scarring occurs at the new junction between the tear sac and the nose lining, which can then close over. There have been different steps taken during the operation to reduce this scarring, but it still occurs. A major bleed following this type of surgery can occur in about 2% of patients and is similar to both approaches. This study is looking at the effect of a drug called Chitosan on bleeding and wound healing. This drug is made of 2 components called dextran and chitosan. We will randomly assign patients to receiving either Chitosan or nothing at the end of their endonasal DCR surgery. The Chitosan comes in the form of a spray, which is squirted once over the site of the operation inside the nose. This does not need to be repeated. At each visit you will be examined as part of the routine post-operative care. The inside of the nose will be examined using a nasal endoscope and assessed for evidence of scarring. The clinic visits will be at 1 week, 4 weeks and 3 months following the surgery. There are no additional clinic dates for you as a result of this study.
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A comparison of fentanyl with pethidine for pain relief during childbirth.
Expand descriptionPethidine is currently the most widely used narcotic administered systemically for the relief of labour pain, but has been shown to have numerous side effects on both mother and neonate. An alternative narcotic, fentanyl when administered intravenously (IV) has been shown to have fewer side effects and a shorter duration of action than does pethidine. There is a lack of research relating to the use of fentanyl administered during labour via alternative routes. Alternative routes have the benefit of being less invasive, requires fewer resources and provides more autonomy to the midwife providing care. This has particular benefits for rural and remote birthing communities. This study will examine the safety and efficacy of fentanyl administered by intranasal (IN) or subcutaneous (s.c) routes for pain relief during childbirth for both mother and neonate. It also will investigate possible maternal and neonatal side effects. Outcomes will be compared with intramuscular (IM) pethidine.
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The effect of iodine supplementation on cognition in school-aged children
Expand descriptionThe study aims to examine the effect of iodine supplementation on cognition in mildly iodine-deficient school-aged children The research hypothesis is that the cognitive test scores of children taking a daily iodine supplement will improve relative to baseline performance and compared to children taking a daily placebo over the 28-week trial period