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The sub-chronic effects of coffee on cognitive function in a healthy older population
Expand descriptionThis study is being conducted to see the sub-chronic effects of various coffee beverages on cognition, cardiovascular function and mood in healthy older adults. The study will compare the effect of different types of instant coffee beverages. Participants will consume one of four types of coffee beverages daily for 3 months. We will measure performance on different cognitive tasks, mood and cardiovascular measures before the consumption of the coffee beverage (baseline), 1-month after consumption of the coffee beverage and 3-months after consumption of the coffee beverage.
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A Group-based Cognitive-Behavioural intervention to treat sleep disorders that negatively impact mood, daily functioning and externalising behaviour in adolescents.
Expand descriptionSleep problems are common during adolescence and have a significant impact on the daily functioning and future potential of young people. This project evaluates the effectiveness of Cognitive-Behavioural Treatment (CBT) for sleep disorders in high-school aged young persons. Young people will take part in a randomised controlled trial in which they will be randomly allocated to complete a 7-week group-based Cognitive-Behavioural program for sleep or a 7-week waitlist control condition. Participants allocated to the waitlist condition will be asked to wait 7 weeks and be assessed again prior to beginning treatment. The effect of treatment will be measured on young persons’ sleep, mood, daily functioning, externalising behaviour and quality of life immediately after completing treatment and 3 months later. Hypotheses: We expect that compared with the no-treatment waitlist group, young people that complete CBT will show: 1) Improved sleep/wake behaviour, including less time to fall asleep, longer total sleep duration, fewer night-time awakenings, and more consolidated sleep. 2) Improved daytime functioning including less reported daytime sleepiness and fatigue. 3) Improved anxiety and depression symptomatology. 4) Improved quality of life. 5) Reduced externalising difficulties on questionnaire measures of disruptive, aggressive and delinquent behaviours. It is expected that treatment gains will be maintained at 3 month follow up.
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A prospective randomized control trial comparing a non adherent dry dressing with a silver foam dressing in the management of Kirscher wire (K-wire) pin sites in the closed fractures of the hand.
Expand descriptionThis study looks at two types of surgical wound dressing used after fixing fractures of the hand with a pin called a K-wire and whether there is a difference in infection rates and the ease of , and pain associated with, application and removal. When a person fractures a bone they may have a closed fracture or an open or compound fracture. A closed fracture is when the broken bone does not penetrate the skin. In this study, we are only looking at patients with closed fractures. In addition, for inclusion in this study, the fracture must be of the hand higher (distal) than the wrist crease. The Kirscher Wire Pin (commonly known as a K-wire) is a sharpened, sterilised metal pin that is used to hold the fractured bone fragments together. After insertion of the K-wire, the wound is dressed and then assessed on a weekly basis for infection. Infection is common (about 10% of cases) because the insertion of the wire through the skin into the bone creates a passage for bacteria. The area around the wire may become red and swollen and there may be a discharge. Antibiotics may have to be prescribed and sometimes the pin needs to be removed prematurely. Current practice involves dressing the wound in Melolin – a dry non-adherent sterile dressing and Mefix – a surgical tape. In this study we would like to compare this dressing with a new anti-microbial barrier dressing which contain nanocrystalline silver. This type of silver has long been known for its antimicrobial properties. The patients would be consented prior to surgery and then randomly allocated one of the two wound dressings. For both arms of the study, the patients will be followed up and assessed in exactly the same manner. If a patient does not wish to participate in the trial the wound will be dressed in the dry dressing as is current practice.
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Improving the care for people with acute low-back pain by allied health professionals: a cluster randomised controlled trial
Expand descriptionLittle is known about ways to promote informed and effective treatment by providers other than medical practitioners. Expanding evidence demonstrates that interventions to change practice should be targeted at specific clinical behaviours and underpinned by appropriate behavioural theory. Existing research into behavioural change in medical practitioners may not be generalisable to other professionals. Acute low back pain (LBP) is common and chiropractors and physiotherapists provide most care for the condition in Australia. The NHMRC clinical practice guidelines (CPGs) for acute LBP provides recommendations with potential to improve quality of care and safety for people with LBP. Relevant CPG recommendations are that x-rays are rarely needed and that patients should be advised to remain active. We are currently investigating the effectiveness of a targeted, theory-based implementation strategy to implement CPGs in general practice (NHMRC project grant 334060). Whether implementation strategies are transferable between professional groups is not known. This project allows us to build on our completed work to date, incorporating qualitative interviews and surveys of physiotherapists and chiropractors to explore barriers and enablers to CPG uptake (NHMRC project grant 436767) in order to develop a targeted implementation strategy for use in physiotherapy and chiropractic clinics. A cluster randomised controlled trial will then be conducted to determine the effects of the strategy. Practices (n=136) will be randomised to receive either the developed implementation strategy, including strategies targeted at clinicians and patients, or to a control group receiving access to the CPG alone. We plan to recruit 2720 patients from the 136 practices. The outcomes of the implementation strategy will be assessed at the level of the practitioner (did the strategy result in a change of practice?) and the patient (did the practice change result in improved patient outcomes?). Subgroup analyses will investigate effects specific to chiropractors and physiotherapists.
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An investigation into the effect of Physiotherapy services in Emergency Departments on patient wait, and treatment times.
Expand descriptionto determine appropriate patients that can be managed by ohysiotherapists in the emergency department and assess the effect on patient waiting times to be treated and have treatment completed when presenting to the emergency department with musculoskeletal or mobility related issue.
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The Exelon Patch (Transdermal Rivastigmine) for the treatment of severe delirium in elderly subacute care inpatients
Expand descriptionAcetylcholine levels are decreased in delirium, a condition of a sudden change in mental capacity occurring due to a illness, medication or similar insult. Rivastigmine is a medication for Alzhiemer's Disease, another condition where there is a change in mental capacity and low levels of acetylcholine. It increases levels of acetylcholine in the brain. THis trial aims to determine if a rivastigmine patch given to elderly patients in hospital after their illness has resolved but who still have delirium will have a less severe delirium.
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Prospective randomised clinical trial assessing the subsidence and rotation of two modular cementless femoral stems
Expand descriptionThis research project sought to assess the migration patterns and rotational stability of two modular cementless femoral stems (K2 and Apex, Global Orthopaedic technology) used routinely for hip replacement surgery.
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A randomised, double-blind, comparator study to assess the safety & tolerability of a single injection into the knee joint of MSB-CAR001 when combined with Hyaluronan compared to Hyaluronan alone in patients who have recently undergone an Anterior Cruciate Ligament Reconstruction.
Expand descriptionThis study is primarily designed to assess the safety of two different doses of allogeneic Mesenchymal Precursor Cells (MPCs) combined with Hyaluronan when injected into the knee joint following Anterior Cruciate Ligament reconstruction. Long term safety, tolerability and efficacy of a single injection of two different doses of allogeneic MPCs + Hyaluronan compared to Hyaluronan alone will be assessed at 6, 12 and 24 months following MPC injection. This study aims to provide prelimanary data to support dose selection for future studies.
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Efficacy and safety of a new fish oil based lipid emulsion (SMOFlipid) compared with olive oil based lipid emulsion (Clinoleic) in pre term (<30 weeks) neonates – a randomised controlled trial
Expand descriptionFat emulsions are an essential part of parenteral nutrition (PN) combining a high energy load with an essential fatty acid (EFA) intake.The primary purpose of this study is to test the safety and efficacy of new fish oil based intravenous fat emulsion (SMOFlipid) as compared to traditional olive oil based intravenous fat emulsion (Clinoleic). This study will specifically look at plasma and red cell fatty acid levels particularly Docosahexaenoic acid (DHA) which plays an important role in development and vision of newborn babies and also oxidative strss levels (F2-isoprostanes) before and after the intervention in a randomised controlled trial.
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Outcome evaluation of the Nepean and Blue Mountains Diabetes Integration Program and the Sessions for Health and Physical Exercise Program
Expand descriptionThis is a before and after evaluation of the impact of group exercise and diet therapy for people with type 2 diabetes. Participants will be assessed at the start of eight one-hour sessions, after the final session, and again three months later. At each time point they will report their exercise and diet activity, and their health status. Their weight, waist circumference and knowledge will also be assessed