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Breakfast Intervention Study
Expand descriptionThis study aims to evaluate the effects of two food bar formulations. One of the bars is wheat bran based, and the other sesame seed based. Both formulations are high in fibre and unsaturated fats, which have been shown in previous studies to reduce heart disease risk factors such as blood cholesterol. This study is designed to assess if different dietary sources of fibre and unsaturated fats will have similar or different benefit in reducing heart disease risk factors. The study will be single-blinded with the study co-ordinator blinded to the sequence of treatment the volunteers underwent. However because of a noticeble taste difference between the two bar formulations, the volunteers will be aware of their treatment.
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Heparin in Severe Sepsis
Expand descriptionIn Australia and New Zealand, around 5000 patients are admitted to Intensive Care Units (ICU) annually with severe infection (sepsis). Despite aggressive treatment, around 35% of these patients will not survive, making severe sepsis the most common non-cardiac cause of death in ICU patients. Even surviving patients often suffer a period of multiple organ failure. Most patients admitted to ICU receive heparin injections to prevent the formation of blood clots in the leg veins which can travel to the lungs, causing major breathing difficulties. Traditionally, the agent most commonly given to prevent blood clots was unfractionated heparin, but over the last decade, more purified forms of heparin (low and ultra-low molecular weight heparins) have become available. These more modern agents are replacing the traditional heparin for blood clot prevention because of reported increased effectiveness. Recent studies in animals, healthy humans and critically ill patients with severe sepsis have suggested that unfractionated heparin may have beneficial therapeutic effects in infection, additional to its action to prevent blood clots. These immune-active effects are related to molecular size and thus may be lost with the current trend to use purified heparin forms. If this is true, then this additional benefit may be lost as we change to more purified heparin forms. We aim to perform a pilot study to assess the feasibility of conducting a large multi-centre study to investigate whether unfractionated heparin is beneficial for patients with severe sepsis. If unfractionated heparin is shown to be beneficial in these patients, this would be a simple, cheap and widely applicable additional treatment for severe infection that could save lives world-wide, and be accessible in first to third-world environments.
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Does Nebulised Lignocaine Reduce Children's Pain When a Nasogastric Tube is Inserted?
Expand descriptionNasogastric tubes are often used in children to give them fluids or medications or to drain their stomach. This involves the insertion of a narrow tube into their nostril and then down into their stomach. We know that this is a very safe and effective way of managing a number of problems in children. However, we also know that this is a painful procedure and we are looking for a way to relieve this pain. Lignocaine is commonly used in children to provide local anaesthetic before painful procedures. It is given in many ways, as an injection, applied to the mouth as a gel and sprayed in the mouth and nose, but it has not been licensed for administration by a nebuliser. Administering a medication in this way means that it is given through a mask so that it can be breathed in. The use of lignocaine in the manner proposed in this study is experimental. However, lignocaine has been administered by a nebuliser to children having different procedures and shown to be safe. It has also been given to adults by nebuliser before the insertion of a nasogastric tube and was shown to make this less painful. We will be asking families for consent for their child to participate in this study to find out whether administering nebulised lignocaine before inserting a nasogastric tube reduces the pain that the child feels. We aim to include 52 children in this study. Half of the children (26) will get the study drug (nebulised lignocaine) while the other half will get a placebo (nebulised salt water).
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Is Dornase alfa (Pulmozyme ) effective if administered at night, in relation to airways clearance techniques? A multi centre, crossover, randomised controlled trial for people with cystic fibrosis.
Expand descriptionThe aim of this study was to investigate if a longer time interval between rhDNase nebulisation and chest physiotherapy improves clinical outcomes of subjects with CF. METHODS: A single-blind randomised cross-over trial was conducted on subjects with CF from outpatients of 4 hospitals. Subjects were in stable health and studied over 6-weeks (utilising 14-day blocks of morning or evening rhDNase administration with 14-days washout). Usual regimes for physiotherapy and exercise were unaltered. Thus changing the times altered the dwell time of rhDNase prior to physiotherapy. Long interval was defined as dwell time of >6-hours and short as <6-hours. Outcomes were measured at pre and post each regime.
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INTIAL STUDY - Indolent Non-Hodgkin's ImmunoradioTherapy Initiated Approach in Lymphoma
Expand descriptionThis study will evaluate the use of I-131 rituximab radioimmunotherapy, together with further doses of unlabelled rituximab immunotherapy, as treatment for advanced stage follicular and low-grade non-Hodgkins lymphoma. Such patients are currently recommended for treatment with systemic chemotherapy and unlabelled rituximab. Many patients are anxious to avoid the toxicity associated with systemic chemotherapy. We have previously demonstrated that I-131 rituximab (as used at Fremantle Hospital) has equivalent efficacy to the licensed agents (I-131 tositumomab and Y-90 ibritumomab) approved for use in the United States in patients with relapsed or refractory non-Hodgkins lymphoma. We expect, therefore, similar efficacy to these agents in patients with newly diagnosed lymphoma Previous North American research has shown that I-131 radioimmunotherapy can achieve response rates similar to those seen with chemotherapy in patients with newly diagnosed non-Hodgkins lymphoma. These investigators used I-131 tositumomab (Bexxar®), a similar product to I-131 rituximab, and achieved an overall response rate of 95%. 75% patients showed a complete remission and, of these, 70% remained in remission for 5 years or more. The 5-year progression-free survival was 60%.
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Randomised trial of dopamine vs dobutamine for treatment of low systemic blood flow in very preterm infants
Expand descriptionLow systemic blood flow in the early hours after birth is a common problem in very preterm babies. It is associated with a range of adverse outcomes. This trial aims to test the efficacy of the two commonly used inotropes in preterm babies. Inotropes are drugs that improve the pumping performance of the heart.
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Fit Bodies, Fine Minds: Physical activity and cognitive training for cognition in older adults
Expand descriptionA feasibility study to compare the relative benefits of a combined physical activity and cognitive training program, a physical activity-only training program, and no-treatment control, for improving cognitive functioning in older adults.
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Salbutamol delivered via Metered Dose Inhaler and Spacer versus Nebuliser to induce bronchodilatation during spirometry
Expand descriptionTesting for bronchodilator response (airway reversibility) is an essential part of spirometry. Traditionally respiratory laboratories use nebulised salbutamol to check such response. New data suggest that inhaled salbutamol via metered dose inhaler and spacer is at least as effective as nebulised salbutamol and may be associated with fewer side effects. Comparison between the two methods of inducing bronchodilatation in the laboratory has not been previously tested. We aim to compare the 2 methods of delivery for bronchodilator response. The patients will be monitored for any potential side effects during the study.
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Understanding the attentional bias of chronic pain patients
Expand descriptionThe objective of this study is to investigate the effectiveness of a new experimental computer task and whether this task will improve the effectiveness of cognitive-behavioural therapy (CBT) for managing chronic pain.
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Investigation of the effects of cues to action on participation in colorectal (CRC) screening - the role of implementation intentions
Expand descriptionThe aim of the study is to investigate the role of cues to actions in motivating participation in screening for colorecetal cancer (CRC) using the faecal occult blood test (FOBT). Specifically, the focus in this study is upon the effect of 'implementation intentions', a practical concept which attempts to move individuals from a generalised intention to undertake screening to the formulation of a plan which deliberately deals with the concrete details necessary for actually carrying out the screening behaviour. It is hypothesised that those who draw up a plan of how they will go about completing the FOBT are more likely to return a completed kit compared to those who do not draw up a plan. The project fits in with the broader aim of attempting to understand the factors that motivate people to participate in CRC screening, and serves as a fundamental basis for tailoring consumer information designed to increase participation in CRC screening technologies.