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A randomised controlled trial of the Practitioner Asthma Communication and Education (PACE) Australia Program
Expand descriptionThe Practitioner Asthma Communication and Education (PACE) Australia study is a collaborative project of the University of Sydney, The Woolcock Institute of Medical Research, The Royal Children’s Hospital, Melbourne and the University of Michigan, funded by the Australian Government Department of Health and Ageing. The aim of the study was to assess the impact of an evidence–based paediatric asthma program for GPs on GP practice and family health outcomes. We recruited a total of 150 GPs and 221 patients from western and central Sydney. We performed a randomised controlled trial with intervention GPs randomly allocated to receive the PACE workshops. Comparison GPs did not receive the PACE workshops until the end of the study. The PACE workshops comprised two 3-hour interactive sessions led by asthma experts. These sessions focussed on best practice approaches to paediatric asthma management and communication strategies with parents. Outcome measures for both GPs and patients were determined at baseline and 12 months. Following the PACE Australia workshops: 1. GPs reported increased use of the recommended communication strategies with their patients; increased use of the Asthma Cycle of Care item numbers and more frequent provision of written asthma action plans. 2. Families of intervention GPs reported increased receipt of asthma action plans and spacer devices, as well as more appropriate medication use. The program resulted in significant improvements in the way in which GPs manage asthma consultations, particularly with regard to doctor-patient communication and adherence to asthma management guidelines with a resultant improvement in key patient outcomes. The PACE Australia workshops were highly rated by all participating GPs. Here’s what some GPs said: “Improved my communication with patients and my knowledge and use of asthma devices.” “I have been able to provide more useful education to the patients by using the models provided at the workshop.” “I have been more interactive with parents & child, involving child more in treatment planning.”
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IBCSG 21-99 - Menstrual Cycle and Surgical Treatment of Breast Cancer
Expand descriptionThe purpose of this study is to evaluate whether the timing of breast cancer surgery during a woman’s menstrual cycle affects her ultimate outcome- the likelihood of recurrence of breast cancer or death from breast cancer. This study involves taking a small sample of blood from the woman close to her surgery to evaluate her menstrual phase on the basis of hormones in her blood. The woman will then go on to have whichever treatments for her breast cancer that she decides with her doctor. The woman will be observed for at least 5 years and information regarding her treatment and disease progression will be submitted.
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A phase III international randomized trial of single versus multiple fractions for re-irradiation of painful bone metastases
Expand descriptionRadiotherapy is an effective treatment for people with cancer that has spread to their bones and is causing problems. Sometimes, a second course of radiation is required. This international randomised trial will determine if it is better for a second course of radiation to be done as one large treatment, or as several smaller treatments.
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Immediate or delayed radiotherapy after surgery for melanoma involving lymph nodes
Expand descriptionSurgery is the standard treatment for melanoma that has spread to nearby lymph glands, but it sometimes recurs despite surgery. Radiotherapy given soon after surgery may redue the risk of the melanoma coming back, but mat also cause side effects. This national randomised trial will determine the benefits and side effects of adding radiotherpay after surgery.
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In extremely low birth weight (ELBW) infants who require positive pressure at birth does the Neopuff Infant Resuscitator compared with the Laerdal Infant Bag improve oxygen saturation measurements in the first ten minutes of life?
Expand descriptionWhile positive end expiratory pressure (PEEP) is always used during intermittent positive pressure ventilation (IPPV), there are no current recommendations about the use of PEEP or continuous positive airway pressure (CPAP) during neonatal resusciation. The Neopuff is a manual ventilation device which delivers PEEP or CPAP. The Laerdal bag is the commonest manual ventilation device in use worldwide and does not deliver PEEP. Our hypothesis is that the delivery of PEEP or CPAP to very premature infants at birth may lead to a more rapid improvement in lung volume and therefore oxygenation.
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Can a coping training intervention (CanCOPE) that includes the support person improve psychological adjustment and immune function in women with breast cancer?
Expand descriptionA key goal in our research is to develop an empirically validated, cost effective psycho-educational coping program to improve pyshcoloigcal and physical adjustment for women with breast cancer and their nominate support persons.
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Effects of lifestyle modification and active risk factor intervention on myocardial and vascular structure and reactivity in diabetes mellitus
Expand descriptionPatients with type 2 diabetes are at risk of developing cardiovascular disease. Lifestyle changes and an exercise program may reduce damage to the structure and function of blood vessels and improve heart function. In this trial, subjects with type 2 diabetes will be randomly assigned to one of two groups – “Usual care” (ie standard treatment of diabetes according to guidelines) or “Active intervention” (additional measures such as frequent follow-up, additional dietary advice and an exercise program, in addition to usual care). The efficacy of these interventions on cardiovascular structure and function, exercise capacity, attainment of target biochemistry and outcome will be assessed after 1 month, 1 year and 3 years
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The impact of perhexiline on regional and global cardiac function in patients with viable myocardium
Expand descriptionNot all of the heart muscle involved in a heart attack is irreversibly damaged. Although bypass operations may lead to improvement in the function of this tissue, the procedure is risky for very many patients who are elderly or sick from other conditions. A number of pieces of evidence suggest that this damaged but viable tissue can be improved by drugs that optimize the use of oxygen in the muscle cells. We will study patients with damaged heart muscle, using one particular agent (perhexilene) that is produced in Australia. We anticipate that therapy will improve regional and global function of the heart, prevent enlargement and improve exercise capacity, and that these changes will correspond to the effects of the drug on cardiac metabolism. This study is based on particular strengths in measurement of regional and global function and use of cardiac magnetic resonance to improve our understanding of the effect of the amount of scarring.
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The acceptability, safety and tolerability of combined methadone-naloxone - Intra muscular (IM) challenge
Expand descriptionThe primary purpose of this study is to test whether intramuscualr methadone-naloxone in a 50:1 ratio precipitates withdrawal in opioid dependent individuals.
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The DAISI Project – Depression & Alcohol Integrated & Single-focused Interventions
Expand descriptionThe DAISI project is investigating treatments for comorbid depression and alcohol use disorders. Specifically, this project aims to directly compare the effectiveness of four approaches to psychological treatment with varying emphasis on depression and alcohol use. Four programs of Cognitive Behaviour Therapy (CBT) and motivational interviewing will be delivered, and outcomes compared over a 3-year period: (i) 10-sessions of CBT that targets depression only (CBT-Dep); (ii) 10-sessions of CBT that targets alcohol use only (CBT-Alc); (iii) 10-sessions of CBT that targets depression and alcohol use concurrently (CBT-Int); and (iv) Brief intervention that targets depression and alcohol use concurrently (BI - control). It is hypothesised that this research will result in the development of an effective treatment program for people with comorbid alcohol and depressive disorders. We further hypothesise that the integrated CBT (CBT-Int) will produce greater, more sustainable reductions in both depressive and alcohol use outcomes relative to the other treatment conditions at the post-treatment follow-up assessments. The knowledge obtained through this research would assist counsellors in the field of alcohol and other drug treatment and mental health professionals to choose the most appropriate treatment for their clients who present with this comorbidity.