ANZCTR search results

Freezing of Gait (FOG) is a devastating symptom of Parkinson’s disease (PD), causing regular falls and nursing home placement. Unfortunately, clinical management of FOG is very challenging with no current treatment completely alleviating FOG. As such, this study sets out to reduce FOG by using a safe and non-invasive magnetic stimulation technique called intermitted Theta Burst Stimulation (iTBS) of the cerebellum, which is a structure known to be involved with Parkinsonian gait disorders. This potential treatment has the advantage of non-invasively accessing a promising target for one of the most debilitating symptoms of PD, without the surgical risks associated with invasive brain stimulation techniques like deep brain stimulation.

This study will compare the effect of robotic and open surgery for prostate cancer on functional and oncological outcomes Who is this study for? You may be eligible to join this study if you are aged 18 years or above, are undergoing prostatectomy for prostate cancer at RPA or Concord Hospitals and are clinically suitable for robotic prostatectomy. Study details Participants will either have robotic assisted laparascopic surgery or conventional open surgery as determined by the treating surgeon. All participants will undergo tests to determine urinary and erectile function, biopsies to determine oncological outcomes and questionnaires to assess quality of life. These assessments will be conducted pre-operatively, post-operatively and at certain follow-up timepoints up to 10 years.

Overview / Synopsis: Antenatal classes are a pivotal point of contact between expectant parents and health care providers. Information is provided on topics such as: care of the newborn; labour and active birth; birth intervention (medical and pain relief); and practical skills for labour such as managing contractions or learning how to be a support person for the mother. Effective communication can optimise the birth experience and the parent’s ability to be flexible in their choices should medical intervention be required. Recently, there has been increasing interest in the choice of words used in the clinical setting, particularly in the form of suggestions. Hypnotic phrasing, commonly known as suggestions, are communications that can lead to subconscious, non-volitional changes in perceptions, mood and behaviour (Perry, Samuelsson, Cyna 2015). Our hypothesis is to identify the way information is described and presented by antenatal educators to see if hypnotic phrasing and metaphor are utilised, as this may have implications for birth expectations and experiences of women and their support people.

Considerable evidence suggests that insulin sensitivity decreases throughout the day, due to circadian variations in glucose homeostasis. Impaired glucose tolerance is a risk factor for metabolic syndrome, Type 2 diabetes, and obesity. This has implications for those whose behavioural phases are inverted to the normal diurnal cycle, such as shift workers. Certain foods (such as those with a low glycaemic value or high protein) may help modify this response as they do not raise blood glucose levels as much as other foods. It is of interest therefore to determine if manipulations of the macronutrient composition of meals could lead to reduced glycaemia at night. The purpose of this study is to explore whether consuming a high protein / low carbohydrate meal would lower the postprandial glucose excursions observed at night compared to an isocaloric control meal in healthy subjects,

Mealtime insulin dosing for type 1 diabetes is a challenging area of practice. Current insulin dosing adjusts the insulin amount dependent on the carbohydrate content of the meal (carbohydrate counting [CC]). Meals high in protein, fat and protein and fat have all been shown to increase postprandial glycaemia. Novel insulin algorithms have been developed to account for the glycaemic effect of fat and protein: Food insulin index (FII) and Pankowska Equation (PE). Our study aimed to compare glycaemic outcomes for CC, FII and PE for a high protein and a high fat meal. Outcomes chosen included postprandial glucose excursions for 300 minutes following the test meal, postprandial blood glucose levels for 300 minutes following the test meal, percentage of time within target range (3.9-10mmol/L) and hypoglycaemic events.

Participants will be randomly allocated to either treatment or control conditions. All participants will be asked to complete a number of pre-treatment questionnaires. These questionnaires will measure stress, burnout, resilience, mood, and related factors. Those participants allocated to the treatment condition will then be provided with access to the online intervention. The intervention will consist of 6 online modules (each of approximately 30-45 minutes duration) that focus on stress management techniques, emotion monitoring and regulation techniques, and selfcare. Participants will have access to one module per week over a six week period. At the start of each module they will also be asked to answer a small number of questions relating to their mood and engagement with skills learnt in the previous module. Participants allocated to the control condition will not be given access to the intervention at commencement of the study. At the end of the six week intervention period, and again three months following the intervention, both control and intervention participants will be asked to complete a small number of questionnaires measuring the same constructs as at pre-intervention, with the addition of a small number of questions relating to satisfaction and experience with the program.

Anxiety and depression are common in the perinatal period (i.e. during pregnancy and the first year after childbirth). Postnatal depression and anxiety disorders affect around 15% of women, with up to 45% of cases beginning in pregnancy (e.g., Austin et al., 2010). Early evidence shows that iCBT is effective for reducing postnatal depression, anxiety, general distress and parental distress (Danaher et al., 2013; Pugh, Hadjistavropoulos, & Dirkse, in press). Tailored iCBT programs are needed to provide women in the perinatal period with practical coping skills to manage depression and anxiety symptoms, as well as deal with the unique difficulties they may face which can impact on depression and anxiety (e.g. complications during pregnancy and/or delivery, body image, difficulty breastfeeding, an unsettled baby, and unrealistic expectations about motherhood). The primary purpose of this pilot trial is to evaluate and gather feasibility of a newly developed internet-delivered cognitive behaviour therapy (iCBT) program, the Perinatal MUMentum Program. Postpartum Pilot will be conducted as a feasibility exercise to get feedback and evaluation on the efficacy and acceptability of an iCBT program tailored to maternal anxiety and depression experienced during the postpartum period, prior to commencing a larger randomised trial. The main hypothesis to be tested for Postpartum Pilot is as follows: 1. Internet cognitive behavioural therapy delivered during the postpartum period will significantly reduce symptoms of anxiety, depression, distress and disability. It is hoped that the findings of this trial will provide further information regarding the efficacy and acceptability of the Perinatal MUMentum Program- in reducing maternal anxiety and depression experienced during the perinatal period- before embarking on a larger RCT.

This study aims to evaluate the efficacy of fractional microablative carbon dioxide (CO2) laser for the treatment of vaginal atrophy in in post-menopausal women with breast cancer on aromatase inhibitors. Who is it for? You may be eligible to join this study if you are a post-menopausal female aged 18-75 years who has completed curative intent surgery and/or chemotherapy and/or radiotherapy for hormone-positive early-stage breast cancer. You will also need to be currently taking an aromatase-inhibitor for a minimum of 6 months and have reported symptoms of genitourinary syndrome of menopause (GSM) such as vaginal dryness or painful intercourse. Study details All participants in this study will receive three treatment sessions scheduled four weeks apart of fractional microablative CO2 intra-vaginal laser (MonaLisa Touch 'Trademark') MonaLisa Touch 'Trademark' is an adjustable probe inserted into the vagina that emits laser energy onto the surface of the vaginal wall to stimulate healthy tissue production and improve blood circulation. This process aims to restore the tissue to its form before you went through menopause and needed to take aromatase inhibitors. The procedure is performed by a gynaecologist (women’s health specialist) and takes approximately 10 mins. No medication or anaesthetic is required beforehand. To assess if fractional micro ablative CO2 laser is an effective in improving vaginal atrophy in women with breast cancer on aromatase inhibitors, a small tissue sampling (vaginal biopsy) under local anaesthetic and vaginal surface scraping (vaginal cytology) will be taken before and at 12-weeks after after completion of treatment for comparison. In addition, participants will be asked to complete questionnaires to assess severity of GSM symptoms and sexual functioning before and at 12-weeks after completion of treatment. Whilst fractional CO2 laser has demonstrated improvement in GSM symptoms in a general population of women, no current literature exists describing the impact of this intervention in a population of post-menopausal women with hormone-positive breast cancer on aromatase inhibitors. In this population, there are no effective long-term strategies to manage GSM.

Current evidence suggests exercise plays an important role in the management of blood glucose levels for individuals with T2DM. The frequency of consecutive exercise session over a two-week period on glucose regulation is not well understood and limited. Previous research have investigated either combined exercise or a single mode of exercise on glucose tolerance, However the comparison of 12 consecutive session of exercise remains limited, especially in a clinical population of type 2 diabetes. We seek to determine how effective treadmill exercise is in managing glucose tolerance since walking/running is freely accessible without the need to sign up to a gym. It is now understood that type 2 diabetes is associated with a chronic state of inflammation. Recent evidence have shown that exercise is beneficial in improving inflammation along with reducing insulin resistance. We aim to identify the influence of exercise on the level of inflammation and glucose tolerance following a two-week training period. Findings of this study may help inform future exercise prescription to improving health status in this population.

To investigate whether using Virtual Reality distraction (using a computer simulation of an environment) can reduce the pain and distress children aged 4 – 11 year olds experience during needle based procedures. In addition, will determine whether Virtual Reality has an impact on the amount of anxiety parents feel about what their children are experiencing, procedural time and number of needle attempts.