ANZCTR search results

Obesity prevalence is rising at an alarming rate, affecting more than 60% of the Australian population, with no trend of slowing down. Obesity is associated with increased risk of diabetes, hypertension, dyslipidaemia and coronary heart disease, all of which lead to increased hospitalization, morbidity and mortality. The obesity epidemic is driven largely by our worsenning dietary habits (with diets high in fats and sugar) and sedentary lifestyles. Strategies to promote physical activity will not only promote weight loss in the obese, but will lead to significant benefits for the cardiovascular health. Beetroot juice is a nitrate source which represents an easy and effective way to increase nitric oxide generation and improve vascular health. Data are emerging suggesting that beetroot juice is not only a beneficial way to lower blood pressure and improve glucose metabolism; it has been shown to improve oxygen consumption during exercise, thereby increasing exercise tolerance and durability. This project aims to determine whether: 1) beetroot juice supplementation for 8 weeks in obese patients will improve exercise capacity, and 2) the mechanism(s) associated with this outcome. The results of this study will be the first to ascertain evidence of whether beetroot juice is an effective and cheap dietary supplementation to improve physical activity in obese patients. Such outcomes will be pivotal for the management of obesity and associated cardiovascular complications.

This study will examine whether using an intervention that aims to increase optimal discharge support for stroke survivors and their support person (SP) impacts positively on depression, anxiety and quality of life. Optimal care includes the use of the Stroke Foundation My Stroke Journey workbook whilst an inpatient, use of the Enable Me portal after discharge, and receipt of a followup phone call 6 weeks after hospital discharge. Stroke survivor and SP pairs will be recruited post survivor discharge from stroke units. Pairs will be randomised to receive usual care or the intervention. Participants in the intervention group will receive clinician facilitated use of the My Stroke Journey workbook. Intervention participants will also receive facilitated access to Enable Me and proactive strategies to encourage use, including: a personalised letter from their stroke physician, short message service or email reminders to access the portal and letters which provide feedback to survivors and SPs on their usage of the portal. The wording used within the proactive strategies will be developed in conjunction with stroke clinicians and the Stroke Foundation. Lastly, intervention participants will receive a followup phone call from the Stroke Foundation to ensure survivors and their SPs are connected with the appropriate resources and support. The control group will receive usual care including provision of the my Stroke Journey Workbook and the 6 week phone call. Survivors and their SPs will complete a survey at baseline and followup webbased, phone or pen and paper surveys at 3 and 6 months after baseline. Quality of life, depression and anxiety among stroke survivors and their SPs will be compared at 3 and 6 months post-baseline. The outcomes of this study may inform strategies to encourage uptake of the portal in stroke units Australia-wide.

The primary aim of the current study is to determine the effect of a moderate protein, high carbohydrate predominantly plant-based diet on appetite control and short-term health outcomes in individuals 65-75 years of age using a meal delivery based dietary intervention. 220 subjects, comprising equal numbers of men and women will be recruited. Participants will attend the RPA-CPC Clinic on 3 occasions. The first will be to attend a screening interview where they will be asked to complete questionnaires on their medical history, medications, cognitive health and eating behaviour. Eligible participants will then be invited to attend a baseline testing morning at the RPA-CPC Clinic. At the baseline testing, participants will arrive after an overnight fast with un-brushed teeth, bringing with them a 7d food diary, completed questionnaires about their lifestyle and general health, a stool sample and a 24hr urine collection. A blood sample will be collected and then an oral health examination will be performed and saliva and bacterial samples from tooth-surfaces will be collected. Body weight, waist and hip circumference, blood pressure, body composition and physical performance will also be measured. Participants will be randomly assigned to one of four dietary interventions. On the week after baseline testing study diets will be provided via a meal delivery company. Participants will be asked to consume the foods ad libitum. Participants will be requested to consume only from study foods and to keep a weighed food diary. During the 4 wk intervention, a study co-ordinator will contact each participant by phone on 5 different occasions. The first will be to ensure food has been delivered on the day before the study is to start, and the remaining 4 calls will be for a 48hr food recall. At the end of the final week of the dietary intervention participants will attend the RPA-CPC Clinic for final testing. At final testing, participants will arrive after an overnight fast with un-brushed teeth and will bring with them their study diary and a 24hr urine collection. A blood sample will be collected and an oral health examination will be performed and saliva and bacterial samples from tooth-surfaces will be collected. Measurements of body weight, waist and hip circumference, blood pressure, body composition and physical performance will be repeated.

The goal of the proposed research is testing the hypothesis that the non-invasive electrical stimulation of the tongue muscle cortical neurons may reduce the desire for nicotine addiction. This hypothesis has been suggested according to a recent evidence (Vicario et al., 2014, The Journal of Psychiatry and Neuroscience) documenting altered electrical activity of this neurons in chronic smokers during tobacco abstinence. Thus, we propose to test the impact of a single session non-invasive electrical stimulation of the tongue muscle cortical representation in one group of chronic smokers (CS) under nicotine withdrawal. This research goal will be pursued by using medical device named transcranial direct current stimulation (Tdcs).

The overall aim is to improve health professional’s management of smoking in Aboriginal and/or Torres Strait Islander pregnant woman in a culturally tailored approach. The study will include 6 Aboriginal Medical Services in 3 states (NSW, SA, and QLD). Each service will receive webinar training to all the staff, audit and feedback, an educational resources package and free oral Nicotine Replacement Therapy for participating pregnant women. This study is a pilot study aimed to assess how the intervention is likely to be feasible in a full clinical study and foresee any implementation challenges we will need to overcome.

This study aims to determine the effect of exercise training on heart function in breast cancer patients undergoing Anthracycline based chemotherapy and to evaluate the use of exercise Cardiac Magnetic Resonance, a novel imaging technique. Who is it for? You may be eligible to join this study if you are between the ages 18 and 70 years old, have been diagnosed with breast cancer and are scheduled for Anthracycline-based chemotherapy. Study details Participants can chose which group they wish to join. Participants can select the intervention group where they will follow a personalised exercise program 2 times per week for 60minutes at the Baker IDI Heart and Diabetes institute and one home based (unsupervised) session for 100min for the duration of their Anthracycline chemotherapy. Whilst participants who elect to be in the control group will not follow an exercise program but are encouraged to exercise at their discretion. All participants will undergo an echocardiogram, VO2 max test and exercise Cardiac Magnetic Resonance (CMR) at baseline and 3 weeks after the last anthracycline treatment cycle. The exercise CMR is a novel technique hypothesized to aid in earlier diagnosis of heart failure. Participants will pedal a specially adapted cycle while lying in the narrow tube of the MRI machine.

The primary purpose of this study is to evaluate the safety of a new cancer drug, APG-1252 which has not yet been tested in humans. The study will also look at the amount of drug in the blood to evaluate the way the body processes the drug and the way the drug acts on the growth of tumours in cancer patients. Who is it for? You may be eligible to participate in this study if you are aged 18 or over, and have been diagnosed with Small cell lung cancer or other solid tumor types with no standard treatment options. Before the study starts, they are asked to sign a consent form. Each participant then goes through a series of tests to see whether the study is suitable for them. These tests include reviewing the participants medical and medication history, a physical examination, an electrocardiogram (ECG), CT and bone scans (to locate and measure tumours), taking urine and blood samples for testing and asking about how able they are to do their usual daily activities. If a participant's test results are satisfactory, they are enrolled into the study. Study details: All participants in this study will receive a specified dose of APG-1252 in 28-day cycles, which is administered intravenously (i.e. directly into the vein), at a starting dose of 10mg. The first set of participants will start on the lowest dose level, with the next highest dose only commencing in the next set of participants once the safety of the first dose has been confirmed. Researchers will take a number of blood samples on days 1, 3, 8, 15, 22 of dosing in each participant to examine the rate that the body processes the drug. Further blood samples, as well as CT, MRI scans other medical imaging/assessments will be taken before treatment and at the end of treatment to look for changes in tumour growth. Participants will also be assessed for side effects throughout the study period. It is hoped that the findings of this trial will show whether APG-1252 can be safely given to cancer patients, and provide information on the rate of processing of the drug in the body. Using this information, researchers hope to find the best dose to use for further testing of APG-1252 in cancer patients.

Many heart conditions impair the heart's ability to pump blood. This is known as heart failure. Exercise training is an important component in the management of heart failure, but in severe cases, symptoms such as breathlessness and fatigue limit patients' ability to undertake and benefit from exercise. Left ventricular assist devices (LVADs) are small pumps implanted into the heart of patients with severe heart failure to assist the heart in pumping blood around the body. LVADs reduce symptoms of heart failure, enabling patients to undertake exercise that wasn't previously possible. However, little is known about the most effective form of exercise training in patients with LVADs. This research project will involve an international multicentre randomised controlled trial investigating the effects of a new approach of exercise training in patients with LVADs, involving alternating bouts of moderate and high-intensity exercise. Six weeks after being implanted with a LVAD, participants will be randomised to either 12 weeks of high-intensity interval exercise or 12 weeks of moderate intensity exercise. Before and after the exercise programs, participants will undergo tests to compare the effects of the two exercise programs on fitness, heart and blood vessel function and quality of life. We anticipate the findings of this project will help optimise exercise rehabilitation for people with LVADs and provide information that will help inform exercise prescription in people with cardiovascular disease more generally.

Obesity has reached epidemic proportions globally and is associated with serious co-morbidities, including type 2 diabetes. Once adipose tissue has been accumulated, and food intake is limited by low calorie diets, counter-regulatory mechanisms induce an increase in appetite and a decrease in energy expenditure, which makes weight loss very difficult to maintain. To combat the global burden of obesity and its co-morbidities, a major challenge lies in the development of effective therapies that increase fullness and satiety, and result in good blood glucose control, while lacking adverse effects that are often associated with current therapies. There is increasing evidence that nutrient stimuli in the gastrointestinal tract play a central role in the control of energy intake and blood glucose. Proteins, and their building blocks, amino acids, are of interest, since high-protein diets are very effective for weight loss, particularly loss of fat, rather than muscle mass, and for improving postprandial glycaemic control, in obese individuals with and without type 2 diabetes. There is some evidence that a number of amino acids (including L-phenylalanine) may also have effects on energy intake, blood glucose and gut function in humans. Thus, they are of special interest in terms of potential therapeutic approaches for obesity and type 2 diabetes. This is an exploratory study and will investigate the dose-related effects of intragastric administration of L-phenylalanine on gastric emptying, gut hormone release, glycaemic control, appetite perceptions and energy intake in healthy, normal weight subjects.

Current cardiac arrest algorithms require assessment of the return of spontaneous circulation (ROSC) following rhythm checks. Current recommendations for assessment of ROSC include observation for patient movement or spontaneous respiration, both of which may be absent in sedated and paralysed patients. Healthcare professionals are advised to check the pulse in the presence of an organized rhythm, however previous studies have shown poor ability to correctly detect the presence or absence of a pulse in a simulated pulseless electrical activity (PEA) arrest. In one study, 45% of participants incorrectly diagnosed pulselessness in cardiac surgery patients no longer on bypass, despite systolic pressures greater than 80mmHg. In coronary artery bypass graft (CABG) surgery, when coming off bypass, blood flow changes from continuous to pulsatile. This may offer a model by which to simulate the return of pulsatile flow, and allow a comparison of radial arterial pressures when pulsatile flow becomes first apparent on 2D US and colour flow Doppler US of the carotid artery. This pilot study proposes to investigate whether pulsatile flow can be reliably assessed by the use of carotid artery ultrasound, and whether CABG patients can be used as a model to evaluate this.