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Given relationships between meal patterns and glucose metabolism, cardiometabolic biomarkers may be beneficially altered by a reduction in energy consumed at the evening meal and increasing that consumed at breakfast. The purpose of the present study is to examine how manipulations to the distribution of energy throughout the day influences blood glucose and insulin metabolism, and appetite control, during periods of prolonged sitting in overweight/obese men and women. This study aims to recruit individuals who are overweight/obese as they are typically those who exhibit tendencies of developing type 2 diabetes and they represent an important target group for evaluating strategies for disease prevention.. It is hypothesised that by increasing the energy intake at the beginning of the day (i.e. a large breakfast) will better distribute the glucose load throughout the day, when not participating in any physical activity (i.e. prolonged sitting).

Diabetes foot ulcer (DFU) is a serious complication of diabetes that leads to prolonged hospitalisation and >80% of diabetes-related lower limb amputations (1). Although a number of health disparities exist between rural and urban areas in Australia, management of diabetes foot ranks as one of the most significant health concerns (2). Compared to Australian major cities, rural/remote areas experience two to three times higher rate of hospitalisation and limb amputation due to diabetes (3). Despite high prevalence of diabetic foot complications in rural/remote areas, there are surprisingly no special programs aimed at reducing the burden of the disease. Significant challenges such as access to the health care centres and staffing limitations have made quality of care comparisons between rural and urban centres difficult. Currently subjects with DFU living in rural/remote areas in the region have to travel long distances to Townsville Hospital Diabetes Centre (THDC) on weekly basis for wound care. The annual Medicare cost for care in patients with diabetes who have foot ulcer is 3 times that of patients with diabetes who do not have ulcer, with inpatient care accounting for 70% of ulcer care costs (4). A program that effectively manages foot ulcers and reduces hospital admissions could substantially reduce costs of care in diabetes. Use of telemedicine may help solve the scarcity of specialist diabetes wound care in such underserved communities in our region. Objectives: to assess clinical and economic impacts of telemedicine in management of foot ulcers in rural/remote areas of North Queensland. References 1. http://www.aihw.gov.au/diabetes-indicators/lower-limb-amputations/ 2. Australian Institute of health and Welfare 2012-2014 http://www.aihw.gov.au/ 3. Queensland Health Patient Travel Subsidy Scheme: http://www.health.qld.gov.au/ptss/

To see if intra uterine installation of a local anaesthetic at end of Hysteroscopy procedure reduces post op pain and delay in recovery

A RCT to compare clinical examination alone versus clinical examination and ultrasound for accuracy of fetal head position prior to vacuum birth.

Pressure injury prevalence in intensive care units remains high, 13.1% to 28.7%, despite efforts to stem the prevalence through the implementation of best practice guidelines. Pressure injuries are avoidable, but medical attention goes first and foremost to the task of stabilising the patient’s condition. Pressure injuries occur when patients are immobilised on admission to hospital as a precautionary measure until spinal injury is excluded, during lengthy hours of surgery and during recovery. Recently, interest in a remarkably simple approach that can reduce the incidence of pressure injury has emerged. The strategy—prophylactic application of a dressing product to areas at risk of pressure injury—has been seen to almost eliminate the incidence of pressure injury on the sacrum and heel and resulted in acute care expenses that were 3.6 times cheaper than usual care. It is suggested that the reason the dressings are effective is because they manage the microclimate of the skin and, specifically, they reduce the amount of moisture on the skin. Though a systemic review of existing trials support the efficacy of this clinical approach, this theory of microclimate management has not, however, been tested in clinical trials to date. More research is needed to confirm prior study results and test if the intervention does alter the microclimate. Participants in this study (n=336) will have been admitted to an Intensive Care Unit (ICU). All patients meeting the eligibility criteria will be randomised to either the prophylactic dressing and standard care study condition (intervention) or the standard care study condition (control). Dressings will be applied to the sacrum, both heels, and the occiput if shaved. The dressing will remain in place for the participant’s duration in the ICU. The primary outcome measure will be the occurrence of a pressure injury in these anatomical locations during their stay in the ICU. Epidermal hydration, erythema and temperature of the pressure prone areas will be assessed for every study participant at scheduled repositioning of the participant during day shift hours. Monitoring of PI’s elsewhere on the body and during the entire acute episode will be undertaken. The cost of the ICU stay and the full acute episode will be monitored. The incidence of PI development and changes in microclimate state at each anatomical location and cost of care will be compared between the intervention and control groups.

The aim of the project is to test the feasibility and effectiveness of the FitMindKit program to reduce symptoms of mental health problems in adults. FitMindKit is an online program that uses brief therapeutic modules (based on cognitive behavioural therapy) to reduce symptoms of common mental disorders (major depression, anxiety disorders, substance use disorders) and suicidal thoughts. Unlike existing internet programs, FitMindKit is tailored to the individual's mental health profile, taking account of multiple mental health problems using rapid screening methods. 570 adults, 18 years and over, with elevated symptoms of depression, anxiety, and/or substance use will be recruited from the community and randomised to receive one of three programs: (i) the FitMindKit program, (ii) a static, untailored version of the FitMindKit program, or (iii) an attention-matched control program containing general health information not directly related to mental health. We hypothesise that: (1) compared to users of the control program, users of both versions of the FitMindKit program will show a greater reduction of symptoms of depression, generalised anxiety, social anxiety, panic, alcohol and other substance use, and suicidal thoughts; (2) users of the tailored FitMindKit program will show a greater symptom reduction than users of the static FitMindKit program; (3) users of both versions of the FitMindKit program will report greater satisfaction than users of the control program; (4) users of the tailored FitMindKit program will have greater adherence to the program; and (5) the FitMindKit program will be cost-effective, through reduced need for primary care and mental health services.

IMAGEN is a multicentre, prospective, parallel group, randomised, double-blinded placebo-controlled trial to assess if 4g of a dietary supplement daily over 12 months will reduce AAA growth. Participants who consent will undergo a thorough screening assessment for safety and suitability. Assessments include; physical and clinical examination, blood test, CT and Ultrasound of the abdomen, quality of life questionnaire and diet assessment. If the participants meet all inclusion criteria and no exclusion criteria they will be randomised (randomly allocated) to either the dietary supplement or placebo group. The participant will be blinded to the supplement name and it will be referred to as "the supplement" from the moment of initial contact. The dietary supplement and a placebo equivalent powder will be separately packaged in 500mg dose capsules. The capsules will be dispensed by an independent and unblinded pharmacist. Participants will be instructed to have four 500mg capsules twice per day at 8am and 8pm. Participants will revisit the site centre at 6 and 12 months after starting the trial to monitor adverse events, compliance and perform assessments. Participants will be contacted by telephone at 1, 3 and 9 months to monitor compliance and adverse events. The team will consist of experienced investigators, vascular surgeons, coordinators and researchers at each site. A steering committee, data and safety committee and publications committee will be established to oversee various aspects of the study to ensure the aims of the study are met while upholding the protocol

Background The effects of FIFA 11+ warm-up program for soccer injuries prevention have been evaluated in several studies. However, the importance of a ‘warm down’ using the FIFA 11+ protocol additional to the warm up has not been investigated and yet may be important. Participating in the 11+ in the fatigued state may challenge the athlete and translate directly into real ‘game-like’ conditions. Objective The main objective of the study is to test whether the intensive FIFA 11+ warm-up combined with warm down program has an additional effect on the incidence, severity of injuries and adherence, compared to the FIFA 11+ warm up alone, among amateur soccer players. . The ‘11+’ before and after the training sessions is hypothesized to reduce the incidence of injury among male amateur soccer players. The prevention of such injuries will be beneficial to soccer players, clubs, football associations, health insurance companies and society. Study design Cluster-randomized controlled trial Methods Male amateur soccer players, aged 18–30 years, will be allocated to interventions or control group. Both groups will perform FIFA 11+ 15 exercises for 20 minutes as a warming up with regular soccer training. The intervention group will additionally perform FIFA 11+ 13 exercises for 10 minutes as a warm-down with every training session. Primary outcome measures are the incidence of initial and recurrent injury and injury severity. A secondary outcome measure is the rate of compliance.

Burns to the face are very common among children. They are caused by scalds from hot liquid or less commonly flash flame burns. Care for burns to the face usually require admission for pain management and regular cleaning with saline soaked gauze (up to three times a day) followed by the application of white soft paraffin (every two to four hours) throughout the day. We are trialling a new product, Glucan Pro 'Registered Trademark' 3000, an ointment that contains paraffin wax and other active ingredients mainly oat beta glucan, an oat derivative which is currently indicated for the management of superficial abrasions, scrapes, and cuts. It has been used for non-facial burns in children with good results Aims: 1) Length of stay: Glucan Pro 'Registered Trademark' 3000 provides an occlusive layer similar to white soft paraffin for wound healing, however the active ingredients (oat beta glucan) has been shown to have a beneficial effect in nonfacial burns. We hypothesise that Glucan Pro 'Registered Trademark' 3000 application to facial burns will acclerate the healing process and result in a reduction in length of hospital stay. 2) Reduction in frequency of application: The current standard of care includes the application of white soft paraffin (every 2-4 hours) to keep the burn wound moist. We hypothesise that Glucan Pro 'Registered Trademark' 3000 will result in a reduction in frequency of application and thus provide a more comforting environment for the paediatric patient. Adverse event: There is a small risk of an allergic reaction with topical treaments (ie. rash), and if this occurs we will stop using the product, seek appropriate medical advice and revert to the usual course of treatment. If infection is identified, participant will be withdrawn from the trial and appropriate medical management will be instituted. All adverse events will be reported to the Department of Pharmacy, Clinical Governance Unit and Women’s and Children’s Health Network Ethics Committee. Analysis: Results of the trial will be analysed using the intention to treat (ITT) methodology. Daily wound review checklist will be analysed to determine variability in the frequency of application of each product Trial review: Conduct and progress of the trial will be reviewed and updated weekly Burns Research/Business Meeting (Wednesday, Level 2, Surgical Services) What are the possible risks: There is a small risk of an allergic reaction with topical treaments (ie. rash), and if this occurs we will stop using the product, seek appropriate medical advice and revert to the usual course of treatment. There may be no direct benefit from the use of Glucan Pro 'Registered Trademark' 3000

Aims: This pilot trial aims to evaluate the safety and tolerability of a Traditional Chinese Medicine herbal combination “AL” (Astragalus membranaceus and Ligustrum lucidum) in people with advanced cancer. It will also investigate whether AL can improve the immune function Who is it for? You may be eligible to join this study if you are aged 18 years or older and have been diagnosed with recurrent or metastatic cancer or have declined or are ineligible for further treatment. Study details All participants in this study will receive AL herbal treatment and take 12 capsules of AL each day for 12 weeks. The study treatment is a combination of two herbal medicines known as “AL” (Astragalus membranaceous and Ligustrum lucidum). “AL” consists of herbal medicines, which have been used together for many years in China especially in people undergoing cancer treatment. “AL” is commonly available as a registered product in China called Zhenqi Fuzheng Capsule. This product is registered by the China State Drug Administrations as a prescribed medicine (Z62020414). At least 17 clinical studies have investigated this combination AL using this same product Zhenqi Fuzheng Capsule in people with cancer who have undergone standard chemotherapy or radiotherapy treatments. We know from studies in other people with cancer that “AL” is usually well tolerated. It is possible that “AL” may help lessen some of the side-effects of cancer treatment – but this is the focus of future studies. The results from this study will be used to design future studies looking at combining these herbal medicines with current treatments. Participant will complete fatigue and quality of life questionnaires, and donate blood for tests at baseline, during AL treatment and after.treatment The ability of participants to tolerate AL will be determined by their treating physician.