ANZCTR search results

BACKGROUND It is well established that emergency workers have increased rates of psychiatric morbidity, which is presumed to be related to their regular exposure to potentially traumatic events. However, to date there is very limited information regarding what strategies may enhance psychological resilience among emergency workers. The RAW program has been developed in close consultation with the emergency services, meaning the findings of the evaluation study are likely to have direct translational benefits. It is anticipated that an engaging and interactive online program will help address the issue of accessibility and delivery that NSW Fire and Rescue faces in terms of offering psychological training and support to their workers. This program differs markedly from the first generation of online therapy programs, which have typically involved the reproduction of cognitive therapy manuals into an online format. Rather than sifting through wordy paragraphs on a website, the RAW Mind program will involve the worker in a highly interactive process of learning by utilising a combination of video vignettes, interactive exercises, audio and animation. To ensure the training is memorable, it will be delivered in a series of six short, attention-grabbing segments, running no longer than 20 minutes. The program will provide firefighters with quick access to a range of adaptive skills, which could enhance their ability to manage stress and cope with trauma more effectively. These core skills are derived from the principles underpinning a number of evidence based cognitive therapies including Acceptance and Commitment Therapy (ACT) and mindfulness based Cognitive Therapy (mBCT) and Mindfulness based Stress Reduction (MBSR). Aims and Objectives The proposed study seeks to examine the effectiveness of a new online mindfulness-based resilience program for emergency workers. Specifically, it will examine whether a combined program of mindfulness training, evidence-based cognitive therapy skills and psychoeducation will increase overall psychological resilience and well-being of emergency workers. Hypotheses: The study will evaluate the effectiveness of the RAW Mindfulness Program to test the following hypotheses: 1. There will be no difference between the intervention and the control group at the point of baseline 2. At baseline, participants with greater mindfulness scores will have higher resilience and bounce-back resilience scores 3. Post training, the intervention group will report higher levels of resilience, bounce-back resilience, and well-being and lower levels of psychological symptoms and maladaptive coping strategies. 4. These differences will be maintained at 6 month follow up If all of the above hypotheses are confirm, this would provide substantial evidence that combined mindfulness training, cognitive therapy skills and psychoeducation is not only useful in terms of building psychological resilience but is also capable of changing firefighters ability to cope and manage stress in an effective and positive way. This project will represent the first ever published RCT of resilience training amongst emergency workers. This resilience program, has been developed in close consultation with the FRNSW, meaning the findings of the evaluation program are likely to have direct translational benefits in terms of informing future prevention programs for emergency services personnel.

This is a phase 1 proof of concept trial measuring the effect of a novel intranasal stent and tolerability of an expiratory positive pressure device on subjects with moderate obstructive sleep apnoea. Hypothesis: The combination fo dilation of the nasal cavity with an intranasal stent combined with a valve that increases pressure to the upper airway on expiration will favorably effect moderate sleep apnoea and snoring.

The primary purpose of this study is to determine whether Metformin and Atorvastatin (taken alone or together) improve outcomes for men with prostate cancer in terms of the aggressiveness and the biology of their cancer Who is it for? You may be eligible to join this study if you are aged 40 to 80 years, have a PI-RADSv2 (Prostate Imaging-Reporting and Data System) score of 4 or 5 and proceed to prostate biopsy with an intention of having a prostatectomy for confirmed high-risk prostate cancer. Study details Metformin is a medication commonly used in the treatment of Type 2 Diabetes to lower blood sugar levels and Atorvastatin is a common cholesterol lowering medication. Previous research has found that people who take these Metformin are less likely to have prostate cancer and those who take Atorvastatin are more likely to have less dangerous prostate cancers. Participants in this study will be randomly allocated (by chance) to one of four groups. The four groups will be divided as: 1) Placebo; 2) Metformin; 3) Atorvastatin; and 4) Metformin and Atorvastatin. You will have to take oral capsules three times a day for 6 weeks and all parties will be blinded regarding patient treatment allocation. Patient outcomes will then be assessed through blood, urine and tissue samples provided before the treatment starts and 6-8 weeks after as well as through medical imaging for some patients. It is hoped that the findings of this pilot trial will serve to help other men after they have had diagnostic prostatic biopsies showing prostate cancer, through providing evidence for a treatment that reduces the aggressiveness of their cancer, although this will need to be established in larger studies.

There is a lack of expert health services for transplant survivors outside the capitals. Various approaches can be utilised to overcome some of these issues. The current solutions include regular dispatch of healthcare professionals to rural centres and ad hoc phone enquiries/consultations. There are a number of difficulties with this, so a pilot study was conducted to see the effectiveness of a health service delivered by qualified staff to improve the patient’s physical and mental wellbeing through web-based technology. The pilot study showed some positive results, and thus we are now proposing this randomised control trial, to be able to compare the difference between standard care and this intervention over time. The use of a standard care control group as a comparison is particularly important, as post-transplant patients will gradually improve over time. The hypothesis is that delivery of home based health services i.e. supervised exercise and stress management with reinforcement strategy via multi-media technology will improve QOL and functional outcomes of patients following HSCT compared to standard care.

Frailty is a common syndrome in older adults caused by a decline in reserve capacity of the body's systems used to maintain health. We are interested as to whether interventions for frailty work BEFORE the involvement of clinical services. We propose to undertake a trial of community dwelling older men to determine whether a simple package of interventions can combat this syndrome.

The primary purpose of this study is to determine whether an accurate liver fat measurement, when reviewed by a surgeon, leads to changes in surgical approaches and hospital care that result in improved outcomes for colorectal metastases patients who require liver resection. Who is it for? You may be eligible to join this study if you are aged 18 years or above, and have colorectal liver metastases requiring liver resection. Study details All patients enrolled in this safety and tolerability study will have a liver resection and will be assigned by chance to surgery with the surgeon having knowledge of accurate fat liver measurements or to surgery where the surgeon is not aware of the liver fat content prior to starting the surgery. Patient outcomes will then be assessed through medical records. It is hoped that this study will aid in developing strategies that could lead to better survival and health outcomes for colorectal metastases patients after liver resection.

Difficulty taking deep breaths or coughing are two of the breathing complications people with a neuromuscular disease and weak breathing muscles face. Over time the lungs and rib cage become stiff, lung volumes are reduced and respiratory function is compromised. Such breathing complications are one of the main causes of discomfort, disability and ultimately death in conditions such as Duchenne muscular dystrophy and motor neurone disease. Lung volume recruitment, also known as breath-stacking, is a simple and inexpensive therapy that may help. It involves taking a few breaths in without breathing out, so that a maximum amount of air is held in the lungs before exhaling. This pattern is repeated so that a group of ‘deep breathing exercises’ is performed. A type of resuscitation bag is used to assist each breath. It is thought that performing these breathing exercises daily might prevent chest stiffness, improve breathing capacity and cough effectiveness, however to date there is no strong evidence to support these ideas. This research will look at the short and medium term effects of breath-stacking exercises on the breathing system, by conducting a prospective, single-blinded randomised controlled clinical trial. This means that half of the people who choose to be involved in the study will be asked to perform breath-stacking exercises each day for three months. The other half will be asked to do ‘diaphragm breathing exercises’ (a treatment we don’t believe will have a very big effect). The type of breathing exercise each individual will be asked to do is randomly allocated, i.e. there is a 50:50 chance of being in either group. We will measure lung volumes, stiffness and cough effectiveness by breathing tests, and breathing symptoms and quality of life by questionnaires. These measurements will take place before the person begins, and then 1 month, 2 months and 3 months into the study. We will perform the 1-month and 2-month measurements in the person’s home, to reduce any potential burden or inconvenience. If breath-stacking is beneficial and lung volume, chest stiffness and cough effectiveness improve then symptoms, quality of life and potentially survival are likely to be better. Importantly, this research would add to the recommendations for the respiratory management of people with neuromuscular disorders by providing much needed evidence to support the use of this technique more widely.

This study aims to evaluate the feasibility of a peer-delivered, telephone-based intervention targeting smoking, fruit and vegetable intake and sedentary behaviour (leisure screen time). Who is it for? You may be eligible to join this study if you are registered as a consumer of Neami services, are currently living with a severe mental illness (e.g. schizophrenia, bipolar disorder), are at least 18 years of age, and can identify a health related personal goal. Study details Participants randomised to the intervention will participate in telephone sessions delivered by peer workers. These sessions focus on reducing cardiovascular disease (CVD) risks by decreasing smoking, increasing fruit and vegetable intake and reducing sedentary behaviour. The intervention involves reinforcement of change, checking on current behaviours and simple behavioural strategies over 8 telephone sessions over up to 11 weeks. Results from this study will inform the development and implementation of interventions to reduce the risk of CVD and cancer in people living with severe mental illness. By tailoring the intervention to be delivered by peer workers via telephone, Better Health Choices may become a more accessible intervention for people within mental health services, with the potential to help reduce the risk of CVD and cancer in this population.

Children diagnosed with Bell's palsy have a sudden weakness of facial muscles on one side of their face. Bell's palsy usually improves in children in about four to six weeks without treatment. However, in some children it may be a year before the facial weakness has completely resoved and in a small number of cases, the facial muscle weakness is permanent. Recent research in adults with Bell's palsy has shown that a short course of treamtent with steroids (prednisolone) led to improved recovery time. Prednisolone is believed to reduce the irritation to the facial nerve. There are no similar studies in children and, because children's bodies respond different to adults', it is not known whether a short course of prednisolone will help children to recover more quickly. Currently, some doctors treat with prednisolone and others do not resulting in confusion and variability in medical care. The study aims to answer the following question: In children presenting to Emergency Departments with recent onset of Bell's palsy, does treatment with prednisolone result in a higher proportion of children with recovery at 1 month compared with placebo. Up to 13 hospitals in Australia and New Zealand will participate in enrolling 540 children/young people, aged 6 months to 18 years, who present to ED's within 72 hours of symptom onset.

To compare ultrasound guidance for subacromial cortisone injection to blind injection of cortisone for the treatment of subacromial impingement syndrome, to see if there's any additional benefit in terms of reduction in pain and increase in shoulder function by using ultrasound to guide the injection.