ANZCTR search results

The aim of this project is to decrease the number of infantry trainees being removed from training and placed into SSW due to preventable injuries. These injuries can be partially attributed to intrinsic risk factors such as poor biomechanics, poor footwear/fitness/body awareness, over training, history of prior injury and BMI <20 or >27. Data collection from six training platoons between 7th February 2011 and 12th August 2011 revealed a mean of 26% of trainees per platoon being injured during the course of training. Of these 53% were classified as preventable injuries and 46% of those trainees were removed from training. This represents a significant number of members incurring injuries that may otherwise have been avoided. From this the concept for implementing some injury prevention training and education evolved and a collective decision was made to examine the implementation and effectiveness of such a program. This will be a randomly controlled trial conducted at the Physiotherapy Department, School Of Infantry, Singleton. It will consist of several components: 1. All members in both the control and intervention groups will be given a questionnaire to fill in regarding intrinsic risk factors to injury. BMI will be assessed. 2. The intervention group will receive a one hour theoretical session on intrinsic risk factors for injuries and how to take active steps to avoid injury (ten tips for injury prevention). 3. The intervention group will then receive a one hour small group practical session looking at biomechanics, posture and body awareness. 4. Trainees identified as having significant risk factor (for example pronating feet) will be given an individual assessment and intervention if required. Potential outcomes of the trial include: - Decrease the number of trainees removed from training and placed in SSW due to preventable injuries - Provide the SOI with an injury prevention strategy that is simple and cost effective - Increase throughput of Infantry members - Reduce number of staff required to manage soldier support wing - Decrease costs associated with trainees moved into soldier support wing (medical, physiotherapy, psychology support, staffing for SSW) - If the program is successful it could be utilised within other areas of the ADF - Increasing retention rates - Decreasing rehabilitation costs and TRW burden - Improve morale amongst trainees by improving health outcomes - Data collection may reveal secondary trends.

The aim of this study was to determine whether prophylactic antibiotic therapy reduced the number and seriousness of respiratory illnesses of these patients suffer due to their chronic obstructive pulmonary disease.

This study will evaluate the usability, acceptability and impact of the Music eScape application and it’s capacity to promote wellbeing in young people. The eScape app is designed for users to identify their current and desired mood states and produce a playlist of mood-tagged music from their own music library that will help them achieve this. Prototype testing will be conducted to inform the development of the Music eScape app. Two groups of five participants will each be asked to complete a 30 minute survey, then attend a focus group to explore the mobile application and test it’s functionality. We are then seeking young people who experience at least mild levels of stress/distress to test the music-based mobile phone application. Young people will complete a brief 10-item screen questionnaire to determine their eligibility for participating in the study. 180 participants who report at least mild levels of stress/distress in the past month will be recruited for the outcome evaluation. Participants will be asked to complete an online survey, which will include questionnaires addressing emotion identification and regulation, wellbeing and involvement in music. Half of the participants will be asked to download the free eScape app on their mobile devices and trial it for one month (referred to as the immediate access group), while logging in their current and target moods, along with the success rate of the application in assisting them to reach their target mood. During their use of the application, details of app usage (e.g., number of times used, duration of use, features used) will be recorded and automatically downloaded. Participants will be followed up at the end of their one month of app use, and again two, three and six months later to complete online surveys addressing emotion regulation, wellbeing and their experience of using the mobile application. Participants will receive 4 SMS’s over their initial first month of app use to remind them to use the app. The remaining half will comprise a waitlist control, whose access to the application will be delayed by one month. Delayed app access provides a control group for comparison of mood regulation in absence of any intervention. Waitlisted participants will receive up to 4 SMS’s to minimise participant attrition. After this month, their involvement will replicate that of the immediate access group, outlined above.

Physiotherapy treatment for patients undergoing Coronary artery bypass graft (CABG) surgery involves pre operative education, and post-operative breathing exercises and coughing, early mobilisation and musculoskeletal exercises to prevent pulmonary complication and to aid in discharge from the hospital and return to activity in timely manner. Pain post CABG may be from surgical trauma, multiple cannulas including chest drains, and harvesting of internal mammary arteries (IMAs). Ferguson et al reported that health professionals often underestimate pain the post CABG patients experience. The most common area the patients experience pain post CABG is the chest, where there is surgical wound, and also where chest drains have been. Studies have shown that CABG patients have limited ability to cough and perform breathing exercises, general activity and ambulation due to severe pain post surgery. There have been six surveys studying physiotherapy practice in Australia and New Zealand, Sweden, the UK and Canada, however, none of these surveys provided information on physiotherapists’ perception of patients’ pain post CABG, or whether physiotherapists believed pain was a limiting factor for patients to reach walking milestone and what guidelines were used to establish milestones for distance to mobilise patients This study will enable the investigators to collect data on physiotherapists’ perception of CABG patients’ pain post surgery in Australian and New Zealand hospitals. The survey will also identify whether physiotherapists believe pain limits patients walking distance and whether they believe pain management post CABG is adequate. Hypothesis: Physiotherapists perceive that patients undergoing CABG surgery experience significant pain, therefore it impacts on their walking distance in Australia and New Zealand hospitals.

This study aims to investigate the interactions and effects of salt and fat on ad libitum intake. The objective is to quantify the contributions of different concentrations of salt and fat in food on satiation in humans classified according to fatty acid taste sensitivity. Fifty participants, aged 18-60 will participate in the study and consume a lunch either low or high in salt and low or high in fat after a fixed breakfast, on four different testing days. Participants will be classified according to fatty acid taste sensitivity, which will be assessed in two different sessions.

Intensive Care Unit (ICU) services cost the Australian economy at least $1.1 billion annually, excluding the cost of longterm morbidity. In particular, patients with a long length of stay in ICU (> 10-14 days) consume a disproportionate amount of resources. A quarter of these patients suffer a severe weakness syndrome defined as ICU-acquired weakness (ICUAW). This catastrophic syndrome results in significant limitations to people being able to perform their usual activities required for living (e.g. standing, walking, brushing teeth, showering, toileting or feeding themselves). People who suffer ICU acquired weakness are more likely to die and experience worse physical function and quality of life up to ten years following their ICU admission. The specific cell level interactions that influence this weakness syndrome are yet to be fully understood. The protein activin limits muscle growth and causes severe muscle wasting. It has recently been shown to not only have strong regulatory effects on muscle mass in mice with cancer, and when blocked, beneficial effects such as reversal of muscle loss. It is known that blood activin levels are significantly higher in people with critical illness who have infection, however the effect this has on muscle mass and weakness has not been established in this setting. There is also emerging evidence that there may be differences in the genes that turn on and off in people within the first 5 days of an ICU stay. It is logical that genes might also turn on and off differently in people who develop severe weakness in ICU compared to those who don‘t. However no studies have looked at differences in these gene patterns and compared them with changes in weakness or the ability to breathe independently. The project will compare levels of the protein activin and gene expression patterns (i.e. differences in genes turning on and off) in people admitted to the ICU with and without severe weakness. The investigators will also test muscle strength and the ability of the patient to do functional tasks (e.g. stand up, walk) and the project aims to provide proof-of-concept of an association between protein and gene measurements with muscle strength and function in ICU patients. the results will be used to design future projects investigating i) mechanisms associated with the development of clinically significant weakness and possible therapeutic pathways and ii) prevention strategies to reduce exposure to agents associated with severe weakness in ICU.

Aerobic energy powers endurance exercises e.g. jogging, long distance running etc. and it is used as a measure of fitness. On the other hand, initiation of any activity (e.g. rushing for a bus, climbing stairs) relies on anaerobic energy that is provided by preformed energy in form of phosphocreatine and glycolysis (breakdown of glucose) that occurs in absence of oxygen. Hence, individuals with inadequate anaerobic energy levels usually struggle to carry out their activities of daily living and suffer from chronic fatigue. What regulates the Anaerobic Energy System (AES) is not well studied and the factors that enhance AES apart from physical training are not known. Adults with Growth Hormone Deficiency (GHD) typically suffer from chronic fatigue and loss of vitality, symptoms suggesting impairment of the AES. These symptoms improve with GH replacement. However, the mechanisms underlying the symptomatology and how it is improved are poorly understood. New research shows that GH plays a vital role in energy provision. A recent study showed that administration to healthy subjects with GH enhanced sprinting, which is a marker of anaerobic capacity. However, GH did not improve any other measures of physical performance. Another research studied the effects of GH treatment in GHD subjects at a cellular level and found that GH favored the use of glucose (anaerobic glycolysis) over fat as a fuel for energy provision in muscle cells. These studies indicate that GH may have a positive role in regulating the AES. The main aims of this study are to investigate the effects of GH on anaerobic capacity and genes governing energy metabolism in skeletal muscle, and study the relationship between the AES and physical function.

The Pharmacokinetics of Testosterone Cream Applied to Scrotal Skin study is a dose finding study to determine the effectiveness of absorption of testosterone cream when applied in an alternative way to current practice. Long-term compliance with testosterone replacement therapy requires convenience in the delivery system to facilitate continuation of treatment with minimal intrusion or disruption to daily life. Current product information for transdermal( via the skin) application of testosterone states it is not to be administered to the genital area. Transdermal application of testosterone depends on the stratum corneum, the layers of dead skin cells which limit permeability of small molecules through the skin. Skin varies widely in thickness and steroidal (cortisol) permeability. The thinnest stratum corneum and highest steroidal permeability is scrotal skin. The study will determine the absorption rate of testosterone cream when applied to scrotal skin. The study will be conducted at the Department of Andrology, CRGH and will aim to recruit 12 healthy male volunteers from the local community. Eligible and consenting participants will visit the study centre 5 times. The men will receive 2 separate intramuscular injection of nandrolone decanoate to temporarily suppress testosterone levels. They will self-administer 3 dose applications (in random order) of testosterone cream to their scrotal skin. Venous and capillary dried blood spots will be collected before and over a 24 hour period before and after application of the cream to monitor hormone levels.

This study aims to use recent advances in PET scanning techniques, in particular Amyloid scanning to assist in the detection of Preclinical, Prodromal and Mild Alzheimer's disease.

This is a 30 patient single-centre, open-labeled, randomised pilot study assessing the effectiveness of a cyclooxygenase (Cox)-II specific inhibitor, Celecoxib, in reducing perioperative inflammation associated with thoracic and major abdominal surgery as assessed by blood and urinary markers. Information regarding Celecoxib's capacity to reduce perioperative pain and morphine consumption will also be sought. Patients will receive standard dosing of Celecoxib in accordance with on-license use. Demonstration of effect and feasibility of inflammation suppression is intended to lead to a multi-centre study investigating the use of perioperative Celecoxib to delay cancer recurrence following Non-Small Cell Lung Cancer (NSCLC) resection surgery.