ANZCTR search results

Objectives: The approved project aimed to develop an effective educational program for use by Australian women with gestational diabetes mellitus (GDM) and by health professionals involved in their care. Educational materials from this project include an information booklet, a web-based program that can be accessed at an information kiosk (touch screen computer) at the hospital diabetes clinic, home PCs, and mobile technologies. Educational materials are initially available in English and Vietnamese languages. Programs contain culturally appropriate information such as typical food for the different ethnic groups, relevant in the area. Methods: Pregnant women aged 18-45 years with GDM who have a singleton pregnancy, are eligible to participate in this study. Women who agree to participate in the study will be given a participant information sheet and consent form. Participants will be recruited from the Pregnancy diabetes Clinic, at Sunshine Hospital and introduced to the GDM educational modules using the touch screen computer located in the clinic. Participants will also be given the URL to access to the program and they can learn the modules at home by using their home PCs, mobile phones, or tablets. At the end of the 4 weeks programs, participants will be asked to complete the questionnaire. The final result will be analysed by using statistic software SPSS v. 20. An appropriate statistical analysis will be used to find out the effectiveness of a web-based educational program on women's knowledge of GDM, including the influence of the program on weights of the women after delivery, baby weights and blood glucose level after delivery. The biostatistician will be consulted when the study is published.

The aim of this study is to explore the effectiveness of Kaufman Speech to Language Protocol in improving the accuracy of words in children with CAS. The hypothesis is that the implementation of the K-SLP approach for CAS will result in more accurate speech production in target words than no treatment.

People with epilepsy consistently report the importance of lifestyle factors that can predispose a seizure. Despite this, lifestyle education is not a standard feature of patient care in clinical practice. Using a randomized controlled trial the objectives of this study are– (1) to inform clinical care practice by examining the impact of a Lifestyle Education Intervention (LEEP) on seizure frequency, well being, quality of life and resilience, (2) to provide information related to seizure control and health related quality of life related to lifestyle self-management, (3) assess the acceptability of LEEP to consumers and (4) to translate the package to practice in a sustainable and effective manner. The study will use a randomized controlled trial design to test six hypothesis which are as follows - H1 Lifestyle self-management education for people with epilepsy program (LEEP) will make a difference seizure frequency; H2 LEEP will improve the patient’s experience of subjective wellbeing; H3 LEEP will make a positive difference to resilience scores; H4 LEEP will improve the person’s health related quality of life (HRQoL); H5 LEEP will improve the person’s self management abilities; and H6 LEEP will be acceptable and affordable to people living with epilepsy. The objectives of this study are– (1) to inform clinical care practice by empirically examining the impact of a Lifestyle Education Intervention on seizure frequency, wellbeing, quality of life, self management abilities and resilience in order to reduce frequency of seizures and unplanned emergency department and hospital re-admissions (2) to provide information related to seizure control and health related quality of life, enhancing resilience and self management and (3) to translate the education package to practice in a sustainable and cost effective and acceptable manner.

Background: The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. Methods/Design: The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. Discussion: There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world.

The study aims to address whether the timing of stereotactic radiotherapy (SRT) after surgical removal of brain metastases impacts on quality of life; that is, whether treatment on local recurrence (disease returning at the surgical cavity) impacts on quality of life more than upfront SRT following resection of brain metastases. Who is it for? You may be eligible to participate in this study if you are aged 18 years or above and have had 1-4 brain metastases surgically removed. Study details: After surgical removal of brain metastases, in the absence of further treatment, about half of patients will develop a recurrence (disease returning) within the surgical cavity(s), while about half will not. For patients who had 1-4 brain metastases surgically removed, SRT targeting the surgical cavity(s) has been shown to provide local control rates of 70-90% at 1 year. Nevertheless, approximately 50% of patients are destined to never recur at the surgical cavity(s); hence close observation, with radiotherapy at the first sign of recurrence is also often practised. This approach spares treatment in potentially half of patients. By using regular 3-monthly MRIs of the brain, most recurrences should be detected while they are small and before symptoms develop. The study aims to address whether the timing of SRT after surgical removal of brain metastases impacts on quality of life. We are also studying the effect of treatment on patient’s neurocognitive function (memory, thinking processes). It is hypothesized that delivering SRT on local recurrence is no worse than upfront SRT to resection cavity in terms of patient’s quality of life.

Obesity is a major health issue worldwide. Despite global research efforts, effective treatments for obesity are limited. There are two kinds of fat in the body: white fat and brown fat. White fat functions mainly as an energy-storing organ and in excess results in obesity and complications such as diabetes and high blood pressure. Brown fat on the other hand releases the energy stored in fat as heat. It protects small animals and newborn human infants from cold temperatures. New imaging techniques have revealed brown fat to be present in significant amount in adult humans. Using special metabolic imaging, called PET scanning, brown fat is shown to be more abundant in lean individuals with lower blood glucose levels, suggesting that brown fat may regulate energy balance and metabolism. In animals, cold temperature and food both stimulate brown fat, resulting in release of energy. This is called adaptive thermogenesis, and it represents a considerable portion of total daily energy expenditure. Whether brown fat controls adaptive thermogenesis in humans is unclear. This is clinically relevant because if brown fat regulates adaptive thermogenesis in humans, strategies can be developed to stimulate brown fat to increase energy expenditure, which may be a new method to help attain weight control and develop treatment of obesity-related disorders. In order to determine the physiologic significance of brown fat activation, we designed a study investigating the effects of cold exposure and food on brown fat in humans. We hypothesize that adaptive thermogenesis in adult humans can be activated by cold or food, and the extent depends on individual brown fat abundance. Brown fat activity can be increased by cold stimulation, which could result in beneficial metabolic changes in the body. The aims of the current project are to: 1) determine relationship between brown fat and adaptive thermogenesis 2) investigate the underlying hormonal mechanisms and significance of brown fat activation Brown fat abundance will first be measured by PET scanning during mild cold condition. Volunteers then undergo metabolic and hormonal testing at standard ambient temperature (24 degrees). A parallel study will examine brown fat biopsies obtained during elective neck surgery to investigate mechanisms underlying brown fat activation. Significance: Based on its role in energy homeostasis and protection against obesity in animals, brown fat is likely to have a similar role in adult humans. Determining the contribution of brown fat to energy metabolism may lead to novel treatment strategies of obesity.

Recent research and clinical evidence indicates that Human adipose-derived stem cells are safe for use in Humans. Researchers suggest that the treatment may alter the operation of the immune system to ameliorate degenerative activity. In a conducive environment supported by a combination of growth factors and certain peptides, stem cells can also be stimulated to differentiate into a range of different cell types when transported to the site of degradation. This trial is investigating to what extent an injection of the Stromal Vascular Fraction obtained from the participants own fat tissue and Platelet-Rich-Plasma, and in combination with proprietary peptides reduces the progression of disease and improves quality of life. The peptides are derived from those that are naturally present throughout the body and are critical to cellular processes particularly growth and regeneration. Age and disease conditions can reduce the levels and effectiveness of these peptides which normally promote healing. This study involves patients with neuro-degenerative disease specifically, multiple sclerosis of all categories.

Using simulated learning environments with standardised patients (SPs) provides a way to scaffold the development of skills for patient safety in a low risk environment. There are no data regarding whether adding SP interactions in early years of physiotherapy training improves safe performance on clinical placement. We aimed to assess the feasibility of recruiting and collecting data from junior physiotherapy students during an SP workshop with a pilot non-randomised trial, also assessing time, cost and scheduling information. Second year physiotherapy students were invited to participate and allocated to either the SP workshop in a simulated hospital environment (with and without video feedback) or usual teaching comprising peer role play. The main outcome measures were participant recruitment, retention and survey response rates, whether the training and workshops were delivered as scheduled and costs for SPs and staff training and workshop attendance. Students self-reported confidence, communication, preparedness for clinic and satisfaction was measured using pre-post surveys.

Resilience is the capacity to rebound, and adjust from adverse experiences and maintain normal psychological and physical functioning, avoiding serious mental illness. Resilience can be built and fostered in an environment of protective factors. For infants the most important protective factor is having secure attachment relationships with their primary caregivers; generally their parents. However the parent-child attachment process is frequently disrupted when the parent/s have a mental illness as they may be less sensitive to the emotional cues of their children and less emotionally responsive. The purpose of this project is to test the effectiveness of two psychologically-based interventions which have been developed to help parents with mental illness or mental health concerns, become more responsive to their infant and foster a secure attachment relationship, thus building resilience in both parents and child.

Since the inception of the after-hours social work service at the Royal Adelaide Hospital in 1999, social work staff providing this service have collected summary data on a per-patient basis. To date, these data have not been formally reviewed. The aim of this retrospective study is to transcribe the data from the hard copies into an Excel file to allow descriptive analysis of the types of patients referred, referral source, their location, the type of social work involvement, complexity of the case and its perceived importance. Additionally, data that have been collected regarding the impact of providing these after-hours services on the provider the following day will be collated. As well as analysing these data collectively, trends and changes over time will be reviewed.