ANZCTR search results

This study will determine whether a cognitive rehabilitation intervention, ReCog, has an effect on cognitive function in cancer survivors. Who is it for? You may be eligible to join this study if you are aged 18 years or above, have had a previous diagnosis of breast cancer, had chemotherapy treatment at Mater Cancer Care Centre, Brisbane, and completed all major cancer treatments. Study details All participants in this study will receive a group education and skills training intervention called “Responding to Cognitive Concerns” (ReCog). The program is based on self-regulatory cognitive rehabilitation and cognitive behavioural principles, and employs manuals for clinicians and participants. The program is run in small groups of approximately 4-9 participants. There will be four sessions run at weekly intervals by an occupational therapist and each session will last for 2 hours. Patients will be asked to practise the learnt strategies and skills in and between sessions, with the ultimate goal of generalising these strategies to their everyday life. Home tasks are expected to take approximately 15 minutes per day. Participants' performance on cognitive tasks (such as tests of memory and attention) will occur before and after the group program. Questionnaires on psychological distress, quality of life, psychological needs and satisfaction will be administered after the group program. It is hypothesised that both their cognitive performance on standard tests and reported everyday cognitive performance on questionnaires will improve.

This research is aiming to test an intervention led by the practice nurse in general practice to discuss people's risk of bowel cancer and screening tests to diagnose it early. Who is it for? You may be eligible to join this study if you are a primary care patient aged between 50 and 74 years who has an appointment with a general practitioner (GP) who is participating in this study. Anyone who has had a previous colorectal cancer diagnosis will not be eligible. Study details: Participants in this study will be randomly (by chance) allocated to one of two groups. Participants in one group will continue to receive the usual care in the primary care clinic. Participants in the other group will go through a web-based colorectal cancer risk assessment with the practice nurse, who will then provide risk output and screening advice which can be discussed with their GP. Our primary aim is to determine how feasible the implementation of this tool is. The results of this feasibility study will assist in the design of a future Australian wide study before it is used more widely in practice. The research is part of a larger body of research: the 'NHMRC Centre for Research Excellence for Reducing the Burden of Colorectal Cancer by Optimising Screening: Evidence to Clinical Practice'.

Familial Hypercholesterolaemia (FH) is an inherited condition which results in excessively high levels of cholesterol in the bloodstream from birth, with increased risk of heart problems by age 40 or earlier if not treated. Early diagnosis and treatment are very effective and reduces long-term disease costs. This study examines the feasibility of employing a new method of detecting FH through GP clinics using a finger prick cholesterol blood test. If FH is diagnosed, close relatives will also be checked so early treatment can be offered. This proposed innovative approach will alleviate hospital load and allow FH to be managed by the patient’s GP and lipid specialist in shared care approach

Evidence suggests that mental imagery plays a causal and more potent role in anxiety disorders than verbal-linguistic activity. The proposed research will compare the efficacy of an Imagery Rescripting Group Cognitive Therapy (IR-GCT) protocol to traditional Group Cognitive Therapy (GCT) and waitlist control for social and performance anxiety. Participation will involve an initial assessment, completion of a 90-minute single IR-GCT, GCT intervention, or waitlist control, and post-treatment assessment. Comparison of treatment outcomes will identify whether imagery rescripting techniques are more potent than verbal-linguistic techniques in reducing performance/social anxiety. Analysis into potential mechanisms of change within both interventions may inform future treatment approaches.

Functional dyspepsia affects a considerable proportion of Australians and results in significant personal and economic cost. There is as yet no cure for this condition and current treatments are generally not effective for the majority of people with functional dyspepsia. New research into the causes of functional dyspepsia have found that the numbers of a type of immune cell, the eosinophil, are increased in the top of the small bowel in patients with dyspepsia. A treatment called Budesonide has been shown to lower the amount of the eosinophils in the top of the small bowel. Budesonide is already an effective treatment in the management of other diseases including coeliac disease, collagenous sprue, oesophagitis and bronchitis. It is suspected that Budesonide will also be a promising treatment for functional dyspepsia but this needs to be properly tested. In this study we aim to test the effectiveness of Budesonide in people with functional dyspepsia in a randomised placebo controlled, double blind study.

Palmitoylethanolamide (PEA), also known as N-(2-hydroxyethyl) hexadecanamide or N-(2-hydroxyethyl)-palmitamide is an endogenous saturated fatty acid derivative. This study aims to investigate the effects of PEA on pain and quality of life in subjects with mild to moderate osteoarthritis and is designed with two active group arms and one placebo arm. The two active group dosages of 300mg and 600mg per day of PEA are similar to dosages used in other studies. The primary outcome measure is the WOMAC OA Index questionnaire. The participant group includes otherwise healthy men and women aged between 40 and 65 years.

In a previous audit, we retrospectively studied 418,897 batches of tests in 42,701 patients for a total of 2.5 million individual measurements of nine laboratory results (Loekito et al, Common laboratory tests predict imminent death in ward patients, Resuscitation 2013; 84(3):280-285). We identified simple laboratory abnormalities (e.g. high plasma urea, low blood bicarbonate level, low albumin), which either alone, but even more so when clustered together in particular pattern were associated with a higher risk of poor outcome (MET call, ICU admission or death) by the following calendar day. This finding suggested that, using routinely measure laboratory results, we might be able to identify those patients, who are at high risk of such outcomes and that, we might, therefore, be in a position to notify the ward where these patients are located of such increased risk. In this pilot study, we plan to extend our assessment the feasibility of such a notification system following a pilot study approved by the Human Research Ethics Committee in 2011. Specifically, we plan to continuously scan the raw data emerging form the pathology lab computers with focus on the 8th floor wards. Then, using a computerized risk identification system based on our retrospective analysis, we plan to identify patterns of laboratory data that identify patients at high risk of the above adverse outcomes by the next calendar day. Once such identification has been achieved, we plan to send every second notification to a dedicated pager carried by the Medical Emergency Team (MET) registrar, who will then visit the patient, review his/her laboratory results, contact the primary team to inform them of the laboratory concerns and modify treatment (if appropriate and agreed) following such discussion . Such notification will occur electronically by automated messages sent to the pager. The purpose of the pilot study is to assess: 1. How many notifications such a system would generate per day for the 8th floor wards; 2. Whether such a system can reliably deliver such notifications; 3. How many at risk patients are identified by such a system and how many are missed per month; 4. The outcome of patients identified by such a system.

This study aims to trial an intensive telephone counselling service for adults with poorly controlled asthma. We aim to improve asthma control and therefore reduce asthma flare-ups, hospitalisations and absenteeism.

Recent advances in genetic sequencing technology have resulted in remarkable improvements in the speed, throughput and cost of sequencing all, or part, of an individual's genome. Our hypothesis is that emerging high throughput sequencing technologies will lead to the rapid identification of new disease genes in genetic renal disease. This project will attempt to elucidate the genetic basis for inheritable kidney disease using next generation sequencing (NGS). The NGS employed may be targeted to a panel of genes of interest, to the whole exome (i.e. canonical protein-coding genes), or the entire genome. The patient cohort will include those whose family history and/or phenotype strongly suggests a genetic aetiology and in whom routine genetic testing is: a) not clinically available b) not feasible given high genetic heterogeneity of the suspected disorder, or c) has failed to arrive at a diagnosis for the likely disorder. Patients will be seen and assessed by a nephrologist and/or clinical geneticist in a Renal Genetics Clinic. Patients meeting minimum requirements for participation will be offered enrolment to the study and informed consent will be obtained. Once consent has been given, a DNA sample will be obtained via a blood test or buccal swab. The DNA will be analysed using NGS technologies. Where possible, family members including parents, siblings and possibly offspring of the affected individual will be recruited and included in the NGS testing. Genomic testing on first-degree relatives is necessary in most cases for the accurate interpretation of genetic variants found in the affected patient. Disease-causing mutations will be specifically sought in genes thought to be related to the patient's condition. If found, these variants will be confirmed with specific testing in a clinical laboratory, if available. Validation studies may be performed in a research capacity on selected novel potentially disease-causing variants or where disease pathobiology is not known. This will include patient-derived induced pluripotent stem cell (iPSC) validation after further patient consent for skin biopsy, urine sample, blood sample or buccal swab. iPSC technology enables ex vivo “disease in a dish” cellular and functional research of human disease owing to the ability to redifferentiate iPSC to many different cell types and thus model and validate how a genetic variant may mediate disease. Mutations previously reported to be disease-causing may also be discovered in genes not related to the patient's condition. Participants will be informed of known or expected, disease-causing variants in primary genes of interest. If chosen at the time of consent, participants will be informed of mutations in genes predicted to be associated with unrelated disease, and for which intervention is available.

Accidental falls remain an important problem for older people. Exercise has proven to be the single most effective intervention to reduce falls. However, sustained adherence to these interventions is poor. Our Standing Tall program is designed in line with evidence-based, best-practice principles for fall prevention that will not only aim to improve balance and reduce falls but also has the potential to maximize long-term adherence.