ANZCTR search results

Cardiac surgical patients routinely receive supplemental oxygen immediately prior to, during and immediately following their cardiac surgical procedure. A major goal of anaesthetic care of the cardiac surgical patient is the maintenance of haemodynamic stability as well as the preservation of myocardial and systemic tissue oxygenation. Often cardiac surgical patients will receive supplemental oxygen and have supra-normal concentration of oxygen as a buffer of safety (Ihnken et al., 1998). However, cardiac surgical patients are particular susceptible to lung and myocardial injury attributable to hyperoxic states. Reactive oxygen species (ROS) are well known for their role in myocardial injury. ROS are free radicals (unpaired electrons) involved with oxidation-reduction reactions with other molecules. During cardiac surgery the formation of oxygen free radicals is accelerated from tissue injury and the use of cardiopulmonary bypass. Clinical studies have demonstrated apoptosis and deoxyribonucleic acid (DNA) fragmentation occurring after ischemia-reperfusion injury. In addition, prolonged high oxygen concentrations have been shown to decrease myocardial contractility and a decrease in heart rate which results in impaired cardiac function and may delay recovery (Joachimsson et al, 1996; Ihnken et al, 1998). The aim of this study is to evaluate the impact of a peri-operative change in oxygen therapy management for cardiac surgical patients based on emerging evidence. The change involved the adoption of a conservative oxygen therapy approach to oxygen therapy management during the perio-operative period. Conservatiive oxygen therapy is involves the deliberate manipulation of fraction of inspired oxygen (FiO2) concentration to achieve normal blood oxygen saturations. We plan to inlcude 100 cardiac surgical patients in the before period and 100 cardiac surgical patients in the after period.

Osteoarthritis (OA) affects more than 20% of Australians aged over 55. The knee joint is commonly affected, resulting in knee pain and difficulty with everyday tasks such as walking or climbing stairs. Current treatments (e.g. medication, surgery, exercise) are only partially effective. Novel therapies that optimize the effects of current treatments are needed to reduce the social and economic burden on sufferers, caregivers and the wider community. Here we aim to conduct a ‘proof of concept’ study to investigate the use of an innovative non-invasive brain stimulation treatment to bolster the effects of exercise therapy in knee OA. We anticipate that the combination of non-invasive brain stimulation and exercise will have a greater effect on the biological mechanisms that contribute to pain, and thus provide greater benefits for pain and disability, than exercise alone.

Best practice management of low back pain (LBP) includes providing information that addresses misperceptions about LBP and encourages self-management. To date no LBP information has been developed for Aboriginal people. Our aim is to develop and evaluate LBP information tailored to meet the needs of Aboriginal people. We hypothesise that tailored information will improve the LBP beliefs and self-efficacy, and will be viewed more positively than a traditional form of LBP information recommended by guidelines.

The aim of this project is to determine whether melatonin supplementation has a dose response effect on clinical pregnancy rates, together with numerous important clinical, biochemical and sonographic secondary outcome measures. This will be achieved by a series of experiments designed to investigate the effect of melatonin on follicular fluid, serum, embryo and oocyte parameters as well as assessing clinical pregnancy rates and delivery rates

There is evidence that suggest exercise can reduce the risk of falls and its associated injuries for the older population living in the community. Clients who are at risk or have a history of falls may be referred to the High Level Balance Group in the community rehabilitation program at Eastern Health, where the exercises are designed to strengthen and build standing endurance to improve an individual’s balance. The other exercise class offered is the Running Re-education Group; patients participate in challenging tasks which demand balance and speed. This trial aims to find out whether running re-education group is more effective in reducing falls in the elderly living in the community.

Changes to the small cerebral blood vessels are commonly obeserved on brain MRIs of the elderly. Two common changes observed are cerebral microhaemorrhages (CMH), which have been reported in 10-60% of healthy elderly subjects, and areas of white matter hyperintensity (WHI). The clinical significance of CMH remains uncertain, though there is a possibility they could predipose to later, clinically overt, haemorrhages. There have been mixed reports, derived from cross-sectional and longitudinal studies, on whether long-term low-dose aspirin increases the risk of CMH but this has not been evaluated in the context of a clinical trial. This study will investigate whether daily low dose aspirin increases the number of CMH after one and three years, as measured on brain MRI, as well as determine whether daily low dose aspirin changes the volume of WHI over the same time period, whether the presence of CMH on MRI at baseline is associated with subsequent incidence of ischaemic and haemorrhagic stroke and cognitive decline, and will also correlate imaging biomarkers measured with MRI with cognitive and clinical outcomes over three years.

Objective: To evaluate the efficacy of a brief four-week group-administered treatment program of cognitive-behavior therapy (CBT-I) for older adults with sleep maintenance insomnia. Design: Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pre-treatment, post-treatment, and 3-month follow up. Setting: Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. Participants: One-hundred and eighteen (mean age = 63.76 years, SD = 6.45, Male = 55) adults with sleep maintenance insomnia. Interventions: A four-week, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education and cognitive restructuring. Measurements: Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, confidence in and beliefs about sleep. Results: The brief group-administered CBT-I program produced robust and durable improvements in the timing and quality of sleep, perceived insomnia severity, daytime functioning, and participants’ confidence in and beliefs about sleep. Conclusions: The treatment program used in the current study has demonstrated impressive potential for a brief, inexpensive, and effective treatment of sleep maintenance insomnia in the older adult population.

The main aim of the study is to develop a home monitoring solution to enable people to remain safely and independently in their own homes for longer. Through the use of remote monitoring via non-invasive, passive sensors and medical devices, it will be possible to monitor a person’s overall activities of daily living for example whether they are sleeping well, eating enough and staying active; their social interactions, their home environment such as temperature and humidity and, as required, monitoring of their physical health, especially for those who are living with a chronic disease. This information gathered will be analysed for presentation that would be easy to understand format to help a person manage their own health and well-being, and, if they so choose, to also provide that information to their families or carers or even health service providers, to enable appropriate support to be provided when and as needed. We also wish to further enhance participants’ wellbeing by providing easy access to high quality videoconferencing technology, to keep them connected socially but also to service providers when required. The solution will also be assessed for its capability to allow for remote consulting with care providers, providing the clinician with a comprehensive picture of the person and their overall health and wellbeing over a period of time. This solution is made possible by the National Broadband Network, which enables reliable transmission of large amounts of data and makes uninterrupted videoconferencing possible.

The aim of this study is to evaluate the feasibility and preliminary efficacy of a resistance training program (CrossFit Teens) for improving fitness, psychological adjustment, cognitive functioning, and self-esteem in secondary school students. Participants from Grades 9 & 10 in a NSW Secondary School will be randomly randomised by class into the intervention (CrossFit) conditions or into the control group (normal PE and sport lessons). The program will be delivered by qualified CrossFit instructors 2 x week (45-1hr) for 8 weeks. The study aims to answer the following research questions 1) What are the effects of CrossFit training on health-related fitness in adolescents? 2) What are the effects of CrossFit training on resistance training skill levels of adolescents? 3) What are the effects of CrossFit training on self-esteem in adolescents? 4) What are the effects of CrossFit training on psychological adjustment in adolescents? 5) What are the effects of CrossFit training on cognitive functioning in adolescents? Participants will be assessed before and after the intervention using a battery of physical tests and a questionnaire.

The study is attempting to gain an understanding of what is being experienced by individuals following cancer therapy in order to establish interventions where required to improve quality of life and therapeutic management. Who is it for? You may be eligible to join this study if you are aged over 18 years, diagnosed with any cancer and will complete cancer therapy during the final two weeks of this trial’s recruitment phase. The trial involves a set of three questionnaires at 3-monthly time intervals and an interview. Where warranted, allied health professionals will assess and assist participants to manage their concerns after cancer therapy. Assessments will be conducted using questionnaires and interviews. The allied health professionals assessing the participants may include counsellors (to help participants with specific concerns such as establishing reciprocal understanding with family and friends regarding health issues being faced following therapy and the effects on lifestyle), physiotherapists (to help participants with managing physiological concerns such as lymphoedema), dieticians (to aid participants with concerns about weight and/or dietary balance), dermatologists (for concerns such as skin irritations), exercise physiologist (to assist with appropriate exercise to aid in recovery), social worker (to help participants manage lifestyle changes related to social networks), and psychologist (to aid with concerns such as depression). Outcomes of allied health professional assessments will enable appropriate intervention to be designed within a survivorship plan. The determination of the requirement for intervention will be based on results from assessment of changes in fatigue, fear of cancer returning, depression, coping with home/work duties, and learning to live with ‘new normal’ in participants in comparison to baseline information.