ANZCTR search results

Epidemiological studies of routine vaccinations and allergic disease have had mixed results, with studies showing positive, negative or no association. Very few randomised studies have been performed. Observational studies have the potential to be confounded by reasons for not receiving vaccination which may be associated with allergic disease. To minimise confounding associated with receipt of vaccination, McDonald et al. (JACI 2008;121(3):626-31) investigated the effect of timing of vaccination on asthma, finding that risk of asthma was reduced when the first dose of DTP was delayed by greater than one month. The HealthNuts cohort was initiated in 2007 to study environmental and genetic determinates of food allergy. This population provides an opportunity to test the association between vaccination timing and food allergy using the gold standard outcome of oral food challenges. We hypothesise that there may be an association between delay in the first dose of pertussis-containing vaccine and protection from food allergy at one year of age. Methods: Enrolment, examination and food-allergy testing have been performed as part of the HealthNuts study. Briefly, 5276 parents agreed to enroll their children in the cohort and 5120 had a skin prick test performed at 1 year of age. 1089 children had a positive skin prick test and were invited for an oral food challenge within the following months, of which 928 children completed, along with 197 skin-prick negative control children. Parents also completed an extensive survey of symptoms of allergic disease, family history of allergic disease, demography, environmental factors, and other risk factors for allergic disease. Data on vaccination doses and timing up to 18 months of age will be obtained for children of the HealthNuts cohort from the Australian Childhood Immunisation Register. Statistical analyses will be performed as described.

Our research team has developed a GP-delivered weight management program for adults in primary care based on the current Australian guidelines. "The Change Program" has already had qualitative review from both GPs and consumer representatives. It will provide GPs with practical support in managing overweight and obese adults, making the current guidelines accessible and implementable in a clinical setting. The overarching aim of this research program is to develop an effective GP-delivered weight management program for adults that can be delivered in Australian general practice. This is a pilot implementation study to determine the feasibility for a larger scale RCT of a weight management program for overweight and obese adults in general practice. It will not have an effectiveness component at this stage. The elements of feasibility that we aim to explore include: recruitment feasibility, dropout rates, refinement of the protocol and collection of cost data, determining time processes. The outcome of this pilot will aim to feed into a large scale, longer term, RCT to determine the effectiveness of this GP-delivered intervention. Currently there are no GP-delivered weight management interventions in Australia and this will be a practical tool that GPs can use in their practice on a daily basis.

Background: Overweight and obesity are major health problems in Australia, with 61% of the population being either overweight or obese. Individuals, low in self-control, consume greater amounts of unhealthy food and are more likely to be overweight. Executive function training, an intervention technique designed to increase self-control and consequently decrease unhealthy food consumption, has demonstrated moderate success. However, researchers employing this technique have not focused on the mechanisms underlying the effect of training. Objectives: To conduct an executive function training intervention to determine whether training buffers against self-control ‘depletion’ effects and results in less unhealthy eating behaviour. Methods: Participants will either complete an executive function training paradigm or an inert version of training, followed by a self-control depletion task or a non-depleting task, and finally a taste test. Expected Findings: Those who receive training will eat less unhealthy food after the depletion task compared to those who did not receive training.

As hyperglycaemia in acute ischaemic stroke is associated with increased infarct size and worse functional outcomes, therapies that can maintain normoglycaemia during stroke are of significant clinical importance. GLP-1 analogues, including exenatide, are a potential therapeutic option for the effective regulation of blood glucose levels in acute stroke, without the risk of inducing hypoglycaemia, which can be associated with intensive insulin therapy. GLP-1 therapy is more straightforward to implement and does not require dose adjustment over time, as is necessary for intensive insulin therapy. This may result in less of a burden on treating clinical staff. Furthermore, administration of GLP-1 may have direct beneficial effects on neuronal cell survival and result in neuroprotection, as suggested by animal studies and preliminary clinical data. Thus, the use of a GLP-1 receptor agonist in the management of hyperglycaemia in acute ischaemic stroke (AIS) may confer a benefit in morbidity and mortality for patients long-term.

People with chronic disease only have access to structured exercise rehabilitation programs in tertiary health services if they have a diagnosis of chronic respiratory disease, chronic heart failure or have suffered a heart attack/undergone heart surgery. Current exercise rehabilitation programs address these conditions in a single disease assessment and management strategy, although the frequency of people with multiple chronic conditions (or multimorbidity) in Australia is increasing. Research suggests that other people with chronic diseases (such as cancer, diabetes, chronic kidney disease) also benefit from exercise training however these people are unable to access structured exercise rehabilitation currently as funding to run these services is lacking. The aim of this project is to pilot the implementation of a generic rehabilitation program for people with chronic disease in a parallel randomised controlled trial. This trial will randomise people with multimorbidity to receiving a generic chronic disease rehabilitation program or usual care. The aim of this pilot trial (one of a pair) is to test the feasibility of implementing a generic chronic disease rehabilitation program (multimorbidity rehabilitation) and to measure effect sizes that will be used to power subsequent large randomised controlled trials to answer the questions of efficacy and cost-effectiveness.

People with chronic disease only have access to structured exercise rehabilitation programs in tertiary health services if they have a diagnosis of chronic respiratory disease, chronic heart failure or have suffered a heart attack/undergone heart surgery. Current exercise rehabilitation programs address these conditions in a single disease assessment and management strategy, although the frequency of people with multiple chronic conditions (or multimorbidity) in Australia is increasing. Research suggests that other people with chronic diseases (such as cancer, diabetes, chronic kidney disease) also benefit from exercise training however these people are unable to access structured exercise rehabilitation currently as funding to run these services is lacking. The aim of this project is to pilot the implementation of a generic rehabilitation program for people with chronic disease in a parallel randomised controlled trial. This trial will randomise people with multimorbidity to receiving either their usual disease-specific rehabilitation or generic chronic disease rehabilitation program. The aim of this pilot trial (one of a pair) is to test the feasibility of implementing a generic chronic disease rehabilitation program (multimorbidity rehabilitation) and to measure effect sizes that will be used to power subsequent large randomised controlled trials to answer the questions of efficacy and cost-effectiveness.

HPV is a sexually-transmitted infection that can lead to several cancers. HPV vaccination is an important way to protect against these cancers, so it’s important that vaccination rates are high and teenage girls and boys complete all 3 doses of vaccines. Exercising at the time of getting the vaccine might be a way to stop some of the side effects children often experience, like pain and redness, and improve the experience of vaccination, helping improve vaccination rates. In this study we will test if a 15 minute exercise task changes the number of adverse event reports, we hypothesise that an exercise task will reduce the number of children who suffer an adverse event like pain and redness at the injection site.

1. To develop a culturally and linguistically appropriate patient education tool to inform conduct of EST in Aboriginal and non-Indigenous Australians 2. To evaluate this tool to determine if it can reduce the proportion of inconclusive EST results Hypothesis: A culturally and linguistically appropriate audio-visual resource will be associated with reduced inconclusive EST results in Aboriginal and non-Indigenous Australians undergoing investigation for possible CHD.

The primary purpose of the study is to determine if comprehensive periodontal treatment reduces progression of kidney disease among Aboriginal Australians living in Central Australia with kidney disease. The study hypothesis is that periodontal treatment will reduce progression of kidney disease. Kidney disease is a growing public health concern in Australia, especially among Aboriginal populations. Kidney disease consumes disproportionate healthcare resources and is the most common cause of hospitalisation among Aboriginal Australians. In spite of the unacceptably high social, medical and financial burden caused by kidney disease, there have been few RCTs that explore the impact of treatment to address key risk factors, such as periodontal disease, on, kidney disease progression . As a consequence, the management armamentarium currently available to slow the kidney disease progression is extremely limited and only partially effective.

Evaluation of a newly developed educational information package which provides information on alchol consumption during pregnancy, links to support, and alternatives to drinking for pregnant women. Study hypothesis states that the intervention will improve knowledge about the effects of alcohol consumption during pregnancy significantly more than standard antenatal care.