ANZCTR search results

The aim of this project is to reduce the deaths caused by Heart Failure in Tasmania. This will be achieved through implementation of a screening program for cardiac dysfunction and the use of protective therapy that will limit the development of heart failure. We plan to show the benefit of testing by recruitment of "at risk" subjects from the community and randomising them to a screening program based on echocardiography. Patients with abnormalities will be entered into a program of cardio-protective therapy, supervised by their general practitioner. Endpoints: 6-minute walk at a minimum of 24 months and comparison of the rate of heart failure among groups.

This study will investigate the molecular mechanisms by which a fruit and vegetable supplement modulates systemic inflammation. Based on previous studies utilising fruit and vegetable supplements and our own fruit and vegetable withdrawal study, we hypothesise that the extract will modify systemic inflammatory pathways, including NF-kappaB, AMPK, MAPK, PPARalpha/gamma and TLR2/4, among others. In addition, various proteins associated with inflammation, lipid metabolism and insulin resistance will be improved. Determining whether the supplement is an effective treatment for reducing systemic inflammation in obesity and identifying the mechanisms involved may assist in reducing the risk of chronic diseases, including CVD and diabetes. This is critically important for reducing the burden of disease in this subgroup of the population for whom weight management/ weight loss has not been achievable.

This study will assess the quality of life of women from a surgical oncology practice in North Sydney, Australia, who have undergone mastectomy for breast cancer, have chosen to have immediate breast reconstruction (IBR) and have also required post-mastectomy radiotherapy (PMRT). The purpose of this research is to provide evidence about the oncological safety and levels of patient satisfaction in this group of women. Study details All participants in this study will be asked to complete five surveys, six months after their final breast reconstruction operation, about their satisfaction with the aesthetic outcomes of their surgery, and its affect on their psychological wellbeing and quality of life. These patient-reported outcomes will be assessed alongside measures of their clinical outcomes, including any post-operative or post-radiotherapy complications, taken from their patient record. A subset of these women will also have a clinical examination and photos taken at six months following their final reconstruction procedure.

Neuraxial anaesthesia (spinal, epidural or combined spinal-epidural anaesthesia) is the gold standard technique for elective lower segment Caesarean section (LSCS) surgery. The traditional and accepted method of performing this anaesthetic procedure involves palpation of the patient’s spinous processes and iliac crests to identify the midline and intervertebral space to appropriately insert the needle and deliver the anaesthetic. The needle is then inserted through the skin, subcutaneous fat and ligaments until the epidural and spinal space is reached. Difficulties can be encountered during this procedure due to the misidentification of the appropriate level of insertion and midline of the spine and needle contact with vertebrae, nerves and blood vessels. Ultrasound images can help identify structures beneath the skin including bone, ligament anf muscle. This study aims to: * determine the accuracy of palpation-based identification of intervertebral level and midline of the spine compared with ultrasound, * assess the efficacy of ultrasound-assisted versus palpation-assisted neuraxial anaesthesia and identify the obstetric population, and * identify the obstetric population at higher risk of difficult neuraxial insertion. Full-term pregnant (>37 weeks gestation, adult patients undergoing elective LSCS surgery who are deemed appropriate to receive a neuraxial anaesthesia will be invited to participate in the study. Patients recruited to the study will be randomised to either the palpation-assisted (control) or ultrasound-assisted (intervention) group. Prior to the performance of a combined spinal-epidural anaesthetic, an anaesthetist will identify and mark the midline and “best” lumbar intervertebral space by palpating the patients hip bones and spine. An investigator will then perform an ultrasound of the patient’s lumbar spine to identify and mark the midline “best” intervertebral space. In the control group, the palpation-identified mark will be used as the needle insertion point. In the intervention group, the ultrasound-identified mark will be used as the needle insertion point. The combined spinal-epidural anaesthetic will be performed using the same standard technique in both groups.

An estimated 4 million Australians have a hearing loss. People with hearing loss are reluctant to seek or accept help for their hearing and listening problems. The literature shows that this reluctance is driven by a fear of stigmatisation and serves as a major barrier to the effective delivery of services which have been designed to reduce the health and social impacts of hearing loss. A population group at risk are farmers with two out of three affected by hearing loss. Permanent hearing damage can be caused by prolonged exposure to noise or immediately by sudden, extremely loud or explosive noises. There are many different and unique sources of noise on farms. This project tests the hypothesis that participating in early intervention hearing services focussed towards farming families will contribute to (a) significant reduction in the impact of hearing loss on farmers and (b) educate and empower farmers on their capacity to reduce their noise exposure.

This research study seeks to look at the best ways of supporting women who have completed breast cancer treatment within the last 12 months to make lifestyle changes (increasing physical activity, improving eating habits, and achieving and maintaining a healthy weight) to promote longer-term health and well-being. Who is it for? You may be eligible to join this study if you are a female aged between 18-75 years who has completed primary treatment with curative intent for stage I-III breast cancer (unilateral or bilateral) within the past 12 months. Study details All participants in this study will receive 6 months of telephone counselling from the NSW Get Healthy Service (GHS), which is a telephone counselling program for physical activity, healthy eating and weight loss. We are interested in whether this program is acceptable and beneficial for breast cancer survivors. In order to determine this, participants will be asked to complete a number of assessments and questionnaires on completion of the program to evaluate feasibility and acceptability of the project, changes in body weight, dietary intake, physical activity levels, quality of life, fatigue, depression, body image and menopausal symptoms.

- The median sternotomy remains the gold standard incision for cardiac surgery procedures and involves division of the sternum (otherwise known as the breastbone) to access the heart and surrounding structures. - After such procedures, patients are routinely asked to follow precautions that restrict upper limb and trunk movements in order to allow the sternum to heal. - However, little is known regarding the sternal healing process and how upper limb and trunk movements affect this process following cardiac surgery. - The primary aim of this research project is to investigate how tasks involving the upper limbs and trunk affect the healing sternum over time. - To achieve this, the research team will measure how much movement occurs at the sternal edges during upper limb and trunk movements with the use of a 2D ultrasound machine. - 75 participants will be recruited to take part in this study. All participants will receive standard pre and post-operative care. - Nested within the above main study is a reliability study which aims to investigate the inter and intra-rater reliability of ultrasound measures of sternal micromotion during upper limb and trunk movements, in acute patients following cardiac surgery (first time point- 3-7 days post-operation). - The first 20 participants recruited to the main study will form the sample for the reliability study.

Hypothermia has great promise as a cytoprotective therapy after stroke given clinical benefit in other brain injury scenarios and animal models of stroke. THAIS is a pilot randomized trial of hypothermia (cooling) versus standard care that focuses on patients with major stroke who have undergone rapid, successful recanalization. This group often demonstrates initial improvement in brain imaging (diffusion MRI) followed by later re-appearance of the lesion which likely reflects a secondary injury. If hypothermia can reduce this secondary injury it has great potential to improve patient outcomes after severe stroke – a patient group that currently have very few treatment options.

Assessment of the prevalence and incidence of glucose intolerance and diabetes in subjects with Cystic Fibrosis.

Myopia (also known as near or short sightedness) is a condition of the eye where objects viewed in the distance appears blurred. Conventional methods of correcting this optical condition include spectacles and contact lenses. The rate of progression of myopia tends to be more rapid in the younger age and high degrees of myopia can lead to complications such as retinal degeneration and detachments, choroidal neovascular membranes and an increased risk of primary open angle glaucoma. Numerous studies have investigated different contact lens optical designs to correct and potentially treat myopia. One theory in the attempt to reduce myopia progression is to target the stimulus on the peripheral retina. Previous studies have shown that the peripheral retinal stimulus plays a role in myopia progression. It is now known that peripheral hyperopia, where the stimulus or focus falls behind the retina, can be a trigger for myopia progression. Myopic eyes tend to have peripheral hyperopia and unfortunately the design of conventional spectacles and contact lenses used to correct myopia, actually exacerbates this. Thus, in an attempt to minimise myopia progression, the optical design of contact lens should bring the focus from behind the retinal periphery to either on or in front of the retinal periphery. This concept has been tested in contact lenses previously and progression of myopia was found to be 34% less than when wearing spectacles only. Newer optical designs with this concept are required to be tested to enhance the myopic progression effect, however, as the lens designs are novel, myopic participants are required to test the lenses and ensure both vision and subjective acceptance of the lens prior to longer term assessments on the efficacy of these lenses. Previously conducted clinical studies assessed numerous prototype lenses after short-term (1.5 and 6 hours) lens wear compared to commercially available equivalent contact lenses in adults. The best performing prototype lenses from the short-term trial have been selected for further testing in the current study against the best performing commercial contact lenses for use in children and young adults.