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Can knee muscle activation be altered using modified clinical exercises in patients with osteoarthritis?
The National Health and Medical Research council’s Guideline for non-surgical management of Hip and Knee Osteoarthritis includes recommendations for the use of quadriceps strengthening specifically, and resistance training more generally. However, further research is needed to best identify what exercise prescription has maximal benefit. Individuals with late stage osteoarthritis have been shown the preferentially activate the muscles more laterally when compared with healthy individuals. The aim of this study is to identify which clinical exercises cause a more balanced activation between the medial and lateral muscles of the lower limb. The results of this study may help give better understanding into roles of specific muscles in knee osteoarthritis patients, in ways to better distribution load, thereby, assisting practitioners in prescribing efficient exercises in treating symptoms and preventing knee osteoarthritis. It is expected that modified clinical exercises will result in a more balanced, or more medial activation of the muscles crossing the knee
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The effect of three different methods of managing heel pain
The aim of this study is to investigate the effects of three commonly used treatments for managing heel pain. It is anticipated that more customized interventions will be more effective in reducing pain.
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Implications of aggressive cardiac risk factor management on the catheter ablation for atrial fibrillation
Catheter ablation of atrial fibrillation (AF) has evolved as an effective therapy for drug-refractory AF, and the indications have broadened in recent years. Despite decreased procedural times, reduced complication rates, post-ablation freedom from AF has not improved proportionately in recent years. Metabolic syndrome (MS) and its components, including obesity, hypertension, diabetes, and dyslipidemia in conjunction with obstructive sleep apnoea, excessive alcohol intake and smoking has been associated with increased incidence of AF. However, the impact of modifications of these risk factors on recurrence of AF after catheter ablation is unclear and has not been tested prospectively. Also, these patients are typically not included in risk-factor reduction programs. The purpose of the study is to evaluate the impact of a structured weight managment program as part of the management of atrial fibrillation. It is also intended to assess the effect of weight reduction on the efficacy of atrial fibrillation following catheter ablation and the effect of weight and risk factor management on autonomic tone/pro-arrhythmic substrate.
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Activity levels in children and adolescents with type 1 diabetes
This study is looking to evaluate physical activity and sedentary behaviour in children and adolescents with type 1 diabetes using the Multimedia Activity Recall for Children and Adolescents (MARCA) and accelerometers. This study will also evaluate associations between physical activity/sedenatry behaviour and markers of diabetes control. Results from this study will be compared to a nationally representative sample of healthy children and adolescents that have similar evaluations of physical activity and sedentary behaviour.
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Reducing impulsivity in repeat violent offenders using a selective serotonin reuptake inhibitor (sertraline)
Violence is a leading cause of death and injury worldwide and a large percentage of prison inmates have histories of violent offending. Numerous studies attest to a strong association between poor impulse control (impulsivity) and violent crime. Impulsivity has been shown to be associated with reduced tone in neural pathways within the brain for which serotonin is the principal neurotransmitter. In a number of studies of impulsive-aggressive individuals, the administration of selective serotonin reuptake inhibitors (SSRIs) has been associated with reduced aggression, impulsivity and depression. To date, there has been no systematic study of the potential benefits of SSRIs for incarcerated impulsive violent offenders who are at high risk of repeat offending. This trial will examine the effectiveness of treatment with an SSRI in impulsive violent offenders on reoffending using a double blind RCT design.
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Red meat, dairy and insulin sensitivity
The aim is to investigate the effect on insulin sensitivity of a high lean red meat diet with minimal dairy; a high dairy diet with no red meat; and a diet that has no red meat and minimal dairy with protein coming from chicken, fish and other sources. Evidence is conflicting about the benefits or risks of consuming meat and dairy products and there is little understanding of the mechanisms behind the findings observed in epidemiological studies. The primary hypothesis was that the red meat diet would produce greater insulin resistance than the high dairy diet with secondary hypotheses that the high dairy diet would produce greater insulin sensitivity than the diet without dairy and that these changes would be greater in those with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) than in those with normal glucose tolerance (NGT).
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Intravenous lignocaine infusion for analgesia following laparoscopic hiatus hernia repair: A double-blinded, randomised, placebo-controlled trial.
Despite the best efforts of medical practitioners, a short period of severe post-operative pain is still experienced by many patients undergoing surgery. This is particularly so in patients that undergo laparoscopic repair of a hiatus hernia, since there are limited pain relief options that do not cause nausea and vomiting (as these could ultimately lead to disruption of the surgical repair). Many studies have shown that intravenous lignocaine infusion in the perioperative period is safe and has clear advantages in patients undergoing abdominal surgery. These same studies concluded that further research is needed to determine the optimum dose, timing and duration of infusion of lignocaine in this setting. This study aims to evaluate the benefits and validate the safety of intravenous lignocaine for pain relief for patients undergoing laparoscopic repair of hiatus hernia.
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A clinical and electrophysiological study of the effects of 4-aminopyridine on upper limb impairment in Multiple Sclerosis
Modified-release fampridine is licensed in Australia for the symptomatic treatment of walking disability in multiple sclerosis (MS). However, many patients with MS have reported beneficial effects on other areas such as fatigue, vision and upper limb function. These benefits have not been formally studied in a trial. In addition, it is not known how modified-release fampridine works and why it seems to work better in some people than others. Electrophysiological techniques such as nerve conduction studies, evoked potentials and transcranial magnetic stimulation can be used to study the nervous system and the effects of drugs on it. These techniques can be used to identify where particular drugs might exert their effect and help to uncover more information about how the drugs work, with the eventual aim of developing new symptomatic treatments for MS. The aim of this study is to use these techniques to examine the nervous system in study participants on and off fampridine and to compare the findings between responders and non-responders to the drug.
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A Pilot Study of patients with Oligometastases from Prostate cancer treated with Stereotactic Ablative Body Radiosurgery
This study is assessing the feasibility and safety of Stereotactic Ablative Body Radiosurgery (SABR) in patients with metastatic prostate cancer. Who is it for? You may be eligible for this study if you have Prostate Cancer that has spread to lymph nodes or the bones. Trial Details: The research project is testing a new treatment for prostate cancer that has spread beyond the prostate to the lymph nodes or bones. The new treatment is called Stereotactic Ablative Body Radiotherapy. Stereotactic ablative body radiotherapy (SABR) is a new form of cancer treatment involving high precision radiotherapy. Stereotactic Ablative Body Radiotherapy (SABR) appears to be effective in controlling cancer in other sites elsewhere in the body, including the lung, kidney and the liver. We aim to test the ability of this new technique to control cancers arising from the prostate, and that have spread to bone or lymph nodes. As part of this study you will be required to discuss your past medical history and progress of your prostate cancer with the doctor. A general physical examination with a focus on where the cancer has spread to is part of the study. You will have standard blood tests including your hormone levels and prostate specific antigen (PSA) level. Also as part of this study you will be required to have a special scan called an 18F-PET/CT (stands for fluoride-positron emission tomography/computer tomography) scan. This involves an injection of a radioactive chemical and then a scan to see where your prostate cancer has spread to. If the tests show that the research study is suitable for you, and you still wish to take part, you can join the study and begin the treatment. Prior to your stereotactic body radiotherapy you will be required to fill out quality of life and pain questionnaires. This may take up to 20 minutes of your time. You will have either a single session of stereotactic body radiotherapy (SABR) or in the rare situation where there is not enough time available you may be required to return for two sessions (if you have two lesions) and three sessions (if you have three lesions). In order to deliver this treatment, you will need to attend a ‘planning CT scan’ session, where you will receive a CT scan and your body measurements are taken in the position that you will be lying in for your radiotherapy. This visit takes approximately one hour. Once the radiotherapy treatment has been planned, a further ‘mock-up’ visit is required to ensure that the radiotherapy plan can be smoothly delivered when it comes to the time of treatment. This session will take between 45 minutes and 90 minutes. When the treatment starts, the total time required to deliver the treatment will be approximately one hour. All sessions are usually conducted on different days and we will contact you to give you the dates and times to attend for these sessions once they have been booked for you. Follow-up will involve a visit at approximately 1 month, and every 3 months until two years after the radiotherapy treatment. At each visit you will be reviewed by the doctor and have a prostate blood test (PSA). At each visit you will be expected to indicate on a questionnaire if you have any pain. At the 1, 3, 12 and 24 month visits you will be expected to fill out a quality of life questionnaire which will take about 20 minutes of your time. You will have a whole body bone scan at 12 or 24 months after your treatment. At 6 months after your radiotherapy treatment you will have another 18F-PET/CT scan, which will be very similar to the scan before your treatment. The purpose of this scan is to assess the effect of the treatment on your lesion(s).
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Hyperbaric Oxygen Therapy and Insulin Resistance.
In a recent series of studies performed by our group, we have shown that exposure to hyperbaric oxygen (HBO) leads to an increase in insulin sensitivity in male subjects and that this improvement can be measured in all men, not just those with diabetes. The aim of this study is to investigate the time course of this effect and explore the mechanisms involved when exposure to HBO induces an increase in peripheral insulin sensitivity. This study will also test whether the same thing happens in female subjects.