ANZCTR search results

This study hypothesises that shorter duration low molecular weight therpay is as effective as standard therapy in post operative orthopaedic DVT prophylaxis. There will be no significant difference in the incidence of post operative thrombotic events such as DVTs and PE. There mat be added advantages of reduced leg swelling and hence pain with the use of mobile calf compressor device as an outpatient.

Patients involved: Those patients with oesophageal-gastric cancer. Intervention: Insertion of lipiodol markers under endoscopic guidance that will allow improved response assessment with imaging such as CT, surgical resection and pathological assessment of the tumour in the surgical specimen. Intervention will also allow image guided radiotherapy for candidates who are suitable for radiotherapy. Outcomes of this study: The outcomes include success of lipiodol marker insertion which will be classified endoscopically and or radiologically on follow up imaging. Visibility of markers for radiotherapy planning Cost analysis of lipiodol markers in comparison to alternative methods such as fiducial/endoclip placement. The rate of successful anatomical correlation of both pre and post neoadjuvant therapy lipiodol images. The rate of successful (RECIST) assessment of tumour response post neoadjuvant therapy. The quantitative improvement in RECIST reporting with lipiodol. The quantitative improvement in correlating metabolic response with pathologic response rate with lipiodol. The rate of successful spatial correlation of pathologic margin (macro and micro) correlation with conventional imaging. (CT, EUS and FDG-PET/CT) Spatial correlation of CT, EUS and FDG-PET/CT and oesophagectomy specimens with radiotherapy volumes in definitive and postoperative settings

Extremely low gestational age newborns represent the smallest and most immature newborns and are at greatest risk of dying or surviving with significant morbidity particularly neurodevelopmental disability. Over 90% of these newborns receive at least one packed red blood cell (PRBC) transfusion whilst in neonatal intensive care with the majority receiving between 3 and 5 transfusions during their primary hospital admission. There is increasing evidence that PRBC transfusions are independently associated with more frequent and severe cardiopulmonary, gastrointestinal and neurodevelopmental morbidities. Indeed, in comparison to other populations, these transfusion associated adverse events are more common in the preterm newborn. Packed red blood cells are biologically active. We have shown that PRBC transfusion results in endothelial activation, inflammation and oxidative stress in preterm neonates. This transfusion related immunomodulation (TRIM) might contribute to the recognised association between allogeneic PRBC transfusion and adverse clinical outcomes. It is unclear if TRIM is a response to red blood cells themselves, the time-dependent accumulation of bioactive substances in the supernatant (storage lesion), or both. However, in adult and childhood populations significant benefit is gained from modifications in blood product processing such as PRBC washing, though this has never been studied in the preterm neonate. Any reduction in PRBC transfusion related harm would be of substantial clinical benefit in this at risk population. This pragmatic clinical trial aims to identify if transfusion with washed PRBCs reduces harm from transfusion in high-risk newborns.

This study aims to test faecal transplant as a potential new therapy for active ulcerative colitis. Patients with ulcerative colitis have a restricted diversity of bacteria in the bowel and faecal transplant aims to replenish the diversiy of the bowel bacteria. Faecal transplant involves the delivery of stool from a faecal donor into the bowel of a patient with the aim of improving symptoms and reducing mucosal inflammation.

Adolescence is a high-risk time for the development of mental health and substance use problems. Evidence shows that young people who experience these issues typically turn to their peers for support rather than seeking professional help. While there are numerous programs that endeavour to improve student knowledge about mental health and substance use, there are few programs that provide students with the practical skills required to encourage their friends to seek help. MAKINGtheLINK is a school based education program that equips young people with correct information and the opportunity to practice assisting a friend at risk. The program teaches students practical skills regarding: signs of problematic substance use and emotional issues, what to say to a friend that you are concerned about to encourage them to seek help, the types of helpers that exists and how to access them. By comparing the knowledge and behaviours of Victorian year 9 students who receive the program with those that do not receive the program, we will be able to measure whether there are improved rates of help seeking and confidence to assist a friend to seek help amongst the group that receive the program.

The project will focus on older adults living independently in the community, and who are on the cusp of Functional Declune (FD). We will conduct a nested RCT within a 13 month longitudinal observational study. In the observational study we will apply a simple, previously untested quality of life screen to detect incipient Functional Decline, one month following an Emergency Dept presentation that did not result in an inpatient admission. Those individuals with low scores at the point of screening will enter the RCT, which will test the effectiveness of a novel, early, home-based, personalised program (compared with ‘usual care’) in arresting or slowing Functional Decline.

Poor core stability is associated with dysfunction and weakness of muscles of the trunk, pelvis and hip (core muscles) and the development of lower limb pathology and low back pain. Core strengthening programs aim to prevent injury and increase stability through improved strength and co-ordination of core muscle activity (Faries & Greenwood, 2007). However, the delivery method of training programs is highly variable and despite widespread use, the evidence for injury treatment and prevention with core strengthening programs is inconclusive. This may be due to the heterogeneity of delivery methods of programs used as the intervention. Investigation of the most effective delivery method of core strengthening programs is required to enable accurate evaluation of efficacy core strengthening interventions. The aim of this project is to compare the effect of supervised core strengthening classes, a home-based core strengthening program and no intervention on specific measures of core stability. It is hypothesised that supervised classes will 1) result in a greater improvement in performance in tests assessing core strength, and 2) increased transversus abdominus (TrA) hypertrophy when compared to a home-based program and no intervention.

Previous studies have shown mixed results on the ability of dietary interventions to improve iron status in women with iron deficiency. Given the popularity of email and mobile phones, communicating through email and text messages may be a promising means to encourage iron-friendly eating habits throughout the day. The aim of this study is to investigate whether email and text messages can improve knowledge, iron intake, and iron stores in women with low iron stores.

The Australian population is ageing, with a disproportionately large burden of disease incurred in older people. Retirement, as a major life transition, may offer an important opportunity for intervening on health behaviours. The primary aim of the Life After Work study is to comprehensively measure changes in activity patterns, health and well-being across the retirement transition, using a use-of-time approach, with the view to inform further health behaviour interventions for this population. A target sample of 120 participants aged 50 years and over who are about to retire will be recruited in two major Australian cities, Adelaide and Brisbane. Participants will undertake a battery of assessments approximately 3 months prior to retirement, and 3, 6 and 12 months post-retirement. Assessments will include self-reported use of time (using the Multimedia Activity Recall for Children and Adults), objective physical activity and sedentary behaviour (using Actigraph GT3X+ accelerometers), self-reported health status and well-being (using a battery of surveys, including the Short-Form Health Survey (SF-36) , the Australian Unity Personal Well-being Index (AUPWI), the Depression Anxiety Stress Scales, the Short Warwick-Edinburgh Mental Well-being Scale, the UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale), retirement circumstances and socio-demographic items, objective anthropometric measures (height, weight and waist circumference), and resting blood pressure. The results will allow a robust examination of the changes in use of time, health and well-being across retirement. The results will provide important new information that will inform the development of lifestyle and policy interventions to address and improve health and well-being in retirement.

Falls and fracture rates are highest in elderly in low-level aged-care than those in nursing homes or in the community, so this is the highest risk group and most likely to benefit from interventions. Drugs cannot be given to large numbers of people so non-drug approaches are needed to reduce the burden of fractures, but must be effective, safe, easily administered, readily available and low cost. Low protein and calcium intakes increase falls and fracture risk because muscles weaken, balance worsens and bone breaks down more quickly making them more susceptible to fractures. On average low-level aged-care residents consume two or less serves of dairy foods per day with more than 75% of residents below the recommended intakes levels for protein and calcium. Dairy foods are a good source of protein and calcium, and fulfill the requirements of safe, accessible, easy to administer and low cost. We aim to determine if two additional serves of dairy food per day will corrected these deficiencies and reduce the rate of falls and fractures in low-level aged-care residents by maintaining muscle mass and function and slowing bone loss. We will study this over 2 years by ensuring that residents consume 4 serves of dairy foods per day. Food service staff with be trained and supported to modify the menus to improve dairy food intake. We will recruit 3000 residents in 60 aged care facilities; 30 facilities will be randomized to intervention and 30 serving as controls. Residents will be transported under supervision to the Heidelberg Repatriation Hospital for bone, balance and body composition measures. Fractures will be monitored in residents from incident reports and verified using hospital medical records. Bone turnover will be measured using serum bone metabolic markers, bone structure measured using high resolution peripheral quantitative computed tomography (HR-pQCT) and bone density and body composition measured using densitometry (DXA). Strength and physical function and questionnaires will be assessed at facilities. All tests are performed before the intervention begins, bloods and strength re-assessed at 3 months and bone structure, density and body composition measured again at 12 months. This study will be the first to assess the anti-fracture efficacy of dairy foods, and the mechanisms and structural basis for this reduction in fracture risk. If anti-fracture efficacy is demonstrated it will provide evidence for a safe, low cost, widely available approach to reduce the burden of fractures in the community.