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Diabetes is a chronic disease where the primary care physician has a central role to play. Historically, evidence has supported the role of diabetes teams in hospital settings being able to provide better care compared with primary care but it has been argued whether this relates to improved systematic and organised care, compared to increased expert knowledge. With appropriate support and recall systems, delivery of diabetes care in general practice can be as good as hospital outpatient care. Recognising this, the United Kingdom has seen the introduction of diabetes clinics conducted by general practitioners with special interests (GPSIs) with demonstrated favourable improvements in HbA1c, cholesterol and blood pressure. To date, Australia has not adopted GPSIs into clinical practice. However, the Australian health care system is facing significant reform aimed at shifting the focus from tertiary and secondary hospital health care to primary health care, including the move towards GP superclinics. This research project focusses on the care of patients with complex T2DM who have been referred by their GPs for specialist diabetes care. This research is based on a novel concept which incorporates the principle of GPs with special interests around a multidisciplinary and coordinated approach to diabetes care in the community. Important to this model is the role of the specialist Endocrinologist in a consulting capacity to review and endorse the advanced skill GPs (GP Clinical Fellows) management plan. Few studies have investigated the staged devolution of diabetes services from secondary/tertiary care to primary care through increasing the capacity of primary care to meet the needs of patients who would otherwise use hospital outpatient services.

Brief summary: Between 10-30% of older community-living population report dizziness often leading to functional disability and psychological distress. The multifactorial aetiology of dizziness combined with a lack of validated diagnostic tests, and a tendency of clinicians to rely on poorly described symptoms and familiar assessments, are significant barriers to objectively establishing a successful diagnosis and implementing effective interventions. Thus, despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will aim to conduct a randomized control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment. We hypothesize that a multidisciplinary assessment (tests of balance, inner ear function, blood pressure, mental health etc) followed by a tailored intervention (exercise program, vestibular rehabilitation, comprehensive geriatric assessment and medication review) will improve diagnosis, reduce self-reported dizziness, enhance postural stability and improve quality of life in older people suffering from dizziness.

Rates of heart failure hospitalisations and deaths in Brisbane increase greatly in winter and in cold weather. Many events could be avoided if people took better measures to protect themselves against the outdoor temperature. A simple and cheap protective measure is thermal clothing. We will randomise patients who have a heart failure event at the start of winter to either a control group, or a treatment group who will receive two pairs of thermal tops and hats. At the end of winter we will retrospectively examine their hospital records to compare the length of time spent in hospital. We will contact all participants by phone at the end of winter to ask them about their self-rated health and their compliance with the thermals. This is a pilot study of 100 patients that will lead to a larger study if the results are promising.

Mechanical bowel preparation causes a marked imbalance in the colonic microflora. This altered microflora may play a significant role in post-preparation symptoms and delay in return of the normal bowel function for that patient. AIM Evaluate the benefit of probiotic use, and associated restoration of the balance of intestinal microflora, for patients undergoing colonoscopy after mechanical bowel preparation. METHODS Prospective double-blinded randomised control trial. Use of probiotics vs placebo in the setting of patients who have undergone full mechanical bowel preparation and colonoscopy A commercially available probiotic or placebo at recommended daily dose for 7 days after the procedure END POINTS Evaluation of post-colonoscopy symptoms - Abdominal pain - Time taken for patient bowel function to return to normal (the usual bowel habit for them)

When nutrients, including fat, empty from the stomach after a meal, they pass into the small intestine where they stimulate signals that initiate contractions in the stomach, and alter sensations like fullness. These responses to fat appear to differ between lean and obese individuals. We do not fully understand how the small intestine senses or “tastes” the presence of fat, but studies have recently identified a number of molecules, or “sensors”, that are present in the small intestine and interact with fat. We want to determine the number and location of these fat sensors in the intestine, and to evaluate whether there are any differences in their levels between lean and obese individuals. We also want to determine whether there are any relationships between the occurrence of these fat sensors in the small intestine with the way in which the stomach and small intestine respond to fat. Therefore, we will determine how fat, infused directly into the small intestine, changes the number of these sensors, contractions in the stomach and small intestine, and the secretion of hormones in the gut.

A study to evaluate the safety, tolerability and metabolism of MK8226 in healthy volunteers. MK8226 is being developed for treatment of patients with moderate to severe atopic dermatitis. However, this study is in healthy volunteers only.

We propose to conduct a 6-month, randomised, double-blinded placebo-controlled trial to assess the effectiveness of daily calcium and vitamin D supplementation in improving bone material properties at the distal tibia and radius in young male jockeys. The three-dimensional capacity of peripheral quantitative computed tomography (pQCT) to assess bone strength and estimates of fracture risk will be superior to previous reports using Dual X-ray Absorptiometry and will contribute new knowledge to the literature. Bone scans at baseline and 6-months will provide a better understanding of the relationship between supplementation and bone properties, including fracture risk. Project Aims We will test the hypothesis that 800 mg calcium (citrate and carbonate) and 400 IU vitamin D per day is effective in improving bone material properties and reducing fracture risk in young male jockeys by; (i) comparing changes to strength stain index (bone strength) at the tibia and radius in participants assigned to receive a 6-month calcium and vitamin D supplementation or a placebo Secondary aims are to: (i) monitor the proportion of young male jockeys who meet the recommended daily intake of calcium (1300 mg/day) (ii) compare the effects of supplementation on weight-bearing (tibia) and non weight-bearing (radius and ulna) bones

Aim: 1.To develop, implement and evaluate family interventions for supporting families of children with ABI in paediatric inpatient rehabilitation. 2.To compare outcomes of families who receive the family intervention to families who receive the “usual care” social work service during their child’s inpatient rehabilitation. Study Design: A sequential comparison group design. Procedure: Eligible participants will be invited to participate in the study at the time of their child’s admission to rehabilitation. During the child’s admission families will be recruited into the Comparison Group or Intervention Group and will receive “usual care” social work service or family intervention respectively. Participants will complete questionnaires at admission (T1), discharge (T2) and 6 weeks post discharge (T3). Data Analysis: The study will compare outcomes of the Intervention Group and Comparison Group at six weeks post discharge.

The aim of this study is to assess the impact of commercial contact lenses on the global peripheral aberrations and retinal image quality.

To evaluate, in overweight/obese patients with type 2 diabetes mellitus the chronic effects (24 months) of an energy restricted, very low carbohydrate (<50 g/day), low saturated fat (<10%) diet compared to an isocaloric high unrefined carbohydrate, low fat diet on: Primary outcomes: glycemic control, cardiovascular disease risk factors and endothelial function Secondary outcomes: weight loss, body composition, appetite, diet acceptance, renal/bone health.