ANZCTR search results

IBD is a complex condition, which is often associated with high morbidity and requires close and continued collaboration between patients, specialist medical care and other holistic, multi-disciplinary facilities. Despite multiple studies documenting differences in health outcomes between rural and urban patients in a number of diseases, little published data exists regarding the level of disease burden in rural patients with IBD and how this compares with what we know about urban populations. Additionally, limited knowledge regarding patient and rural practitioner perspectives on the barriers to optimal medical care exists. This is important as a large burden of disease exists outside of the metropolitan area, where specialist gastroenterology serves are absent and consequently the majority of long-term care is carried out by rural general practitioners and surgeons. The aim of the study is to initially describe the disease burden and treatment experience of IBD, in patients living in rural areas as compared to metropolitan locations. We then aim to identify any perceived barriers to the care and management of patients with IBD in the rural setting compared with their urban counterparts from the perspective of rural practitioners, IBD nurses, surgeons and gastroenterologists. Finally we will obtain the patient perspective. The study design is predominantly based upon questionnaires aimed at identifying rural practitioners IBD experience, level of IBD knowledge and perceived barriers. Perceived barriers will also be identified from a group of interested gastroenterologists and then all results will be compared to previously studies. Patients will then be surveyed to obtain their perceptions on barriers to care. Differences in healthcare outcomes will be looked at through review of a South Australian database and a new cohort in Mt Gambier and compared to a previously collected control. This study will provide quantitative data and highlight any real differences in healthcare outcomes compared with metropolitan cohorts. It will then review knowledge of and attitude to IBD amongst several medical cohorts and finally investigate perceived barriers to care from a number of different perspectives. Through the data obtained we aim to identify common perceived barriers to optimal care, which may subsequently guide the development of multi-disciplinary interventions/strategies that could be introduced to enhance rural IBD patient care. Given the current limited published data regarding this issue, it highlights an exciting opportunity to obtain such information to determine if and how interventions may be introduced that would aid in over-coming such obstacles and optimise care of this cohort in the long term.

The primary purpose of this study is to extend and optimise sleep and improve athletic performance parameters in a group of Australian Football League (AFL) players over a 6 week period using education, monitoring and feedback. The main hypotheses are: 1. Increasing total sleep time will lead to improved overall performance in terms of improved sleepiness and vigilance. 2. Increasing total sleep time will improve athletic performance and aid in player recovery.

The primary purpose of this study is to investigate whether breast MRI and a PET-CT scan can accurately predict which women with locally advanced breast cancer (LABC) treated by initial Primary Systemic Treatment (PST), can undergo Breast Conserving Surgery (BCS), without compromising local control or Disease Free Survival. You may be eligible to join this study if you are over 18 years old, female, with Clinical Stage III (non-inflammatory) unilateral breast cancer. All patients receive PST as per local practice before operability is then assessed. MRI and PET-CT scan will be taken up to four times during the study; 1/pre-treatment, 2/between 4 and 5 weeks from start of PST, 3/between 3 and 5 weeks after PST is completed and 4/between 10 and12 weeks after radiotherapy treatment (for participants that are inoperable). Each MRI scan will take 20-40 minutes to complete. Each PET-CT takes 60-90 minutes to complete. * If LABC becomes operable, either mastectomy or BSC is performed as well as Sentinal Node Biopsy (SNB) and axillary node dissection. All patients receive radiotherapy 6-8 weeks post-operatively. * If LABC remains inoperable, radiotherapy is given to the breast and nodes. 5-7 weeks after completion of radiotherapy and the patient is re-assessed. If disease has become operable, mastectomy and axillary node dissection is performed. * All patients with a hormone sensitive tumour commence hormonal therapy 14 days after the completion of treatment to the breast and nodes. This study aims to find out if women with LABC can have BCS instead of mastectomy with a low chance of the cancer returning.

This project builds on an earlier project and seeks to examine the efficacy and acceptability of the Pain Course when provided with different levels of clinical support. We expect that people in the treatment groups will report similar levels of clinical benefit and acceptability.

The aim is to determine the effect of improving diet quality on measures of vascular function in people with type 1 and type 2 diabetes.

Weighed food records are considered the gold standard for determining dietary intake. Twenty hour urine samples are the gold standard for measuring sodium and potassium intake. However, these methods are burdensome to complete. The DQES (V2) food frequency questionnaire, a much less burdensome method of measuring dietary intake, has been previously validated in non-diabetic populations, however there has been no validation in people with diabetes.

The aim of this study is to measure the acute (2-hour) effects following consumption of wheat whole-grain foods differing in processing treatment on obesity-related measures. This study hypothesises that the grain products that have undergone selected additional processing will contain greater nutrients and bioactive compounds and have favourable outcomes on postprandial measures compared with regular whole-grain products.

This investigation is a single centre, double blind, parallel groups design assessing the effects of two doses of glucose alone and a dose of caffeine- glucose combination on cognitive performance, fatigue, stress and mood associated with extended multi-tasking. Using a randomised double blind crossover design, up to 160 healthy frequent caffeine consumers will attend 2 sessions (1 practice and 1 test session). During the practice session participants will complete a battery of cognitive tasks, mood and fatigue ratings. During the test session they will complete a battery of cognitive tasks, mood and fatigue ratings once before and once after receiving one drink corresponding to: 1. Placebo - Britvic Tango Orange Sparkling Drink, Diet sugar free fizzy orange drink 2. 25g Glucose - Lucozade energy (International) diluted with Tango orange 3. 60g Glucose - Lucozade energy (International i.e. outside UK) 4. 60g Glucose/40mg Caffeine - Lucozade energy (UK)

This pilot study will investigate if an exercise and education program is useful to help keep persons with Multiple Sclerosis exercising in the community by themselves. We hypothesise that the program will improve walking speed and be a feasible and safe program.

Background: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service (AAMS). Methods/design: Design: Multicentre, randomized controlled trial Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 18 weeks gestation with a singleton pregnancy and do not have a chronic medical condition. Trial entry and randomization: Eligible women with asthma, stratified by disease severity, will be randomized into one of two study groups: either the ‘Standard Care Group’ or the ‘Intervention Group’ Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the ‘Standard Care Group’ will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the ‘Intervention Group’ will receive additional care through the nurse-led Antenatal Asthma Management Service, based in the antenatal outpatient clinic. Women will receive asthma education with a full assessment of their asthma at 18, 24, 30 and 36 weeks gestation. Each antenatal visit will include a 60-90 min session where asthma management skills are assessed including: medication adherence and knowledge, inhaler device technique, recognition of asthma deterioration and possession of a written asthma action plan. In addition, subjects will receive education about asthma control and management skills including trigger avoidance and smoking cessation counseling when appropriate. Primary study outcome: Asthma exacerbations during pregnancy. Sample size: A sample size of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up). Discussion: The integration of an adapted model of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation rate of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes.