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Treating Aspirin Resistance with GuidEd Therapy in Diabetes (TARGET-Diabetes) Study
People with type 2 diabetes have both greater risk of heart attack and are likely to be resistant to drugs such as aspirin commonly used to prevent heart attacks. Furthermore, while some clinicians currently change drug therapy or increase the dose given to people with diabetes, no studies have been done to assess the risk or benefit of such action and there is a need for clear, evidence based, clinical guidelines to be established. Therefore we aim to pilot a study which will assess the effect of increasing frequency of aspirin dosing, adding alternative drug therapy, or better management of hyperglycaemia to improve markers of heart attack risk. We hypothesize that these approaches will improve markers of platelet activation in aspirin resistant diabetics.
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The Effects of Narrow Band Ultraviolet B (UVB) Phototherapy on Vitamin D levels in patients with Psoriasis and Broad band Ultraviolet B and A used for dermatitis
We propose to measure Vitamin D levels in a group of patients attending the Fremantle Dermatology clinic pre and post UVB and UVA phothterapy, to see whether there is any change in the levels post phototherapy.
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AN2728 Topical Ointment in Sensitive Areas of Healthy Volunteers
The aim of this study is to assess the local tolerability of an experimental ointment called AN2728. This ointment has been tested in 11 clinical trials to date, and is being developed as a treatment for patients with psoriasis. In the laboratory this ointment has been shown to reduce inflammatory chemicals in the body that are involved in inflammatory skin diseases. This study will help doctors find out how well people will tolerate the application of the ointment to sensitive areas in terms of any local reaction (ie. irritation, redness, itchiness). Participant's skin will be monitored closely at various times throughout the study to assess any effect that the drug has on their skin.
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The 3 and 5 year follow up of children who participated in the DOMInO study: growth and insulin resistance follow-up.
The primary aim of the study is to determine the effect of maternal dietary supplementation with n-3 LCPUFA in pregnancy on the percentage body fat in children at 3 and 5 years of age. the pathway to obesity begins early in life, and reducing this early accumulation of excess body fat represents an essential strategy for improving health outcomes across the life course.
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Complementary Medicine techniques for Labour and Birth: A Mixed Methods Study.
We have chosen two established antenatal education programmes (‘SheBirths’ and 'Acubirth'), which together introduce 6 different CM techniques for the management of labour and birth. We plan to introduce the programme via 10 two-day workshop to 96 women and their birth partners over a period of 12 months. We will adapt the programme for implementation at 2 large teaching hospitals in NSW. Participants and their birth partners will be recruited from Antenatal clinics from 24 weeks of gestation and randomly allocated to attend the CM birth education program plus standard care or to standard care alone. The CM birth education programme is an intervention which introduces techniques of: Physiology of birth, the Fear-Pain-Tension cycle; Movement and positions for birth; Acupressure techniques; Guided visualisation; Breathing techniques. Outcomes: The primary outcome to be evaluated is the rate of epidural use. Secondary outcomes to be evaluated include: pharmacological pain relief, instrumental delivery; caesarean section; length of labour; Apgar scores; admission to NICU/SCN; gestational age at delivery; satisfaction/control scores and post-natal depression scores.
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Follow-up of children whose mothers participated in the DOMINO trial: does fish oil supplementation in pregnancy influence child development at 4 years?
The primary aim is to determine whether supplementing pregnant women with DHA-rich capsules from 18-21 weeks of prengnacy until delivery will enhance the general cognitive ability of children at 4 years of age. Hypothesis: Children whose mothers took DHA-rich fish oil capsules during the second half of pregnancy will have enhanced cognitive development at 4 years of age compared with children whose mothers consumed a placebo. This will be investigated using psychometric assessments.
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Pre-Hospital Assessment of Noninvasive Tissue Oximetry Monitoring
A lot of the things we do when looking after patients with significant injuries after accidents relies on using monitors to provide us with information. When it comes to the brain, we often measures things elsewhere in the body and assume that if those things are normal, we're doing the best we can for the brain, but we can't be sure. This study is designed to look at a kind of monitor that you can apply to the skin which gives you information directly about oxygen balance in the brain. The hypothesis is that there is an association between the values shown by the monitor in injured patients and how well they recover after their injury - meaning that if the numbers are abnormal, it correlates with worse recovery later.
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Internet-based treatment of Panic Disorder and/or agoraphobia (the revised Panic program): A randomised controlled study exploring the role of a clinician.
Our previous research indicates that the Panic Program, an Internet-based treatment program for people with Panic Disorder with or without Agoraphobia is effective at helping people to learn to manage their symptoms of panic. The study described here aims to find out whether therapist support is required for people to successfully complete the Panic Program. We expect that people completing the Panic Program without therapist support (but who receive weekly telephone reminders) will still benefit, but not as much as those receiving the usual levels of therapist support.
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Boosting influenza vaccine responses in the elderly using a brief bout of exercise
Acute exercise mildly activates the immune system; we have found that a short bout of exercise immediately before receiving a vaccine helps your immune system to respond better and give you more protection from disease. This has been seen in young healthy adults; now we want to test this unusual idea in people who could benefit most: the elderly. Those aged over 65 years are at greatest risk for influenza illness, and have been found to show weakest and worst maintained responses to vaccination. As such, a simple, safe, cheap and cost-effective intervention to enhance the vaccine response in the elderly is highly relevant and offers a unique, promising possibility that should be explored to better protect the elderly from ‘flu.
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Frequency and Pulse Duration Programming in Spinal Cord Stimulation
In this study we seek to investigate the effect of varying pulse width and frequency on paresthesia perception. This study seeks to confirm the findings of Yearwood et al (2007, 2010) that varying pulse width can shift the focus of paresthesia and to provide the first findings on the effect of frequency on paresthesia perception. In addition, we will report on the interaction between pulse width and frequency changes.