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Optimal Therapy for Obesity Hypoventilation Syndrome
Not being able to breath enough overnight is a major problem for an increasing number of Australians with obesity. Obesity hypoventilation syndrome, as this problem is known, is now the major reason for complex, overnight breathing support in Australia. This potentially fatal disease can be managed using two different strategies; a cheaper, simpler option available to more people or a more expensive approach that requires specialised services. The more complex approach may not be better if fewer people are able to take advantage of it. In this twelve month study, people with obesity hypoventilation syndrome will be randomised (like flipping a coin) to receive either the simple or the complex way of managing the disease. The primary question we are looking to answer is whether the more complex approach is really better than the simpler one. Specifically, the study will determine which treatment is better for patients in terms of quality of life, blood test results and and how easily they can get out and about. The study will also help establish which of these approaches is more cost-effective for the community.
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TRiM – Trial for Reducing Weight Retention in New Mums: A randomised controlled trial investigating the effectiveness of an innovative postpartum weight loss program.
Retention of weight gained during pregnancy contributes to overweight and obesity and subsequent chronic disease risk, with the associated personal, financial and public health burdens. Women who are overweight or obese at beginning of pregnancy are more likely to gain excess weight and retain this weight after pregnancy. Women who do not lose weight by 6 months postpartum are more likely to be overweight or obese over the long term. Approximately one third of women who deliver at the MMH are overweight or obese at the beginning of pregnancy. A 2008 MMH Nutrition and Dietetic audit demonstrated that, of the 102 women surveyed, 50% of the women who were overweight, 75% of women who were obese and 100% of women who were morbidly obese gained in excess of their recommended weight gain range for pregnancy. Our MMH patients are at very high risk of retaining weight after pregnancy and developing associated chronic diseases, thus implementation of weight management interventions is urgently required. Limited data exist regarding the most effective methods of supporting weight loss after pregnancy. However, diet and exercise, with behavioural change and support are known to be important elements to be included in any program. Usual models of weight loss care (e.g. multiple group/clinic attendances) are not as appropriate in this population group due to childrearing demands. Our research aim is to develop, implement and evaluate an innovative postpartum weight management program that includes evidence-based behaviour change strategies to support postpartum weight management that is delivered in a format suitable for MMH postnatal (PN) patients.
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A substudy of the PLAPCI trial comparing Phospholipase A2 release with tissue characteristics as determined by invasive ultrasound and infrared imaging of the heart arteries in patients with coronary artery disease undergoing coronary artery stenting.
The aim of this study is to assess the effect of elective coronary stenting procedures on the release of enzymes (PLA2) found in the wall of the coronary artery, and how this release relates to the characteristics of the artery wall as assessed by novel invasive imaging tools
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Promoting Recovery and Enhancing Outcomes Pre and Post Surgery (PREOPPS): Effects of preoperative oral carbohydrate loading on clinical outcomes.
The literature suggests that a carbohydrate rich beverage before surgery positively affects postoperative recovery and improves subjective patient wellbeing. The positive effect of carbohydrate rich oral fluid intake on perioperative urine output and fluid and electrolyte balance has also been shown. Although the metabolic and electrolyte advantages of using a carbohydrate rich preoperative beverage have been demonstrated, there is less information about whether these advantages translate into improved postoperative clinical outcomes, such as whether preloading with a carbohydrate drink reduces hospital length of stay. The current study has been designed to establish the efficacy of preoperative carbohydrate drink in shortening time to discharge in a prospective randomised clinical trial for gastroenterology patients undergoing elective bowel surgery.
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The Healthy Start to Pregnancy study - an evaluation of a new early antenatal health promotion model of care for improving maternal health behaviours.
Women with a healthy lifestyle during their pregnancy have healthier pregnancies and healthier babies. Their long term health is also improved, resulting in a better quality of life for them and their family, as well as lower health system costs with fewer doctor and hospital visits required. Currently, we do not know the best way to support women to make lifestyle changes to ensure they have the healthiest start to their pregnancy. This study is looking at how effective a workshop that is delivered early in pregnancy, that covers important diet, exercise, and smoking cessation advice, support and referrals, is to improve the health of pregnant women attending a large maternity hospital in South East Queensland.
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Re-Frame It: A trial investigating the impact of an e-health intervention on suicide risk among school students
The overall aim of this study is to examine whether or not a web-based intervention employing a cognitive-behavioural therapy approach, can reduce the risk of suicidal ideation (SI) in young people who have presented to the school counselor for help. Secondary aims are to examine whether or not the intervention can increase coping and problem solving skills and help-seeking (these are measured as a means of understanding the underlying mechanisms that may lead to a reduction in risk). We will also assess the acceptability of the intervention, treatment adherence, how long people remain on the website and whether or not the intervention causes undue distress. Hypotheses The primary hypotheses are that the intervention will: 1. Reduce SI among participants Secondary hypotheses are that the intervention will: 2. Reduce symptoms of depression, anxiety and hopelessness 3. Increase help-seeking 4. Improve coping and problem solving skills 5. Participants will find the receipt of this intervention acceptable, and 6. The intervention will not cause undue distress.
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A Phase III Randomised, Double-blind, Placebo-controlled Trial to Assess the Efficacy of Tranexamic Acid in Reducing the Blood Loss in Patients with Per-rectal Bleeding
A study to assess the effectiveness of oral tranexamic acid to placebo in reducing the amount of blood loss from lower gastrointestinal bleeding, and to reduce the amount of blood needed to be transfused.
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Lung cancer: the role of exercise training in optimising recovery after resection
This study will explore the role that supervised exercise training has in helping Stage I or II lung cancer patients to recover. Who is it for? You can join this study if you have previously had a lung resection (lobectomy) for lung cancer (Stage I or II non-small cell). With or without chemotherapy, and live in the metropolitan Perth area. Trial Details Following completion of previous treatment for lung cancer (surgery with or without chemotherapy), you will be randomised either to a group that receives 8 weeks of supervised exercise training, or usual care where you will be followed up by weekly phone calls for general discussion about your recover. Measures will be made before and after this 'intervention' period. Specifically, measures will be made of; (i) lung function, (ii) exercise capacity, (iii) disease-specific health-related quality of life, (iv) feelings of anxiety and depression, (v) peripheral muscle force (i.e. strength) and, (vi) daily physical activity. This trial will be the first randomised controlled trial of supervised out-patient exercise training in this patient population, and look to optimise recovery for patients following lung cancer resection.
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A comparative study assessing the efficacy and acceptability of anorectal swabs for antenatal Group B Streptococcus (GBS) screening
For antenatal screening for Group B Streptococcus (GBS), current guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommend both a low vaginal swab (LVS) and an anorectal swab (ARS) to be taken. The addition of an ARS to a LVS is reported to increase the GBS detection rate compared to performing a LVS alone. Despite these recommendations, many clinicians perform a LVS alone for GBS screening, and patient and physician acceptability may be responsible. We aim to assess the pain and acceptability of the LVS and ARS, and the detection rate for GBS from each swab.
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A prospective randomised controlled trial comparing pelvic floor treatment by a pelvic floor physiotherapist, versus extracorporeal magnetic stimulation, for women with stress urinary incontinence.
The purpose of this study is two compare the benefit of two different treatments for patients with stress urinary incontinence. This is a condition in which women may leak urine with increases in abdominal pressure, such as coughing, sneezing, lifting, walking or running. The first treatment is five individual physiotherapy sessions. The second treatment is 20 sessions on a special magnetic chair. Patients are assessed prior to starting treatment, at three months after competing treatment, and again at six months.