ANZCTR search results

The researchers wish to compare the outcomes of a longer duration(14weeks) to a shorter duration (7weeks) exercise rehabilitation following lung transplantation. Those who give informed consent will be randomised to longer or shorter programs and will be over 18years of age. All participants will undergo standard exercise program for 7 weeks, comprising thrice weekly supervised exercise in the physiotherapy department. The longer duration will receive a further 7 weeks of exercise training. Both groups will receive standard post transplant education sessions and maintain an exercise diary. Functional exercise capacity, lower limb strength training and quality of life measures will be obtained at baseline, 7 weeks, 14 weeks and 6 months. At present there is no data describibg the likely magnitude of differences in outcomes between longer and shorter rehabilitation programs.

A common aspect of obesity and ageing is that both are associated with reduced arterial compliance. Reduced arterial compliance is in turn associated with impaired cognitive function, particularly in people with metabolic syndrome. For instance, it has been demonstrated that an inverse relationship between ankle brachial index and cognition was exacerbated in people with the metabolic syndrome. Furthermore, prospective studies have indicated that reduced arterial compliance is associated with a more rapid progression of cognitive decline. Therefore, effects on arterial compliance might provide a common link between the effects of these conditions on both CVD and impaired cognitive function and interventions which improve arterial compliance may improve both CVD risk and cognition in older adults with obesity. A preliminary study conducted in Manitoba showed that the consumption of1/2 cup of pulses for 8 weeks improved arterial function (arterial compliance and ankle-brachial index), body composition (BMI) and blood lipids in patients with peripheral artery disease. Given the aforementioned associations between improved arterial function and cognitive performance, it is possible that incorporating pulses into an ad libitum diet will improve cognitive function in overweight/obese adults. The aim of this research is to evaluate the health benefits of regular pulse consumption (100g per day) by: a) demonstrating that the incorporation of pulses into the diet can improve cerebral vasodilator responsiveness in older overweight/obese adults who are at risk of obesity- and age-related cognitive decline and, b) that improvements in cerebral vasodilator responsiveness are associated with improvements in cognitive and blood vessel function arising from reductions in cardiovascular disease risk factors and inflammation.

This investigator driven pilot study aims to determine whether vaccination of stem cell donors with Zostavax can reduce the rate of Herpes Zoster reactivations in transplant recipients. As we know, infection is a leading cause of morbidity among allogenic transplant patients. Varicella zoster virus reactivation is one of the commonest infections occurring following allogeneic transplant. Primary varicella infection in transplant recipients can cause serious widespread and sometimes fatal viral infection. Reactivation of Varicella known as herpes zoster or shingles can cause rash and severe prolonged pain known as neuralgia. Shingles typically presents as a localised skin rash. The most common complication of shingles is postherpetic neuralgia (PHN). Individuals who suffer from PHN report constant burning, throbbing, and intermittent sharp or electric shock-like pain. In a patient already recovering after chemoradiotherapy, primary varicella infection, shingles and PHN can markedly impair quality of life. ZOSTAVAX vaccine has been approved in Australia for the prevention of shingles and its complications in people 50 years of age and older. The purpose of the study is to find out whether vaccination of stem cell donors with Zostavax can reduce the infection rate of shingles in transplant recipients. We hypothesise that boosted immunity in these donors may transfer to recipients at the time of stem cell infusion and reduce the rate of shingles after transplant. Normal donors (Stem Cell Donors) over the age of 50 years will be eligible to receive the vaccine. Donors will receive vaccination once only by the subcutaneous route and be followed up for 1 week for any adverse reaction. We would report any adverse event among the stem cell donor related to vaccine to the Therapeutic Goods Administration via the "Blue Card" . Stem Cell recipients will be followed up for 12 months after their transplant.

When a person has severe sepsis or septic shock, a severe infection, their body reacts to the infection by a process known as inflammation. This inflammation impairs the working of and can damage important organs in the body such as the heart, kidney and lungs. The purpose of the study is to find out the best way to detect and monitor infection and inflammation in the body. We know from previous studies that severe sepsis and septic shock is usually caused by bacteria. We would like to investigate the concentration of bacteria in the blood of persons with severe sepsis when they first present to hospital and also to monitor changes in the concentration of bacteria in the blood over time to determine what the effects of these factors are on organ failure and survival of patients.

The overall aims of this project are to optimise the care of women at risk of an early preterm birth and so improve the chances of survival and long term good health for their preterm babies. The project will provide data from a cohort of mothers and their babies born early that will allow monitoring of the use of a new therapy for the prevention of cerebral palsy, as well as the assessment of changes in mortality and morbidity. It will also provide clinical indicators for care that can be used for quality improvement within participating hospitals. The specific aims of this project are to nationally monitor and improve uptake of the use of antenatal magnesium sulphate as a neuroprotective therapy immediately prior to imminent (birth planned or definitely expected within 24 hours) early preterm birth (less than 30 weeks’ gestation) to reduce the risk of the baby dying or having cerebral palsy.

Around 30,000 women annually suffer from postnatal depression (PND) and untreated depression has negative long-term consequences for mothers and infants. Figures from previous research indicate that only 30-50% of women who are distressed in the perinatal period seek treatment. Currently, no effective, evidence-based strategy to enhance access to services exists. There is an urgent need to redress this and determine whether we can improve uptake of treatment by women experiencing PND. The aim of this study is to examine whether a brief motivational interviewing intervention delivered in the context of a routine postnatal screening and emotional health assessment improves access to treatment when women experience PND. The key concept is to prepare and motivate women to take action for their own emotional health needs in the year following childbirth. Motivational interviewing has shown enormous success in other fields of healthcare.

Propofol is the trade name of the most commonly used intravenous general anaesthetic medication in Australia. This project will measure the level of impairment of driving skills after the administration of intravenous Propofol to a patient as part of an anaesthetic for gastrointestinal endoscopic procedures. Following informed consent, the patient’s ability to drive on a video-game style driving simulator will be measured immediately prior to their surgical procedure prior to any medications being administered. This will constitute the patient’s baseline driving skill level. The patient will then undergo their preplaned endoscopy procedure with propofol-only sedation. During the procedure, an extra cannula will be inserted in the opposite arm of the patient. After anaesthesia has been ceased, the patient's driving skill will be re-measured on the same simulator at regular intervals (30 minutes, 1 hour, 2 hours, 3 hours post cessation of anaesthesia). each simualtion will take approximately 10 minutes. Before each simulation, a blood sample will be taken from patients to determine the blood propofol concentration of the subjects.

Female pelvic organ prolapse, which is a protrusion of vaginal walls beyond the hymen, is both common and have a high burden of suffering. The traditional operation to treat utero-vaginal prolapse has been vaginal hysterectomy and concomitant vaginal repair, which is not without operative morbidity. The uterus itself may not be the cause for prolapse. There is also increasing recognition that women may wish to avoid hysterectomy at the time of their prolapse operation. Modern advances involve development of minimally invasive procedures which saw the introduction of vaginal mesh kits which provides better success rates when compared to the traditional operation, although not without its own sets of operative morbidity. These procedures involve inserting synthetic material anchored to the sacrospinous ligament to provide reinforcement and support to the vagina following its repair. Uphold is a new mesh kit which utilises a standard synthetic mesh using a surgical approach (anterior sacrospinous) that has been well established since 2001. The purpose of this project is to evaluate the success of Uphold vaginal mesh support or vaginal hysterectomy in the treatment of women with utero-vaginal prolapse.

New epidemiological and experimental evidence, from our group and others, indicates that prolonged sitting is associated with adverse cardio-metabolic consequences, independent of time spent in moderate-to-vigorous physical activity. Furthermore, we have recently reported for the first time that breaks in sedentary time (such as standing from a seated position) are beneficially associated with several cardio-metabolic biomarkers, independent of total sedentary and moderate-to-vigorous activity time. Our pilot research in a cohort of Australian workers indicates that office-based workers spend more than three quarters of their total work time sedentary. Combined with evidence from the USA that workplace sitting time is associated with cardiovascular disease risk, these new findings suggest that reducing prolonged periods of unbroken sitting in the workplace may offer a novel and economically viable means of improving cardio-metabolic health in the working population. No intervention study has systematically investigated the effects of reducing workplace sitting time on cardio-metabolic risk factors. Preliminary data from our laboratory indicates that brief bouts of light intensity activity during prolonged periods of sitting acutely improves postprandial glucose and insulin in older, sedentary adults during a single-day intervention. The proposed study will extend upon these findings and examine -- in a simulated office environment -- the short term (10-day) effect of reducing workplace sedentary time through systematic, sustained bouts of standing, on biomarkers of cardio-metabolic risk. Given the enormous societal burden associated with cardiovascular disease and its associated conditions, this is an important and timely study. Furthermore, the workplace has been identified by the National Preventative Health Taskforce as a key environment for health promotion and disease prevention. Findings from this rigorous, experimental study will determine whether reducing workplace sedentary time through increased standing is beneficial to cardio-metabolic health. This novel experimental investigation will provide a key element of the evidence base to underpin the development of future workplace innovations, programs and policy strategies which aim to reduce sedentary behaviour.

The primary purpose of the study is to measure the prevalence of vitamin D deficiency in the HIV population at the Alfred Hospital, and then to evaluate the effectiveness of vitamin D supplementation in this population.