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New treatments for troublesome bleeding in Implanon users
Recruited subjects will maintain a daily menstrual diary chart for a minimum of 90 days, and will be enrolled into the treatment phase provided that they have met one of the World Health Organization criteria for prolonged or frequent bleeding (in the 90 day reference period one episode of bleeding and/or spotting lasting > 10 days, or more than 4 bleeding/spotting episodes) Following the initial 90 day record, women will begin designated treatment on day 1 of the next episode of bleeding or spotting. Analysis of the subsequent menstrual pattern will begin from day 1 of treatment and will continue through 90 days. Analysis of the pre-treatment menstrual pattern will include the 90 days immediately preceding the bleeding episode in which treatment starts. Menstrual pattern analysis will be carried out according to World Health Organization definitions and clinically important bleeding pattern criteria.
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A prospective, longitudinal study of growth, nutrition and sedentary behaviour in young children with cerebral palsy to measure growth, dietary intake, physical activity, participation, health resource use and quality of life
This population based longitudinal study of children with CP from the age of 18 months to 5 years will permit the first comprehensive evaluation of the impact of functional attainment and lifestyle factors (dietary intake and habitual physical activity) on growth, body composition and nutritional status. This study will enable more accurate prediction of the early natural history of nutritional and growth problems in young children with CP linked to activity levels and health outcomes.
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Transition from hospital to home: Effectiveness of an occupational therapy home visit discharge planning program for at-risk older adults
The National Health and Medical Research Council (NHMRC) funded clinical trial will assess the effect of occupational therapy discharge planning for older adults on functional independence. The intervention will consist of in-hospital rapport building and discharge planning, a pre-discharge home visit, post discharge home visit and two follow up phone calls all completed by the same occupational therapist. 400 participants will be recruited from three hospital sites. Primary outcomes are functional independence and reintegration to normal living. Secondary outcomes include falls, physical acticity, health related quality of life, readmission rates and length of stay and self effciacy in every tasks. Cost effectiveness analysis of the program will also be undertaken.
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Does acupuncture/dry needling applied as a sensory discrimination training tool decrease pain in chronic low back pain patients more than acupuncture alone?
Evidence obtained from this study may further increase our understanding of the CLBP experience and may potentially help us to develop a more effective treatment for management of this problem. Furthermore, it may also give us a new insight about the mechanism of acupuncture/dry needling. We hypothesis that CLBP patients will derive greater benefit from acupuncture when it is used as a sensory discrimination training tool
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A prospective study of antimullerian hormone as a potential predictor of chemotherapy induced menopause
This study aims to investigate whether antimullerian hormone levels can be used to predict which patients will develop menopause following chemotherapy. Chemotherapy is known to induce menopause in some patients however at this point we do not have a test which allows us to give a patient their individual risk of developing menopause post chemotherapy. The hypothesis for our study is that patients with lower antimullerian hormone levels prior to the start of chemotherapy will be more likely to develop chemotherapy induced menopause.
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A physical activity intervention to delay the progression of cerebrovascular disease in older adults with mild memory problems
The primary aim of this randomised clinical trial was to determine whether physical activity can delay progression of cerebrovascular disease (CVD) in older adults who have mild cognitive impairment or have concerns about their memory and have at least one risk factor for CVD (eg high blood pressure, heart disease, smoking). After baseline testing, participants were randomised to either the intervention (PA) or usual care. Participants were individuals with subjective memory complaints (SMC) or MCI who were also participants in the Australian Imaging, Biomarkers and Lifestyle (AIBL) study in Melbourne. Potential participants were initially be screened over the phone. The intervention was based on the Stages of Change model and comprised three components: the tailored, home-based PA program, the behavioural intervention package, and telephone monitoring. Pedometers were used. Participants were asked to gradually progress to 150 minutes a week of moderate-intensity activity (such as walking) for 24 months. The primary outcome of interest was change in white matter hyperintensities (WMH, which indicates CVD) as measured by magnetic resonance imaging (MRI) at baseline and after 24 months. We also used a series of well-established tests and instruments to collect cognitive, physical and clinical parameters. Follow-up assessments were conducted at 6, 12 and 24 months. At baseline and 24 months, a blood sample was taken and analysed for biomarkers of CVD and a positron emission tomography (PET) scan was performed to measure amyloid deposits in the brain.
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Quantitative Electroencephalography in Stroke
Stroke is a leading cause of death, disability and huge socio-economic burden. It is caused by reduced blood supply (acute ischaemic stroke = AIS) or bleeding in the brain (intracerebral haemorrhage = ICH). Clinical prognosis and management in the acute post-stroke period are vitally informed by neurological assessment and accurate characterisation of brain injury. It is known that stroke-affected brain regions generate abnormal electrical signals which can be detected with electroencephalography (EEG) using electrodes placed non-invasively on the head. Quantitative analyses of EEG (QEEG) have been utilised over the past decade in stroke and other patients. EEG has a significant advantage in that it is virtually without contraindication or side effects and can be continuously performed at the bedside. This enables QEEG to monitor response to treatments as well; especially in consonance with the current brain imaging techniques. However, despite mounting evidence, QEEG surprisingly remains relatively under-utilised in acute stroke patients. An apparent reason for this is that it is unclear which parameter(s) is able to predict the patient’s clinical outcome most precisely and; whether this varies with stroke sub-type or timing of EEG. Broadly, this research is intended to identify the optimal QEEG parameters (timing, frequency/amplitude vs. interhemispheric symmetry measures) for prognostication in AIS & ICH.
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Can nitrate-rich green leafy vegetables lower blood pressure?
The primary objective of this study is to determine if regular consumption of nitrate-rich green leafy vegetables can reduce blood pressure in men and women with high-normal blood pressure. We will also investigate the claim that dietary nitrate contributes to the body’s NO stores and that these stores represent a physiologically relevant reservoir of NO.
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HELP-AF: A randomised controlled trial assessing Home-based Education and Learning Program for Atrial Fibrillation
Atrial fibrillation (AF) is the most common abnormal heart rhythm in the population and its prevalence is rapidly increasing. Sufferers of atrial fibrillation have a significantly impaired quality of life and their medical management is placing a growing burden on the Australian health care system. The proposed study will examine whether a home-based education program, will reduce hospital use and improve quality of life in AF patients compared to those patients who experience usual medical care.
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Healthy Schools, Healthy Futures: a randomised controlled trial to assess the efficacy of a school-based resilience intervention to decrease tobacco and alcohol use in secondary school students
A cluster randomised controlled trial study is proposed in 32 schools to test the efficacy of a comprehensive three year resilience intervention in decreasing the self reported health risk behaviours of secondary school students. Twenty schools will be randomly allocated to the intervention group and a further 12 schools randomly allocated to the control group. For evaluation purposes, web-based surveys will be conducted with a cohort of students in grade 7 attending both intervention and control schools at baseline (prior to intervention delivery), and three years after baseline data collection when the cohort are in grade 10. The surveys will include measures of self-reported health risk behaviours (including tobacco, alcohol, marijuana and other illicit drug use; nutritional intake, physical activity and sexual practices for those students in grade 10) risk of mental health problems, as well as student resilience scores. Comparisons will be made at follow up between grade 10 students in intervention and control schools to examine any differential changes in student health risk behaviours, risk of mental health problems, and resilience scores.