ANZCTR search results

The aim of the study is to evaluate cognitive-behaviour therapy (CBT) for adolescents with delayed sleep. It is hypothesised that CBT will result in more night-time sleep and fall asleep earlier.

Bone loss occurs at an accelerated rate in women after the menopause. This has been attributed to reduced calcium absorption in the gut and increase excretion of calcium in the urine. This bone loss may be greater in those on low calcium diets compared with those on high calcium diets. This has been shown in animals and some human studies have been able to link low lumbar spine density to low calcium diets.

Headache is a common condition associated with significant socio-economic impact and reduced quality of life (Schwartz, Stewart, Simon & Lipton, 1998). Cognitive Behavioural Therapy (CBT) is an effective treatment for headache, however it has several limitations, precluding it’s successful use in many headache sufferers (Fumal & Schoenen, 2008). Particularly, CBT requires considerable time for both therapist and patient, and encourages avoidance rather than coping with headache, which may increase sensitivity to headache triggers and aggravating factors (Martin, 2001). Brief mindfulness based therapy (BMBT) is an emerging behavioural intervention not subject to the above limitations of CBT. Several reports support the efficacy of BMBT in reducing pain and improving functioning in chronic pain conditions such as back pain (Morone et al 2008), fibromyalgia (Creamer et al 2000) and groups of heterogeneous chronic pain sufferers (Kabat-Zinn et al 1985; Kabat-Zinn et al 1986; Kabat-Zinn 1982). BMBT has also been shown to reduce acute pain sensitivity in healthy subjects (Creamer et al 2000, Zeiden et al 2009). This is particularly relevant to headache, in which increased pain sensitivity is a common finding, and thought to be of pathophysiological significance (Cathcart et al 2009). We recently demonstrated that headache is triggered by factor aggravating the already increased pain sensitivity in headache sufferers. Despite the potential benefits of BMBT for treating headache, the efficacy of BMBT as an intervention for headache has not been reported to date. BMBT may reduce headache by inhibiting increased pain sensitivity in headache sufferers. The present project therefore examines effects of BMBT on headache activity and pain sensitivity in frequent headache sufferers.

This project sought to determine whether specialist mental health consultation was more effective in treating the depressions of aged care residents with dementia than standard care. We screened 389 aged care residents for dementia and major depression. Forty-four were ultimately included in the intervention sample, selected from 20 aged care facilities located in Melbourne, Australia. Facilities were allocated to an intervention condition involving the provision of multidisciplinary specialist consultation surrounding the best-practice management of depression in dementia, or to a care as usual condition. Consultations involved individually tailored medical and psychosocial recommendations provided to care staff and General Practitioners (GPs). All residents participated in a comprehensive pre-intervention diagnostic assessment, including the administration of the Cornell Scale for Depression in Dementia (CSDD). This assessment was repeated approximately 15 weeks post-intervention by a rater blind to study condition. We found that specialist mental health consultation was significantly more effective in treating the clinical depressions of aged care residents with dementia than care as usual. At follow-up, the majority of the intervention group no longer met criteria for major depression, nor did they score above critical values on the CSDD. These results suggest that the psychosocial and medical management of depressed aged care residents can be improved by increasing access to specialist mental health consultation.

The aim of this project is to compare the effect of home-based exercise plans and telephone follow-up to a 12 month gym program with health professionals. 114 participants will be recruited from Southern Health’s community-based health programs in Melbourne’s south east, following their participation in health service based exercise program. Participants will have at least one risk factor for readmission that include: multiple co-morbidities, impaired functionality, aged 65 and over, recent hospital emergency department admissions, poor social support, and history of depression. Base-line data will be collected upon participant recruitment that include: demographics, health and medical history (obtained from the clients’ health record), endurance and strength will be assessed. Outcome measures include: health-related quality of life, depression scale, social isolation, health and labour questionaire, health care utilisation, endurance and strength tests. Participants will then be randomly allocated to either a control group or intervention group. The control group will receive the usual care, a 12 month home exercise program with telephone follow-up. The intervention group will involve a 12 month individualized gym-based exercise program supervised by an exercise physiologist from the health service. At 3 months post-discharge, participants will be re-assessed over the telephone (survey instruments only). At 6 months post-discharge, the participants will be re-assessed on both survey instruments and physical capacity tests for endurance and strength, health related quality of life, depression, social isolation, At 9 months post-discharge, participants will be re-assessed over the telephone (survey instruments only). At 12 months post-discharge, the participants will be re-assessed on both survey instruments and physical capacity tests for endurance and strength, health related quality of life, depression, social isolation.

Continuous haemofiltration is performed in ICU to support patients with acute renal failure. The patient’s blood is pumped through a haemofilter where uraemic toxins are removed and then it is returned to the circulation. This is a continuous process that necessitates safe reliable large bore access to the circulation. The vascular access catheters are inserted percutaneously, usually into the femoral or internal jugular veins. There are number of commercial vascular access catheters available, but the industry standard for the past 10 years has been Bard Niagra, Bard Access Systems Inc. Utah, USA. This has large diameter channels, allowing high blood flows, but it occasionally can be difficult to insert. A new product, the Gambro Dolphin Protect, Gambro Lund Sweden, vascular access catheter has become available. It has a similar wide bore channels, but the shape of the cannula might make insertion easier and the catheter is impregnated with an antibacterial material that might reduce the rate of infection. These claimed advantages are only valuable if its basic function matches that of the industry standard. The aim of this study is to compare the two vascular access devices in a randomised controlled trial. The primary outcome measure will be trans-access resistance, a mathematically derived measure of the ease of blood flow through the catheter. Secondary outcome measures will be time to insert (in minutes) and ease of insertion measured on a visual analogue scale, presence of colonisation of the catheter at the time of removal (all tips will be sent for culture), presence of skin erythema at insertion site at time of removal, and haemofilter life (time to failure of haemofilters connected via the test cannula).

This project aims to evaluate individual care packages compared with usual care for complex and unstable symptom management and high care needs patients wishing to return home earlier from hospital or Palliative Care units AND for those requiring high level End of Life Care who wish to remain at home. This may include patients who have cancer or non-cancer diagnoses. Care packages at home could include nursing, domestic support, and equipment provision as well as more expeditious access to Specialist Palliative Care multidisciplinary team (MDT) services and General Practitioners. The evaluation project will explore the net incremental effect on patients and caregivers outcomes and associated net incremental costs relative to usual care.

To examine the safety and tolerability of Everolimus in combination with 5-azacitidine in Acute Myeloid Leukaemia.

Adolescents with diabetes display limited joint mobility. Because of the association with high pressures under the feet, poor sensation and foot ulceration with disease progression, limited joint mobility assessment is a standard procedure in diabetic foot care. Clinical interventions to reduce high pressures under the feet include orthoses, footwear and surgical correction. While stretching has been reported to improve ankle joint range of motion in the general population, limited evidence is available for individuals with diabetes. The evidence for calf stretching in adolescents where prevention of contractures and high plantar pressures in the early stages of disease may be most beneficial have not been investigated. This study will use a randomised control study to investigate the efficacy of stretching on the ankle and big toe joints to reduce high pressures under the feet and contractures of the ankle and foot joints.

The overall aims of the project are to design, implement and evaluate an educational campaign, known as MindWise to help raise mental health literacy in higher education students and staff. Data will be collected on mental health problems (anxiety, depression and alcohol misuse), knowledge of and beliefs about mental health problems, stigmatizing attitudes, self-help and help-seeking behaviours at baseline, at the end of the 2010 academic year and the end of the 2011 academic year. Data will be collected via telephone interviews carried out by the Social Research Centre.