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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?
Expand descriptionThe 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
Expand descriptionA 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.
Expand descriptionOur 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
Expand descriptionAcute 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
Expand descriptionIn 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.
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Outcomes of stage 4 & 5 chronic kidney disease patients attending 2 different models of outpatient care.
Expand descriptionThe key clinical and psychosocial outcomes of our current, physician-led, multi-disciplinary CKD clinic (M-DCKD clinic) can be sustained by transitioning to a nurse-led, multi-disciplinary CKD clinic. Furthermore, while CKD patients will be reviewed once in the nephrologist-led clinic compared with 2 times in the nurse-led clinic, we propose that the nurse-led M-DCKD will be more economically viable. Aim: To test the above hypothesis in a randomised controlled trial of stage IV-V CKD patients attending a single physician-led multidisciplinary team outpatient clinic compared with attending multiple visits at a nurse-led multi-disciplinary team outpatient clinic. The key clinical outcomes are derived from clinical key performance indicators as well as psychosocial and economic analyses.
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An examination of the relationship between self-compassion, emotion regulation, happiness and stress in practising psychotherapists, and an a randomized controlled trial of a web-based self-compassion training program for postgraduate psychology trainees
Expand descriptionResearch suggests that psychotherapists tend to report higher levels of work-related stress- and burnout- spectrum conditions than many other occupational groups. Work-related stress has serious implications for the mental and physical well-being of psychotherapists, and may lead to professional impairment, thus compromising the provision of care. As a result, researchers have highlighted the importance of identifying variables that (a) enhance psychotherapists’ psychological wellbeing and resilience to stress; and (b) are capable of development through training. In particular, it has been argued that the development of interventions to improve resilience and psychological health amongst trainee psychologists is of paramount importance, given the elevated levels of stress amongst this sub-group. Recent research suggests that self-compassion is a promising construct for psychotherapists in terms of its ability to promote psychological well-being and resilience to stress; however, the potential benefits of self-compassion are yet to be thoroughly explored amongst this occupational group. Study One will involve conducting a cross-sectional, correlational study of self-compassion amongst practising psychotherapists (including trainees), and using Structural Equation Modelling to explore the relationship between self-compassion and stress, as well as the potential mediating role of happiness and emotion regulation in this relationship. In Study Two, a randomized controlled trial will be conducted to investigate the utility of a self-guided, self-compassion-based intervention delivered via the Internet for increasing self-compassion, and promoting psychological well-being and resilience to stress amongst postgraduate trainee psychology students currently engaged in clinical work.
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Effect of vitamin D replacement in patients with chronic kidney disease
Expand descriptionVitamin D deficiency is common in patients with chronic kidney disease and has been associated with increased risk of heart disease and death. Correcting vitamin D deficiency may improve risk for heart disease through its effects on blood vessel, immune and bone cell function. Stiffness of the arteries (arterial stiffness) is associated with increased risk of heart disease and can be measured using simple non-invasive methods. The effect of vitamin D replacement on arterial stiffness has not previously been studied in patients with kidney disease. This study will examine the effect of vitamin D, a commonly used over-the-counter medication, compared with placebo (“dummy tablet”) on blood vessel function in people with moderate to severe chronic kidney disease who are vitamin D deficient. In this study, you will be randomly assigned (”like flipping a coin”) to take either vitamin D or placebo (1 tablet monthly) for 6 months. If at 3 months, your vitamin D levels remain low, you may need to take the study medications every 2 weeks till the end of the study. Both the vitamin D and placebo medication will be supplied by a specialist compounding pharmacy with a state of the art compounding laboratory and is accredited by the Pharmacy Guild of Australia as a quality care pharmacy and as such operates under a quality care program. If you enter the full study, you will have blood tests and blood vessel function studies before you start and after you complete the study medication. During the study, you will not know which treatment you are on. Your other medications will remain constant. The study requires you to attend the Research Unit at Sir Charles Gairdner Hospital 4 times over a 6-month period.
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Investigating the role of targeted therapy Sorafenib - the Fms-like tyrosine kinase 3 (FLT3) inhibitor, in combination with intensive chemotherapy, for previously untreated adult patients with Acute Myeloid Leukaemia (AML) with FLT3 mutations. A Phase II randomised placebo-controlled multi-centre study
Expand descriptionThis study aims to determine the safety and efficacy of treatment with the drug Sorafenib, in combination with intensive chemotherapy for adults with previously untreated acute myeloid leukaemia (AML). Who is it for? You may be eligible to join this study if you are aged between 15-65 years and have been diagnosed with AML with FLT3-ITD mutation. You must have received no previous treatment for AML. Trial details All participants in this trial will undergo intensive chemotherapy over a period of minimum twelve months. Participants will be randomly (by chance) allocated to one of two groups. One group will receive the oral drug Sorafenib whilst undergoing chemotherapy and for a period of 12 months afterwards. The other group will receive a placebo (inactive) treatment in conjunction with chemotherapy. Participants will not know which group they are in until completion of the trial. Participants will be assessed at regular timepoints for a period of up to 5 years to determine the safety and clinical benefit of Sorafenib treatment in combination with chemotherapy. Treatment Duration will be a minimum of 1 year. This Phase II study will: Investigate the clinical benefit of frontline Sorafenib in combination with chemotherapy and during maintenance therapy in adult AML Optimise the dosing schedule of Sorafenib based on the kinetics of circulating FLT3 ligand levels after chemotherapy Investigate the clinical benefit of Sorafenib in relation to additional molecular AML lesions Identify pharmacokinetic and pharmacodynamic correlates of response predictive of treatment outcome.
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Anterior Elevate or Laparoscopic Abdominal Sacrocolpopexy in women with post hysterectomy apical prolapse – a Randomised Controlled Trial
Expand descriptionFemale 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 post hysterectomy vaginal apical prolapse has been either abdominal sacrocolpopexy or vaginal sacrospinous fixation. Although the abdominal approach comes with a greater cure rate, it has a longer operating time, longer return to Activities of Daily Living and costs more than the vaginal approach. Modern advances involve the development of minimally invasive procedures which included a laparoscopic approach to abdominal sacrocolpopexy and also the introduction of vaginal mesh kits which provides better success rates when compared to the traditional vaginal 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. Anterior Elevate 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 Anterior Elevate vaginal mesh support or laparoscopic sacrocolpopexy in the treatment of women with vaginal apical prolapse.