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Antenatal Education for Epidural Anaesthesia in Labour - A Pilot Study
Expand descriptionWe hypothesise that multi-media patient education technology is superior to pamphlet delivery of this information. A secondary hypothesis is that increased understanding of epidural anaesthetic in labour will increase patient anxiety levels.
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Lung function at rest and during exercise in patients with newly-diagnosed early-onset type 2 diabetes mellitus: a pilot study
Expand descriptionDiabetes and obesity are global pandemics. Currently more than 25% of the Australian population are obese and the prevalence of diabetes is one of the highest of any developed nation. There is an alarming increase in diabesity in younger people and thus younger patients with more aggressive disease will increasingly present for treatment, e.g. exercise therapy, respiratory management of acute and chronic disorders, and for assessment and treatment of diabetes complications. To date, no study has investigated lung function during exercise and/or the effect of co-morbid obesity on pulmonary function in patients with newly-diagnosed type 2 diabetes. Given the potential of newly-diagnosed patients to institute lifestyle change, and the aggressive nature of early-onset diabetes, this group represents an ideal target for preventive and ameliorative therapies. However, prior to evaluating effects of therapy (e.g. weight loss, exercise training, improved glycaemic control), baseline data are required. This pilot study is thus designed to provide evidence that will facilitate targeted design of a larger clinical intervention trial. This pilot study aims to quantify lung function at rest and during exercise in obese and non-obese patients with newly-diagnosed early-onset type 2 diabetes (T2D) compared with controls without diabetes.
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Multi-centre audit of ACE inhibitor associated angioedema
Expand descriptionThis is an audit of patients who present to hospital with angioedema (swelling around the head and neck) associated with the use of a common blood pressure medication, the ACE inhibitors. The purpose is to try to determine how frequently this problem occurs across a range of hospitals, and also, to provide more information to enable an estimation of the proportion of cases where there is serious concern (ie threatened or real airway obstruction or death).
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Comparison of minimally invasive cardiac output monitors in the detection of hypovolaemia in awake volunteers.
Expand descriptionthis study seeks to determine if minimially invasive monitors can detect blood loss in awake patients. Our hypothesis is that the monitors will be able to detect a known blood loss of 10% of estimated blood volume. We will test this by bleeding volunteers a known amount of blood and then looking to see if the monitors detect this blood loss.
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Effects of oral protein load on the rate of gastric emptying, intragastric meal distribution, gastrointestinal hormone release, appetite sensations and energy intake in lean subjects.
Expand descriptionThe ingestion of nutrients induces a number of changes in gastrointestinal function which are associated with the modulation of appetite and energy intake. These changes include the slowing of gastric emptying, which sustains gastric distension and is associated with proximal gastric relaxation and changes in small intestinal motility. It has been established that fat and carbohydrate empty from the stomach at an overall rate of 1-3kcal/minute irrespective of volume, while the load of fat and carbohydrate is known to effect gastrointestinal motor activity and slow gastric emptying rate. To date, research documenting the gastric emptying rate of protein is limited and the effect of varying the protein load has not been characterised. Moreover, the relationship between gastric emptying and the regulation of energy intake by dietary protein remains unclear. Effects on gastrointestinal hormone release also occur with macronutrient ingestion. Small intestinal administration of fat has been shown to increase plasma CCK, PYY, and GLP-1 to a greater extent than carbohydrate in both healthy young and older men. However, evidence for load-dependent effects of protein on gut hormones is inconsistent. Since these gastrointestinal hormones have an important role in the regulation of appetite and energy intake, it is imperative that changes in the magnitude and temporal pattern of their release is established in response to varying protein loads and also related to changes in gastric emptying and intragastric meal distribution. Thus, this study has been designed to investigate how the load of orally administered Whey Protein Isolate effects gastric emptying rate, intragastric meal distribution, gut hormone concentrations, appetite sensations, and subsequent energy intake in healthy, lean individuals.
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Can less be better? Is it possible to improve constipation symptom control in palliative care patients when the underlying causes of bowel dysfunction are objectively assessed?
Expand descriptionConstipation is a common, distressing and serious symptom, affecting between 50-90% of people referred to specialist palliative care services, with 40-70% of people failing to achieve adequate symptom control. The number of people failing to achieve satisfactory symptom relief is not acceptable as inadequate symptom relief is responsible for adding to individual and societal burdens. In palliative care, decisions regarding the prescription of laxatives are based predominantly on clinical experience and institutional approaches. Many of these do not consider the pathophysiological basis that underlies the symptom of constipation. This approach is very dissimilar to that adopted by gastroenterologists in the treatment of non-palliative care patients. The most striking difference is the limited information to categorise the palliative population into the groupings that gastroenterologists would routinely use, thereby limiting the ability to tailor interventions to improve symptom control. This study will aim 1). To develop an approach to constipation that enables the underlying problems (slow transit of colonic contents, delayed outlet of colonic contents or an overlap of these problems), to be quantified in palliative care patients using well-tolerated and validated diagnostic methods; 2). To compare whether the constipation severity of those patients randomly allocated to a mechanistic approach to the assessment and treatment of constipation within different sub categories have better patient outcomes than people palliated using standard current clinical care.
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Evaluation of "Anxiety Online": A public online mental health service
Expand descriptionThis project is examining the user-experience and evaluating Anxiety Online, an internet-based treatment clinic for consumers with anxiety symptoms and disorders. Consumers can complete a comprehensive psychological assessment (e-PASS), following which they receive a report which provides them with details as to the type and severity of their anxiety and other mental health problems and appropriate treatment recommendations. If they show symptoms of anxiety consumers have the option of completing a treatment program on their own or with email assistance from a therapist. Programs are available for generalised anxiety disorder, obsessive-compulsive disorder, panic disorder, with or without agoraphobia, post traumatic stress disorder and social anxiety disorder. Consumers are asked to complete e-PASS post-program (week 12) and invited to complete it yearly from 1-year post-program through to 5-year post-program. It is expected that at post-program consumers will show a reduction in the severity of their anxiety symptoms, K-6 scores and total number of clinical diagnoses/symptoms. In addition, it is expected that quality of life and confidence in managing one's own mental health care will increase at post-program.
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Cognitive and neural benefits of brain training.
Expand descriptionResearch suggests Brain Training may be effective for improving the brain’s ability to store and process information, and imaging studies suggest Brain Training may also lead to positive changes to brain structure and function . However, most of the research to date has simply measured effects by comparing data before and after a period of Brain Training. The effects of Brain Training during the training period has yet to be properly examined. We would therefore like to answer three main questions: 1. What is the minimum duration of Brain Training required to produce cognitive benefits? 2. By what rate do any positive cognitive effects decay after the cessation of Brain Training? 3. How do different brain changes (as revealed by brain imaging) develop over time?
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Evaluation of a tailored online same-sex attracted youth focused transdiagnostic/multi-symptom mental health and wellbeing program
Expand descriptionThis study aims to develop and evaluate an online mental health and wellbeing program for same-sex attracted youth (SSAY) aged between 18-25 years. The program will deliver symptom-relevant material across multiple mental health symptom categories, where relevant, so as to present individual users with an integrated mental health and wellbeing program that respects their individuality, and acknowledges the reality and frequency of co-occurring mental health problems. The mental health symptoms covered will include depressive symptoms, generalised anxiety, panic, obsessions, compulsions, post traumatic stress, specific phobia and social anxiety. In addition, participants will receive access to a module that provides psycho-educational information about suicide. By using the results of an automated online screening questionnaire, the program will tailor content based on participants' current symptom presentation and their gender. We will evaluate the outcomes and user acceptability and satisfaction of the mental health and wellbeing program with approximately 76 SSAY (recruiting about 200 initially to allow for attrition). A randomised controlled trial will be conducted, with assessments at pre-program, post-program and 3 month follow-up. Participants will be randomly allocated to receive the mental health and wellbeing program with treatment as usual or a 20 week delayed access control with treatment as usual.
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Evaluation of the Living Well Feeling Well program for the general public
Expand descriptionThis study is evaluating the effectiveness of the online program, Living Well Feeling Well, for improving mental and physical health. The study is a randomised controlled trial with an intervention group and a waitlist control group. We are aiming to recruit 100 participants and to follow them up at 3 months. The Living Well Feeling Well program contains 5 sections designed to help people cope with challenging situations and enhance their mental and physical health. Participants are given 3 weeks to complete the program, which involves about 2 hours of reading material. Participants in the waitlist group are asked to wait 3 weeks before being offered the program. We predict that at post-intervention participants in the intervention group will report greater wellbeing and satisfaction with life, better coping with stress, and less psychological distress.