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The current dietary fibre recommendations are 25–30 g/day, given the benefits of higher fibre intakes on lower body weight, BMI, waist circumference, improved plasma lipid profiles, improved glycaemia/ insulinaemia and risk reduction for metabolic syndrome, CVD and type 2 diabetes. However, most Australians, Canadians and Americans do not meet the recommendations because most find it difficult to consume enough fruit, vegetables, legumes and whole grains through their daily diet. Therefore, using fibre supplements may be an alternative way to increase daily fibre intakes. A simple strategy of PGX fibre supplementation may offer an easier solution to long-term weight loss and then management as well as improvements in metabolic syndrome without the need for other nutrient modification. The effects of PGX supplementation may be better than that of psyllium due to its higher viscosity levels and its effects on postprandial glucose/insulin. Therefore, the results from this trial have the potential to provide the necessary scientific evidence required to endorse the use of PGX supplementation, over psyllium in the dietary management (prevention and treatment) of chronic diseases.

It is a standard part of performing keyhole surgery (laparoscopy) in gynaecology to insert a urinary catheter at the time of surgery. The optimal time to remove this urinary catheter is unknown. Some surgeons remove it immediately, whilst others keep the urinary catheter for some time (usually until the next day). The duration for which the urinary catheter is left in may have an effect on post-operative lower urinary tract symptoms and complications, such urinary tract infections and difficulty emptying the bladder. Up to 2 in 10 women may have difficulty passing urine or emptying the bladder properly after surgery. It is hypothesised that earlier removal of the urinary catheter after surgery may potentially increase the risk of this happening. Around 1 in 10 women may get a urinary tract infection after surgery. It is hypothesised that the risk of this occurring may be increased if the urinary catheter is left in for longer durations, or if a woman has difficulty emptying her bladder properly after surgery. Moreover, it is unknown as to what is the best means to assess whether a woman is emptying her bladder properly before being discharged from hospital after keyhole surgery. In the Department of Endo-Gynaecology at the Royal Hospital for Women and for patients of Dr Stephen Lyons at the Mater Hospital, there is a standard protocol where, after removal of the urinary catheter, women undergo serial bladder scans to measure the volume of urine left inside the bladder after voiding (post void residual urine volume, PVR). Women are not discharged from hospital until they are able to void at least 150 ml of urine on 2 consecutive occasions, and have a PVR of <100 ml after each of these voids. In contrast at many other institutions, no such protocol exists, and women are eligible for discharge from hospital without undergoing any bladder scans. It is hypothesised that women who are discharged from hospital with undiagnosed difficulty in emptying their bladder properly after their keyhole surgery may potentially have a higher risk of developing urinary tract infection and lower urinary tract symptoms. The objective of the study is to test these hypotheses, and thus allow more evidence-based practice in bladder care after gynaecological laparoscopy. This study is a prospective, randomised, multi-centre, clinical study, enrolling 690 women undergoing gynaecological laparoscopic surgery for benign indications, who would usually be expected to stay overnight due to their surgery. Women randomised to the study will have their scheduled surgery according to their treating team’s recommendations. Before surgery, subjects will complete a validated questionnaire regarding urinary symptoms and have a urine test to look for urinary tract infection. They will also be asked to void into a special device which will measure the rate and volume of urine flow (uroflowmetry), and a PVR will be measured. At the time of surgery, women will be randomised to one of two equally sized groups. One group of women will have the urinary catheter removed at 0600 hours on the morning after their surgery. This group of women will be managed according to the current standard protocol of the Department of Endo-Gynaecology at the Royal Hospital for Women. The other group of women will have the urinary catheter removed immediately at the end of surgery. This group of women will be eligible for discharge from hospital when they are able to void at least 150 ml on 2 consecutive occasions. These women will also undergo bladder scans after voiding, but the results of the bladder scan will be blinded from the staff and patient, and will not influence the decision for hospital discharge. After surgery, all women will be followed for 6 weeks post-operatively with health care visits and have their urinary function monitored. Permission will be sought from subjects for follow-up at 1 year after surgery.

The purpose of the study is to investigate whether the addition of six standing balance circuit classes to usual therapy over a 2 week period improves balance, mobility and physical functioning among rehabilitation inpatients. Participants will be allocated at random into one of two groups (Usual Care and Additional Training). People in the Usual Care group will receive standard care as offered by the Bankstown Lidcombe Hospital Physiotherapy service. People in the Additional Training group will receive usual care as well as participate in a 1 hour standing balance circuit class, involving exercises aimed at improving balance, three times a week for two weeks. All participants will be assessed at enrollment into the study, 2 weeks later, and again at 3 months. Assessments will include a questionnaire about mobility and activities of daily living, as well as physical tests including a 4 metre walking test, chair stand test, and balance tests.

Dignity Therapy, a brief psychotherapeutic intervention based on empirical research into the concept of dignity at the end of life, has proven successful at increasing hope, sense of meaning and will to live in a palliative care population where most patients had cancer diagnoses (Chochinov, Hack et al. 2005). This study will establish the feasibility and acceptability of offering Dignity Therapy to the MND patient population, and measure associations of the intervention with increased hope, meaning and dignity. It will lay the groundwork for a possible future experimental study. This study will also examine what impact Dignity Therapy has on the MND family carer during the caring experience, specifically looking at whether Dignity Therapy with the patient is associated with an increase in hope or decrease in anxiety, depression and caregiver burden in the family carer. Previous Dignity Therapy studies focused on the intervention’s positive influence on the bereavement experience of family members, but did not look at how the intervention may affect the carer during the caring experience.

Obstructive sleep apnoea is a common sleep-related breathing disorder. Oral appliances worn during sleep to gently hold the lower jaw in a forward position are a novel treatment often appealing to patients. Currently use is limited as there is no means to determine if patients will be treated successfully. There is a need for simple, clinical methods to predict which patients are best suited to this new treatment approach and this project will address this by developing such a method. This study will use a combination of data measured from patients with obstructive sleep apnoea including sleep characteristics, lung function and facial dimension measured from photographs to produce a virtual model to predict whether or not a patient will respond to treatment with an oral appliance.

This study is to investigate which strategy is best in terms of preserving physical function in older adults (greater than 65 years) who are obese. The interventions are a very low energy diet (VLED - Optifast) plus exercise, diet plus exercise or exercise alone. The trial will last for 12 weeks. We will also look at the effects of these measures on body composition, blood pressure, glucose, cholesterol and memory/thinking.

This project will assess the effect of progesterone therapy on pregnancy outcomes in women presenting with threatened miscarriage. It is hypothesised that progesterone supplementation for early threatened pregnancy increases the live birth rate.

Individually and as the constituents of proteins, amino acids perform numerous and often essential functions. The current researchers have previously demonstrated clearly defined population subgroups based upon urinary amino acid profiles in chronic fatigue and pain patients, each group with specific nutritional requirements for amino acids. The same subgroups were also identified in healthy individuals with profiles differing from the patient groups only in the degree of excess or depletion of amino acids. The current project aims to determine whether distinct subgroups can be identified in healthy individuals reporting sub-health on the basis of urinary amino acid patterns. Sub-health is typically seen as a reduction in energy levels, change in sleeping patterns, increased incidence of viral infections and a loss of vitality with no defined disease being diagnosed. It can be defined as a chronic condition of deteriorated physiological function between health and illness. The project also aims to assess the ability of amino acid supplementation to improve the general well-being of individuals experiencing sub-health based upon membership of the subgroups identified in stage one. The current researchers have developed a nutritional formulation to alleviate fatigue containing a complex range of amino acids. The study will trial the amino acid supplement in subgroups of healthy individuals reporting sub-health. The study will involve a large group of adults reporting fatigue and sub-health but who are free from any significant medical or mental illness. Prior to supplementation all participants will be required to provide a urine sample and to complete general health and fatigue questionnaires. Urinary amino acid excretion patterns will be assessed with the aim of identifying subgroups based upon differential amino acid homeostasis. Once the subgroups have been differentiated, smaller groups of twenty individuals from each subgroup will trial the supplement for 30 days. At the completion of the trial participants will provide another urine sample and again complete the general health and fatigue questionnaires. General health, fatigue and urinary amino acid levels will be analysed to determine whether supplementation can bring about changes at both a symptom and biological level. It is believed that participants will derive significant benefits such as reduced fatigue but that the response to supplementation will be influenced by amino acid profile subgroup membership. This study will determine whether readily identifiable amino acid profile subgroups exist, each with specific amino acid requirements, allowing for the development of more effective dietary supplements in the future. The project’s hypotheses are as follows: 1. It is possible to identify major subtypes of amino acid homeostasis in a population. 2. Amino acid supplementation is capable of alleviating symptoms of sub-health and the symptoms and degree of alleviation will be determined by membership of subgroups based upon amino acid homeostasis.

This project will assess the effect of progesterone therapy on pregnancy outcomes in women previously diagnosed with subfertility. It is hypothesised that progesterone supplementation in early pregnancy decreases the likelihood of miscarriage, and potentially late pregnancy complications in women with previous subfertility.

Background A healthy start to life requires adequate motor development and physical activity participation. Currently 5-15% of children have impaired motor development without any obvious disorder. These children are at greater risk of obesity, musculoskeletal disorders, low social confidence and poor mental health. Traditional electronic game use may impact on motor development and physical activity creating a vicious cycle. However new virtual reality (VR) game interfaces may provide motor experiences that enhance motor development and lead to an increase in motor coordination and better physical activity and mental health outcomes. VR games are beginning to be used for rehabilitation, however there is no reported trial of the impact of these games on motor coordination in children with developmental coordination disorder. Methods This cross-over randomised and controlled trial will examine whether motor coordination is enhanced by access to active electronic games and whether daily activity, attitudes to physical activity and mental health are also enhanced. Thirty children aged 10-12 years with poor motor coordination (below 15th percentile) will be recruited and randomised to a balanced ordering of ‘no active electronic games’ and ‘active’ electronic games. Each child will participate in both conditions for 16 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is motor coordination, assessed by kinematic and kinetic motion analysis laboratory measures. Physical activity and sedentariness will be assessed by accelerometry, coordination in daily life by parent report questionnaire and attitudes to physical activity, self-confidence, anxiety and depressed mood will be assessed by self report questionnaire. Discussion This is the first trial to examine the impact of new virtual reality games on motor coordination in children with developmental coordination disorder. The findings will provide critical information to understand whether these electronic games can be used to have a positive impact on the physical and mental health of these children. Given the importance of adequate motor coordination, physical activity and mental health in childhood, this project can inform interventions which could have a profound impact on the long term health of this group of children.