ANZCTR search results

More than half of the Australian population do not meet the levels of physical activity recommended to achieve health benefits. The Internet has become an increasingly important communication tool and Internet based physical activity interventions which include innovative technology have the potential to reach large groups of individuals and contribute to the promotion of physical activity and behaviour change. Each year there is a proliferation of health-related and health-promotion websites, yet virtually no work has been done to study the utility and effectiveness of these population-targeted websites. This study will develop a website featuring Web 2.0 applications and evaluate the efficacy and utility of the website to promote physical activity in comparison to a conventional (Web 1.0) physical activity promotion website and a control group. The study will initially test the efficacy of the intervention in this randomised control trial (RCT). The RCT will investigate the efficacy, adherence and behaviour change in a rigorous, controlled setting with high internal validity. Following the commencement of the RCT and an ecological trial (ET) will commence. The ET takes advantage of the unique 'real world' sample available to the research team through the existing 10,000 Steps website to evaluate engagement by users from the broader community. The ecological trial will be registered separately. We expect that the current proposal will provide an increased understanding of the benefits of newer web-based technologies and applications in engaging and retaining participants on web-based physical activity promotion sites. This work has the potential to improve health outcomes from increased engagement/retention in physical activity.

This research project composes of collecting echocardiographic and cardiac MRI (CMR) data on two populations of patients; those with severe aortic stenosis and those with systemic hypertension and comparing them to healthy subjects. We would like to use the data collected on these two cohorts of patients to look at 2 dimensional strain imaging, tissue Doppler imaging, three dimensional volumes and myocardial fibrosis. By using these advanced imaging techniques we can evaluate and quantify left ventricular (LV) hypertrophy and myocardial characteristics. This may give us a better understanding of cardiac remodelling and the function of the heart muscle in each of these disease states. We hypothesise that differences in myocardial function and tissue characterisation detected by these imaging techniques may be detected in patients aortic stenosis and hypertension with similar degrees of LV hypertrophy.

Hepatobiliary disease is a common manifestation of inflammatory bowel disease (IBD). Usually this is apparent by the development of abnormal liver function tests (LFT). In the majority of cases deranged liver tests are transient, can be related to the activity of the inflammatory bowel disease and have no clinical sequalae. However, There are several other causes for deranged LFT’s in IBD which may lead to permanent scarring of the liver. A scarred or fibrotic liver often may not declare itself by abnormal liver tests and transient elastography (TE) is a non invasive method of measuring liver stiffness now used widely in research and clinical practice. In the field of hepatitis C, it is largely replacing the need for a liver biopsy to exclude advance fibrosis and cirrhosis. In this project we seek to find out the prevalence of liver injury in IBD patients by measuring liver stiffness using an operator independent machine called FibroScan (RT).

We wish to study and determine early predictors of cardiac toxicity during combined trastuzumab and/or anthracycline chemotherapy in patients with breast cancer by way of precise assessment of sub-clinical right (RV) and LV systolic and diastolic function. Volume measurements and determination of oedema and myocardial fibrosis will be performed by CMR and advanced echocardiography in order to identify sub-clinical changes of probably significance for development of later manifest ventricular dysfunction. Secondary aim is to correlate observed cardiovascular changes with cumulative dose chemotherapy, age and pre-existing cardiovascular risk factors and biochemical markers or cardiac dysfunction and fibrosis. We hypothesise that: - CMR images will show evidence of myocardial oedema, before patients develop chemotherapy induced cardiomyopathy - tagging imaging techniques will demonstrate lowered active diastolic function - degree of cardiac dysfunction will be proportional to number of chemotherapy cycles conducted - CMR and advanced echo will allow for identification of patients at high risk of heart disease - Abnormalities seen on advanced echo and features of fibrosis on CMR will correspond with abnormal biochemical markers

The purpose of this study was to compare the relative efficacy of the traditional one-on-one physiotherapy format (control group) with a combined one-on-one/group-circuit physiotherapy format (experimental group) during post-acute lower-limb orthopaedic inpatient rehabilitation. The study’s research questions were, for post-acute lower-limb orthopaedic in-patient rehabilitation: 1. Does a combined one-on-one/group-circuit physiotherapy format offer ‘cost-savings’relative to a traditional one-on-one model of physiotherapy service-delivery? 2. Is a combined one-on-one/group-circuit physiotherapy format as clinically effective as the traditional one-on-one model of physiotherapy service-delivery? 3. Are there any specific measures of recovery particularly influenced by the model of service-delivery? 4. How do the discharge scores for key functional mobility measures compare with normative data?

The purpose of this project is to explore whether a clinician-guided treatment program can help to reduce PTSD symptoms in a population of adults (aged 18-75), when administered over the internet. A secondary purpose is to determine how acceptable people find this form of treatment. The study will inform how services can best improve future treatment programs for adults with PTSD.

Breast cancer is most common cancer in women. Aproximately 75% of patients diagosed will have hormone receptor positive breast cancer. Tamoxifen has long been considered the gold standard for adjuvant therapy for postmenopausal women with endocrine sensitive early breast cancer. Aromatase inhibitors (AIs) are commonly used and are in fact superior in improving disease free survival. As a result, it is expected that in coming years the use of AIs in the current setting will increase dramatically. However, trials of AIs for breast cancer treatment have indicated that more than 40% of women taking AIs experience joint pain and stiffness which doesn't respond to conventional pain medication and may cause discontinuation of AI treatment. Acupuncture is one such alternative technique currentlyused for treating a variety of conditions including musculoskeletal pain. The analgesic mechanism of acupuncture is uncertain but it is speculated that analgesia may be mediated by release of opiod peptides and serotonin.

Cardiovascular disease is the leading cause of mortality in type 1 diabetes (T1D). Prevention of vascular complications of diabetes requires strategies that begin early in the disease process. Risk factors in childhood track into adulthood and correlate with early markers of atherosclerosis such as vascular endothelial and smooth muscle function. We have shown that children and adolescents with type 1 diabetes have detectable endothelial and smooth muscle dysfunction that relate to body mass index (BMI). A significant number of youth with T1D are also overweight with insulin resistance. Metformin reduces insulin requirements and weight gain in type 1 diabetes. In type 2 diabetes Metformin substantially reduces risk of cardiovascular events and improves endothelial function. However there are no studies of cardiovascular outcomes or their earlier cardiovascular markers in type 1 diabetes despite the increasing prevalence of overweight status in this population and the fact that this is a major modifiable risk factor for cardiovascular disease. Determining the effect of Metformin on vascular function in overweight youth with type 1 diabetes in a double blind randomized placebo controlled parallel trial will provide additional strategies to intervene in early in the process of atherosclerosis.

Heart Failure (HF) is a leading cause of heart disease and mortality in developed countries. It is the leading reason for hospital admission among patients over 65 years and the most costly cardiovascular disorder in Western countries. A first hospital admission for HF has been shown to confer a worse prognosis than a first admission for bowel or breast cancer. The burden of HF is expected to increase in Australia due to the ageing population and improved survival from acute cardiac events. New cardiac imaging tools, such as cardiac MRI and novel applications of echocardiography (ultrasound of the heart), now permit an insight into some of the fundamental processes that underlie why some individuals don’t respond to conventional HF treatment. In particular, our research will focus on the scarring within the heart muscle, and the loss of coordination of the heart as it pumps, in perpetuating the vicious HF cycle. Furthermore, we will explore the role of a simple blood test, to measure markers of scarring from the heart, in predicting patient outcomes in the setting of a new diagnosis of HF. An understanding of these elements in the pathogenesis of cardiomyopathy will help clarify the mechanistic cascade of HF, and may thus lead to novel therapies to interrupt such an adverse process. This research may thus change the way cardiomyopathy is viewed and treated.

Chronic Lung Disease (Bronchopulmonary dyplasia) is a common and serious complication in extremely preterm infants below 28 weeks. In 2008 in Western Australia, over 120 infants were born at less than 28 weeks. 28% of the survivors developed Chronic lung disease. With it’s immunomodulatory effects, Pentoxifylline is emerging as a promising treatment for conditions such as sepsis, NEC and Chronic Lung disease. Whilst trials are encouraging for Pentoxifylline’s effect on Chronic lung disease; well organized, properly blinded trials have not been published. This trial aims to address this and discover whether nebulized pentoxifylline might help prevent bronchopulmonary dysplasia in extremely preterm infants.