ANZCTR search results

To investigate the effects of: (1) acute (4 days) energy restriction on GI function and appetite, in both lean and obese subjects, (2) prolonged (3 months) energy restriction on GI function, appetite and weight loss in obese subjects, in response to duodenal nutrients.

We will study patients with peripheral arterial disease (PAD) – either symptomatic claudication (measured by the Edinburgh claudication scale) or asymptomatic (ankle brachial index measurement), with a history of having one or more of risk factors. Future cardiovascular risk will be defined by a trained study nurse, starting with a standard clinical history and lipid profile, and carotid imaging for plaque using a Intima thickness scan (IMT) and Clinical variables (age, diabetes, cardiac history) and biochemistry (renal function, lipid status) will be available for risk adjustment in the multivariate analyses. Other baseline measures will include quality of life. Patients will then be randomized into usual care or a PAD-specific disease management program (DMP). Patients in the usual care group will have current PAD guidelines sent to the treating General Prcationer (GP), but statin use will be restricted by the current Pharamceutical benefits Scheme (PBS) guidelines. Total cholesterol (TC) >6.5 mmol/l or >5.5 mmol/l if High Density lipid (HDL) <1mmol/l). The DMP group will have a full clinical evaluation, education (including contact with Heartline), medical therapy of Blood Pressure(BP), glucose and lipids to current targets, smoking cessation, weight reduction and exercise advice. Patients in this group will receive aspirin 100 mg/d. Generic simvastatin will be given to those ineligible for statins according to Pharmaceutical Benefits scheme (PBS) guidelines, to a target LDL-C <2.0 mmol/l. Patients in the DMP group with one or more of the modified risk factors will undergo Dobutamine Stress echocardiogram (DSE), using standard protocols.Those with a positive study will be started on metoprolol (titrated to a resting Heart rate (HR) of 60 beats per min.), excluding patients with contra-indications to beta-blockade. Coronary angiography will be arranged for those at highest risk (>30%). Patients already on beta blockers account for <15% of major noncardiac surgery patients in our experience: if randomized to the DMP group, they will be optimized to a resting HR of 60/min.

To compare the interface sub-bandage pressure between two multilayer compression bandage systems during supine position, standing, exercise and recovery. Alternate hypothesis: The difference between mean Sub bandage pressure of elastic and inealstic bandage compression systems exceeds 10 mmHg.

The aim of the current study is to implement the early intervention program, COPE (Comparisons, Openness, Peers and Esteem), designed to build resilience and improve factors related to mental health problems among primary school children. It focuses on children aged between 8 and 10 years, as this is a crucial time to implement early intervention strategies to enhance children’s abilities to cope with psychosocial stressors and foster the development of positive mental health and well-being. This is also the age when children begin to frequently use social comparisons and are most vulnerable to the negative impact of these comparisons. Social comparisons are frequently used by children to learn about their own abilities and individual differences. As these social comparisons are an integral component of children’s social and emotional development, they can not be eliminated. However, for many children, an over reliance on social comparisons can lead to maladaptive coping skills, negative thought processes, pessimistic attributions, low self-esteem, and other negative beliefs about the self; all of which are known to be factors that heighten the risk of developing mental health problems. We have developed and trialled our program, COPE, which will build children’s resilience and equip children with strategies to identify, appraise and modify the use of social comparisons in ways that strengthen their self-esteem and other self-concepts, and thus reduce the risk of developing mental health problems. COPE specifically targets the use of social comparisons in four domains that are particularly salient and important for fostering the well-being of children. These include physical appearance, relationships with peers, physical activity and sport, and school achievement. For the current project we will conduct a more extensive evaluation of the COPE program, with a particular focus on how it improves the mental health of 8 to 10 year old girls and boys. It is expected that children who participate in the COPE program will demonstrate increased positive affect, lower levels of negative affect, lower depressive and anxiety symptoms, higher levels of resiliency, and more positive self-concepts than a wait-list control group. The effectiveness of COPE will be evaluated at the completion of the program and also at five follow-up periods: 1-month, 6-months, 12-months, 18-months and 24-months post-intervention.

En bloc resection (ie. in a single piece) is the goal for removing large sessile colonic polyps. Currently this is limited to 20mm in size with the standard submucosal injection solution (ie. normal saline). Succinylated Gelatin is a colloid, that has been proven to be safe and superior to normal saline for EMR in a porcine model. With Human Research approval, this study is to assess the efficacy and safety of succinylated gelatin for sessile colonic polyps sized 20mm or greated.

This randomised controlled trial will compare the outcomes of a 10 week, twice a week community based exercise programme for young people with Down syndrome aged 14-22 years. It will establish if a student mentored intervention can improve the work performance, muscle strength and level of physical activity undertaken by young people with Down syndrome.

Acute Respiratory Illness is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand. Parental smoking is a significant and preventable source of childhood morbidity, especially related to respiratory illness. Rates of adult smoking amongst Indigenous Australians and Maori are much higher compared with non-Indigenous populations; consequently Indigenous infants in both countries have higher rates of exposure to environmental tobacco smoke (ETS), compared with non-Indigenous children. The aim of this study is to trial the effect of a family-centred tobacco control program about ETS on the respiratory health of Indigenous infants up to 12 months of age.

Mental health problems such as posttraumatic stress disorder (PTSD) and depression are significant and persistent consequences of traumatic injury. Early interventions that address the secondary prevention of PTSD and depression after traumatic injury have the potential to be an essential component of public health efforts that target injury rehabilitation. The proposed study aims to investigate the effectiveness of a stepped care model of early intervention in the identification, prevention and treatment of posttraumatic stress disorder (PTSD) and depression symptoms that develop following traumatic injury. We expect that early intervention will be more effective than usual care in the prevention and treatment of posttraumatic stress and depression symptoms post injury.

Despite the impact of breast cancer on distress and quality of life (QOL), most Australian women refuse to participate in group psychological treatments. Therefore innovative interventions are required. The current study aimed to evaluate whether an interactive self-help workbook (WB) has greater improvements than an information booklet in depression, anxiety, traumatic stress, QOL and coping for women recently diagnosed with breast cancer.

The purpose of this clinical study is to determine the predicted long-term safety and effectiveness of the anthology cementless femoral stem using an RSA technique to yield early results in small numbers of patients. The secondary purpose of this study is to assess the efficacy of fully coating this stem with hydroxyapatite (HA) compared to a proximally-HA coated stem.