ANZCTR search results

Participation, as defined by the International Classification of Functioning, Disability and Health, reflects the societal consequences of health conditions. Despite being a key component of functioning and an important goal of rehabilitation, participation is not measured consistently in ageing research. Falls are a major public health problem. Fortunately, well-designed exercise interventions have been shown to reduce falls in older people. To date, evaluation of these interventions has focused on rate of falls, impairment of body function and performance of tasks. The consequence of falls prevention programs on functioning at a societal level have not been evaluated. Increased understanding of how falls prevention interventions affect participation may provide opportunities to enhance outcomes for people at risk of falling. The objectives of this study are to: - Evaluate the extent to which measurement of participation has been reported in trials of fall prevention interventions with an exercise component. - Determine whether exercise interventions targeting falls increase ICF participation in older people. We will undertake a systematic review with meta-analysis of randomised controlled trials of interventions including exercise that aimed to reduce falls in older people in the community, aged care facilities or hospital. Studies will be extracted from the Cochrane Review of interventions for preventing falls in older people living in the community(1) and the Cochrane Review of interventions for preventing falls in older people in nursing care facilities and hospitals.(2) We will re-run the search strategies used in these Cochrane Reviews in Medline, EMBASE, AMED, PsychINFO, CINAHL and CENTRAL. The original Cochrane Reviews searched CINAHL via the Ovid platform. As this is no longer available, CINAHL will be accessed via EBESCO. The searches will run from the final date searched by Gillespie et al(1) and Cameron et al,(2) to May 2010. Language restrictions will not be applied. Measurement instruments used in the trials will be linked to the ICF then assessed against instrument classification criteria, to determine whether they measure participation. Trials with published participation data at baseline and at least one follow-up time-point will be included in the meta-analysis. In order to minimise bias, the following methods will be used: - Study selection. One author will independently examine the titles, abstracts and keywords to identify potentially relevant trials from the search results. Full text reports will be obtained for all potentially eligible studies. Based on the full text reports, two authors will independently decide on study inclusion. Differences will be resolved by discussion or, if necessary, arbitrated by an independent third author. Details of discussions will be kept. - Data extraction. Data regarding trial characteristics and estimates of effect of the intervention will be extracted from the included trials by one author and checked by a second author. Disagreement will be resolved by discussion or, if necessary, arbitration by third author. - Duplicate publication bias will be avoided by comparing author names, sample sizes, interventions and outcomes. - Publication bias will be assessed using Egger’s test and observation of the funnel plot. - Assessment of bias of included studies. Two authors will independently assess risk of bias using the Cochrane risk of bias tool, outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Bias will be considered from the study level (assessment of sequence generation and adequacy of allocation concealment) and also the outcome level (evaluation of the methods used to measure the participation outcome in each study: blinding of outcome assessors, completeness of participation data and selective reporting of participation data). Any disagreement will be resolved by consensus or third-party arbitration. (1) Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009(2):CD007146. (2) Cameron ID, Murray GR, Gillespie LD, Robertson MC, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010(1):CD005465.

Cystic fibrosis (CF) is a chronic hereditary disease affecting respiratory and endocrine systems. There is no cure for this disease but treatment advances have seen increases in life expectancy. Adults with CF have to adhere to a strict life-long regime of self care including chest physiotherapy, antibiotics, vitamins and exercise. Exercise is now a regular treatment tool with benefits including increased respiratory function, fitness and strength. This project seeks to investigate if participating in an exercise program using the recently developed Nintendo Wii is an alternative to a regular exercise program.

The GLAMA study is a pilot program to evaluate the provision of leadership training to Year 10 girls so they can implement physical activities during Physical Education with Year 7 students and then independently during lunchtimes. The activities have been designed to provide opportunities for thinking, team work and physical activity to promote positive attitudes to physical activity.

No research data supports decisions regarding the impact of increasing supervisor to student ratios on learner performance, to increase system capacity (Lekkas L, et al 2007, Ladyshewsky,1995). Our study will determine the best model of education to be utilised when clinical educators are supervising multiple students. This will then allow for studies to effectively evaluate the typical one-to-one clinical educator to student teaching ratio with higher student to educator, supplying essential data with which to evaluate the potential for capacity growth associated with a shift in the design of clinical educator and student models.

Surfactant replacement is the mainstay in prevention and therapy of respiratory distress syndrome (RDS) in preterm neonates. Early treatment with surfactant reduces mortality, and incidence of chronic lung disease (CLD) and air leaks in preterm infants at risk of RDS. Current therapy consists of instilling a liquid bolus of surfactant into the trachea through an endotracheal tube, followed by mechanical ventilation of variable duration. This treatment actually requires the patient to be admitted to a level III care nursery and a risk of ventilator induced lung injury. We propose a new approach to surfactant treatment for moderately preterm infants born with respiratory distress, as well as for more mature infants born in a non-tertiary hospital setting. By using nebulised surfactant, we propose that babies will have their mild-moderate respiratory disease treated without the need for invasive ventilation or transport to a tertiary neonatal unit.

The purpose of this study is to investigate the amount of movement, if any, of a metal backed partial knee replacement using x-rays taken at follow-up visits. A computer program will be used to analyse the x-rays to measure if the replacement has moved and how much it has moved since it was put in or since the previous follow-up visit.

The main goal of asthma treatment is to achieve good asthma control. This cluster randomised trial will test the effectiveness of two brief asthma management interventions, delivered by GPs, for improving asthma control in primary care. The effect of both interventions separately and their interaction will be tested by multiple linear regression.

The aim of this clinical study is to determine the safety and effectiveness of the cemented Total Hip System (E2 stem/P2 cup). This will be done by collecting information and data on measured outcomes on the Total Hip System, using RSA method to provide early results on the implant. The intended use of this implant is for patients with degenerative joint disease who require a primary total hip replacement.

Clinically significant levels of emotional distress and behavioural avoidance are quite frequent after a traumatic brain injury. Interventions with a traumatic brain injured (TBI) population have demonstrated general benefits of group programmes in addressing some of these issues but to date, programs have utilised cognitive behavioural therapy (CBT) as a treatment protocol. At this time, there appears to be no published studies using acceptance and commitment therapy (ACT) with a TBI population. Acceptance and Commitment Therapy (ACT) is one of the ‘third wave’ of behavioural therapies. It aims to change our relationship with internal experiences (thoughts, feelings, memories and physical sensations) so they no longer act as barriers to valued behaviour. The aim of the study is to implement a psychological treatment program to improve psychologically functioning following a traumatic brain injury utilising Acceptance and Commitment Therapy (ACT). With improved psychological functioning it is anticipated that participants will increase their participation in rehabilitation and movement towards a more valued life. The study will be a randomised controlled group treatment programme. Clients of the brain injury rehabilitation unit demonstrating clinically significantly levels of psychological distress will be randomly allocated to either the treatment group or the control group (consisting of an active control based on Befriending protocol). It is anticipated that the treatment will be offered over a two year period. The intervention will consist of six by two hour group treatment sessions offered weekly at the brain injury unit with a one month follow up session. Content of the sessions will be based on ACT theory including identification of values, defusing techniques, self as context and mindfulness. Testing will be undertaken prior to the commencement of treatment and after the one month follow up with brief measures being undertaken weekly at the beginning and conclusion of each treatment sessions relating to motivation and capacity to complete homework tasks. Demographic information will be collected and elicited from the existing brain injury unit database. Participants on the wait list control will be given the opportunity to participate in the intervention after the second outcome measures are undertaken. De-identified data form the outcome measures will be analysed statistically for changes pre and post intervention. De-identified demographic and medical information will provide descriptive data about the participants. Attendance at other therapy appointments in the brain injury unit will be reviewed to measure level of participation.

The objective of the study is to determine the acute neurocognitive effects of a dose of Panax quinquefolius in healthy middle aged volunteers. The Cognitive Drug Research (CDR) computerized assessment battery will be used to evaluate effects of Ginseng on attention, working memory and secondary memory. Mood will also be assessed. Several paper and pencil questionnaires will also be completed which are designed to evaluate state and trait feelings of anxiety and depression and also to asses any symptomatology associated with the extract. Furthermore the neurophysiological effects will be measured using high spatial resolution electrical brain recordings measured by the Steady State Probe Topography technique (SSPT)