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Investigation of Stress Symptoms and Interventions in Firefighters
Stress is a ubiquitous concern for people however it may be more prevalent in firefighters who routinely face arduous working conditions. Chronic stress has been shown to have detrimental effects on mental health and the ability to self-regulate mood and behaviour. Neurofeedback (NFB) is a brain-computer interface biofeedback intervention. The objective was to investigate whether NFB could substantially alter self-regulation capacity positively to improve self reported symptoms of stress. There were three hypotheses proposed including, H1: firefighters in the experimental group would show improved scores on self-report measures pre and post intervention. H2: firefighters in the experimental group would maintain these changes at long term follow up. H3: firefighters in the control group would show no change from baseline to follow up. Neurofeedback training involves watching a computer display to use mental activity to control brain waves of interest. The display and sound changes, in real time, as changes in participants’ brainwaves occurs. The feedback allows for the participants learn to regulate their mental activity. If the mental activity successfully changes the brainwaves in the desired direction to reduce stress and produce calming, participants are rewarded with points. With practice, consistent with how learning occurs participants can improve their response to stress.
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Acceptability and Feasibility of a Family Intervention for Autistic Children Who Are Bullied
We will conduct a clinical case series to investigate the acceptability and feasibility of Resilience Triple P for mainstream primary school students in Australia who have been diagnosed with ASD and are bullied by their peers. We will recruit 20 to 25 families and they will complete Resilience Triple P immediately. Children, parents, and teachers (if applicable) will complete assessments. It is expected families of autistic children will be satisfied with Resilience Triple P as an intervention for decreasing bullying victimisation and they will provide important insights into improving the delivery. Autistic children who participate in Resilience Triple P are expected to experience reductions in bullying victimisation, mental health problems, and school refusal. It is expected each family of an autistic child will use a different combination of strategies from Resilience Triple P depending on what their specific goals are.
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An evaluation of a mental health literacy program in primary schools
Mental disorders are common in childhood, but many young people do not receive adequate professional support when they experience mental ill health. Help-seeking interventions may bridge this substantial treatment gap. In adolescents, there is evidence that interventions targeting mental health literacy and mental health stigma can increase help-seeking. However, there has been limited research on such interventions in primary-school aged children. The aim of the proposed study is to evaluate the effectiveness of the newly established Thriving Minds program in increasing literacy, reducing stigma and promoting help-seeking in children aged 7-12 years. Children from at least 12 primary schools will participate in a pragmatic controlled trial to assess intervention effects, while select school staff will participate in semi-structured interviews to evaluate program satisfaction and identify other observable effects of the intervention on student learning and wellbeing. It is expected that Thriving Minds will improve children's help-seeking for difficult emotions. The proposed study will provide important new knowledge on the effectiveness and acceptability of mental health awareness programs in children. If found to be effective, the Thriving Minds program could be scaled up for delivery across Australia, providing a low-intensity and accessible intervention to promote mental health and timely help-seeking in our children, now and into the future.
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A one year follow-up study of the MedWalk South Australian participants to assess maintenance of lifestyle changes and selected health measures.
Research trials have demonstrated the short-term benefits of the Mediterranean diet (MedDiet), showing improvements to cholesterol levels, blood pressure and antioxidant levels in the body. Evidence is quite strong that people who follow a MedDiet have improved cardiovascular health, and now we are trying to find out if it might also protect us against dementia and cognitive decline. During 2021 and 2022 we completed a 12-month long study called MedWalk with 74 older Australians. We asked half of them to try the MedDiet, while the other half stayed on their usual diet. Those following the MedDiet were also asked to be active, aiming for 30 minutes of physical activity per day. We were interested in their cognitive function, but also their mental health and wellbeing, their cardiovascular health, fitness and their frailty. While 12 months will tell us about some short-term changes, it is not really long enough to see changes in long-term cognition or dementia diagnoses. So this follow-up study will ask those same 74 people to come in and have some measures taken, to see if they have kept on following the MedDiet, kept up the physical activity, and to see if there is any benefits to their cogntive health 24 months since starting the MedWalk trial (12 months since their final MedWalk visit). We are hoping to see that our participants have maintained some aspects of the MedDiet and their physical activity levels from the study, and we may perhaps see that the control group have also adopted some of these changes since finishing the trial. If we see benefits to cognitive health or in some of the other outcomes, this will be strong promotion for older Australians to adopt a more Mediterranean lifestyle through diet and physical activity.
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A trial to assess the visual performance of novel myopia management spectacles in short-sighted young adults
The purpose of this trial is to compare the visual performance of various novel myopia management spectacles to a commercial control spectacle in myopic young adults. Visual performance will be assessed with vision testing and questionnaires. It is hypothesized the visual performance of test spectacles will be no different to control spectacles.
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A digital anxiety intervention for children with reading difficulties
The overall goal of this research is to evaluate the efficacy of a digital anxiety intervention developed for children with poor reading. We are aiming to answer the following research question: Does a digital anxiety intervention modified for children with poor reading significantly reduce anxiety symptoms and result in greater remission of anxiety for children aged 7 to 12 years compared to the control condition? We aim to evaluate this through a randomised controlled trial (RCT) with a primary timepoint (post-intervention) at 12 weeks, an interim timepoint (mid-intervention) at 5 weeks, and a secondary timepoint (follow-up) at 24 weeks. We hypothesise that the intervention will significantly improve children's anxiety.
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Energy needs in adult critically ill patients with infection.
Indirect calorimetry is a highly accurate instrument which measures energy needs by monitoring the amount of oxygen consumed and carbon dioxide produced. Despite best practice recommendations to use indirect calorimetry in critically ill patients, clinicians often rely on less accurate and quicker estimations of energy needs using predictive equations. There is little published data on how frequent indirect calorimetry measures should be undertaken to capture energy changes in patients with infection during the course of their ICU admission in a busy ICU setting. The primary aims of this study are to compare measured energy expenditure using once daily indirect calorimetry with usual standard of care estimations using predictive methods and determine feasibility of indirect calorimetry from a practitioner perspective, in critically ill patients with a suspected infection. The secondary aim is to describe correlations between measured energy expenditure and infection markers and infection severity predictors. This is a prospective quantitative observational study conducted at Sir Charles Gairdner Hospital ICU that commenced participant recruitment on 17th August 2021 and completed participant recruitment on 9th March 2023. Inclusion criteria includes: Critically ill adult (18 years or older) mechanically ventilated patients with a suspected infection, requiring vasopressors within 24hours of admission and expected to stay within the ICU for at least 24 hours.
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Paediatric Asthma and Wheeze Study - Part 1
Wheeze, a breath sound that may indicate asthma, is very common in children; ~50% of all preschool aged children have an episode of wheeze and 40% of these children have recurrent wheeze. Also, asthma is the most common chronic illness in children. Yet, identifying wheeze is challenging for parents (disagreement rate between doctors and parents are >50%) and indeed many cultures (including Indigenous Aus) do not have a word for wheeze. Our multicentre study addresses the need to define wheeze accurately using digital technology. We will use WheezeScan (WzS) digital technology during face-to-face clinics as well as remotely (child’s home) in Queensland (including outreach clinics), Darwin and Sydney. Recruiting children from the hospitals and outreach clinics, we plan a cohort study involving 102 preschool children suspected of having asthma. We aim to determine whether using WzS improves the diagnosis of asthma, patient related outcomes (PROs) and health cost. WzS’s dependable accuracy will provide parents/caregivers and doctors the ability to discern if a child is wheezing-subsequently providing the confidence and clarity over the next steps that need actioning. Our study will improve the detection and consequently the management of preschool wheeze by the accurate diagnosis of reversible airway obstruction/asthma. Our proposal will fulfil a large unmet clinical need and research gap, identified by our patients, parents, parent advisory group, clinicians, Asthma Foundation of NT, as well as Australian data and international surveys.
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Calculation Of Lung Inflation in Neonates
Chest x-ray (CXR) are a simple and commonly used tool to assess the lungs of a neonate. Most neonates receiving assisted mechanical ventilation will have a CXR at some stage after starting treatment (many will have serial CXRs over time). Clinicians often use CXRs to help determine the impact of mechanical ventilation (use of a breathing machine to support diseased or sick lungs) on a patient’s lung. It is commonly taught that lung volume can be assessed through the number of posterior ribs seen above the diaphragm in a CXR (diaphragm position; the more ribs the larger the lung volume). This is commonly used in adults to assess for emphysematous changes, or hyperinflation, in chronic obstructive lung disease or asthma. Counting ribs on a CXR, as a mechanism of quickly assessing lung, volume is often recommended in neonatal ICU guidelines. Normal inflation of the lung is considered to be between a diaphragm position of the 8-9th posterior rib, with less than 7 ribs indicating underinflated lungs and over 10 ribs indicating overinflated lungs, although varying thresholds are used. Estimation of lung volume using diaphragm position assessment is also commonly used to titrate specific ventilation settings. Despite being used to guide clinically important decisions, there have been few studies that have assessed and analysed the relationship between the number of ribs above the diaphragm and lung volume. Those that have assessed this question, have either found no significant relationship,2 or have formulated a 3D structure of the lungs from multiple scans to accurately represent lung volume, a method which is not used in clinical practice. There is a need to determine whether this common practice (counting ribs on CXR) to guide important intensive care interventions is useful as a measure of lung volume in neonates. Computed Tomography (CT) is a gold standard measurement of lung aeration and volume. It provides detailed information regarding the aeration of the lungs (such as the absolute amount of lung tissue collapsed or overdistended) and can provide the value and measurements of lung volume in ml/kg for an individual. However, due to the associated increased radiation exposure, CT is not routinely performed in neonates. The aim of this retrospective observational study is therefore to evaluate the relationship between the number of the ribs above the diaphragm on a CXR and the lung volume and aeration as measured through a CT chest. This study will be completed through a retrospective analysis of neonatal chest CTs from a data bank at the Royal Children’s Hospital in Melbourne, Victoria. Lung volume and aeration measures will be derived from CT imaging and compared to diaphragm position on the scout CT image (which is the same as a CXR) performed at the start of every CT. The relationship between lung volume, lung aeration and diaphragm position will then be compared.
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MRI Guided Stereotactic Focal Ablation of Prostate Cancer
This study is investigating the feasibility, safety and effectiveness of delivering targeted radiation therapy using a device with in-built magnetic resonance (MR) imaging to identify and deliver the radiation doses specifically to the prostate tumour. Who is it for? You may be eligible for this trial if you are a male aged 40 years or over, you have been diagnosed with a solid prostate tumour that is appropriate for radiation treatment and the cancer has not spread to any other organs. Participants will also need to be able to undergo MR imaging, additional criteria for MR imaging will apply. Study details Participants will receive radiation to the prostate gland using a Linear Accelerator device with MR imaging capability. The intervention is intended to be delivered as 2 sessions over 2 weeks. Participants will be asked to provide blood samples to check the PSA level throughout the study to assess the response to treatment. Data on prostate specific antigen (PSA) response to treatment, as well as any changes to the participants' urinary/bowel habits and sexual function will also be collected. It is hoped that this study will determine whether an MRI-guided approach to radiotherapy is a feasible, safe and effective method for the treatment of prostate cancer that has not spread to other organs.