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The primary goal of this acute study is to compare breathing behaviour across various loads during parallel back squats between unstable load training (ULT) and traditional training (TRAD). Secondary objectives involve investigating the effects of stable versus unstable conditions across various loads on muscle activation, exercise stability, mechanical performance and perceptual fatigue. The primary hypothesis is that there will be a greater inspiratory volume, a higher rate of breaths, a longer duration of breath-holding, and a larger expiratory volume with an increase in load during squats in both the ULT and TRAD conditions.

In health-related disciplines such as nursing and medicine, practical assessment centre around high acuity simulated patients. In the emerging field of undergraduate paramedicine education, little research has explored this type of assessment nor the associated physiological and cognitive stress. We don't know whether this stress enhances or hinders learning? Acute stress response is well known to lead to performance degradation, so are these students being set up to fail when really educators should be encouraging learning as a priority. Research must be undertaken to determine how much physiological and cognitive stress is too much. Our hypothesis is that students who appraise a scenario as a threat will perform at a lower clinical ability than those who adopt a challenge appraisal.

The general aim of this pilot study is to establish correlations between parameters of electrical impedance tomography with standard clinical parameters. The specific aims are to: 1.Assess lung ventilation distribution in patients with high spinal injuries (T8 and above) 2.Collect clinical data on ventilatory mechanics including level of spinal deficits, ventilatory mechanics (invasive, non-invasive, ventilator settings) intraabdominal pressure, FiO2 ratio, and end tidal CO2 to arterial CO2 gap 3.Assess correlation between EIT parameters and clinical data Validity and reliability of EIT systems has been demonstrated in several studies, indicating that EIT may be effective in the assessment of ventilation distribution in patients with asthma, COPD and cystic fibrosis. Furthermore, EIT has also compared well with lung measures such as lung volumes and lung density quantified by CT. However, there is currently little or no studies of the use of EIT in monitoring of patients with restrictive lung disease, in particular patients with spinal injuries.

This purpose of this study is to assess the effectiveness of using Quitline as a referral pathway into lung cancer screening, and to assess whether combining Nicotine Replacement Therapy and Quitline telephone counselling interventions in current smokers is effective for people at risk of lung cancer. Who is it for? You may be eligible for this trial if you are aged between 50 – 80 years old, have a Prostate Lung Colorectal Ovarian model 2012 (PLCOm2012) score of >=1.51% and are a person who currently smokes with a 20-pack year smoking history. The PLCOm2012 model has been developed for lung cancer detection, and a score of >=1.51% means you are eligible for lung cancer screening. Study details Participants will be randomly allocated by chance (similar to flipping a coin) to the intervention group or the control group. Participants allocated to the intervention will be receive Nicotine Replacement Therapy and Quitline telephone counselling interventions for 12 months. While those participants who are randomised into the control group will Nicotine Replacement Therapy and Quitline telephone counselling interventions for 12 weeks (3 months). Participants who are eligible for lung cancer screening (based on certain criteria [PLCOm2012 > 1.5%, Have a > 20 pack year smoking history), will have a free CT scan of the lungs (within 12 months of enrolment in the study). Questionnaires will be collected every three months for the first year to assess the acceptability of the intervention and then once a year for 4 years to assess patient reported outcomes. It is hoped this intervention will help design a national Australian Lung Cancer Screening Program.

Depression and obesity in men are two of the largest public health concerns in Australia. These conditions also appear to be linked as men with overweight or obesity are ~30% more likely to develop depression than healthy weight men. Furthermore, men with depression are 43% more likely to develop obesity than men without depression. The SHED-IT: Recharge randomised trial (ACTRN12619001209189) tested a self-guided eHealth program combining lifestyle behaviour change advice and mental health support to reduce depression (and weight status) in men. It was the first RCT of an integrated mental and physical health intervention for men with depression. Results indicated significant and clinically meaningful intervention effects on both depressive symptoms and weight loss at post-intervention compared to the control group, which was maintained at 6-month follow up. However, because the program targeted physical and mental health it was unclear which components were most important for driving changes in the men's depressive symptoms. As such, the purpose of this pilot trial is the examine the feasibility and preliminary efficacy of comparing an online program focused only on lifestyle behaviour change to an online program focused only on mental health support for men with depression and overweight or obesity.

Like endometriosis, adenomyosis is a benign uterine disorder and is histologically defined by presence of endometrial tissue in the myometrium (muscle layer) of the uterus. The prevalence of adenomyosis is difficult to determine, since histological confirmation is necessary following surgical biopsy or more commonly hysterectomy. For women wanting to retain their uterus, hysterectomy is not an option. Imaging technologies (e.g. transvaginal ultrasound and MRI), are used as a less invasive method of diagnosis and detection, although they have limitations. The Australian Endometriosis Clinicians Collaborative (AECC): adenomyosis substudy is a prospective longitudinal clinical study that will: 1. compare diagnosis and treatment of adenomyosis with regards to impact on pain, bleeding patterns, general health symptoms and quality of life using validated questionnaires 2. determine cost-effectiveness of diagnostic and treatment options 3. establish a national biobank of adenomyosis (and endometriosis) for future research capacity. Outcomes will determine optimised diagnosis and treatment pathways for clinicians that improve quality of life for women with adenomyosis.

Ageing results in gradual loss of bone mass, which increases our risk of fracture. Increased stress responses are also associated with ageing and may contribute to accelerated bone loss. This study will be the first to investigate whether Tai Chi (a gentle, mind-body exercise) is able to reduce stress responses and optimise osteoporosis rehabilitation outcomes (i.e. improve bone mass, falls risk) when practised in combination with high-intensity resistance and impact exercise.

A significant number of neonates and infants require systemic-to-pulmonary artery shunt procedures as a part of staged treatment of their congenital cardiac condition. These shunts are at risk of thrombotic occlusion. Shunt patency is critical for survival of these children. The interim mortality of shunt dependent children has been found to be as high as 14%, and about 33% of these are due to thrombosis of the shunt. Some eventually undergo correction of their cardiac anomalies while the remaining undergo further surgeries for a single ventricle palliation (Fontan pathway). The children with single ventricle palliation are dependent on the patency of their subsequent shunts for survival. They are at risk of life-threatening thrombosis throughout their lives. Cross-sectional surveys of post-Fontan patients have reported a prevalence of intracardiac thrombosis of 17% to 33% and incidences of venous thrombosis and stroke ranging from 3% to 19%. The reported mortality from post-Fontan surgery thromboembolism is 25%. Aspirin has been the cornerstone of thromboprophylaxis in such children and its use has been associated with a significantly lower risk of mortality. Unfortunately, not all children respond equally to aspirin with an increase in the dose of aspirin suggested to reduce the incidence of thrombosis in some while the remaining have no response to aspirin. The prevalence of aspirin unresponsiveness in adults is estimated to be 0.4 to 35%, however this information in lacking in the paediatric population. The primary objective of the study is therefore to determine the prevalence of aspirin resistance in children undergoing cardiac surgery in Queensland. Secondary objectives are: 1) to assess if response to aspirin is dose dependent and 2) assess the incidence of thrombosis in children who respond to aspirin.

Despite the high burden of developmental vulnerability in Aboriginal infants, there has been no systematic implementation of early child neurodevelopment programs starting in the first four weeks of life (neonatal period) implemented by primary health care providers. We will be addressing developmental vulnerabilities by implementing the “Care for Child Development” program in Aboriginal and Torres Strait Islander (Aboriginal) children in Perth, Western Australia. Australia has a well-funded and developed universal health care system. Yet, almost 1 in 3 Aboriginal children commence school in Western Australia with at least two developmental vulnerabilities. The ‘Care for Child Development’ (CCD) program, created by WHO and UNICEF, provides an evidence-based, theoretically sound model for improving early child development, parental responsiveness and maternal depression in low and middle-income countries. The CCD program has been implemented in 19 countries and 23 sites, with providers in a range of sectors being able to implement the approach after appropriate training. It combines responsive caregiving and promoting early learning, can be delivered from the first month of life up to 36 months and provides caregivers with practical recommendations on playing, responsive stimulation, caregiver-child interaction, and maternal depression. The most recent effectiveness study of the CCD program in a large, factorial, cluster-randomized trial published in The Lancet Global Health found ‘low intensity’ CCD delivered to infants aged 0-24 months resulted in substantial improvements at 12 and 24 months in cognitive child development compared to the control group. We will undertake a 2-year community-based, randomised effectiveness trial of 400 caregiver-infant pairs with a team of national and international experts. We aim to address the low level of an Aboriginal child’s development attainment by improving primary health care’s capability to deliver world-leading child development services for Aboriginal babies and children. We will do this by determining whether the CCD program delivered through child health checks from the neonatal period will improve caregivers’ abilities to play, communicate and respond to their child’s neurodevelopmental needs throughout the first 24 months of life postpartum.

'Aboriginal’ & 'Indigenous’ are used to respectfully refer to Aboriginal and/ or Torres Strait Islander peoples. We are testing a practical solution to improve engagement of Aboriginal young people with primary care for mental health. Currently <25% of Aboriginal adolescents attend a health clinic to receive a Medicare-funded annual health check. We will compare a new model of health care to standard primary health care to test which best supports the mind, body and spirit of Aboriginal youth. It was developed with Noongar young people, parents/ carers, health workers and Elders in Perth and Bunbury. The new model of care supports the wellbeing of young people in two ways. - A new online health check tool to use before visiting a GP. - A new type of health worker to help young people with their wellbeing needs. This is a specially-trained outreach health support worker role. This health worker supports all the decision made by a young person. They might help with making health appointments, or finding activities to help a young person feel good (like job training or taking part in cultural events). They will have $500 per youth to support wellbeing activities. To be a part of this trial, a person must: – Be an Aboriginal person aged 15 – 24 years – Be living in or near Perth – Have high levels of distress (youth must consent to answer short 10 question tool to measure distress level) A trial research assistant will identify and recruit potential participants via connections with the Aboriginal community, peer group leaders, organisations working with young Aboriginal people and ‘snowball’ sampling of young Indigenous people. For recruitment, trial promotion may include, but is not limited to, the following: brochures, radio, newsletters, websites and private study page on social media. A young person must consent to join the trial before being assigned to a group. Two groups are being compared. A youth is put into a group by random chance, like flipping a coin. Briefly, the: • Intervention group receive guided care though an Outreach Service Navigator in Perth for up to 5 months. They complete an online health check tool which is not the current standard tool used by GPs. A GP at Derbarl Yerrigan Health Service will develop a mental health care plan with the youth based on the new health check. • Waitlist control group receive standard care at Derbarl Yerrigan Health Service in Perth for up to 5 months. The control treatment includes the standard Indigenous health check (Medicare 715) and GP care at DYHS. A GP will develop a mental health care plan with the youth. After the 10 month assessment, a control participant can choose to receive Intervention treatment. At 3 timepoints, participants complete assessments (baseline, 5 months & 10 months). Baseline is after consent and before randomisation. Assessments will measure level of distress, quality of life, social factors, use of health services, work/ study and government support.