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Treating auditory problems in children with neurofibromatosis type 1: extension trial
Learning disorders are one of the greatest causes of morbidity in children with the genetic syndrome, neurofibromatosis type 1 (NF1) and result in academic underachievement, reduced quality of life, and are of significant concern to families and their teachers. There are minimal evidence-based interventions for these problems in NF1, and there is an urgent need for trials targeting this area of clinical need. This registration form details the extension study from the Treating Auditory Problems in NF1 "TAP-iN" trial. The extension study described on this registry form will enable us to establish the efficacy of an RML device in treating central auditory deficits in children with NF1 and will allow us to determine whether treatment benefits extend to broader areas of learning and behaviour. Outcomes are clinically meaningful and include measures of speech perception, literacy skills, attention, fatigue, social function and quality of life. If realized, this study will provide powerful evidence for a novel, non-invasive intervention targeting a common and impairing problem in NF1.
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Treating auditory problems in children with neurofibromatosis type 1
Learning disorders are one of the greatest causes of morbidity in children with the genetic syndrome, neurofibromatosis type 1 (NF1) and result in academic underachievement, reduced quality of life, and are of significant concern to families and their teachers. There are minimal evidence-based interventions for these problems in NF1, and there is an urgent need for trials targeting this area of clinical need. The parent TAP-iN study described on this registry consists of a randomised controlled four-week crossover trial conducted in children with NF1 and auditory processing difficulties. The proposed study will enable us to establish the efficacy of remote microphone listening devices in treating central auditory deficits in children with NF1. Outcomes are clinically meaningful and include measures of speech perception and functional hearing ability. If realized, this study will provide powerful evidence for a novel, non-invasive intervention targeting a common and impairing problem in NF1.
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The REDUCE Study – Safety of the Endobronchial Thermal Liquid Ablation (ETLA) for the Treatment of Severe Emphysema with hyperinflation – A First in Human Study (CSP-11121
This is a prospective, multi-center, single-arm phased study assessing the safety, feasibility and efficacy of the ETLA system for the treatment of severe emphysema with hyperinflation. The ETLA System is a minimally invasive bronchoscopic treatment designed to deliver heated normal saline to targeted emphysematous lung regions with hyperinflation to cause tissue ablation and subsequent volume reduction as a means for treating emphysema. The ETLA therapy will be delivered sequentially over two (2) procedures. The magnitude of clinical benefit associated with ETLA is anticipated to correlate with the relative volume of diseased tissue removed/reduced, therefore it is anticipated that higher relative volume treated may result in larger improvement.
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Clinical validation of circulating cell free DNA [ccfDNA] as a biomarker of metabolic health
Obesity and its associated diseases have rapidly risen to become a significant burden on health systems across the world. Australia is not immune to this upheaval, with nearly 2 in 3 adults in this country classified as overweight or obese. In line with rising obesity, rates of diabetes have also risen dramatically. In the 2017-2018 Australian Bureau of Statistics Health Survey, 4.9% of respondents reported a diagnosis of diabetes. Furthermore, it is estimated that diabetes was an associated or underlying cause for 11% of deaths in the year 2018. Even without progression to diabetes, obese individuals are at risk of a host of other health issues such as the development of Nonalcoholic fatty liver disease (NAFLD). There is an urgent need for new ways to manage the metabolic diseases of obesity. However, there is a lack of diagnostic tests that can accurately predict diabetes before to the appearance of the symptoms that indicate that the first steps into full disease have already occurred. New evidence shows that inflammation of the deep fat stores that surround our organs plays a key role in health and obesity. It is now known that fat tissue is not just a passive storage site for excess energy but rather a complex organ that can disrupt the healthy hormonal and metabolic profile of obese patients. This inflammatory process occurs very early on in the development of disease, before the onset of diabetes and pre-diabetes symptoms. Ongoing inflammation of organ fat results in high rates of cell death in this tissue and the release of unwanted cell free DNA into the surrounding tissues and blood circulation. This free DNA can actually increase the level of inflammation via a negative feedback loop that serves to strengthen this unwanted response. At CSIRO, we have developed a new blood test that can measure the amount of DNA being released by these fat cells. This new test may provide a window into health for obese patients that can help doctors predict and monitor long-term health well before a diabetes diagnosis could be determined using current measures. This study will test the validity or our new blood test, in a group of patients who will be profiled for a well defined set of biomarkers that measure metabolic and liver health. This study is funded by CSIRO.
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The CareNET trial: Caring for carers of people with advaNced cancer at hospiTal discharge
CareNET is an intervention that is integrated into existing discharge processes and uses the Carer Support Needs Assessment Tool- Intervention (CSNAT-I) to identify and meet the carers needs preparing for the person they care for to return home from hospital. This study aims to determine whether it is feasible to deliver the CSNAT-I to carers both in the hospital setting and in the first few days when they person they care for returns home. Who is it for? You may be eligible for this study if you identify as a carer for someone who has advanced cancer. For this study a carer is someone who is in a close supportive role who share in the illness experience of the patient and who undertake vital care work and emotion management for the patient. Patients with advanced cancer who are currently in-patients at a specialist cancer centre will also be invited to participate. Study details Patients who choose to participate in this study will be asked to meet with an occupational therapist to determine their needs related to achieving discharge home. While the patient is still in hospital, carers who choose to participate in this study will also be asked to meet with the occupational therapist (OT) to identify and prioritise their caring needs using the CSNAT-I tool. Following this initial assessment, the OT will meet again with the carer to develop an action plan for prioritised needs prior to the patient being discharged. Within 3- 7 days after the patient has been discharged home, the carer and OT will review and discuss whether the identified needs have been addressed, including review of any new needs identified by or referring to relevant service providers (e.g., GP, community palliative care service, nurse coordinators). It is anticipated that these meetings may occur face-to-face or via video- or teleconference per the carer's preference. Meetings should take no more than 30-40 minutes. Carers and patients will be asked to complete a series of surveys regarding their experience with the intervention and their health, they may also be asked to participate in a one-on-one interview with a member of the research team to discuss their experiences of the study. It is hoped this research will determine whether it is feasible to deliver the CSNAT-I intervention to carers of patients with advanced cancer. This includes understanding what is required to conduct a larger trial that can test how effective it is in benefiting the patients and carers and how we can translate it into everyday practice. The results of the larger trial may then lead to improved health and wellbeing for future carers and patients.
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A Randomized Controlled Trial of a Smartphone App for addressing distress and wellbeing in a high-trauma risk population
This project aims to examine the efficacy of a smartphone application [the Build Back Better app] in providing evidence-based prevention strategies for psychological distress, anxiety, depression, and posttraumatic stress (PTS) symptoms in people who have experienced potentially traumatic experiences. Based on user feedback of a previously conducted feasibility pilot study (Meuldijk et al. 2022, in preparation) within a sample of Emergency Service Workers (ESWs) (n=63) the Build Back Better app has been refined and a fully functional version is ready for formal testing in a randomized controlled trial (RCT).
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Nutritional biomarkers comparing a healthy versus a typical Australian diet: a Feeding Study in Australian Adults.
A randomized cross-over feeding study conducted in free-living healthy adults aged 18 years and older old recruited from the local Hunter region. Participants will be enrolled in an 8-week dietary intervention consisting of a 2-week run-in period (habitual/usual diet) followed by 2 x 2-week dietary intervention periods that include a 2-week washout between them. The 2-week diet periods will consist of a ‘Healthy Australian Diet’ that aligns with Australian recommendations and a ‘Typical Australian Diet’. These will be allocated in a randomized order. During the 2-week washout period the participant returns to their / usual diet). The entirety of the diet (i.e., 3 main meals and snacks per day) will be provided to participants during dietary period 1 and 2. Participants will supply their own meals and foods during the run-in and washout periods. Study participation involves completing self-administered questionnaires (e.g., food frequency, health. demographic, physical activity questionnaire); collection of biosamples (fasted blood sample, urine and faecal sample) and physical measurements such as blood pressure, arterial stiffness, anthropometry and body composition. Researchers hypothesise that distinct nutrition biomarkers will be detected that are representative of each diet phase.
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Brain Pulse Monitoring Study in patients with or at risk of developing stroke to provide earlier detection of stroke
The brain pulse monitor is a new non-invasive method that uses light to monitor brain oxygen levels and blood flow. The purpose of the study is to determine if the brain pulse monitor accurately detects falls in brain oxygen and blood flow associated with stroke. The study will enrol adult patients with or at risk of developing a stroke. The target group are patients presenting to hospital with stroke, patients with sub-arachnoid haemorrhage that develop vasospasm and patients undergoing surgeries associated with a risk of stroke, such as carotid and cardiac surgery. The major outcome is to assess the accuracy of the brain pulse monitor to detect reduced brain oxygen and blood flow changes associated with stroke.
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A Phase III study to investigate the effect of EMD-RX5 on symptoms of psychological distress in adults with chronic pain
Symptoms of psychological distress, also described as acute stress, anxiety or nervous tension are particularly common in patients suffering chronic pain. EMD-RX5 is a cannabidiol (CBD) capsule. Some research indicates that CBD affects receptors (a group of cells that control the movement of chemicals and molecules) in the brain, that may alter a key hormone (serotonin) relating to mood, happiness and feelings of well-being. The purpose of this study is to determine whether EMD-RX5 improves symptoms of psychological distress in patients experiencing chronic pain.
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Walk-and-Talk Psychotherapy for Men with Low Mood: A Pilot Study
Background Depression is a highly prevalent mental illness that affects over 109 million men worldwide and one in eight Australian men every year. Characterised by persistent feelings of sadness and hopelessness, untreated depression is devastating for individuals, families, and communities. Due to COVID-19, the Australian prevalence of depression increased by 10% in 2020 alone. In Australia, men with depression are often referred to psychotherapy (also known as counselling). However, while effective for treating depression, psychotherapy often fails to engage men who most often report that the process ‘doesn’t feel right’. Given the dominant form of masculinity in Australia encourages men to suppress emotions, it is unsurprising many find it hard to be vulnerable with a relative stranger, in a formal and unfamiliar environment, for a substantive period of time. Recently, the Australian National Men’s Health Strategy highlighted the need to tailor existing mental health services to be more engaging for men. In contrast to traditional psychotherapy, which almost exclusively takes place indoors, ‘walk and talk’ therapy in natural settings has potential to engage men for several reasons. First, walking outdoors may represent a less confronting context (e.g., less direct eye contact, shared ownership of physical space). Second, the biophilia hypothesis suggests humans have a ‘biological attraction to natural environments’, and gain health benefits by simply being in nature. Finally, physical activity has a known anti-depressant effect, that can enhance the benefits of psychotherapy. Despite these benefits, no studies have examined the value of walk-and-talk therapy for supporting men. Study aims Primary aim: To test the feasibility of outdoor, walking-based psychotherapy for men with depression compared to usual care (seated indoor therapy). Secondary aim 1: To investigate the preliminary efficacy of outdoor, walking-based psychotherapy for improving the mental health of men with depression compared to usual care. Secondary aim 2: To investigate differences in perceptions of therapy and the therapeutic alliance between men who participant in outdoor, walking-based psychotherapy compared to usual care.