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Myopia or nearsightedness is characterized by elongation of an eye length that is greater than normal. The prevalence of the condition is high (>90% of young adult Taiwanese are myopic) in many parts of the world and rising elsewhere. Higher levels of myopia lead to several sight threating complications such as retinal detachment, glaucoma and cataract. Myopia is associated with a significant economic and health burden. There exist treatment strategies that can slow the progression of myopia in children. Evidence suggests that ocular growth and refractive development is sensitive to visual signals including optical defocus. Imposing hyperopic defocus (i.e., have the image plane fall behind retina) can lead to ocular elongation whereas myopic defocus was found to slow ocular elongation in chicks, guinea pigs, and monkeys. Spectacle and contact lens designs incorporating segments or sections of the lens devoted to myopic defocus were seen to significantly reduce myopia progression in children. Interestingly, observations indicate that wearing range of multifocal lens designs may slow myopia progression compared to wear of full field negative lenses. Thus, there is a need to better understand the response of a human eye to multifocal lenses to determine if there are differences in responses to different types of multifocal lenses. PRIMARY AIM: To investigate changes if any in axial length (central and peripheral) of myopic eyes to short term (60 mins) wear of multifocal spectacle lenses. Secondary Aims: To investigate changes if any in, - refractive error (central and peripheral) - choroidal thickness - contrast sensitivity function Potential significance of study: The findings of the study will help understand the ocular response to different types of optical blur and may play a role in development and/or refinement of optical strategies to slow myopia.

First responders and emergency service personnel are exposed to significant stress and potential trauma in their roles and are at risk of significant mental health issues such as PTSD, depression and problematic alcohol use. Through three interconnected programs, the project aims to promote wellbeing and further strengthen resilience in first responders with a key goal of reducing the risk of mental health problems. The first program is an online wellbeing and resilience program for police and fire service members in their first five years of service, supported by a wellbeing ‘coach’ who checks in regularly during the program. This is supported by a parallel program tailored for members’ significant others, the 'Be Well' program, while the third program provides supervisors with training and skills to promote good mental health and identify and work with members who may have mental health challenges. The project will evaluate key indicators of wellbeing and mental health, index cost-effectiveness of the programs, and conduct substantial follow-up of participants.

The GMK® SpheriKA is a total knee replacement device developed by Medacta International SA as a product line extension of the GMK® Sphere femoral component (class III CE marked). GMK® Sphere has been on the market since 2011. The design of the SpheriKA femoral components is optimized for the kinematic alignment technique, with particular focus on those cases when the position of the femoral component may represent a challenge for the patella tracking. The purpose of the study is to assess the clinical effectiveness and survivorship of the GMK SpheriKA device. This will be achieved by; evaluating patient reported outcome measures (PROMs), clinical outcomes, radiological outcomes and survivorship. Medacta may use the results of this project in their application to the Prosthesis List Advisory Committee (PLAC) for assessment. The GMK SpheriKA is not yet listed on “the Prosthesis List”. A patient reported outcome measure (PROM) is defined as any report of a patient’s health status that comes directly from the patient without the interpretation by others. Incorporating PROMs not only enables the inclusion of this unique and critically important perspective of the patient’s opinion, but also broadens the range of outcomes that can be evaluated. With specific regard to joint replacement, PROMS can provide meaningful information on the extend of pain and disability prior to surgery, as well as the extent and timing of recovery and the presence of complications. The successful collection, knowledgeable interpretation and integration of PROMs with other outcomes can improve the benefit and cost effectiveness of health care delivery. The hypothesis is that the 2-year survivorship for the GMK SpheriKA knee system is not inferior to the survivorship rate of the other medial pivot knee designs.

Open craniotomies, including procedures for tumour resection, aneurysm clippings or Arteriovenous Malformations (AVM), require an open wound including the removal of a section of skull to access to the brain. Standard practice is to leave the open wound exposed to the operating theatre environment for the duration of the surgery, which may be anywhere from two to eight hours. The air in the theatre is cold and dry (18-21 degrees celsius and 20-50 percent relative humidity) compared to the normal physiological conditions within the brain (37degrees celsius, 100 percent relative humidity). The wound is also subjected to the light from the surgical microscope which is used continuously for several hours for the microsurgical portion of the procedure. This light is very powerful and has the potential to produce high temperatures concentrated in and around the surgical site. This leads to continuous evaporation from the wound resulting in drying and desiccation of the neural tissue, intracranial blood vessels and dura mater. Current practice to manage tissue desiccation is to repeatedly irrigate the wound throughout the procedure. Each time irrigation is applied the surgeons view of the surgical site is obscured and excess irrigation must be removed via suction. The frequent irrigation - visual obstruction - suction cycle disrupts the surgeon’s workflow and cyclically interrupts the procedure. Warmed and humidified carbon dioxide insufflation is a therapy designed to deliver warm (37 degrees celsius) saturated (greater than 95 percent relative humidity) carbon dioxide to the surgical wound during the procedure, to prevent evaporation and desiccation. The intent of this study is to evaluate the safety of this insufflation to the surgical site during the craniotomy procedure.

This project aims to investigate the effectiveness of an online, personalised intervention on salt reduction (called SaltED) in adults with high blood pressure. It hypothesises that SaltED is effective in reducing salt intake. Participants will be automatically randomised into two groups (active intervention or wait-listed control) by a computer algorithm to conceal allocation the first time they access the SaltED website. The intervention includes 6 modules of personalised salt intake advice delivered over 6 weeks. Module content will be personalised based on the participant's current salt intake (measured using a short questionnaire at week 1) and knowledge and use of food labels. Participants in the active intervention group will receive the intervention content from week 1. Participants in the control group will not receive the personalised intervention materials, until after their post-intervention measures, when they will be invited to access the intervention materials. Participants' sodium score and dietary sodium intake will be measured as primary outcomes at week 1 (baseline) and week 6 (post-intervention). Participants will also be invited (optional) to complete the 24-hour ambulatory blood pressure and urinary sodium measurements at baseline and post-intervention as secondary outcomes. Participants' acceptability and use of the platform will also be investigated using a survey post-intervention.

The prevalence of overweight and obesity in young men is increasing as physical activity levels decline, suggesting strategies to promote and enhance physical activity levels should be improved. Goal-oriented guided mental imagery is a technique that we believe may enhance physical activity levels among overweight and obese young male adults. It has been shown to be an effective strategy to enhance physical activity among women with overweight and obesity, compared to observing set written goals. Therefore, the purpose of this study is to compare the efficacy of goal-oriented guided mental imagery and traditional goal-setting techniques for increasing physical activity levels among inactive overweight and obese young male adults. This study will compare the effects of these interventions on exercise compliance (prescribed cardiorespiratory exercise and strength training sessions), weekly physical activity levels, intrinsic motivation, enjoyment of exercise, and muscular endurance during a 6-week telehealth exercise program. Focus group data will be collected at the end of the program to obtain qualitative feedback on the feasibility and sustainability of the interventions and exercise program for future use. The research question for this study was derived using the acronym PICO (Population, Intervention, Comparison, Outcome). The research question is: Does goal-oriented guided mental imagery provided to young inactive overweight or obese male adults result in increased physical activity levels compared to setting goals alone? We hypothesize that compared to the goal-setting group, participants in the goal-oriented guided mental imagery group will: 1. Achieve greater adherence to cardiorespiratory activity based on logbook entries (e.g., at least 150 minutes of moderate-intensity physical activity each week over 6 weeks); 2. Achieve greater adherence to resistance training sessions based on logbook entries (e.g., complete at least two resistance exercise sessions per week over 6 weeks); 3. Have a greater magnitude of improvement in their muscular endurance results (i.e., muscular endurance pre- and post-assessment); 4. Have a greater magnitude of increase in physical activity levels (metabolic equivalents [MET] minutes) across the 6-week training intervention based on logbook entries. 5. Attain greater intrinsic motivation based on the ‘Exercise Motivation Scale’ and experience a greater level of physical activity enjoyment based on the ‘Physical Activity Enjoyment Scale'.

The purpose of this study is to test out an engagement strategy called Making it Meaningful (MiM). The MiM has been designed for people from culturally and linguistically diverse (CALD) backgrounds who use cancer services and may be undergoing a change in their medications. Who is it for? You may be eligible for this study if you are a cancer patient aged 18 or older, who is attending a cancer service at the Prince of Wales hospital and your primary language is Russian or Mandarin. Study details Participants who choose to enrol in this study will be randomly allocated by chance (similar to flipping a coin) to either receive the MiM intervention tool, or to receive standard care provided by the cancer service. Participants who are allocated to the MiM group will attend an appointment with their health practitioner (nurse or medical practitioner) who will use the Make it Meaningful Tool (MiM) to facilitate communication at the individual appointment where medications are changed or at discharge from hospital. It is anticipated that this appointment will take no longer than your usual consultation. The health care practitioner will provide a paper copy of the MiM for the patient to take away from the appointment. The health care practitioner will also provide instructions to the patient about how the tool can be used to inform them of who to contact if they have any concerns or experience side effects, etc.. Participants who are allocated to the standard care group will not receive the MiM tool, they will instead discuss the new medications together with their health care practitioner using the existing medication management tool. All participants will be asked to complete a series of questionnaires over the phone when they first agree to participate in the study, 1 week and then 4 weeks after the medication discussion with their health care practitioner. It is expected that completion of these questionnaires will take 15 minutes. It is hoped this research will determine that use of the MiM tool is practical and acceptable to cancer patients who are from culturally and linguistically diverse backgrounds. If this small study shows that the MiM tool is helpful for cancer patients, it may be studied further in a larger trial that may lead to improvements in medication communication for cancer patients in the future

The fundamental premise underpinning the research is that exposure to PAC, combined with genetic and lifestyle factors, creates chronic and systemic inflammation that underpins cardiometabolic conditions. This antecedent cluster of risk factors contributes to a ‘pre-cardiometabolic syndrome’. In this trial, the first of a series of studies, we will measure the plastic-associated chemicals (PAC), phthalates and bisphenols (A, S, F), which leach from multiple plastic products in everyday use and enter the human body, as evidenced by urinary excretion of those chemicals. The challenge is to demonstrate that decreasing exposure to PAC will reduce inflammation, and there are methodological issues to overcome which we will address in this study. Including how to accurately identify sources of exposure and measure exposure levels, and how to identify the mechanisms by which PAC alter biomarkers at a cellular level triggering endocrine disruption. In addition, biostatistical methods will be applied to account for multiple and overlapping interactions, and exposures to chemical compounds. This protocol will establish methods to assess exposure using new tools, and measurement of PAC by urinalysis. The data gathered from the 200 participants in this 14-day study will provide baseline data for a pilot intervention testing the hypothesis that decreasing PAC exposure results in reduced excretion of PAC, and reference data for future research.

To evaluate the effects of oral care agents on white spots, healthy human participants will wear appliances with tooth enamel slabs containing artificially-created early decay (white spots) attached. During one of the two treatment periods, a gel containing oral care agent will be applied to the surface of enamel slabs on the appliance. For each of the two treatment periods, participants will also be required to apply an oral care tooth crème on the enamel slabs on their appliances three times per day for 14 days. After completion of each treatment, the enamel slab surface colour change and mineral content in the white spots will be analysed. The study hypothesis will be that topical application of oral care agents on white spots will have no effects on colour changes and mineral content change in enamel in situ.

Footwear has the potential to influence balance in either a detrimental or beneficial manner, and is therefore an important consideration in relation to falls prevention. The objective of this study is to evaluate balance ability and gait patterns in older women while wearing prototype footwear and insoles designed to improve balance.