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McArdle disease and carbohydrate ingestion before exercise: The effect of timing
Expand descriptionThis research project is being undertaken to investigate and bring more clarity to the highly contentious management technique of sucrose ingestion prior to exercise in individuals with McArdle disease. While the technique has theoretical and physiological merit, the current guidelines regarding conditions under which the technique should be deployed are severely inadequate. The research aims to more clearly define exercise and activities of daily living in which the prior ingestion of sucrose would be of benefit. The project involves participants completing a series of clinical exercise trials with and without the prior ingestion of sucrose under the guidance and supervisor of highly qualified and highly experienced Exercise Scientists and Exercise Physiologists.
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Does hormonal contraception use increase breast cancer risk for BRCA1 and BRCA2 mutation carriers?
Expand descriptionWomen with a germline BRCA1 or BRCA2 mutation have markedly increased risks of early-onset breast cancer. The purpose of this study is to assess the association between hormonal contraceptives and breast cancer risk for BRCA1 and BRCA2 mutation carriers, using individual participant data from several cohort studies that have collected prospective data. Who is it for? This study will assess data on females who are aged 18 years or older (who were born after 1920), have a pathogenic (class 4 or 5) BRCA1 or BRCA2 germline mutation, do not have a personal history of cancer (except non-melanoma skin or CIN cervix) or history of bilateral mastectomy at cohort entry and have follow-up information available. Study details It is hypothesised that: 1) Current hormonal contraception is associated with an increased risk of breast cancer for BRCA1 and BRCA2 mutation carriers that decreases with time since last use 2) The association between current hormonal contraceptive use and breast cancer risk for BRCA1 and BRCA2 mutation carriers does not differ from that for the general population 3) Duration of use, age at first use, and use before first birth are not associated with breast cancer risk independently of current use and recency of use. Studies of the association between oral contraceptive pill use and breast cancer risk for BRCA1 and BRCA2 mutation carriers have had conflicting results and there are no data are available regarding the risk of breast cancer associated with the use of other types of hormonal contraception, such as hormonal implants and hormonal intrauterine devices in BRCA1 and BRCA2 mutation carriers. Quantifying any association between use of hormonal contraceptives and breast cancer risk is very important for these women, because it will help optimise their personal breast cancer risk management plan.
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Screen2Quit: An electronic smoking cessation resource for smokers undergoing lung cancer screening.
Expand descriptionThe goal of this study is to undertake rigorous scientific evaluation of the most popular Australian high-quality smoking cessation app. Screen2Quit (formally known as My QuitBuddy) in current smokers scheduled to undergo lung cancer screening. Who is it for? You may be eligible for this study if you are aged 55 years and over, you currently smoke, and you are eligible for lung cancer screening. Study details Participants will be randomised (i.e. allocated by chance) to either receive access to the Screen2Quit app, or will be directed to a tailored smoking cessation resources webpage. Participants in the Screen2Quit group will be sent a link to download the app to their phone, through which users may enter their planned quit date, smoking history, and set goals for quitting smoking. The app sends daily reminders and provides daily updates on health benefits of quitting, money saved, can be tailored to interact with the participant at self-identified "danger times" for smoking. Each participant’s use of the app will be determined through questionnaires and by accessing app analytics. Participants who do not receive access to the app will be directed to an online resource according to their jurisdiction (e.g. Queensland participants will be directed to the Qld government smoking cessation website QuitHQ). Participants will be instructed to use the app/web page resources ad lib in conjunction with whichever standard smoking cessation therapies are recommended by their treating health team (e.g. Quitline counselling, pharmacotherapy). All participants will be followed-up for 12 months post-enrolment to assess their self-reported quit rate, biochemically verified abstinence from smoking using a urine test, quit attempts, motivation, and use of counselling/pharmacotherapy. It is hoped that this study may show that the Screen2Quit app, when used with usual care, increases quit rates compared to usual care alone in smokers undergoing lung cancer screening.
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Acute Kidney Injury in patients randomised to the ARISE FLUIDS Randomised Controlled Trial
Expand descriptionThis prospective nested cohort study of Acute Kidney Injury (AKI) in a cohort of patients recruited to the ARISE FLUIDS randomised controlled trrial aims to describe the incidence of AKI with differing strategies of vasopressor use/ fluid resuscitation in patients presenting to the Emergency Department (ED) with septic shock, and to describe the relationship between these resuscitation strategies and sensitive biomarkers of AKI. As part of the ARISE FLUIDS trial, patients will be randomised to either 1. A ‘restricted fluids and early vasopressor strategy’ whereby ongoing hypotension is managed by a vasopressor infusion titrated to the desired blood pressure, or 2. A ‘larger initial intravenous fluid volume and later introduction of vasopressor strategy’ whereby an additional litre of intravenous fluid will be given for persisting hypotension, and then further, more liberal boluses of fluid as required. Patients recruited to this nested cohort will have additional granular renal data (creatinine, urine output, etc) collected through the subsequent admission, to determine the incidence and severity of AKI, and important renal outcomes. In addition, a novel sensitive biomarker (urinary insulin-like growth-factor binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases (TIMP-2) will be measured at enrolment and 24 hours. The relationship between this biomarker, resuscitation strategy, and renal outcomes will be explored.
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Establishment of the National Endometriosis Clinical and Scientific Trials (NECST) Registry to study the life course and impact on quality of life of people living with endometriosis.
Expand descriptionThe project is part of a national collaborative project by Australian clinicians and researchers, the National Endometriosis Clinical and Scientific Trials (NECST) Network. The NECST Registry will be a national resource of participant data that will facilitate high quality research aiming to understand the causes of endometriosis, improve diagnosis and treatment outcomes, and reduce the burden of disease for patients with endometriosis-related symptoms or diagnosed with endometriosis. Currently, there is a lack of clinical data about endometriosis. This is why there can be a delay of 7 – 12 years before a diagnosis of endometriosis is made for some people. In addition, clear care management plans are not yet available due to the lack of understanding of how endometriosis develops or changes during a woman’s lifetime. The NECST Registry will collect and securely store demographic and health related information from consenting participants, who experience and/or seek management for endometriosis and/or endometriosis-related symptoms or conditions (e,g., adenomyosis).
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A research study of behavioural activation treatment for depression for adolescents with mild to moderate intellectual disability
Expand descriptionThis study aims to determine whether behavioural activation treatment reduces symptoms of depression in adolescents with intellectual disability and depression, using a treatment called Beat-D. Behavioural activation treatment involves increasing people’s behaviours and engagement in things they enjoy doing, aiming to improve their mood and overall wellbeing. Half of the participants involved in the research study will be randomly allocated to receive the behavioural activation treatment, and the other half will be randomly allocated to continue to receive their usual care.
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Examining methods to support self-guided attentional bias modification for alcohol consumption in young adults
Expand descriptionThis study will investigate the effectiveness of Functional Imagery Training (FIT) as a motivation enhancement to self-guided attentional bias modification training (ABM) for young people seeking to reduce alcohol consumption. ABM training for alcohol is an emerging intervention designed to train individuals to disengage attention to alcohol cues in order to disrupt the cognitive elaboration process that precedes alcohol consumption as posited by Elaborated Intrusion theory (EI; Kavanagh et al., 2009). This project will extend our understanding of motivational enhancements to improve adherence to self-guided, digital health interventions. While there is promising early evidence for effects of FIT on treatment participation, this intervention has not yet been applied to improving adherence to ABM training regimens. Therefore, the results of this study will contribute to our knowledge about the potential for FIT to improve training completion rates and lead to better outcomes for ABM users and creators of self-guided applications. The aim of this study will be to determine if a self-guided, online FIT add-on, developed based on results and feedback from the earlier studies, increases adherence to multi-session ABM. The following hypotheses will be tested. Hypothesis 1: Participation in FIT will increase adherence to internet-based attentional bias modification training (intervention) for young people compared to ABM training and breath counting training (control), as measured by a significant group difference in the number of training trials completed. Hypothesis 2: Participation in FIT will be associated with improved therapeutic outcomes compared to control group, measured by a difference in self-reported number of alcoholic drinks consumed in the seven days prior to the conclusion of the trial compared to the seven days prior to commencing the trial.
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An educational intervention to understand Attitudes and address Barriers to Care in Age-related Macular Degeneration: A randomised controlled trial
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Exploring first time mothers' knowledge and experience of induction of labour
Expand descriptionThis will be a mixed-method, observational study and will be undertaken at the Royal Prince Alfred Hospital, Women and Babies Department. The study hypothesis is: Women feel more prepared for the induction of labour process when they access antenatal education, receive adequate clinical information and feel part of a shared-decision making process in the antenatal period. Women who feel prepared and satisfied with their decision to proceed with induction of labour feel more supported and greater contentment with their birth outcomes. The study will be conducted via a participant questionnaire (quantitative) and an audio-recorded interview with women at 6 to 8 weeks postpartum (qualitative). Electronic medical notes will also be reviewed to measure pregnancy and birth outcome data. The purpose of this design is to review the association between women who access antenatal education services, the reason given for induction of labour, women’s perspectives and experiences with the induction of labour process and delivery outcomes. The sample size calculation is approximately 100 participants for the survey and 15 participants for the interview, or until saturation with themes has been reached.
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The effects of different types and intensities of exercise on arterial stiffness and blood pressure throughout pregnancy.
Expand descriptionIn this study we will be looking at the effects of vigorous intensity exercise during each trimester of pregnancy on blood pressure and blood vessels, as well as foetal heart rate. More specifically we want to see if exercising at a higher intensity may be more beneficial to vascular function during pregnancy. During pregnancy adaptations occur to the circulatory system to support the growing foetus. Sometimes these changes can result in negative health outcomes for the mother and the baby, e.g. gestational hypertension and pre-eclampsia. Exercise during pregnancy has been shown to have a range of benefits, including reducing blood pressure and the risk of pre-eclampsia. Higher intensity exercise has been shown to have more benefits on blood pressure in non-pregnant populations, however research on the effects during pregnancy is currently lacking.