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People with coeliac disease have an acquired immune reaction that can cause acute symptoms similar to food poisoning within two hours of eating gluten. This study aims to define the minimum amount of gluten that activates the immune response to gluten, injures the gut and causes symptoms in patients with coeliac disease. This will be achieved by assessing symptoms and measuring a specific type of molecule (biomarker) in the blood and tissue called interleukin 2 (IL-2) after participants consume a defined dose of gluten. Study findings may be used to inform food safety standards for people with coeliac disease and will advance knowledge and understanding of the clinical effects of gluten in people with coeliac disease.

Stroke survivors suffer from impaired movements that affect their activities of daily living. Conventional physio and occupational therapies are provided to regain some of these lost motor abilities. However, even with intensive conventional therapy, a large portion of patients do not receive sufficient recovery to function independently. This deficit leads to significant social and economic burdens. Therefore, there is a clear need for the development of novel and effective intervention strategies. To address the gap, alternative therapies, including brain-computer interfaces, have been proposed to recover impaired hand functions following stroke. A brain-computer interface (BCI) can translate the imagination of hand movement to the movement of an object on a screen or even the actual hand movement provided by a robotic hand. In a BCI system, a specific cap records the electrical activity of the brain on the surface of the scalp during the imagination of the hand movement. A machine learning algorithm processes the recorded brain signals and determines if the imagination of movement has been performed. When the algorithm detects the movement imagination, it sends commands to the outside world and provides feedback to the user. A specific type of feedback may be supplied via a robotic hand to move a paralysed hand passively, during the imagination of the hand movement. There is a growing body of research, demonstrating the promising primary results of the application of BCIs for movement recovery after stroke. However, to supply BCI as standard therapy in clinics, its consistency and efficacy need to be improved. One of our prior studies suggests the outperformance of proprioceptive feedback over traditional visual feedback in the provision of a better substrate for the occurrence of operant learning. Further, we have demonstrated that provision of the correct delay between the brain activation and the passive hand movement is critical and must be customised according to individual’s attributes. Putting together the findings of the two prior studies, we improved the hand movement of a stroke patient, who had had a stroke 3.5 years before the study, by 36% after ten sessions of therapy. Observing the promising results of the aforementioned studies, we are investigating how our novel BCI therapy recovers the hand movement for a group of stroke survivors.

Preterm babies can develop brain injury which leads to long-term developmental problems. Most brain injuries occur within the first 5 days of life and protection of the brain during this critical period is essential. Fluctuating brain oxygen levels is one reason for brain injury to develop, which can also cause bleeding in the brain. Keeping brain oxygen levels in a specific range may be protective. The purpose of the study is to investigate in preterm babies, whether it is possible to keep brain oxygen levels in a specific range for the first 5 days by NIRS monitoring and following a dedicated clinical treatment guideline. We hypothesise that a combination of brain oxygen monitoring and offering treatment when brain oxygen levels are outside the range may reduce fluctuations in brain oxygen levels and reduce brain injury. Babies in this study will have either (a) the usual treatment (given to all babies), or (b) they will be in the group where the focus is on keeping brain oxygen levels in a specific range for the first 5 days of life using NIRS monitoring.

This study is investigating whether it is feasible to administer an exercise program prior to radical surgery for patients with bladder cancer. Who is it for? You may be eligible for this study if you are aged 18 or older, you have been diagnosed with bladder cancer, you will be undergoing radical open cystectomy and you have been invited to participate in the program by one of the investigating urologists who are based in Western Australia (Professor Hayne and Dr La Bianca). Participants who are not being treated in Western Australia will not be eligible for this study. Study details Participants who are invited to participate in this study will be prescribed an exercise program to be completed 2-3 times each week for a maximum of 4 weeks, dependent upon when their surgery has been scheduled, for cystectomy only and for those undergoing neo-adjuvant chemotherapy for approximately 12 weeks. Participants will undergo one-on-one training with an exercise physiologist for 2-3 one hour sessions each week, and will also be asked to complete another 20-30 minute exercise sessions (e.g. walking) on the other 2 days at home. The supervised sessions will involve two types of exercise, resistance training that may involve lifting weights or performing strength exercises, and aerobic training that may involve walking or jogging on a treadmill, cycling or rowing on a stationary machine. The exercise regime will finish prior to your scheduled surgery. You will be asked to complete a series of questionnaires before starting the exercise program, after completing the program, and 3 months after your surgery. It is hoped this research will demonstrate that a pre-surgical exercise program is safe and feasible to deliver to patients with bladder cancer, and that the exercise program may improve post-operative outcomes in these patients.

We will assess the effect of Photobiomodulation therapy (PBMt; ‘light therapy’) on nipple pain in breastfeeding women to contribute information for establishing optimal treatment settings. The study will be conducted at The Possums Clinic, Brisbane. Forty-six eligible participants with nipple pain will be recruited for this study and randomised into either intervention Group A (standard gestalt intervention plus light therapy) or Group B (standard gestalt intervention plus sham light therapy). In addition to the review of the gestalt therapy techniques at every appointment (thrice weekly for the duration of the study), light therapy will be administered three times per week and thrice weekly treatment will continue until the participant reports zero pain, or for 4 weeks, whichever occurs sooner. We expect that the use of light therapy will reduce nipple pain earlier than would be expected with standard gestalt therapy alone.

Fatigue and excessive daytime sleepiness are common complaints in individuals living with multiple sclerosis (MS). Fatigue and excessive daytime sleepiness are associated with the emergence and exacerbation of cognitive, motor and mood disturbances and over time lead to impaired rehabilitation outcomes, a decline in the capacity to perform daily activities and reduced quality of life. Treatment of fatigue and daytime somnolence in individuals with MS is therefore essential. Over the last three decades a large body of evidence has accumulated noting the positive effects of non-pharmaceutical strategies for treating sleep and circadian rhythm disturbances in individuals with sleep disorders. Among these, sleep hygiene and light therapy have been shown to be efficacious for sleep and circadian rhythm disruption. Despite this large body of evidence, a relatively small number of studies have evaluated the therapeutic utility of sleep hygiene and light therapy for the treatment of fatigue and daytime sleepiness in individuals with MS. Preliminary evidence suggests that these strategies are feasible and effective in treating fatigue and daytime sleepiness in individuals with traumatic brain injury and Parkinson’s disease. However, there is a fundamental need to replicate these findings in individuals with other neurological conditions, including MS, using larger randomised controlled trials. Furthermore, there is a need to evaluate the synergistic effects of both therapeutic approaches for these populations. The purpose of this study is to evaluate the feasibility and therapeutic effects of light therapy in combination with sleep hygiene, compared to sleep hygiene alone, in individuals with MS. It is hypothesised that both therapies will have positive effects on fatigue and daytime sleepiness, however, light therapy plus sleep hygiene will be more beneficial in reducing symptoms of fatigue and daytime sleepiness in individuals with MS than sleep hygiene alone.

Fixed airway narrowing is a common complication of long standing asthma. It occurs despite good treatment with puffers that are effective in controlling inflammation. It causes symptoms such as wheeze, cough, shortness of breath and there is no known treatment for asthma related fixed airway narrowing because the mechanisms and causes are poorly understood. It is more common in older patients who have had asthma for many years, in whom there are also greater symptoms. The underlying mechanism of airway and lung tissue remodelling are unknown but preliminary data support a crucial role for inflammatory cells, and in particular, neutrophils and macrophages. Neutrophils, as well as other inflammatory cells such as macrophages release proteolytic enzymes that mediate tissue remodelling and tissue destruction. This is supported by both CT and histological evidence of lung tissue remodelling that explains the loss of lung elastic recoil in longstanding asthma. Inflammation driven remodelling of peripheral airways and surrounding lung is therefore a likely mechanism causing FAO in older people with longstanding asthma. The aim of this research is to determine how neutrophils and macrophages affect the function of the smaller airways, and how they can cause airway and lung damage in older people with asthma. We will recruit people with asthma who are >40 years of age, are non-smokers and have no other significant lung or heart problems. Participants will undergo breathing tests, CT scanning and a bronchoscopy, using a small camera on the end of a flexible tube, to obtain samples from their lungs. The significance of this study will be the discovery of the mechanisms that underlies this major complication of asthma. It will assist in overcoming the major barrier halting progress to an effective treatment strategy for which the mechanisms are unknown.

It is unclear what constitutes standardised or routine head injury management whilst in the emergency department (ED). Further, ED head injury discharge processes, management and communication to patients, families and carers is often inconsistent or ad hoc. This inconsistent management of head injury both within the hospital environment and transition to home in the community may not optimise best patient outcomes. Further, how clinicians communicate the discharge plan and manage activities such as return to work/study and or resuming sporting activities needs to be explored further. In addition, patient compliance and adherence with discharge instructions is also critical for optimising the recovery trajectory, health outcomes and avoidable representations and yet little is known about patient compliance and adherence for this group. To date little is known of how concussion is managed in the community by both adults and parents whose child has experienced a head injury and is symptomatic of concussion. Therefore, this study seeks to better understand the characteristics of people that present with head injuries and symptoms of concussion to an ED and how on discharge concussion is managed in the community.

This study involves the evaluation of safeTALK workshops delivered to secondary school students in North-West Melbourne. As part of the questionnaires used to evaluate the training, students will also be screened for risk and referred to the school wellbeing team. It is hypothesised that completion of the safeTALK workshop will be associated with: increased intentions to intervene with a suicidal person; higher levels of suicide literacy; higher levels of perceived behavioural control regarding intervening with a suicidal person; reduced stigma towards suicide and suicidal behaviour, increased health-service use; increased help-seeking from informal sources; and, improved attitudes towards help-seeking. It is hypothesised that the screening will lead to the identification of students at risk of suicide-related behaviour who had not previously sought help. Finally, it hypothesised that the safeTALK program or screening will not be associated with iatrogenic effects.

Informed medical consent is how clinicians communicate important information to patients about procedures/treatments they are recommending. The process of communication is highly individualised, time consuming and at a pace that is usually set by the healthcare worker. It is therefore not surprising that patients report variable and inconsistent comprehension and understanding of clinicians’ explanations of procedures/treatments. The literature demonstrates that audiovisual consent, when used to supplement current methods, improves the patient experience, including higher satisfaction, better comprehension and less anxiety. We will, for the first time in the procedure of kidney biopsies, evaluate patient reported benefits of video-assisted electronic consent compared to a conventional consent process, that being a clinician consenting the patient.