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Effect of Synbiotics on Gastrointestinal Chemotherapy Symptoms
This study is aiming to explore the effect of a synbiotic formulation (combination of prebiotic and probiotic) on gastrointestinal chemotherapy symptoms in patients with solid tumours. Who is it for? You may be eligible for this study if you are aged 50 to 75 years old, have a solid tumour cancer, and are starting chemotherapy treatment. Study details Study participants will be randomly allocated (by chance) to one of two arms. One group will receive a synbiotic formulation taken twice daily for two weeks at the start of the first chemotherapy cycle, while the other group receives a placebo formulation taken twice daily for two weeks at the start of the first chemotherapy cycle. After a two week break from treatment, a second chemotherapy round will take place, with group one given a placebo formulation and group two given a synbiotic formulation. This sequence will repeat in the third and fourth chemotherapy cycles. Incidence and severity of gastrointestinal symptoms will be monitored using FACT-C questionnaire , Bristol stool score and LPS assay. We hope that this research will improve health outcomes such as gastrointestinal symptoms alleviation from chemotherapy and better tolerability of chemotherapy leading to improved quality of life.
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Effects and recovery from daily and alternate-day instillation of various low-dose atropine eye drops
Atropine eye drops are known to affect pupil reactions and the ability of the eyes to focus on near objects. This study will quantify the effects of different concentrations of atropine eye drops on these ocular structures when given daily or in an alternate day dosing schedule.
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Coronary artery disease in Aboriginal and Torres Strait Islander people
Aboriginal and Torres Strait Islander people die from acute coronary syndrome (ACS), the life-threatening manifestation of ischaemic heart disease, at younger ages than non-indigenous Australians. The reason for this is unknown, as are the risk factors for ACS in Aboriginal and Torres Strait Islander people. This lack of knowledge limits the usefulness of emergency department (ED) risk assessments for Indigenous patients with suspected ACS, which have been developed using data from a general population and are not specific for Aboriginal and Torres Strait Islander people, despite evidence of clear differences in risk for coronary artery disease (CAD) (the underlying cause of ACS) based on ethnic background in no- Aboriginal and Torres Strait Islander cohorts (African-American, Hispanic, Caucasian, Asian). Chest pain risk assessment allows for rapid diagnosis and treatment of ACS and prevention of over-investigation in patients deemed to be "low-risk". In the absence of evidence, current guidelines recommend a cautions approach and consider Aboriginal and Torres Strait Islander patients with chest pain at higher risk of ACS than non-indigenous patients. We will conduct a prospective, cross-sectional study of Aboriginal and Torres Strait Islander people who present to the Cairns Hospital Emergency Department with chest pain. The primary aim is to determine the rate of CAD, measured by coronary artery imaging. Eligible patients will be asked to consent to provide access to their clinical data for the duration of the study. Participants will receive usual clinical care in the ED and be classified as either "high-risk" or 'not high risk". All "not high-risk" participants will undergo an exercise stress test as part of usual care, followed by coronary artery imaging. All patients will be followed-up after two months to record the subsequent occurrence of cardiac death, acute myocardial infraction, urgent/emergency revascularisation, and cardiac re-presentation to the ED and primary care physicians. The cost of health care utilisation over the two months follow-up will also be determined. Participants will be classified as having clinically significant coronary artery disease (>50% stenosis in at least one coronary artery) or not, and as having ACS or not. Demographic and clinical characteristics will be compared between patient groups. We will recruit 80 patients, which will allow us to measure and expected rate of coronary artery disease of 6.3% with 3% precision. The expected findings from this study will 1) allow ED doctors to determine a baseline level of risk of ACS for Aboriginal and Torres Strait Islander patients who present with chest pain, and 2) provide preliminary information necessary for the design of large- scale research studies with the goal of determining specific risk factors and determine optimum investigative strategies for ACS in Aboriginal and Torres Strait Islander people.
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Can Intrapartum SildEnafil safely Avert the Risks of Contraction-induced Hypoxia?
The iSEARCH Trial will determine if, in women in labour at term receiving oral 50 mg SC vs placebo given in less than or equal to 3 doses, reduces a primary composite endpoint, determined up to 28 days after birth, of ten perinatal outcomes related to intrapartum hypoxia.
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Dementia Training for Physiotherapy Practitioners and Students using Artificial Intelligence-Enhanced Virtual Reality Technology
In order to enhance person-centered care of individuals with dementia specific training for health professionals should go beyond just knowledge acquisition, and also target empathy and attitudes . Artificial Intelligence (AI)-Enhanced Virtual Reality (VR) technologies can facilitate learning experiences that simulate adaptable scenarios of real-life practice from both patient and practitioner perspectives. The aim of this project is to develop and pilot test an AI-enhanced VR dementia training program for physiotherapy practitioners and students. This training has the potential to enable an empathetic approach to care, and improved perceptions of people with dementia.
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The INJECT study - effect of a self-management intervention on needle fear in adults receiving haemodialysis.
The INJECT pilot feasibility study is comprised of a patient self-management psychological intervention to address needle distress in adults receiving haemodialysis foe end stage kidney failure. the intervention is based on Cognitive Behavioural Therapy (CBT) principles and it consists of 6 learning modules which will provide strategies patients can apply to manage needle distress. There is also an option to use virtual reality (VR) technology as a distraction during dialysis. Patients will be supported by nurse practitioners and a research officer during the intervention. The goal is for patients to feel empowered in self-managing needle distress and to have access to tools/resources that will support skill building and be available to them as needed for revision and reinforcement of learning. This structured and novel intervention enhancing patient self-management and empowerment represents a major advance in addressing needle fear and reducing this aspect of the psychological burden experienced by dialysis patients. It can be translated rapidly into clinical practice and may benefit other patients receiving frequent needles as part of therapy, for example for cancer. It is inexpensive and feasible to deliver across sites. Partnership with patients and nurses at all stages ensures the intervention is useful and successfully implemented into clinical care.
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Effect of a novel herbal and nutritional supplement for pain management in chronic pain
A randomized placebo-controlled pilot trial on palmitoylethanolamide (PEA) and curcumin for pain management in patients with chronic non-cancer pain. The overarching aim of this study is to evaluate the efficacy of a combined herbal/nutritional supplement for pain management and quality of life (QOL) indices for patients with chronic pain. Primary Objective • Evaluate the effect of combined PEA/curcumin capsules on pain management in patients with chronic pain in comparison to placebo. Secondary Objectives • Evaluate the effect of combined PEA/curcumin capsules on associated QOL parameters and daily functioning in patients with chronic pain in comparison to placebo. • Compare pain medication consumption between PEA/Curcumin group and placebo group • Evaluate safety of combined PEA/curcumin capsules with existing pain medication.
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A study assessing the feasibility, toxicity and efficacy of Magnetic Resonance Imaging guided stereotactic radiotherapy to locally recurrent prostate tumours after prior radiotherapy
This study is investigating the feasibility of delivering salvage re-irradiation to the prostate gland in men who have previously received radiation. Who is it for? You may be eligible for this trial if you are a male aged 18 years or over, have previously treated been treated for prostate cancer with external beam radiotherapy or brachytherapy and have a local recurrence within the prostate, with no more than 5 distant metastases. Study details Participants will receive radiation to the prostate gland using Magnetic Guided adaptive radiotherapy on the MRI linear accelerator. The intervention is intended to be delivered as 5 radiotherapy sessions over 2 weeks. Participants will be asked to provide 9 blood samples throughout the study to assess the response to treatment. Data on toxicity and prostate specific antigen (PSA) response to treatment will be collected. Information from this study will be used to determine whether a MRI-guided approach to radiotherapy is a feasible clinical approach for the treatment of recurrent prostate cancer.
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Can an integrated care service (ED PainPATH) improve the value of care for people with chronic pain frequently attending NSW Emergency Departments?
People with chronic pain frequently attending NSW Emergency Departments need access to support services that help them better manage in the community. The project will evaluate the effectiveness and value of a care coordination pathway called the Emergency Department Pain Management Pathway (ED PainPATH), to support people with chronic pain to better manage in the community, thereby reducing their need for Emergency Department care.
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Examining the delivery of Smooth Sailing in Secondary Schools
Smooth Sailing is a web-based mental health service for secondary school students developed at the Black Dog Institute in partnership with schools, school counsellors, students, parents, and health professionals. Smooth Sailing uses a website to register students, screen and monitor their mental health, allocate them to an appropriate level (or “step”) of care, engage them in youth-oriented evidence-based information and activities about mental health, depression, anxiety, and help-seeking, and connect them with a school counsellor when face-to-face support may be required. This trial aims to evaluate the effects of two different Smooth Sailing service enhancements (class allocation and incentive) on reach (operationalized as module completion). Another objective of this trial is to evaluate the effect of variations in reach on students’ help-seeking intentions and behaviours and mental health outcomes (depression and anxiety). We will also explore the effect of contextual factors on outcomes, and the barriers and facilitators affecting the implementation of the Smooth Sailing service.