ANZCTR search results

Long-term cannabis use is associated with deficits in areas of cognitive functioning. It is important to intervene at the cognitive level as cognitive deficits impede everyday functioning (i.e., driving) and health outcomes for individuals who have engaged in prolonged substance use (Aharonovich, Brooks, Nunes, & Hasin, 2008; Cousijn & Filbey, 2015; Sofuoglu, DeVito, Waters, & Carroll, 2013). For example, poor inhibitory control can reduce the ability to refrain from drug use and hence increase the risk of relapse (Goldstein & Volkow, 2002). There is a need to provide cognitive intervention to cannabis users to 1) improve everyday functioning, and 2) alleviate cognitive problems to hopefully empower individuals to cease cannabis. Pharmacological interventions are being investigated for assisting drug abstinence, however, such treatment often has unwanted side effects (e.g., headaches, suicidality) and typically does not result in long-term abstinence (Le Foll, Gorelick, & Goldberg, 2009; Levin et al., 2011; McRae-Clark et al., 2015; Schoedel et al., 2011). Pharmacological interventions at the cognitive level has received less attention and existing studies provide mixed results across populations (Boggs et al., 2018; Hindocha et al., 2018; McGuire et al., 2017; Solowij et al., 2018). Moreover, novel pharmacotherapies can be exorbitantly priced and some have restricted access in Australia. In various reviews, researchers emphasise that effective cognitive-enhancing interventions need to be identified as there are few successful pharmacotherapy options for assisting cognitive problems among people who use substances, such as cannabis (Coles, Kozak, & George, 2018; Cousijn, 2015; Flöel, 2014). Cognitive training has received some attention but with mixed results and researchers are now investigating brain stimulation techniques to target cognitive-related brain regions, such as the dorsolateral prefrontal cortex. The aim of this pilot study is to determine the feasibility of using transcranial Direct Current Stimulation (tDCS; HDCStim, Newronika s.r.l. Italy) to enhance cognitive functioning in individuals who have engaged in long-term, regular cannabis use. We will provide a single session of tDCS (20 minutes, 1.5mA, DLPFC) and measure decision making and inhibitory control before and after tDCS. Urine will also be collected before and after tDCS in order to investigate potential urinary biomarkers (specifically, a panel of amino acids such as glutamine and GABA) of cognition in relation to cannabis use. Our hypothesis is that cognitive functioning, as measured by objective cognitive tests, will increase from pre- to post-tDCS and that changes in urinary biomarkers will be associated with changes in cognitive functioning as a result of tDCS. The group of individuals who use cannabis are expected to show greatest improvements in cognition compared to the control group.

Respiratory limitations to exercise such as reduced oxygen in the blood, fatigue of the muscles used in breathing and the resulting impact on blood supply to the limb muscles, pressure effects on heart output, increased energy spent on breathing and breathlessness are well researched in younger adults, athletes and clinical patients. However, little is known about whether age related changes in respiratory structure and function, fatigue of muscles used in breathing and the electrical activation of these muscles by the nervous system, limit exercise tolerance in apparently healthy older adults. This research aims to identify if these changes limit exercise tolerance in older adults. The aim of this project is to compare the energy spent on breathing, fatigue of muscles used in breathing (specifically the diaphragm and abdominals), exercise tolerance (time to exhaustion) and breathlessness in older (65 to 84 years) and younger (18 to 35 years) adults in response to exercise. This data will then be analysed against age and fitness to look for differences. This analysis will identify the effect that training has on work of breathing, respiratory muscle fatigue and dyspnoea, and whether these effects are identical in younger and older adults. We will also determine whether fitter older adults reach their respiratory limits more quickly than less fit older adults, potentially resulting from the increased demands that their 'stronger' muscles place on the respiratory system. We hypothesise that older adults may experience hyperinflation of the lung during exercise (i.e., air is increasingly trapped in the lungs with each respiratory cycle), will fatigue sooner during exercise and demonstrate greater rates of diaphragm and abdominal fatigue post exercise, than younger adults. Ultimately, we hope this project will lead to future research focussed on reducing respiratory limitations to exercise, thereby improving exercise tolerance and physical activity levels in older adults. We believe this project is worthwhile as increased participation in physical activity has benefits such as reduced mortality, improved mental health, improved cognition, reduced disease progression, symptoms reductions in many diseases, improved quality of life and reduced medical costs.

The purpose of this study is to compare two different types of PET-CT scans (Positron Emission Tomography - Computed Tomography) for imaging prostate cancer. Who is it for? You may be eligible for this study if you are aged 18 or over, have a confirmed diagnosis of prostate cancer or suspected prostate cancer recurrence, and your doctor believes that a PET scan would be helpful for treatment decisions. Study details All participants in this study will have two PET scans. One will be a routine standard-of-care scan (68Ga-PSMA), and the other will be a newer investigational scan (18F-PSMA). Before each scan, participants will be injected in the arm with a different tracer chemical. These tracer chemicals will localise to the prostate cancer. For one scan, this will happen 50 minutes before, and in the other it will happen 3 hours before. An optional subgroup will have additional scans (but no additional injections) on the day of one of these scans. The scans on this day will be one hour, two hours, and three hours after the injection. This will measure how the injected tracer moves through the body at different times. It is hoped this research will demonstrate the two tracers are equivalent, or the newer one is better. This may provide additional imaging options for patients with prostate cancer.

Aims: To determine whether an individual’s response to pain, as measured by preoperative questionnaires examining pain hypervigilance and central sensitization, can accurately predict poor postoperative total knee replacement outcomes. Participants: All patients at Austin Health who are undergoing elective Total Knee Replacement Surgery Methods: - Patients who are undergoing an elective TKR at Austin Health will undertake voluntary questionnaires at preoperative physiotherapy clinic, and at postoperative review clinic at 3 weeks, 6 weeks and 12 months. - Patients at preoperative physiotherapy clinic and postoperative review clinics are currently routinely asked to do the Knee Society Score and Oxford Knee Score Questionnaires to monitor functional outcomes - Our proposed study would utilise this data, in addition to a preoperative, one-time questionnaire of the Pain Vigilance and Awareness Questionnaire (PVAQ) and Central Sensitisation Inventory (CSI) which are both validated questionnaires. - Our proposed study would also add a pre and postoperative additional functional score, the Forgotten Joint Score (FJS), another validated questionnaire. Expected Outcomes: We expect to see a pain hypervigilance (as measured by the PVAQ), and central sensitization (as measured by the CSI) to correlate with inferior postoperative outcomes.

This project examines whether tap water effects the natural spatial and temporal organisation of the gut microbial communities (the microbiome) during infancy and early childhood. The addition of chlorine to metropolitan drinking water is one of the most effective means to deliver safe drinkable water because it produces a residual disinfectant that persists within the water distribution system. Levels of chlorine used to treat metropolitan water are considered safe for the individual based on toxicity studies. However, to our knowledge there have been no studies examining whether persistent chlorine exposure from tap water is also safe for the friendly gut bacteria that colonise the gastrointestinal tract. Chlorine has potent anti-microbial properties, and potentially forms disinfection by-products that can disrupt the intestinal microbiome in early childhood. Persistent exposure to low levels of chlorine may potentially cause an imbalance in the types of organisms present in the gut and may contribute to a range of health conditions. The present study is a randomized controlled trial (RCT) comparing the gut microbial colonisation patterns in early life. The RCT will enroll 220 healthy infants at six months of age, who will be randomised into two groups to experience the following drinking water regimes: 1) unmodified tap water as distributed by the local public water supply (‘control’ group); and 2) filtered tap water with chlorine and other contaminants removed (‘treatment’ group). Infants will be followed up through to 18 months of age. The primary outcome will be changes in the gut microbiome at 6 months, 12 months and 18 months of age. The secondary outcomes will be infant clinical health outcomes at 12 months and 2.5 years of age.

Work-HIIT will be evaluated using a RCT design (N = 50 workers) to encourage staff to manage sedentary time by attending at least 3 HIIT sessions a week, for a Semester (16 weeks). All HIIT sessions include a range of body weight and aerobic exercises. A range of health and wellbeing outcomes will be assessed using validated measures. Staff at the University of Newcastle who report they are mostly sedentary at work will be recruited (aged 18+ years, and have no existing medical conditions).

Early and repeated acute lower respiratory infections (ALRI) in young children increase the risk for chronic lung diseases, such as bronchiectasis which is highly prevalent among First Nations populations. Our hypothesis is that First Nations and Timorese children receiving long-term azithromycin will have fewer medically-treated episode of ALRI within the first 12 months.

People living with dementia (PWD) have an average of 5 to 6 comorbidities and are often treated with many medicines. We want to investigate whether reducing multiple medications (deprescribing) is helpful for them. Our hypotheses are that the negative effects on health associated with polypharmacy in PWD are reversible, and that improving medication use will enhance clinical outcomes and wellbeing. The study aims to determine the effect of using a Team Approach to Polypharmacy Evaluation and Reduction (TAPER) in PWD who are taking 5 or more medicines on emergency presentations and/or unplanned admission to hospital, and to determine whether improving medication use will enhance clinical outcomes, wellbeing and health system costs.

In this randomised controlled pilot trial, we will evaluate the efficacy of an integrative treatment (Personalised Integrative Therapy/ PI Therapy) for mild-to-moderate depression and/or anxiety in adults. 60 participants will be randomly allocated into one of three conditions: (1) PI Therapy (PIT), (2) PI Therapy plus supplements (PIT+S), or (3) Cognitive-behaviour therapy (CBT). All participants will attend a one-day workshop (PIT, PIT+S or CBT) and will then receive 6-weeks of SMS or email support. In the one-day CBT workshop, principles, techniques, and exercises based on a CBT framework will be presented. In the PI Therapy workshops, areas targeted cover the domains of diet/nutrition, psychology/coping skills, lifestyle/environment, social/spiritual, and medical/physical. PIT+S will also include a discussion on the potential benefits of several natural supplements which will then be provided to participants in this group. Over the following 6 weeks participants will set weekly goals to enhance their CBT skills (CBT group) or skills/areas of change covered in PI Therapy. We will assess changes in mood, quality of life, negative thinking patterns, diet, sleep, supplementation, and physical activity over time. We will also examine if the treatment conditions have differing effects in these areas. Finally, we will assess if changes in these areas (i.e., diet, physical activity, sleep, supplements, negative thinking patterns) are associated with changes in mood over time.

The purpose of this study is to improve our understanding of coronary microvascular disease (small vessel disease in the blood vessels supplying the heart), and to evaluate whether microvascular disease correlates with poor outcomes. We aim to measure blood flow in the large and small vessels that supply the heart in a range of participants, as well as assess the function of the cells that line the blood vessels. We hope to enhance our knowledge in this area and develop new strategies to treat future patients with this under-recognized condition.