ANZCTR search results

The bond that develops between an infant and their caregiver shapes their developing brain and provides the framework through which they see themselves, others, and the world. Attachment theory provides a structure in which to understand this unique and important relationship. Research has shown that having a secure attachment provides resilience against adverse experiences while a poor attachment can lead to mental health problems and relational difficulties. Therapeutic interventions have been developed, which have been shown to be effective in helping caregiver­child dyads develop a secure attachment. However there is a need for these types of interventions to be less intensive and targeted at modifying the caregiver’s internal working models to increase sensitivity. This research proposes that modification can be done with psycho­education and increasing the caregivers reflective functioning. This research project proposes an attachment­based intervention using education and increasing the caregivers reflective functioning can be effective. Conducting the intervention using an internet based format will provide easily accessible and cost­effective means of helping parents and caregivers

Anxiety affects 7% of young people & only 50% receive help. This project aims to test the feasibility of a new, stepped care, internet based Cognitive behavioural treatment (iCBT) model for youth anxiety utilising the BRAVE Program. Therapist supported iCBT demonstrates equivalent efficacy with face to face CBT, but cost and insufficient numbers of clinicians means therapist guided iCBT is often not available or unsuitable to reach large numbers of anxious youth. Self help iCBT (no therapist) offers one solution. A national trial of BRAVE Self Help (>16,000 registrations in 2 years) showed meaningful anxiety reductions for youth completing the program. Many children failed to complete the treatment without support and not all were successfully treated. There is a need to identify models of care that can reach large numbers and provide appropriate support; such as a Stepped Care Model (SCM). Within a SCM, all young people would first receive the less intensive treatment. Those who have not responded well to the first step then receive a more intensive intervention. In this project, all participants would first receive 5 sessions of self help iCBT (step 1; psychoeducation, skills acquisition). Those who respond will receive 5 more self help sessions (skill rehearsal & maintenance). Those who fail to respond after step 1 would `step up' to receive their remaining 5 iCBT sessions with therapist guidance (step 2). Pilot evidence supports the use of a SCM in high intensity face to face CBT for childhood anxiety. To date, no studies of SCMs for iCBT exist. If a SCM approach, using self help plus therapist guided iCBT is as effective as therapist guided iCBT alone, we will have identified a scalable, easily disseminated model that can produce clinical outcomes similar to standard clinical therapy. This particular project utilises a very simple form of therapist support, primarily delivered via emails from the therapist, which can be conducted anywhere, anytime. Therefore, a stepped care model of intervention where people step up to email therapist support presents a model of care that can be easily distributed and is not intrusive to young people.

This study is an open-label clinical trial aiming to explore the effectiveness, feasibility and tolerability of oral ketamine on suicidality. The pathology and neurobiology of suicidality will be examined via MRI and EEG as neurological measures. The primary outcome of change in suicidality will be assessed using the Beck Scale for Suicide Ideation.

The primary aim of this study is to evaluate the effectiveness of an incremental goal-setting intervention (‘Small Steps’) on total sitting time, and blood glucose levels in older Australians living with T2DM. The secondary aim of this study is to explore the preliminary effectiveness of the intervention on self-reported types and context of sedentary behaviour, and quality of life (QOL). Associations between daily sitting time, and the time spent in prolonged bouts of sitting and changes in blood glucose levels in older adults with T2DM will also be explored.

This is a randomised controlled pilot study to examine the effect of key-hole surgery on pelvic pain in women aged 16-25 years old who present with pain with no obvious cause to the gynaecology service at the Royal Hospital for Women. Women will be randomised into either non-surgical (oral medications) or surgical (laparoscopic) management. Laparoscopy is generally performed to investigate and treat endometriosis although it is common for there to be no findings on laparoscopy, and if endometriosis is found, pain can persist despite surgery. Therefore the optimum management for pelvic pain in adolescent and young women is unknown. The objective of this study is to demonstrate the effect of laparoscopy on pre operative; immediate and long-term post-operative pelvic pain and quality of life using standardised questionnaires. Patients will be followed-up at 6 weeks, 6 months, 12 months and 24 months after initiation of treatment.

Health literacy interventions typically address health literacy by presenting information in a simpler format. Whilst there is strong evidence that this supports comprehension of health information, the evidence is less clear for self-management behaviours. This is consistent with reviews reporting that key strategies to promote action (e.g. action plans) are often underutilised in health literacy interventions. Existing strategies to promote action are often unsuitable for people with lower health literacy because they are cognitively demanding. Our recent study addressed this issue by evaluating a ‘health-literate’ action plan. This included simple language and images, and guided users to generate effective plans. After four weeks, participants with lower health literacy who used the health-literate action plan significantly reduced their reported intake of unhealthy snacks compared to those using a ‘standard’ action plan. The reverse was true for participants with higher health literacy, indicating that the health-literate action plan must target the appropriate audience to be optimally effective. This tool was effective in a general population for a behaviour that is key to diabetes self-management. The current study will test a similar intervention to improve self-management for people with diabetes and/or overweight/obese BMI. The current study will also explore two practical options for targeting people with low health literacy: a validated screening question for low health literacy; and allowing people to freely choose between the two action plans. The latter has the added advantage of increasing intervention satisfaction, which is likely to increase engagement. AIMS AND HYPOTHESES AIM 1. To replicate the findings of the previous study in a clinical sample of Australians with type 2 diabetes, and identify the most effective action plan formats for this population. AIM 2. To investigate the optimal method to allocate people to the action plan that is most appropriate for their health literacy level, to inform implementation via two diabetes apps. AIM 3: to evaluate whether assessment of participant preference for an intervention prior to random allocation influences the effectiveness of the intervention. Hypotheses: 1. The health-literate action plan will be more effective at reducing unhealthy snacking for people with lower health literacy, whereas the standard action plan will be more effective for higher health literacy. 2. The intervention will be more effective at reducing unhealthy snacking for people who are allocated an action plan using the health literacy screening tool compared to those who are asked to select their preferred plan. Both of these allocation methods will be more effective than random allocation to an action plan. 3. Assessing preference will negatively impact plan effectiveness, an effect which will be greater for those who are randomised to the plan which is discordant with their preference.

Social media use by young Australians is very common. Despite many positive benefits of social media interaction, its use can also lead to negative outcomes including body dissatisfaction, eating problems, and depressed mood. Social media literacy is a new approach to help prevent these negative effects This approach involves thinking critically about social media content and recognising the purpose behind posts as well as thinking about whether or not social media posts reflect real life or only a slice of the “best” bits, or a highlight reel. The project aims to examine effects for body dissatisfaction, eating problems, and mood for young men and women who take part in the social media literacy program, REEL2REAL, compared with people who receive the program after a short delay. We expect that people will experience a benefit from participation for their body dissatisfaction, eating problems, and mood.

Obstructive sleep apnoea (OSA) is characterised by a partial or complete collapse of the upper airway during sleep. Continuous Positive Airway Pressure (CPAP) therapy acts as a positive airway splint, delivering a fixed positive airway pressure to the upper airway via a tube and mask. CPAP compliance is strongly influenced by the patient’s mask system. As masks are worn every night the comfort, seal, stability and ease of use of a CPAP mask is highly important. The product development of mask systems is an iterative process. Evaluation of the comfort, seal, stability and ease of use of the mask system by patients in their home environment provides the required information for these iterative design changes. This project will allow the iterative testing of mask systems by patients by comparing them to already released masks or acceptable subjective levels.

This study aims to evaluate the effectiveness of the 'Faecal Immunochemical Test' (FIT) as a diagnostic tool in patients considered at elevated risk for colorectal cancer and who have an upcoming surveillance colonoscopy. Who is it for? You may be eligible to join this study if you are male or female, aged 18 years or older, are enrolled in the SCOOP Program and have a scheduled surveillance colonoscopy. Study details All patients enrolled in the SCOOP program, with a pending surveillance colonoscopy will be invited to complete and return a FIT kit, two weeks prior to their colonoscopy so the results from the FIT and the colonoscopy, can be compared to each other to validate the FIT as an effective surveillance tool. The purpose of this study is to understand the accuracy of FIT relative to colonoscopy with regard to detecting both colorectal cancer and polyps that are pre-cancerous. While much is known about the effectiveness of FIT as a general screening tool, we would like to gather data on its effectiveness when compared to colonoscopy, in a population of people who are under surveillance with colonoscopy. Our research may lead to increased confidence and validation in the use of FIT as an effective surveillance tool for patients with an elevated risk for colorectal cancer and reduce the need for unnecessary colonoscopies for patients within the SCOOP Program.

The research aims to examine the relationship between mental health and martial arts, specifically considering the mental health and behavioural effects resulting from participation in a 10-week martial arts based therapeutic intervention, delivered to participants (age range 11 to 14 years) in high schools using a randomised controlled trial research methodology. As previous research of this topic is limited and ambiguous, the study is expected to demonstrate to what extent martial arts are an efficacious alternative therapy that reduces mental illness, such as mood and behavioural issues; and promotes characteristics associated with mental health and wellbeing, such as self-efficacy and resilience.