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Exploring threat and fragility in individuals with low back pain
This project will use an online survey to profile beliefs regarding fragility of the back, its fitness for purpose and the resultant sense of threat in patients experiencing low back pain. Our primary hypothesis is that a significant number of people with LBP will harbour beliefs about their pain associated with a high degree of threat and structural fragility. We expect that the questionnaire score will correlate with fear of movement, pain catastrophisation and health anxiety. Finally, we expect the questionnaire will exhibit strong test-retest reliability.
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An observational study of penicillin levels in an urban predominately Aboriginal paediatric cohort receiving secondary prophylaxis for rheumatic heart disease
This six month observational study was undertaken to better understand the differences in the pharmacokinetics (if any) who receive secondary prophylaxis with benzathine penicillin G in individuals aged 5-21, for acute rheumatic fever and/or rheumatic heart disease. It is well established that plasma levels of penicillin vary greatly. To date no studies have been undertaken in an urban cohort which are predominately Aboriginal. Other aspects such as inflammatory response will be assessed through repeated measurements of anti streptolysin O titres throughout the study
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The physiological effects of zolpidem in people with obstructive sleep apnoea
The purpose of this physiology study is to determine the effects of zolpidem (10mg) on obstructive sleep apnoea severity, upper airway muscle activity, the respiratory arousal threshold and breathing parameters during sleep.
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This study will examine the impact of a prognostic gene profiling test EndoPredict® – on adjuvant treatment recommendations in early breast cancer patients, who are ER positive seen at Westmead BCI, VCCC or St Vincent's Hospital.
This study will examine the impact of prognostic gene profile testing using EndoPredict on adjuvant treatment recommendations in early breast cancer patients who are ER positive. Who is it for? You may be eligible for this study if you are a female aged between 18-80 years and have early stage invasive breast cancer which is estrogen receptor positive and HER2 negative. Potential participants will also need to be patients at the Westmead Breast Cancer Institute, Victorian Comprehensive Cancer Centre and St Vincent’s Hospital Sydney. Study details This study will involve participants going through their usual cancer treatment. Participants will be followed up for 10 years on an annual basis to assess treatment recommendations and decisions in that time. This study will enable the researchers to accurately identify those women who can safely avoid chemotherapy
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Experiences of Parenting. Understanding parents' views on parenting and programs for parents
The purpose of this trial is to evaluate the effect of different engagement strategies in the early stages of parenting interventions, particularly recruitment, enrolment, and first attendance. To achieve this, the current trial is evaluating specific elements of two theories (i.e. Health Belief Model and Theory of Planned Behaviour) that have been explored previously in other studies. The results from this trial may inform which combination of format and message is a more effective engagement strategy compared to others. This information will be useful for researchers and practitioners in order to know what elements are more relevant to communicate to parents regarding how to consider parenting interventions as a source of support and thus benefit from them.
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The effectiveness of shoe insert intervention on participants following first metatarsal distal osteotomies with fixation.
Shoe inserts may be used after surgery for bunions and are proposed to help support the foot, reduce pain and improve the movement in the first toe joint. However it is unknown whether having shoe inserts soon after surgery or waiting for complete healing is better to achieve these outcomes. This study will investigate if early (6 week) intervention or later (12 week) intervention with shoe inserts is better for improving first toe joint pain and range of motion following a first metatarsal distal osteotomy with fixation.
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Hearing Aids to Support Cognitive Functions of Older Adults at Risk of Dementia
Dementia is the leading cause of disability among Australians aged 65 or older and also the second leading cause of mortality. Nearly 400,000 Australians are currently living with dementia and, without a cure, this number is projected to reach 1.1 million over the next 30 years, with an estimated cost to the Australian community of more than $36.8 billion. Developing effective strategies to prevent dementia has become a global health priority, with projections suggesting that the total number of people living with dementia could be reduced by 13% (or about 400,000 people) if the onset of symptoms could be delayed by 10 years or more. The Lancet Dementia Taskforce concluded that hearing loss could account for 9% of all cases of dementia. Age-related hearing loss (ARHL) is a highly prevalent form of sensory impairment in later life, affecting 40% to 45% of people aged 65 years and 83% of those aged 70 years or above. At present, it is unclear if the reported association between hearing loss and dementia is causal and if the clinical remediation of sensory impairment could reduce the rate of cognitive decline among older adults at risk of dementia. The study will also explore the cost- effectiveness of the intervention compared to the control arm.
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A survey of participants enrolled in the Southern Co-Operative Program for the Prevention of Colorectal Cancer (or SCOOP program) to assess attitudes toward their current surveillance intervals and methods.
The primary purpose of this study is to Investigate consumer opinions and preferences on screening and surveillance type and frequency. Who is it for? Participants for this study will be people who are part of the SCOOP program who are between 18 and 75 years old, who are at mild to moderate risk for colorectal cancer and who undergo regular surveillance and screening with colonoscopy and FOBT. Study details: All study invitees will be sent via mail a study invitation letter and a questionnaire. The questionnaire contains questions about their previous experiences with colonoscopy and FOBT, attitudes toward managing health, fear of cancer, levels of anxiety, trust in the healthcare system, and basic demographic questions (including age, education level, country of birth). A four week period will be allowed following the mail out of letters for return of completed questionnaires. If the questionnaire has not been returned during this time, then a reminder letter will be sent. The findings of this trial will determine consumer preference for colorectal cancer surveillance. This information will help to guide the clinicians in any policy changes related to surveillance programs, such as with plans to extend surveillance colonoscopy frequency.
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MyFootCare: a pilot study for a mobile application to engage patients with diabetic foot ulcers in self-care.
Diabetic foot ulcers (DFUs) are common, costly and take a toll on patients, families and communities. In Australia, the annual estimated expenditure exceeds $1.6 billion. Despite improved clinical management, effective treatment also relies on self-care away from the clinic. Unfortunately, adherence to self-care is typically low. To address this challenge, the research team developed a mobile phone application (MyFootCare) designed to motivate and engage people with DFUs in their self-care. This project aims to determine the feasibility, usability and perceived value of using MyFootCare to engage patients in the self-care of their DFUs. Participants will include patients with a DFU, their carers and the treating clinicians. All patient participants will use MyFootCare in addition to receiving standard evidence-based care. This project is a predominantly qualitative study using interviews and direct observation, whilst collecting some quantitative measures via application usage log data. The expected outcome is a novel mobile application that seeks to engage patients with DFUs through goal-setting, progress monitoring and reminders to enact self-care.
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Risk-guided strategy for reducing readmission for Acute Decompensated Heart Failure
Heart Failure (HF), often accompanied by comorbidities, is characterised by high rates of death and hospital readmissions. Hospital readmissions consume beds and resources. There has been a lot of effort in the USA (less to date in Australia) to reduce them. This seems to vary from >30% at one month in Victoria and Tasmania, to 20% in South Australia. (CSANZ 2017). The disease management program (DMP) is one of the variables most associated with readmissions following index admission for HF. DMPs are expensive making their availability difficult, hence if applied uniformly to all patients, they may prove wasteful in low-risk, and insufficient, in high-risk patients. Data from the TasHELP study have shown that such readmissions can be predicted (JAMA Cardiol 2016;1:362-4) and possibly prevented, opening the possibility of risk-based targeting of DMP. This proposed PhD project, that will follow a prospective randomised controlled trial, will apply TAS-HELP risk algorithm focusing on intensities of HF DMPs to investigate its effectiveness in reducing 30-day readmission following HF diagnosis and lowering costs. Consecutive patients admitted for HF from July 2019 will be screened for eligibility and asked to participate following their informed consent. Enrolled patients will undergo evaluation of readmission risk and those 50% or more risk will be randomnised to usual care or intervention arm. The Victorian hospitals participating will include The Alfred Hospital and Western Health Footscray and Sunshine Hospitals. The impact of comorbidities on readmission will also be evaluated. A secondary outcome of this RCT will focus on quality of life (QoL) measures and fluid status. Patients in the control arm will receive hospital's usual care while those in the intervention arm will receive hospital care plus the following: DMP intensity adjusted for risk, based on five steps: i) adequate pre-discharge review of fluid status, ii) continuity of transitional care to the community, iii) a nurse-based home DMP lead by independent HF- Nurse, iv) surveillance and v) home-based pre-crisis management. In addition, the intervention group will be offered our HF app. This app is designed to deliver education for HF patients. It also measures QoL, HF Knowledge and self-care behaviors. Throughout the duration of the program which is 52 days, the patient records daily weight and is being given tasks and goals to achieve. The HF app is designed based on Heart Foundation guidelines. This proposed RCT will provide the strongest possible evidence for a home based nursing follow up base on risk for hospital readmission. The novelty of this study is the intervention delivered by an independent health practitioner, ensuring external validity and the application of both an avatar style patient education program, as well as the addition of a portable echo assessment in patient’s home.