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The effect of antenatal pelvic floor muscle exercises on female sexual function: A randomised controlled trial
The primary aim of this study is to explore the impact of antenatal pelvic floor muscle exercises (PFME) on sexual dysfunction and quality of life in women during pregnancy and in the first three months following birth. A secondary aim is to determine the effect of antenatal PFMT on labour and birth outcomes, urinary and faecal incontinence and specific quality of life three months following birth. This is a randomised controlled trial and the primary hypothesis of this study is that: women who perform antenatal PFMT have better sexual function during pregnancy and three months following birth compared with women who receive antenatal standard care alone. The secondary hypothesis is that; women who perform antenatal PFMT have improved childbirth outcomes, less urinary and faecal incontinence symptoms and also better specific quality of life compared with women who receive antenatal standard care alone. Findings from this study will help to establish an evidence base for the use and effectiveness of antenatal pelvic floor muscle exercise to improve primiparous women’s quality of life, sexual function, childbirth outcome and urinary and faecal incontinence symptoms.
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Understanding Australian adults' eating patterns: relationships of frequency and/or timing of eating occasions, including meals and snacks, with dietary intakes, obesity and blood pressure
Little is known about dietary intake at the level of an “eating occasion (EO)”, which includes meals and snacks. Current dietary advice is framed around the amount and types of food populations should consume, rather than a consideration of eating patterns. Eating patterns describe the frequency and temporal distribution of meals and snacks. Eating patterns are likely to be important determinants of adults’ dietary intakes and health; however, the nutritional and health impacts of EO, meal and snack frequency and temporal eating patterns are inconclusive. Further, inconsistent evidence for eating patterns and health may be partly attributed to the lack of consensus on approaches for defining an EO or for assessing temporal eating patterns. The aims of these secondary analyses were to: 1) explore the influence of different definitions of EOs on the characterisation of eating patterns, 2) to examine temporal eating patterns using a novel data-driven analytic approach, and 3) to investigate associations of different eating patterns (e.g. frequency of all EOs, meals and snacks; temporal eating patterns) with nutrient intakes, overall diet quality and measures of adiposity and blood pressure. The Census and Statistics Act 1905 provides ethics approval for the Australian Bureau of Statistics to conduct household interview components of national surveys, including the National Nutrition and Physical Activity Survey (NNPAS). At this is a secondary analysis of the NNPAS data which is de-identified, an exemption for ethics approval was granted by the Deakin University Human Research Ethics Committee on April 16, 2015. (Project number: 2015-073).
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Study of ZYN001 (transdermal patch) in Healthy Volunteers
What is this study about? The purpose of this study is to investigate how safe and tolerable a single dose (worn for 24 hrs, 3.5 days or 7 days) and repeat doses (worn for 14 days) of ZYN001 transdermal delivery system is in healthy volunteers. The study will look at how the body absorbs, distributes, breaks down and then removes the study drug from your body. This will be done by analysing the levels of ZYN001 in your blood and urine at various times following drug administration. Your skin at the application sites will be checked to see if there is any irritation or reactions present when the ZYN001 patch is removed. The study will also investigate if ZYN001 affects your brain functioning by administering a number of neuropsychological tests. Who is if for? You may be eligible to join this study if you are aged between 18 and 55 years and are in good health. Study details: This study will investigate different formulation of patches containing ZYN001 compared to a placebo patch (a treatment with no active ingredients which looks like the real thing but it is not). This study is ‘double-blind’ which means you and your study doctor, together with the study staff administering the study treatment will not know whether you are receiving ZYN001 or a placebo patch. What does study participation involve? Initially, the study will investigate four (4) different patches in each study period. All patches will have the same amount of THC drug within a study period but the ingredients in the patches will be different. You will report to the clinic the day before receiving treatment (Day -1). You will participate in either: • Period 1 - one patch worn for 24 hours • Period 2 - one patch worn for 3.5 days • Period 3 - one patch worn for 7 days OR, you will participate in either: Period 4 - one patch applied and worn for 3.5 days, removed and patch #2 applied and worn for 3.5 days, removed and patch #3 applied and worn for 3.5 days, removed and patch #4 applied and removed 3.5 days later Period 5 - one patch applied and worn for 7 days, removed and patch #2 applied and worn for 7 days You will receive application of ZYN001 or a placebo patch. The patch will be applied to either your left or right upper arm. Throughout the study you will have various medical tests (physical examinations, vital signs measured, ECG measured, neuropsychological tests) and will have several blood and urine samples collected for laboratory analysis.
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A study to determine the safety, tolerability and ability to provoke an immune response of graded doses of the STX-100/Alhydrogel vaccine in healthy volunteers
STX-100/Alhydrogel, the study drug being researched in this project, is an experimental vaccine being developed by Sentinext Therapeutics. This means that it is not an approved treatment in Australia, and is not yet approved anywhere else in the world. STX-100/Alhydrogel is a vaccine that is intended to prevent hand, foot and mouth disease. The primary objective of this study is to determine the safety and tolerability of STX-100/Alhydrogel vaccine compared to placebo controls when administered to healthy adults.
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Measurement of Physical Activity during General Inpatient Rehabilitation
The aim of the project is to measure the physical activity of participants on the rehabilitation ward over their inpatient hospital admission. The research design is a prospective pre-post study. Data will be collected on 161 participants (control group) over their inpatient rehabilitation admission. Changes to ward practice will be then be implemented. These changes include, but are not be limited to, increased group therapy (balance, community access, gardening), meals in the dining area and education sessions. Data will then be collected on another 161 participants (treatment group) over their inpatient rehabilitation admission. An activity monitor (ActivPAL micro) will be taped and a waterproof dressing applied to one thigh on each participant's midthigh. The activity monitor measures sedentary (lying/sitting), standing, stepping and metabolic equivalent time (MET); as well as step and transition (sit to stand) counts and cadence. The activity monitor will removed weekly, data uploaded to computer and into Sydney Local Health District Targeted Activity and Reporting System (STARS) in the late afternoon, charged and reapplied the following morning. Data from the activity monitors will be matched to participant data from STARS. Specifically, Australian National Subacute and Nonacute Patient (AN-SNAP) classification, change in motor Functional Independence Measure (m-FIM) and length of stay.
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The Real Happy Study: a prospective assessment of the real-world effectiveness of the HAPIFED program: a Healthy APproach to weIght management and Food in Eating Disorders
This research study will look at the 'real world' effectiveness of a novel approach to treating overweight/obesity with co-morbid binge eating disorder, bulimia nervosa or other specified feeding and eating disorder by way of the HAPIFED program, which combines behavioural weight loss therapy with enhanced cognitive behaviour therapy. It is hypothesised that the HAPIFED Program will result in an average weight loss of greater than or equal to 5% of body weight in the group overall and in at least 50% of participants. In addition, it will result in a global score on the Eating Disorder Examination Questionnaire (EDE-Q) of less than 1 standard deviation above Australian community norms (i.e. below 2.46) in at least 40% of participants, at 52 weeks after commencement of treatment.
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The Childhood to Adolescence Transition Study (CATS): Health Risks in the Pubertal Transition
Recent studies have suggested that the transition through puberty is marked by an increased risk of behavioural and emotional health problems. These include common emotional problems such as depression and anxiety; substance use; eating disorders; self-harm; antisocial behaviours, and functional somatic disorders such as headaches and irritable bowel syndrome. Previous studies have not adequately answered whether differences in social, lifestyle and biological transitions during puberty may explain the emergence of these difficulties. This is despite the evidence that adolescent mental and behavioural disorders have become more common in recent decades with the reasons likely to lie in changes in the social and lifestyle context of development. The aim of this study is to prospectively examine the factors that may influence the onset and course of pubertal-onset health problems. This study will provide the most comprehensive quantification of the association between puberty development and the major health problems that become prevalent in early adolescence. Participants will be 1239 grade 3 students (age 8-9 years) at public, Catholic and independent schools in metropolitan Melbourne. There will be annual assessments, over a nine-year period. Participants will complete web-based questionnaires covering a range of topics including mental and physical health, pubertal development, social context, activities of daily living and emotional style. Additionally, participants’ height, weight and waist circumference will be measured. A saliva sample will also be collected from each student in order to measure saliva hormone levels (another measure of pubertal stage). Parents and teachers will also be asked to complete a questionnaire. Parents will provide information regarding socio-demographics, family background, child behavioural and emotional adjustment and parental health and lifestyle. Teachers will be asked to complete a very brief questionnaire about the strengths and difficulties and academic attainment for each student.
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Trialling the feasibility and acceptability of physical activity self-monitoring and supervised exercise interventions for adults with mental illness
This pilot study will be a randomised controlled trial of two physical activity (PA) interventions for adults with mental illness: i) PA self-monitoring using technology (wrist-worn Garmin Vivofits, which provide real-time feedback on the face of the device), and ii) supervised exercise intervention at a community gym. As a pilot study, the primary outcomes will be 1) feasibility of the trial, and 2) feasibility and acceptability of the interventions. Secondary outcomes will be the impact on PA behaviour change (assessed using accelerometers and self-report questionnaires), PA motivations, physical health (weight, waist, blood pressure) and psychosocial wellbeing (self-reported sleep quality and psychological distress). The interlinked aims of this pilot study are to: i) Assess the feasibility of the trial ii) Assess the feasibility and acceptability of the PA interventions iii) Compare the change in PA participation in response to interventions that either promote PA motivation, or provide PA opportunity. Additional aims are to assess: i) The utility of the 6-min walk test, wrist-worn accelerometry, and questionnaires on physical activity, sedentary behaviour and sleep. ii) The impact of the intervention on mental and physical health. It is hypothesised that: i) The trial will be feasible to conduct on a larger scale. ii) The PA interventions will be feasible to implement in the mental health service iii) There will be a qualitative difference in the acceptability of the interventions, dependent upon how they influence capability, opportunity and motivation to promote behaviour change. Inclusion criteria: i) Current adult consumer of Metro North Mental Health Services and Metro South Addictions and Mental Health Services (other than acute care teams) ii) Aged 18-65 years iii) Willingness to provide written informed consent. Exclusion criteria: i) Diagnosed with an eating disorder (assessed by referring clinician) ii) Identification of medical risk factors on the Adult Pre-exercise Screening Tool, and NOT cleared to participate by a medical professional iii) Physically active, defined as more than 300 minutes/week of self-reported moderate-to-vigorous PA (assessed using the Active Australia questionnaire)
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Pregnancy outcomes when adding a progesterone pessary dose amongst women who are receiving frozen embryo transfer with hormone replacement therapy, compared with placebo.
FETs using HRT stimulation occur with no corpus luteum. This means endometrial growth, maturation and maintenance is entirely dependent on the effect of HRT for at least the first 2-5 weeks post-transfer. By 10 weeks post-transfer the placenta is producing adequate hormone to support the endometrium. Although intramuscular progesterone treatment is popular in North America, in Australia and Europe vaginal preparations are preferred. Natural and HRT FET cycles have been compared and show equivalent live birth rates on meta-analysis. The local experience at Monash IVF is different, with a significantly lower live birth rate for HRT compared to natural FETs (14.5% vs 22.4% - OR 0.59 (0.55-0.62)) for all comers. This difference is maintained when 20 potential confounding factors are allowed for using logistic regression (patient age; number of embryos transferred, embryo maturity etc) with an adjusted odds ratio of 0.55 (0.48-0.64). A recent publication from Yovich (2015) showed a significantly higher live birth rate in women undergoing HRT FETs, where the mid-luteal phase serum progesterone was >50 nmol/L. Review of the Monash IVF dataset investigating serum progesterone concentrations after 14-18 days of treatment in HRT FETs confirmed a significantly higher live birth rate (26.4% vs 11.3%). A shortcoming of measuring progesterone both at mid-luteal and Day 14-18, is that the opportunity to change management and improve outcome has potentially already passed. A further retrospective review of Monash IVF HRT FET cycles investigating progesterone dosage, Day 14-18 serum progesterone and live birth rates, suggested that dose frequency may be as important of actual dosage. This study aims to investigate “at risk” women with low serum progesterone (<50 nmol/L), but measure this after 2 days of treatment and then assess the effect of adding an extra dose of progesterone each day upon the live birth rate.
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Trends in dietary sodium from food sources in Australian children and adolescents from 2007 to 2011/12
The aim of this study was to assess trends in sodium intake from food sources among Australian children and adolescents from 2007 to 2011-12. To do this we have completed secondary data analysis of two existing data sets, the 2007 CNPAS and the 2011/12 NNPAS.