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vSHADE - An internet-delivered, evidenced-based treatment program for mental health and alcohol use in contemporary Veterans
Expand descriptionThe mental health and well-being of serving and ex-serving Australian Defence Force (ADF) personnel is of paramount importance, with a recent national audit indicating mental health disorders including depression, anxiety, post-traumatic stress, substance use, and suicide, are a major cause of reduced quality of life for many members, with direct impacts on their families. SHADE is a 10-session internet delivered program which has demonstrated effectiveness in the general population for reduction of depressive symptoms and hazardous alcohol use. This study will pilot and evaluate the use of the SHADE program amongst ex-serving ADF personnel with and without the addition of a psychologist moderated social netoworking site, "Breathing Space."
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Evaluation of the Safety, Tolerability and Pharmacokinetics of Intravenous TIMP-GLIA in Healthy Volunteers.
Expand descriptionThe phase 1 trial will be conducted in two parts, initially, it will comprise of a single-centre, subject blinded randomised single ascending dose study of TIMP-GLIA to 6 cohorts. Each cohort will contain six participants two will be randomised to placebo and four to TIMP-GLIA. At the beginning of each dose level, one sentinel (TIMP-GLIA) participant and one placebo participant will be dosed. The remaining four participants will be dosed 48 hours after the sentinel participants. A Safety Committee will meet after the completion of each cohort dosing to ascertain safety prior to the next dose level is given. In the second part of the trial, a repeat dosing strategy will be employed (maximum, two doses seven days apart) at the Level 4 and Level 6 dose. Following a screening period (up to 28 days), eligible participants will be randomised to TIMP-GLIA or placebo using a computer generated randomisation schedule which will be held by an unblinded pharmacist.
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Can motor imagery improve strength during periods of restricted weight bearing in older adults?
Expand descriptionThe negative effects of immobility such as reduced muscle strength and cardiac function are evident after a few days in care, particularly for older adults. These effects are more profound in those older adults with restricted weight bearing status as they are more confined to bed. There is a need to identify interventions that can be completed in bed while reducing the effects of immobilization. One such intervention is motor imagery, where participants imagine performing certain tasks without overt muscle activity. Motor imagery has been used successfully in stroke patients but has not been used in older adults during periods of immobilization. The aim of this study is to identify whether motor imagery combined with standard physiotherapy care is superior at improving strength and mobility compared to standard physiotherapy care alone. Participants will be subacute residents undergoing rehabilitation, aged 65 years or more that have been prescribed restricted weight bearing for at least one week. Participants will be allocated to standard physiotherapy (Control) or standard physiotherapy plus motor imagery (experimental). It is expected that participants in the experimental group will have more rapid gains in strength and mobility than those in the control group.
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Tuning in to Teens for Residential Care Workers: A Pilot Study
Expand descriptionWhen parenting does not meet the subscribed Department of Health and Human Services (2013) standard of good enough parenting it may result in children and young people being removed and placed in residential, foster or kinship care due to concerns for their safety and wellbeing. When a young person is placed in residential care, the workers must fulfil the function of a good enough parent. But residential houses are often filled with conflict and difficulties, and many houses are troubled by constant critical incidents and problems with residents and staff. Parenting and parent-adolescent relationships play a central role in adolescent wellbeing. Problems in this relationship are closely associated with poorer emotional functioning in the young person. Little is known about what works for improving the quality of ‘parenting’ care provided to children and young people residing in residential care settings. Tuning in to Teens for Residential Care Workers (TINT RCW) is based on a parenting program (Tuning in to Teens) and aims to improve relationships within residential homes by delivering the program to residential care workers. This study will examine whether TINT RCW increases responsive patterns of parenting/care, reduces negative escalating interaction cycles, improves house functioning, and increases residential care workers’ emotion coaching. Several residential care homes will be recruited to the study and randomised into immediate intervention or a care as usual control condition. Self-report and observational measures will be used to examine differences between houses in the two conditions and to see whether there are changes over time. TINT RCW aims to teach residential care workers to assist the adolescents in their care in understanding and regulating emotions while also helping workers to manage their own emotional reactions. The program aims to increase skills in the RCWs and it is expected that these skills will assist the residents to better manage emotions, reduce conflict, and for the residential houses to function more effectively.
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Exploring the value of peer mentoring on the psychosocial wellbeing of junior doctors: a qualitative randomised controlled study
Expand descriptionObjective To evaluate the impact of a peer mentoring program for newly qualified interns on psychological wellbeing, and assess the demand for such a program within an Australian hospital setting. Design, Setting and Participants Through a randomised controlled study, interns in a tertiary teaching hospital (Perth, Western Australia) were recruited to be mentees and resident junior doctors were selected to be mentors. Methods and Main Outcome Measure Interns were randomised 1:1 to receive, or not to receive, a mentor. Mentors were recruited. Qualitative outcome data was collected using semi-structured interviews and focus groups at 12 months and used to assess psychosocial wellbeing and job satisfaction. Results Fifty-three interns applied to participate in the program. Twenty-six mentor-mentee pairs were matched. Twenty-seven interns were allocated to not receive a mentor. Through iterative data analysis, the overarching themes concluded the value of the program in aiding navigation through the complex healthcare system while enhancing a sense of community. Participants with mentors reported high satisfaction with a positive impact on stress levels, morale, sense of support, job satisfaction, and psychosocial wellbeing. Conclusion A peer mentoring program enhances junior doctor support structures, builds a sense of community and helps interns navigate their new professional environment. To our knowledge, this is the first research of its kind involving Australian prevocational junior doctors and provides a feasibility model that may be adapted regionally or nationally.
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Continuous Video EEG Monitoring in Acute Paediatric Ischaemic Stroke
Expand descriptionThere is a retrospective and prospective component to the study. Retrospective patients will be identified through the LCCH clinical stroke database, the Paediatric Intensive Care Unit database and a hospital ICD code search. Appropriate data will be collected and interpreted retrospectively. No additional Video-EEg monitoring will occur. The patients will be followed (neurovascular outpatient clinic and the Queensland Paediatric Rehabilitation Service). This will mainly include standard outpatient appointments. Outcome measures will include the Paediatric Stroke Outcome Measure (PSOM), development of epilepsy and standardized speech and language and cognitive assessments. Outcome will also be comparative to allow for possible baseline developmental delay. Prospective patients will be notified to the study team by neurology, neurosurgery, the emergency department or the paediatric intensive care unit. Study duration will be 2 years. Retrospective patients will be identified from the 2 years preceding the study start date. Follow up is planned for the usual stroke clinic care and for 5 and 10 years. For prospective patients, Video EEG monitoring will occur alongside standard paediatric stroke care. Stroke management will be based on the Australian Paediatric Stroke Guidelines (currently in draft format). Duration of video EEG monitoring will be a minimum of 24hrs. Standardised data will also be collected on all patients with ischaemic stroke over the 2-year study period. The treating clinician will use their discretion to delay or remove the video EEG monitoring if it impedes standard clinical care. The decision whether or not to treat sub-clinical and clinical seizures is at the discretion of the treating clinician however guidance is provided in the Australian Paediatric Stroke Guidelines. Acute neuroimaging (MRI brain) will be reported as per current clinical practice. For study purposes, a second paediatric radiologist will review the imaging. This radiologist will be blinded to the occurrence of clinical or sub-clinical seizures. Neuroimaging analysis will include stroke type and location, presence or absence of haemorrhage and vascular imaging analysis. Where possible volumetric analysis will be performed. Stroke severity will be assessed based the pedNIHSS (Pediatric National Institute of Health Stroke Scale) in concordance with the Australian Paediatric Stroke Guidelines. For the retrospective component of the study the PedNIHSS will be applied retrospectively. Follow-up (outpatient clinic setting) will occur through the neurovascular outpatient clinic and the Queensland Paediatric Rehabilitation Service. Outcome measures will include the Paediatric Stroke Outcome Measure (PSOM), development of epilepsy and standardized speech and language and cognitive assessments. Patients will be treated as per usual standard of care and the only difference for prospective patients will be the duration of the Video-EEG monitoring.
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Utilisation of ambulatory pumps in the inpatient setting to administer long term antibiotic therapy: A patient risk reduction and rehabilitation Strategy (The MOBILISE Study)
Expand descriptionThe MOBILISE study is a randomised control trial comparing antibiotic administration via a small pump with a continuous antibiotic infusion to the traditional method of a hospital pump and pole with multiple daily dosing of antibiotics.
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Predictors of clinical outcomes in patients admitted with influenza and whether troponin levels during hospital admission predicts clinical outcomes in patients with influenza?
Expand descriptionSeasonal influenza is responsible for significant morbidity and mortality around the world. It may result in 200,000 to 500,00 deaths per year and numbers can be higher during pandemics. The frequency of myocardial involvement in influenza is variable with rates up to 10% having being reported in literature and depends upon the methods used to detect myocardial involvement. It is unclear how common asymptomatic cardiac involvement of influenza is although it has been reported as anywhere from 0 to 53% of cases. Although influenza is known to be associated with adverse cardiovascular outcomes but limited studies have studied relationship between troponin levels during hospital admission and clinical outcomes and it is unknown whether increased troponin levels can be used to predict clinical outcomes in these patients. The primary objective of this study will be to determine variables associated with adverse clinical outcomes in hospitalized patient admitted with influenza and other objective will be to determine whether troponin levels during admission correlates with length of hospital stay, complications during hospital admission and readmissions within 1 month and 6 months following discharge. This study will involve only retrospective collection of data of all confirmed cases of influenza admitted in Flinders Medical Centre and Royal Adelaide Hospital between January 2014 and October 2017. The anticipated benefits are possibility of finding new variables, which can predict clinical outcomes in patients admitted with influenza and thus may help in directing strategies to high-risk patients in future.
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Randomised controlled trial of online vocational support for young people with mental ill health
Expand descriptionThis research project is investigating online support for young people looking for work. Young people who experience mental ill health often also experience disruption to school and work. This project will look at whether or not online platforms can help young people find and stay in work. Young people who agree to take part in the project will be randomly assigned to use one of two online platforms. These platforms are both designed to help young people find work and stay in work. They include ways to learn about looking for work, work skills, and information about workforce participation. Depending on which platform participants are allocated to, you may also receive online help from vocational support people and/or talk to other young people online about looking for work. Each component of the platforms are optional and there is no minimum time that you have to spend on the platform. You will also be asked to complete questionnaires about yourself (e.g. demographic information, questions about your mental health, questions about hopefulness and how confident you feel about work) and about looking for work and your work history. You will be asked to complete these questionnaires at three times: 1) when you start as a participant in the study (baseline), 2) 26-weeks after baseline, and 3) 25-weeks after baseline. You will also be asked to let us know how many hours you have worked each week for 26 weeks. Each time you complete the questionnaires it will take approximately 45 minutes. You can complete these questions online and will be reimbursed $20 for the questionnaires that are done at the start (baseline), middle (26-weeks), and end of the study (52-weeks). You may also be asked to participate in an interview about your experiences of using the online platform. We will ask you what you thought of different sections of the platform and what it was like in terms of helping you look for and obtain work. This interview would be at the middle of the study (26-weeks) and again close to the end of the study (52-weeks). If you agree to do this, the interview will be audio recorded and transcribed. This is because it is the best way to remember exactly what you said in the interview. When the recording is transcribed any details that identify you (e.g. name) will be removed. The interviews will last approximately 45-60 minutes depending on how much you have to say and you will be reimbursed $30 for your time and travel expenses.
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Steroid Nasal Spray for Sleep Disordered Breathing in Children
Expand descriptionBreathing problems in sleep (known as sleep disordered breathing - SDB) is a common problem in childhood (seen in up to 10%). SDB can affect children along a spectrum from snoring without sleep disruption, to obstructive sleep apnoea (OSA) with severely disrupted sleep and pauses in breathing. SDB symptoms are now the most common reason for tonsillectomy surgery in children. However, some of these children may benefit from less invasive medical treatment. This study is trying to find out if a nasal steroid spray (INS) (mometasone furoate) can help reduce SDB symptoms. We will ask children 3-12years old to be part of the study. We will do an examination and ask parents to complete questionnaires on their child’s SDB symptoms, and other things related to good sleep such as their child’s emotions and behaviour, and quality of life. We will give them either INS or saline spray (salty water) for 6 weeks, and then repeat the assessments to see the effect of the INS versus saline. We will also monitor who has surgery over the next two years. We expect that INS will reduce the symptoms of SDB, and ultimately reduce the need for surgery, thereby improving the health and quality of life of children with SDB, and also reducing health care costs.