ANZCTR search results

A significant proportion of women struggle with anxiety and stress during pregnancy, and this can affect the health of both the mother and her baby. Relaxation interventions might be helpful, however the evidence is not conclusive. The purpose of this feasibility study is to explore the potential of two programs aimed at helping to decrease anxiety during pregnancy: 1. a partner delivered relaxation massage program; and 2. a self-directed stress management program. Pregnant women will be invited to participate in the study and randomly assigned to one of the two programs.

During general anaesthesia, obese patients are at risk of oxygen levels in the blood rapidly falling when not breathing. This rapid reduction is due to the combination of reduced chest wall and diaphragmatic tone, the increased incidence of lung collapse, and secretion retention. Administering oxygen before general anaesthesia is less effective than in patients with a normal weight and obese patients pose more difficulties with airway management. Transnasal humidified Rapid-insufflation ventilator exchange (THRIVE) has recently gained popularity within anaesthetic practice due to the respiratory safety benefits it provides in patients who are not breathing. THRIVE increases the time in which patients can be not breathing before oxygen levels in the blood begin to fall. The aim of this study is to identify the safety benefits of high-flow nasal oxygen deliver (Transnasal humidified Rapid-insufflation ventilator exchange (THRIVE)) in obese patients undergoing elective bariatric surgery. It may potentially increase the time to hypoxia and increase carbon dioxide elimination in obese patients who are not breathing, who are at higher risk of lung complications.

This study builds on pilot work testing 2- and 3-session perfectionism programmes with early adolescents which found improvements in emotional problems, self-imposed perfectionistic standards (sustained at 4-week follow-up), and well-being, sustained at 3-month follow-up (Fairweather-Schmidt and Wade, 2015; Vekas & Wade, 2017). The modified programme for the current research expands the pilot programme to include an emphasis on the difference in pursuing excellence and pursuing perfection, as gifted students will be offered the intervention. To date no research has examined whether perfectionism interventions can increase intrinsic motivation and academic goal progress. Research objectives 1. To examine the impact of the LIFE curriculum on primary (perfectionism) and secondary (anxiety, depression, wellbeing, self-compassion, academic motivation and satisfaction). 2. To test whether improvements in certain outcome factors (anxiety, depression, well-being, academic motivation and satisfaction) are mediated by the following outcome factors: self-compassion and perfectionism. We hypothesize that the intervention group will experience significantly greater decreases in perfectionism, anxiety, and depression, and significantly greater increases in wellbeing, self-compassion, academic motivation and satisfaction, at follow-up. We also hypothesize that decreases in perfectionism and increases in self-compassion between baseline and end of treatment will mediate the association between group and follow-up changes in anxiety, depression, well-being, academic motivation and satisfaction.

Stroke is a leading cause of long term disability with around 60,000 people experiencing a stroke each year in Australia. In the acute post-stroke period over two thirds of patients experience some level of reduced upper limb function, while 15-30% of stroke survivors suffer permanent motor impairments despite extensive rehabilitation. Although extensive research has been devoted to establishing novel treatment modalities, few have made significant and reliable improvements to stroke rehabilitation and recovery. Brain based interventions which target affected brain networks are likely to be highly effective. Transcranial direct current stimulation (TDCS), a form of non-invasive brain stimulation, has demonstrated some promise for improving upper limb function post stroke. TDCS can facilitate motor learning by increasing network excitability. This raises the possibility that combining TDCS with therapy may lead to functional recovery beyond that normally achieved by therapy alone. However inconsistencies of both physiological and behavioural responses to TDCS suggests a ‘one-size-fits-all’ treatment might not be optimal. The neural sequelae arising from stroke are highly heterogeneous with the extent of subsequent impairment dependent upon lesion location and disruption of brain networks. Therefore individual differences in residual integrity of the lesioned motor network may contribute, at least in part, to variable TDCS responses. Motor network connectivity may be a valuable predictor of those who will benefit from TDCS application in general, or alternatively, benefit for different stimulation approaches (e.g. facilitatory vs inhibitory TDCS or ipsilesional vs contralesional stimulation). Biomarkers predictive of TDCS response would be beneficial to improve clinical translation of this ‘state-of-the-art’ intervention capable of substantially transforming stroke therapy and improving recovery. We hypothesise connectivity of the lesioned motor network will be greater in stroke patients who demonstrate a strong response to TDCS combined with upper limb exercise therapy.

The safety and performance of the Apex Total Knee Replacement system manufactured by Omni Life Science and Global Orthopaedic Technology will be evaluated following primary total knee arthroplasty.

Social isolation is a major cause of depression onset and relapse in young people. Yet this is not directly targeted in current treatments for depression. To address this disconnect, our project will conduct a randomised controlled trial to assess the efficacy of a novel intervention that targets social isolation in young people with depression (called Groups 4 Health). Our trial will compare the effectiveness of Groups 4 Health to another effective treatment, group Cognitive Behaviour Therapy (CBT), at program completion and one-year follow up. Participants will be 200 young people aged 15-25, recruited from public and private mental health services in the Southeast Queensland region. We expect that both interventions will be effective in reducing depression symptoms, but that Groups 4 Health will be superior in reducing the social isolation that causes depression. This trial will test the capacity for Groups 4 Health to function not only as a treatment, but also as relapse prevention for young people at risk of depression recurrence. Therefore, the benefits of Groups 4 Health are expected to be particularly apparent by the one-year follow-up. This program offers a new approach to treatment and relapse prevention of the leading cause of disability among young people in Australia.

Thinking Maths has been developed by the South Australian Department of Education and Child Development (SA DECD), based on its Teaching for Effective Learning Framework. The program aims to address a significant drop in mathematics performance in NAPLAN from Year 7 to Year 9. The program supports Year 7 and Year 8 teachers in the deep learning of mathematical content as outlined in the Australian Curriculum Mathematics. The project focuses on the following three areas for better teaching and learning of mathematics: • Quality task design; • Sequencing of conceptual development and; • Research-informed effective pedagogies Five professional learning days are run over two terms by facilitators who model rigorous teaching and learning processes, undertaking tasks with multiple entry and exit points to differentiate the curriculum to cater for students with a wide range of mathematical experience and dispositions. After each session teachers make a commitment to implement high gain strategies to improve student achievement and engagement. Between sessions, telephone, email and online platforms support teachers’ improvement efforts in a professional learning community. At each session after the first, there are three to four presentations from participants to share their experiences, successes and challenges. The SA DECD has identified the drop in mathematics performance between Year 7 and Year 9 as a critical state-wide issue and has designed this program in response to it. In order to inform the Department’s understanding of the effect and cost-effectiveness of the program, a rigorous and independently-funded trial is useful. As a decline in mathematics performance is also evident in Australian students’ results more widely, the findings from this trial may be of interest to other Australian practitioners and policy makers, as well. To date, there has been no rigorous evaluation of the impact this program has on student achievement in mathematics. The program however uses approaches which have a basis in research evidence, Teachers in the program receive explicit feedback from peers on their instruction and feedback, on average, yields 8 months’ learning progress for students. Further, the professional learning has been designed with key findings from Timperly et al’s Teacher Professional Learning Best Evidence Synthesis (2007) in mind. The program evaluator, the Australian Council for Educational Research (ACER), is the leading independent Australian organisation in educational research. The trial is structured as a clustered randomised control trial (RCT), with pairs of Year 7 and Year 8 Maths teachers recruited from 167 South Australian government schools. 120 recruited teachers (57 pairs and 6 individuals in 63 schools) will receive the intervention and the other 198 teachers (94 pairs and 10 individuals in the remaining 104 schools) will as act as a business-as-usual control.

Smiling Mind is a not for profit organisation that develops app-based mindfulness programs to support the wellbeing of children, young people and adults. Smiling Mind has previously developed mindfulness-based programs for primary and secondary school age children. In partnership with Early Childhood Australia (ECA) they have developed a mindfulness program for pre-school age children, called the Early Minds program. The program has been designed to be implemented by trained early childhood educators within Early Learning Centres (ELCs). Educators will be trained by two online learning modules prior to implementing the program, which consists of 8-weeks of mindfulness–based meditations and activities. The aim of this pilot study, led by the Murdoch Children’s Research Institute, is to evaluate the feasibility and acceptability of conducting the Early Minds program within selected Victorian ELCs. Educator’s experience of the program, use of the program, and barriers to use will be examined. Secondary aims will explore preliminary impacts of the program on educator and caregiver reported child wellbeing and behaviour. Educators will be randomised into the program group or the usual care group. Children will be placed in the group their educator is in. Participants will complete surveys at three months post-randomisation to assess primary outcomes.

Traditionally, the only treatment options for patients diagnosed with severe aortic stenosis were relatively invasive interventions such as surgical aortic heart value replacement (SAVR) or balloon aortic valvuloplasty (BAV), or non-invasive treatment such as medical therapy. The preferred treatment option for patients with severe aortic stenosis has long-been surgical aortic value replacement (SAVR) due to the superior outcomes over medical therapy, however, a number of patients, such as those in advanced age with additional diseases, have not been suitable for surgery, often due to the considerable risks associated with surgical procedures in these patients. More recently, there has been the development of a procedure known as transcatheter aortic heart value implantation (TAVI) which is a less invasive surgical procedure than the standard surgical aortic valve replacement (SAVR) and has allowed doctors to treat patients with severe aortic stenosis who have previously not been suitable for the surgical intervention. This TAVI procedure could therefore be beneficial to many patients with severe aortic stenosis who have been considered too high-risk to undergo the standard surgical procedure and have had to rely on medical therapy alone. What we therefore aim to do in this study is to find out the value of the TAVI procedure in comparison to other treatment options, both surgical and non-surgical, by looking at patient outcomes, patient quality of life and cost effectiveness of those undergoing each of the treatment options.

Adhesive capsulitis (AC), rotator cuff tears (RCT) and osteoarthritis (OA) is a disabling and poorly understood pathological conditions of the shoulder joint. The current study aims to increase our understanding of the pathogenesis, diagnosis and clinical outcomes of people with AC, RCT and OA by investigating: 1) transcriptome-wide alterations in gene expression of the glenohumeral joint capsule compared to people with non-inflammatory shoulder instability (controls); 2) serum and urine biomarkers to better understand diagnosis and staging of AC, RCT and OA; and 3) clinical outcomes in people with AC, RCT and OA compared to controls 12-months following arthroscopic capsular release or labral repair respectively. The study is a multi-centre, non-randomised study investigating people undergoing surgery for AC, RCT and OA compared to people undergoing arthroscopic stabilization for shoulder instability. Tissue samples collected from the anterior glenohumeral joint capsule during surgery will undergo RNA-seq to determine differences in gene expression between the study groups. Gene Set Enrichment Analysis will be used to further understand the pathogenesis of AC as well as guide serum and urine biomarker analysis. Clinical outcomes regarding pain, function and quality of life will be assessed using the Oxford Shoulder Score, Oxford Shoulder Instability Score, Quick DASH, American Shoulder and Elbow Society Score, EQ-5D-5L and active shoulder range of movement. Clinical outcomes will be collected pre-operatively and 12-months post-operatively and study groups will be compared for statistically significant differences (p<0.05).