http://hdl.handle.net/2328/2974 2013-05-20T16:49:39Z 2013-05-20T16:49:39Z Davis-Lameloise, Nathalie Philpot, Benjamin Joel Laatikainen, Tiina K M Bunker, Stephen Best, James D Vartiainen, Erkki Lo, Sing Kai Janus, Edward Denis Dunbar, James Anthony Reddy, Prasuna Kilkkinen, Annamari http://hdl.handle.net/2328/11258 2013-05-13T01:38:23Z 2008-01-01T00:00:00Z

Title: Depression: an important comorbidity with metabolic syndrome in a general population Authors: Davis-Lameloise, Nathalie; Philpot, Benjamin Joel; Laatikainen, Tiina K M; Bunker, Stephen; Best, James D; Vartiainen, Erkki; Lo, Sing Kai; Janus, Edward Denis; Dunbar, James Anthony; Reddy, Prasuna; Kilkkinen, Annamari

2008-01-01T00:00:00Z Laatikainen, Tiina K M Dunbar, James Anthony Chapman, Anna Kristina Kilkkinen, Annamari Vartiainen, Erkki Heistaro, Sami Mikael Philpot, Benjamin Joel Absetz, Pilvikki Bunker, Stephen O'Neil, Adrienne Elizabeth Reddy, Prasuna Best, James D Janus, Edward Denis http://hdl.handle.net/2328/3175 2013-05-13T01:30:26Z 2007-09-19T00:00:00Z

Title: Prevention of Type 2 Diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT) Diabetes Prevention Project Authors: Laatikainen, Tiina K M; Dunbar, James Anthony; Chapman, Anna Kristina; Kilkkinen, Annamari; Vartiainen, Erkki; Heistaro, Sami Mikael; Philpot, Benjamin Joel; Absetz, Pilvikki; Bunker, Stephen; O'Neil, Adrienne Elizabeth; Reddy, Prasuna; Best, James D; Janus, Edward Denis Abstract: Background Randomised controlled trials demonstrate a 60% reduction in type 2 diabetes incidence through lifestyle modification programmes. The aim of this study is to determine whether such programmes are feasible in primary health care. Methods An intervention study including 237 individuals 40–75 years of age with moderate or high risk of developing type 2 diabetes. A structured group programme with six 90 minute sessions delivered during an eight month period by trained nurses in Australian primary health care in 2004–2006. Main outcome measures taken at baseline, three, and 12 months included weight, height, waist circumference, fasting plasma glucose and lipids, plasma glucose two hours after oral glucose challenge, blood pressure, measures of psychological distress and general health outcomes. To test differences between baseline and follow-up, paired t-tests and Wilcoxon rank sum tests were performed. Results At twelve months participants' mean weight reduced by 2.52 kg (95% confidence interval 1.85 to 3.19) and waist circumference by 4.17 cm (3.48 to 4.87). Mean fasting glucose reduced by 0.14 mmol/l (0.07 to 0.20), plasma glucose two hours after oral glucose challenge by 0.58 mmol/l (0.36 to 0.79), total cholesterol by 0.29 mmol/l (0.18 to 0.40), low density lipoprotein cholesterol by 0.25 mmol/l (0.16 to 0.34), triglycerides by 0.15 mmol/l (0.05 to 0.24) and diastolic blood pressure by 2.14 mmHg (0.94 to 3.33). Significant improvements were also found in most psychological measures. Conclusion This study provides evidence that a type 2 diabetes prevention programme using lifestyle intervention is feasible in primary health care settings, with reductions in risk factors approaching those observed in clinical trials. Description: Trial Number Current Controlled Trials ISRCTN38031372

2007-09-19T00:00:00Z Bearsley-Smith, Cate Browne, Mark Sellick, Ken Villanueva, Elmer V Chesters, Janice Francis, Karen Reddy, Prasuna http://hdl.handle.net/2328/2975 2013-05-13T01:30:27Z 2007-10-04T00:00:00Z

Title: Does Interpersonal Psychotherapy improve clinical care for adolescents with depression attending a rural child and adolescent mental health service? Study protocol for a cluster randomised feasibility trial Authors: Bearsley-Smith, Cate; Browne, Mark; Sellick, Ken; Villanueva, Elmer V; Chesters, Janice; Francis, Karen; Reddy, Prasuna Abstract: Background Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT). The study described in the current paper has two main objectives. First, it aims to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents for the treatment of adolescent depression within a rural mental health service compared with Treatment as Usual (TAU). The second objective is to record the process and challenges (i.e. feasibility, acceptability, sustainability) associated with implementing and evaluating an evidence-based intervention within a community service. This paper outlines the study rationale and design for this community based research trial. Methods/design The study involves a cluster randomisation trial to be conducted within a Child and Adolescent Mental Health Service in rural Australia. All clinicians in the service will be invited to participate. Participating clinicians will be randomised via block design at each of four sites to (a) training and delivery of IPT, or (b) TAU. The primary measure of impact on care will be a clinically significant change in depressive symptomatology, with secondary outcomes involving treatment satisfaction and changes in other symptomatology. Participating adolescents with significant depressive symptomatology, aged 12 to 18 years, will complete assessment measures at Weeks 0, 12 and 24 of treatment. They will also complete a depression inventory once a month during that period. This study aims to recruit 60 adolescent participants and their parent/guardian/s. A power analysis is not indicated as an intra-class correlation coefficient will be calculated and used to inform sample size calculations for subsequent large-scale trials. Qualitative data regarding process implementation will be collected quarterly from focus groups with participating clinicians over 18 months, plus phone interviews with participating adolescents and parent/guardians at 12 weeks and 24 weeks of treatment. The focus group qualitative data will be analysed using a Fourth Generation Evaluation methodology that includes a constant comparative cyclic analysis method. Discussion This study protocol will be informative for researchers and clinicians interested in considering, designing and/or conducting cluster randomised trials within community practice such as mental health services. Description: Trial Registration Australian Clinical Trials Registry ACTRNO12607000324415

2007-10-04T00:00:00Z