ANZCTR search results

For the many individuals with established osteoporosis who will not, or cannot take medication there are currently no recommended therapeutic alternatives. Calcium and vitamin D are vital but insufficient therapies and are similarly limited by poor patient compliance. Recent evidence suggests high intensity exercise is an effective stimulus for bone. Whole body vibration (WBV) can also be anabolic to the musculoskeletal system. Early research has shown that WBV is a simple, passive therapy with greater appeal to the target population than exercise or drugs. This trial will be the first to use rigorous methods to examine the effects of WBV alone, and in combination with high-intensity exercise, in participants on and off bone medications, to improve risk factors for hip fracture (bone density, balance and muscle strength).

The primary purpose of this study is to investigate if people with Parkinson's disease have the usual reduction in pain threshold following exercise (i.e. exercise induced analgesia). We hypothesize that people with Parkinson's disease will have the usual exercise-induced analgesia response to exercise. The secondary purpose is to investigate the relationships between measures of exercise-induced analgesia with pain, physical activity levels, sleep quality and mood in people with Parkinson’s disease and the relationships between physical activity levels, sleep quality, mood and pain in people with Parkinson’s disease. We hypothesize that increased physical activity, better sleep and better mood will be associated with a better exercise-induced analgesia response and with less pain in people with Parkinson's disease.

The purpose of this study is to assess monitoring of anaesthetised and sedated patients in intensive care using devices that assess different parts of your brain activity which reflects your level of consciousness and sedation. Sedation management is based on a wide range of factors including variable assessments of amnesia and recall, comfort level, risk of self-injury, and nurses’ judgment. At present the standardised sedation scoring systems such as the Richmond Agitation Scoring Scale (RASS) and the Glasgow Coma Score (GCS) are used frequently by doctors and nurses to manage sedative medication to ensure patient comfort. Monitoring device such as the Bispectral Index (BIS), which measures electrical activity of the brain via small external pads attached to the forehead, is used in patients undergoing general anaesthesia fairly routinely. Comparison of these three different sedation monitoring techniques with the different combinations of standardly used anaesthetics and analgesics will hopefully determine more accurate ways of tracking patient’s sedation levels and improve management in both surgery and intensive care settings. Furthermore, as light sedation is highly desirable in intensive care patients, this study will test the feasibility of using OMT in achieving light sedation more effectively than with clinical scales.

To assess the long term quality of the tendon, it’s isometric strength and the clinical outcomes of a piriformis sparing approach to total hip arthroplasty as compared to a standard posterior approach. A randomised, controlled cohort of 100 patients previously followed to the 5 year period will be assessed at 10 year follow-up with clinical scores.

Major joint replacement surgery has an important role in improving the quality of life for many people. As Australia’s population grows and ages, joint replacement surgery will be performed more often. In 2014, over 11,000 hip joint replacements were performed in Victoria alone. Improved postoperative and longer-term mobility and comfort provides benefits not just for an individual, but also for the whole community. The anaesthetist’s role as a perioperative physician means that one clinical responsibility is to provide patients with rapid recovery to an appropriate level of function. This can be achieved by providing effective analgesia, which can be administered well, with few side effects. In practice, there is sometimes a trade-off in the balance between these goals. The widely used technique of infiltrating local anaesthetic into the hip joint during surgery is simple, with seemingly few side-effects. It is usually used together with analgesics such as paracetamol, anti-inflammatories and morphine tablets. However, recent studies have questioned its effectiveness at reducing pain in the traditional surgical approach to hip replacement. To date, no study has examined its effectiveness in the setting of less invasive surgery (anterior hip replacement). We aim to determine whether adding intraoperative local anaesthetic infiltration to standard multimodal oral analgesia will improve recovery after anterior hip replacement. 160 participants will be randomly allocated to receive infiltration of local anaesthetic or saline placebo during surgery. Any improvement in general wellbeing and mobility, or reduction in postoperative pain, will have a positive impact on a large surgical population. A negative result will provide evidence that the local anaesthetic infiltration technique should no longer be used for pain relief after anterior hip replacement surgery.

Acute respiratory infections in children are one of the most common reasons for consulting in primary care. An antibiotic is prescribed in the majority of cases, despite high quality evidence that antibiotics provide marginal benefit for many common acute respiratory infections, which may be outweighed by exposure to common harms (such as diarrhoea, vomiting and rash) and development of antibiotic resistance - now a global public health crisis. Shared decision making - which aims to elicit patients’ expectations, clarify misperceptions, and discuss the best available evidence for treatment benefits and harms - may enable clinicians and parents to choose appropriate treatment or management options, including the decision to not use an antibiotic. Decision aids are a tool that have been shown to improve communication between patients and their doctor, and their active participation in decision making. Therefore, the aim of the current study is to develop and evaluate (pilot) decision aids about antibiotic use for common acute respiratory infections (middle ear infection, sore throat and acute cough).

The Australian Capital Territory It's Your Move is a community-based obesity prevention intervention for secondary school students, aiming to promote and support healthy nutrition and physical activity systems. It is expected that students experiencing healthier nutrition and physical activity systems will prevent an increase in the number of adolescents classified as overweight or obesity.

This study will determine the effect of respiratory muscle training on the inspiratory muscles after pleurodesis in cancer patients with malignant pleural effusion. It will assess whether this is a promising therapy to improve clinical outcomes in cancer patients with malignant pleural effusion. Who is it for? You may be eligible to join this study if you are aged 18 years or above, have had a diagnosis of malignant pleural effusion and have had pleurodesis with no significant fluid re-accumulation on clinical assessment 3 weeks after. Study details Participants in this study are randomly allocated (by chance) to one of two groups. Participants in one group will receive inspiratory muscle strength training twice daily for 6 weeks using a Powerbreathe Medic device. While participants in the other group will perform deep breaths to improve lung capacity using the same device. Participants will perform tests of the strength of the breathing muscles, lung capacity and the oxygen fuel economy of the breathing muscles. An ultrasound test will be performed to check the thickness of the main breathing muscle. Participants will answer questionnaires to compare the effectiveness of the two interventions. If the respiratory muscles can be trained, this may reduce the need for further invasive drainage procedures and/or improve dyspnea.

General practitioners enrolled in the trial will be randomised to either the "intervention" or the "control" group. The intervention group general practitioners will then be sent reports of their chlamydia screening and test positivity data, that compare their performance to the relevant guidelines and to their peers. The sub-project will then monitor and compare testing rates and patterns between the intervention and control groups over the next six months

We hypothesize that the underlying pathogenesis of Diabetic Macular Oedema (DMO) may be related to a combination of inflammatory and angiogenic cytokines. Although anti-VEGF agents are commonly used for the treatment of DMO, either as a primary measure or more usually in refractory cases, the response to treatment is unpredictable. We propose that measurement of known diabetes association cytokines may allow accurate prediction of response to anti-VEGF treatment and allow a more individualised treatment strategy for patients.