ANZCTR search results

This project will explore the feasibility and treatment effectiveness of nicotine replacement therapy and motivational interventions for smokers who have a history of homelessness. It will evaluate the impact of treatment location on participation, retention and smoking cessation rates. The trial design involves a treatment period of 12 weeks, with a further 9 months follow-up. Trial patient will be broken into two groups: (1) Thirty (30) trial participants who smoke and live in a housing facility for homeless people will receive motivationally-based counselling interventions and will commence on 21mg x 24 hour transdermal nicotine patch plus one of the forms of oral nicotine replacement therapy of the participant's choice. The dose of nicotine patch will be titrated up to a maximum of 42mg in response to withdrawal and relapse. Treatment will be delivered within the residential facility. (2) Thirty (30) trial participants attending a hospital-based opioid treatment program at Royal Prince Alfred Hospital, who smoke and have a history of homelessness, will receive motivational counselling interventions to help them to stop smoking. Treatment will be delivered within this outpatient facility.

The ductus arteriosus DA is a blood vessel that connecting the two major vessels exiting the heart. It is a normal structure that is present in every baby before birth and closes very soon after birth in healthy term babies. In babies born prematurely before 32 weeks gestation, the DA can continue to remain open (or patent –PDA). The continual presence of the PDA in preterm infants may cause ongoing breathing difficulties, feeding problems or blood pressure issues. The doctors looking after your baby will generally want to give medication to close the PDA. The standard treatment is to use a medication called ibuprofen given as an intravenous injection. Recently, doctors is Australia have become aware of reports from other centres overseas that suggest paracetamol (a common medication for fever and pain) may be as effective as intravenous ibuprofen to help close the PDA. However, these reports currently do not provide sufficient scientific proof yet to guide doctors here to use to paracetamol routinely to treat PDAs. Therefore we propose to conduct a research study to compare whether oral paracetamol is as effective as intravenous ibuprofen in treating PDAs.

The purpose of this study is to collect information on the ability of the Vivosight OCT system to distinguish basal cell carcinomas that require surgical treatment from those that would respond to non- invasive therapy based on lesion depth. In the future this might allow the clinician to select the appropriate treatment course without requiring a biopsy to determine how deep the lesion is, preventing possible recurrence in the cases where the lesion is deeper than anticipated. Who is it for? All patients with pink patches suspicious for superficial BCC will be recruited into the study at their first visit. Study details During the patient’s first visit, a clinical photograph, and dermoscopy photograph of the lesions will be taken. The OCT scan will also be taken, which is a non-invasive, optical imaging technique, lasting less than 1 minute. A skin biopsy will then be taken to confirm the diagnosis. With the results from the skin biopsy, patients will be advised on treatment option. If patient has a superficial BCC, the treatment will be topical and these patients will be followed up in 6 months. If patients do not have superficial BCC, they will be advised on appropriate treatment option, but will not be required to have 6 months follow up. At 6 months, all superficial BCC cases will be followed up with clinical photograph, dermoscopy photograph of the treated lesion. The OCT scan and skin biopsy will be taken again to determine the clearance of the treated BCC. Based on the skin biopsy results, further treatment advice will be given. This will not be part of the protocol and is based on best clinical practice.

Comparing two treatment approaches, Imagery Rescripting (ImRs) and Eye Movement Desensitisation and Reprocessing (EMDR), for adults with PTSD related to childhood based trauma. ImRs is where the individual imagines a different ending to the trauma memory, so that the person can change the meaning of the event. EMDR uses a sequence of eye movements to help an individual to reprocess thoughts and feelings associated with trauma experiences. This purpose of this research is to compare the effectiveness of these two approaches and to test if the element of the treatments that facilitate change is the same for both approaches.

The aim of the trial is to conduct the first study of the impact of Phenytoin administration (4mg) on key mechanisms involved in social communication in youth aged 16 years and older with Autism Spectrum Disorders. We hypothesize that Phenytoin will, in comparison to an identical and matched placebo: increase gaze duration and fixations to key face regions, improve accuracy and the speed of identification of facial emotion recognition, increase heart rate variability, and improve accuracy of response to social cues.

The Research Team recently conducted a randomised controlled trial demonstrating that a capacity building intervention (‘Good Sports’) was effective in increasing compliance of licensed community football clubs with liquor licensing laws, and reducing excessive alcohol consumption by club members. If the benefits of such interventions are to be ongoing, the changes adopted by sporting clubs need to be sustained over time. Research that describes the sustainability of health promoting policies and practices in community settings generally, and in sports clubs specifically, is limited. The proposed research will be the first randomised trial investigating the effectiveness of web-based intervention in sustaining best-practice alcohol management practices by community sport clubs.

Living with a child who has Autistic Spectrum Disorder (ASD) is challenging for all families. Despite growing evidence on the effectiveness of educational and behavioural treatment strategies in addressing the core features of ASD, access to and availability of therapy services in rural communities is sparse. The overall aim of this research project is to test the effectiveness of the Therapy Outcomes By You (TOBY) playpad application as an early intervention complementary therapy, for 2-6 year olds living in rural WA, who have received an ASD diagnosis within the past 12 months The outcomes of the research will provide evidence on the effectiveness of the TOBY playpad application as a complement to existing therapy for recently diagnosed 2-6 year old children with ASD, living in rural communities.

Background: Fluid bolus therapy (FBT) is common in critically ill patients. With the exception of traumatic brain injury, FBT with human albumin solution appears safe and perhaps superior in severe sepsis/septic shock patients. However, 4% and 20% albumin solutions have different chloride contents and deliver different volumes. Objective: To compare the physiological and biochemical effects of FBT with 4% vs. 20% human albumin solution. Design: Retrospective observational study Setting: Tertiary intensive care unit Subjects: Critically ill patients receiving FBT with either 4% or 20% human albumin solution according to clinician preference Measurements and Main Results: We recorded demographic and clinical data for 202 patients (101 patients in each group). We obtained biochemical and hemodynamic data at baseline and at 1, 2 and 4 hours after the administration of either 4% or 20% human albumin solution. We compared the effect of FBT with the two solutions. Patients receiving 20% albumin had a higher incidence of pre-existing liver disease (P=0.003), were more likely to be on renal replacement therapy (P=0.005) and had higher APACHE III scores and predicted risk of death on admission (P=0.007 and <0.0001 respectively). Patients in the 4% group received a median volume of 500mls of albumin compared to 100mls in the 20% group (P<0.0001). There was a trend in higher mean arterial pressure values in the 20% group at 2 and 4 hours following the fluid bolus (P=0.056). There were no significant differences in absolute or percentage change of any haemodynamic parameters over the four hours following fluid bolus. Patients receiving 4% albumin demonstrated higher serum chloride levels and more negative bass excess (P =0.027 and 0.017, respectively). The difference in base excess was greater following post-hoc adjustment for risk of death (P=0.003/ 0.004) . Conclusions: FBT with 100 ml of 20% human albumin solution is hemodynamically equivalent to FBT with 500 ml of 4% human albumin solution but has a lesser effect on chloride levels and delivers 80% less fluid.

The aims of our study are to: 1. Determine the frequency of NTHi infection (defined by >10E4 cfu/ml BAL) in the lower airways of children who have received PHiD-CV; 2. Determine the frequency of NTHi carriage in the upper airways of children who have received PHiD-CV; and 3. Evaluate the influence of PHiD-CV on the systemic adaptive immunity to NTHi in`children with chronic suppurative lung disease.

This study aims to establish the validity and precision of continuous glucose monitors (CGM's) for determining glycemia in response to diet and exercise. CGM's are a new, minimally invasive technology that provide greater insight into the direction, magnitude and frequency of daily glucose fluctuations. Postprandial glycemia is a significant determinant of glycemic control in individuals with impaired glucose tolerance. Given the prevalence of diabetes, it is important to identify effective lifestyle interventions to treat and manage pre-diabetes, and quantify the capacity to monitor daily variations in glucose control. We hypothesise that CGM precision will be reduced during high glucose excursions and strenuous exercise, and that high intensity exercise will be superior for promoting the return of glycemia to basal levels.