ANZCTR search results

This study aims to evaluate the effectiveness of fish oil for the prevention of skin cancer in lung transplant recipients. Who is it for? You may be eligible to join the study if you are over 18 years of age, and are a lung transplant recipient for at least 1 year. Study details Participants in this study are randomly allocated (by chance) to one of two groups. Participants in one group will take 4 x 1000mg oral capsule of omega-3 fish oil supplement daily for 12 months. Participants in the other group will take 4 x 1000mg of placebo (olive oil) daily for 12 months. Participants will not know which treatment they are taking until the end of the study. All participants will be asked to complete questionnaires, blood tests and skin exams at baseline and at the end of the study at 12 months.

Severe burn injuries are associated with considerable psychological trauma and burns patients are at increased risk of developing Post Traumatic Stress Disorder (PTSD), depression and other mental health disorders. EMDR is an effective evidence-based treatment for psychological trauma, it has been well researched, however there have been very few studies on early EMDR intervention as a means of preventing PTSD. To date there is no research on EMDR and burns related trauma in a primary care setting. Hypothesis and Aims Effective early intervention may enhance patients’ outcome, resilience and coping. The aim of this research is to establish that early EMDR intervention is safe and effective in this acute and medically complex setting. It is hypothesised that early EMDR intervention integrates traumatic memories thus preventing the development of chronic pathology. This research then aims to explore the effects and efficacy of early EMDR interventions on burn patients’ mental health outcomes with a primary focus on posttraumatic symptoms and secondarily tracking mood and coping, which are often poorly addressed during rehabilitation. The opportunity to promptly intervene with simple and effective psychological treatment to avoid sequelae in those who were previously well warrants investigation and sits with clinical observation that even good psychological “first aid” with counselling and Consultation-Liaison Psychiatry support appears to be insufficient to support best recovery. The hypothesis that early EMDR intervention/treatment has a positive effect on burns patients’ mental health outcomes, in terms of reduction in PTSD and depression will be tested. This study aims to improve psychosocial care of burns patients. Knowledge gained from the proposed research can be utilized to inform and further develop more effective early trauma interventions. Early EMDR interventions may facilitate improved psychosocial recovery of burns patients and this study is aims to establish basic proof of concept that early EMDR intervention is safe, useful and valuable in this acute and medically complex setting. Research Plan Protocol Stages: Stage 1- Screening for posttraumatic symptoms. All patients admitted to the SBIU, RNSH will be screened within the first two-four weeks following injury (or the first 2 weeks following discharge from Intensive Care using the Impact of Event Scale –Revised (IES-R). Patients whose baseline scores on this scale indicate moderate-to-severe posttraumatic stress symptoms will be considered for recruitment (IES score =26).The remainder of the questionnaires are used to track depression, anxiety and coping style, pain and alcohol use. Information re burn depth, size and location will also be obtained (collected routinely in all burns patients).These measures will be repeated at Burns outpatient follow-up visits at 3 monthly intervals over the first year and then annually for five years. Stage 2_- Clinical assessment to identify exclusions and pre-treatment variables. The subgroup of patients with elevated IES scores from the screening study will be evaluated further via a full psychiatric assessment by the Consultation-Liaison Psychiatry team to determine clinical exclusions and Ms Kwiet will also perform a fuller psychosocial research assessment, including evaluation of dissociative symptoms via interview and the Dissociative Experiences Scale (DES). Past trauma history as well as other risk and resilience factors, such as past psychiatric illnesses, family history, medications, premorbid personality and functioning and levels of social support will also be assessed. This will be obtained via a semi-structured interview incorporating these clinical domains, the Adult Attachment Interview (Burns Modified with Social Support probes) and the CAPS (the gold standard interview measure of PTSD). Patients identified as having unresolved chronic complex trauma (including prior PTSD) and high levels of dissociation will not be considered for inclusion in the RCT, as they are likely to require a prolonged period of stabilization and treatment within a longer term therapeutic relationship. Other potentially relevant biopsychosocial variables were obtained by the screening study to which will be added the (PCL-C), and current medications and pain relief. Stage 3: Randomized treatment Patients with (uncomplicated) moderate to severe posttraumatic stress symptoms will be recruited and randomly allocated into two groups. One group will receive three hours of EMDR as per the Acute – Traumatic Incident Procedure (A-TIP) and the other group will receive three hours of supportive psychotherapy, which will include basic psychological stabilization and stress management, considered as psychological “first aid”, provided within a supportive psychotherapeutic relationship. At commencement and completion of each session of treatment the IES will be repeated to track any change in the interval between screening and treatment and any interval changes between sessions. Stage 4: Residual symptoms and crossover to EMDR. Those patients in the control group whose IES scores remain elevated at the end of 3 sessions will be offered the EMDR treatment after 3 months out of ethical concern. Stage 5: Outcome and Follow-up assessments The IES (24) will be administered to all patients following each treatment intervention and at 3 months follow-up the Clinician-Administered PTSD Scale (CAPS) the gold standard for PTSD symptoms will be administered to all participants from both groups. At the 12-18 month follow up Ms Kwiet will perform another Burns Modified Adult Attachment Interview to all participants from both groups. The COPE , DASS and DES will also be re-administered to each patient at each follow up. Outcomes of both groups will then be compared to evaluate the effectivness of EMDR in improving burns patients mental health outcomes (specifically reduced reate of PTSD, depression, anxiety and greater quality of life)

This project aims to evaluate the effectiveness of different commercially available moisturizer in managing xerosis, a common skin condition in general population. These moisturizes will include different concentrations of urea and will be tested in the general population. Through the use of validated measurement tools, which include the Xerosis Assessment Scale (XAS) and Specific Symptom Sum Score (SRRC) we will be able to measure the efficacy of each moisturizer. Other areas of further interest and secondary outcomes to the project include evaluating the associated side effects, cost, ease of use and the overall patient satisfaction with each moisturizer.

Eating Disorders are a very serious illness with severe and psychiatric and health consequences. Current treatment outcomes are less than optimal, with room for improvement. Research is required to find out ways in which these outcomes can be improved. Research has shown that the provision of patient progress feedback to clinicians can enhance therapy outcomes, although the body of literature into the provision of feedback within an eating disorder treatment setting is minimal. This study seeks to implement a symptom based clinical feedback tool into the course of eating disorder therapy, and compare it to an already established, more general, therapy process-based feedback tool.

Intravenous fluid therapy may influence outcomes in critically ill patients. Some of these outcomes have been linked to the contents of intravenous fluids, including colloid source and electrolyte compositions. The chloride content of intravenous fluids has recently emerged as an area of interest in terms of renal injury. For example, a double-blind randomized controlled trial in healthy volunteers showed significantly better renal cortical tissue perfusion following a 2L infusion of a low-chloride fluid (Plasma-Lyte-Registered Trade Mark) compared with a high-chloride fluid (0.9% saline) (Chowdhury et al 2012). Similar effects were seen with the administration of hydroxyethyl starch (HES) in a low chloride solution compared to HES in saline (Chowdhury et al 2014). These studies suggest that excess chloride administration may modulate renal perfusion in man. However, the clinical implications of reducing chloride administration remain poorly understood. We previously reported the findings of a before-and-after study of restrictive vs. liberal intravenous chloride administration in a tertiary intensive care unit (ICU). Although our study found a beneficial renal effect of restricting chloride administration, it was suggested that a Hawthorne effect induced by preparation and education for the before-and-after study may have accounted for the findings . Accordingly, to mitigate the impact of such a putative Hawthorne effect, we extended the control and the intervention periods of our study from 6 months to 1 year to include a longer control period and an intervention period when the most common prescribers (ICU residents and fellows) had not received any specific training and simply rotated through the ICU when only low chloride fluids were available. We hypothesize that extending the study period will not affect our earlier finding of decreased incidence of acute kidney injury with chloride-restrictive intravenous fluid strategy compared with chloride-liberal strategy.

This study will determine whether reducing the doses of anti-rejection drugs is effective in preventing squamous cell carcinoma of the skin in kidney transplant recipients. Who is it for? You may be eligible to join this study if you aged 18 years or above, are a kidney transplant recipient with a previous squamous cell carcinoma of the skin. Study details Participants in this study are randomly allocated (by chance) to one of two groups. Participants in one group will have monitored dose reduction in immunosuppression, whilst participants in the other group will remain on their current drug regimen. Participants will be follow-up for 60 months, in order to determine how many new squamous cell carcinomas develop and whether they are aggressive. There are several test of the immune system to make sure the risk of acute or chronic rejection is very low but your kidney function will be followed for up to 60 months to make sure the dose reduction is safe over the long term.

Vitamin D is essential for human well-being. Skin conversion of 7-dehydrocholesterol to previtamin D3 by UVB radiation from sun exposure remain the most abundant source of vitamin D for most humans. Available evidence suggests that relatively high proportions of people in many different countries, including in Australia and New Zealand, have low vitamin D status. However exposure to the sun causes skin cancer and it is therefore critical to develop a better understanding about possible balance between the risks and benefits of sun exposure. In particular, it is important to know how much sun exposure is needed to optimize vitamin D in different groups of people. The aim of the study is to measure the magnitude of effect of natural sun exposure three days a week for three weeks on the vitamin D level of fair-skinned indoor workers. This study will be a two-arm randomized controlled trial. Fair-skinned indoor workers aged 18 to 60 years will be randomized into two groups – control and intervention. Participants in the intervention group will be exposed to natural sunlight three days a week for three weeks while those in the control group will go about their business as usual. Blood samples will be collected from the participants pre- and post-intervention to study their levels of vitamin D. A follow up blood sample will be collected from all participants four weeks after the intervention to determine any wash-out effect. The participants’ incidental sun exposure will be monitored through UV monitors. Questionnaires will be administered to gather demographic, sun exposure and sun protection behavior as well as outdoor activity in the weekends during the intervention period. It is anticipated that this study will offer us a better understanding about the extent of effect sunlight has on vitamin D levels of people with fair skin.

The study will compare a non contact infrared thermometer (temple) with a conventional thermometer used on the neonatal unit and evaluate levels of agreement. The use of the non-contact thermometer will ensure minimal disturbance to infants. All Infants admitted to the special care nursery will be able to participate in the study. Temperature recordings will be recoded at each care time. Each infant will be enrolled for the period of time it takes to obtain temple and axilla temperature. We hyponthesize that the non-contact thermometer will be in agreement with the reference thermometer therefore enabling its use in this population.

This intervention seeks to measure the efficacy of Mental Health First Aid (MHFA) training with first year nursing students. Participants will be recruited and randomly assigned to the control or intervention group. The intervention group will receive MHFA training. It is hypothesised that the MHFA training will increase the mental health literacy of the nursing students within the intervention group. The control group will be waitlisted and be eligible to complete the MHFA training post trial.

Patients recovering from surgical procedures generally require pharmacotherapy to assist in post-operative pain management. Corticosteroids are anti-inflammatory agents often administered in their injectable form by podiatric surgeons during pre-operative analgesia in order to assist in reducing post-operative inflammation and pain associated with foot surgery. Despite their wide anecdotal application in podiatric practice, there are few studies supporting the use of injectable corticosteroids for this purpose, and no guidelines presently exist in regards to appropriate drug or dosage selection. A prospective, single-blind randomized controlled-trial will be conducted to demonstrate and compare the efficacy of short-acting dexamethasone sodium phosphate versus intermediate-acting triamcinolone acetonide in participants undergoing a surgical procedure to correct hallux valgus, facilitated through The University of Western Australia Podiatric Surgery Clinic. This study aims to investigate and compare the efficacy of the two different corticosteroids in post-operative pain management, assessed over a 14-day period through 4 end points: Brief Pain Inventory short form, time to post-operative analgesic medication, post-operative analgesic consumption and proportion of participants within each group that received post-operative analgesic medication. We hypothesized that injectable triamcinolone acetonide is more effective in reducing post-operative pain than dexamethasone sodium phosphate, following hallux valgus surgery.