ANZCTR search results

Fever is an adaptive response to infections which occurs widely in the animal kingdom. The suppression of fever increases the risk of mortality in animals, although the effect of antipyretics in critically ill patients is unknown. The objective of this study is to determine whether paracetamol influences the risk of mortality in critically ill patients with fever and known or suspected infection. A phase 2b double blind randomised placebo controlled trial of paracetamol will be undertaken in 700 patients with fever and known or suspected infection in New Zealand and Australia under the auspices of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG). If either the aggressive or permissive antipyretic regimes influence outcomes including survival in patients with fever and infection, the findings will have a major impact on the burden of infectious disease in New Zealand and internationally. Pilot study registered at http://www.anzctr.org.au/ACTRN12611000981921.aspx

In this study we will evaluate the acceptability, feasibility, safety and initial clinical benefits of an online intervention (HORYZONS) designed to maintain the benefits of early intervention services for psychosis over the long term. We expect that HORYZONS will be well-received, safe and seen as a valuable treatment option by young people suffering from psychosis.

This study aims to build on the work by Wisoff 2007 published in circulation that showed superior benefits of high intensity interval training over moderate intensity continuous training in heart failure patients. It is hoped that with a larger sample size and longer follow up and intervention period the primary outcome, mortality will be significantly improved.

The aim of this study is to understand how the body adapts to a mild cold temperature and whether this differs in people who have evidence of the following metabolic abnormalities: a large waist circumference, high blood fats, low "good" cholesterol, high blood pressure and high blood glucose levels. We believe that those who have these abnormalities will not be able to adapt as well to a cold temperature than those without the adnormalities. This will be detected by us as a smaller rise in metabolic rate and the healthy blood protein adiponectin, both before and after a simple meal, like glucose.

Chronic obstructive pulmonary disease (COPD) is a respiratory condition characterised by dyspnoea, excessive sputum production, chronic cough, bronchitis and emphysema. Functionally, exercise tolerance is poor for people with COPD and is linked to difficulty in performing daily tasks. More specifically, exercise difficulties are due partly to dyspnoea and lower limb skeletal muscle dysfunction. The benefits of gentle exercise that does not exacerbate the disease while improving exercise tolerance is salient. Whole-body vibration is a mode of gentle exercise known to improve muscular function of the lower limbs, yet efficacy has not been investigated for a whole-body vibration intervention conducted in a community setting for people with COPD.

This study evaluates a new non-invasive technique for early diagnosis of melanoma. Who is it for? You may be eligible to join this study if you are at least 18 years old and have a pigmented lesion that is suspected of being a melanoma which requires surgical removal. Trial details: This research study proposes to use a novel non-invasive method called Epidermal Genetic Information Retrieval or EGIR to assess skin lesions that are suspicious for melanoma. The method of retrieval is via tape stripping. Tape stripping allows recovery of cells of the upper epidermis (superficial most skin layer). These skin cells will be studied to identify markers capable of distinguishing between melanoma and benign (harmless) pigmented lesions. Unlike standard biopsies, tape stripping is non-invasive, rapid, easy to perform and painless. Therefore, the identification of such markers by this method could help physicians determine the nature of suspicious lesions of the skin without having to perform a biopsy. Tape stripping has been tested previously and has shown promise in identifying markers for other skin disorders and is now being tested through this research study for melanoma. All participants in this study will undergo collection of skin samples via the tape stripping procedure. The tape (0.7inches in diameter), similar to a band-Aid will be applied to the skin lesion and rubbed in circular motions. 4 skin tapes will be placed on the same skin lesion. A normal looking skin area (an area that does not have a lesion) will be used as a comparator. After the skin taping procedure is completed, the skin lesion will be biopsied or removed as per the normal clinical practice. The tape strips will be couriered to the Sponsor DermTech International where they will be analysed. The Biopsy specimen will be sent to a nominated pathologist for this study and results will be sent back to the investigator. The tissue slides will be sent to an independent pathologist for a second review.

Why are we doing this study? * ACT Health and The Canberra Hospital are motivated to provide care that is both family and patient centred. Currently in the Centre for Newborn Care parents are not involved in clinical bedside rounds. This study will allow parents to attend these rounds for a specified period and gain feedback from the experience via surveys. * We aim to use the information gained from this study to introduce a new way of doing clinical beside rounds in our soon to be completed Womens’ and Childrens’ Hospital. What does the study involve? * After obtaining consent, the participant (parents or guardian) will be randomised to one of two arms: 1. PPBCR group (attending bedside clinical rounds with health care professionals) or 2. Non-PPCBR (non-attending bedside clinical rounds with health care professionals). * Each group depending on the baby’s gestation will rotate between attending and not attending rounds spending 3 (if the infant gestation is more than 30 weeks) or 7 (if the infant gestation is less than or equal 30 weeks) days in each group with a similar break in between. * The participant will be given regular updates on their baby condition during non-PPCBR and washout break * At conclusion of each arm, the participant will be asked to complete: 1. NICU parental stressor scale and 2. A satisfaction survey about being involved in clinical bedside rounds What do we hope to achieve with this study? Through your involvement in this study we aim to: * Improve communication between families and the clinical team within the Centre for Newborn Care. * Families being more aware of current clinical management and care plan for their babies, in turn reducing stressors they may experience.

The purpose of this study is to determine the degree to which Docosahexaenoic acid (DHA) supplementation reduces the incidence of bronchopulomonary dysplasia (BPD), as assessed by the requirement for supplemental oxygen and/or assisted ventilation at 36 weeks post menstrual age.

This study seeks to examine the effect of normobaric hypoxia exposure and exercise on changes in body mass and body composition. It is hypothesised that there will be no additional effect of exercising in normobaric hypoxia on the rate of change in body composition induced by regular exercise.

Knee osteoarthritis may reduce physical activity due to associated pain, depression, impaired gait and balance and lower-extremity muscle weakness. Abnormal joint loading (in particular increased knee adduction forces due to malalignment of the knee); obesity, muscle weakness, systemic and local inflammation, dietary intake of fat, antioxidants and other micronutrients alter the risk and progression of osteoarthritis. Elevated knee adduction forces are vitally important, as it has been shown to increase the risk of radiographic medial knee osteoarthritis progression by 6.5-fold, more than any other characteristic. Lifestyle programs have great potential to target these underlying factors, thus acting as disease-modifying interventions rather than simply providing pain relief. This distinguishes lifestyle therapy from pharmacologic/analgesic therapy for osteoarthritis, justifying its role as central to the treatment of osteoarthritis. A theoretically-grounded lifestyle modification program that better addresses the aetiology of disease onset and progression is needed if we are to actually alter the underlying pathophysiology of knee osteoarthritis. Postural control and gait training to reduce abnormal joint loading and progressive resistance training are far more specific for the impairments of knee osteoarthritis than aerobic exercise, for example, which may be intolerable in moderate-to-severe knee osteoarthritis. Similarly, a low glycaemic index/load weight loss diet has been shown to be more effective at reducing weight and lowering systemic inflammation/insulin resistance than standard energy and fat restriction. We hypothesise that participants with medial knee osteoarthritis randomised to either Gait Training or Progressive Resistance Training or High Protein/Low Glycaemic Index Group or all three interventions combined will have significant reductions in abnormal joint loading (KAM) compared to controls given standard lifestyle advice at 12 months.