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19 clinicians within an AOD service on the Central Coast of New South Wales, Australia, will be recruited to the trial. Consenting clinicians will participate in a baseline focus group discussion designed to explore their experiences and perceived barriers to adopting innovation in their clinical practice. Computer comfort and openness to innovation will also be assessed. Throughout the trial, current, new and wait-list clients will be referred to the research program via the clinical service, which will involve clients completing a baseline and 15-week follow-up clinical assessment with independent research assistants, comprising a range of mental health and AOD measures. Clinicians will also complete session checklists following each clinical session with a client, outlining the extent to which the SHADE computer program was used. Therapeutic alliance will be measured at intake and discharge from both the clinician and client perspectives. This study will provide comprehensive data on the factors associated with the adoption of an innovative, computer-delivered evidence-based treatment program, SHADE, by clinicians working in an AOD service. The results will contribute to the development of a model of dissemination of SHADE, which could be applied to a range of technological innovations.

There is abundant observational evidence that midazolam, a benzodiazepine drug used for sedation, use is associated with delirium in ICU patients. However, despite the availability of an equally effective alternative, benzodiazepines usage remains high. The most likely explanation for is that clinicians are not sufficiently convinced by the quality of the observational studies. This is a reasonable criticism, as it is unlikely that it was possible to adjust for all sources of indication bias in these studies. We hypothesise that introducing a clinical guideline for intubated patients in the Austin Hospital ICU that restricts midazolam use to patients with one of a select list of indications will a. reduce the use of midazolam and b. reduce the incidence of surrogate markers of delirium in ICU patients, without c. significantly increasing cost of sedative medications in the ICU.

Infection after c/section is a concern for women and health workers. Prophylactic antibiotics are used to prevent infection but some will still develop the complication. betadine is routinely used for skin preparation prior to c/section. It is believed that its use again immediately prior to skin closure may further reduce the infection rate. This is an open randomsied controlled trial. Hospital infection control dept routinely make contact with all c/section women. This source will be used to gather information on women who develop any problem with ht ewound. They routinely provide consent to be contacted for this purpose and therefore no additional consent will be required .

This pilot study will investigate quality of life issues related to having brain cancer, other cancers which spread to the brain or advanced cancer of other types; where the person is required to take regular dexamethasone (a corticosteroid) for disease management and/or chemotherapy. The study will enable us to follow how patients are doing during their treatment for cancer by looking at the severity and frequency of side effects that occur with dexamethasone, in particular by using a new instrument which assist patients and their caregivers to tell us about the possible side effects they might be experiencing in relation to dexamethasone treatment and their severity. The study will also look at factors that might help us decide how to improve the management of dexamethasone use.

This project is a randomised controlled trial of an established online bulletin board for depression. It has been estimated that millions of people worldwide use peer-to-peer bulletin boards, forums or internet support groups (ISGs) for health conditions. However, little is known about the effectiveness of these groups in terms of symptom reduction or improvement in quality of life. To our knowledge, this is the first randomised controlled trial of the effectiveness of a pre-existing, well-established online bulletin board for depression in the community. The aims of the project are to determine whether BlueBoard, an established online bulletin board for depression, improves mental health, quality of life, and related outcomes among members of the community with high levels of self-reported psychological distress and previous history or current experience of depression.

Around 30-50% of adults will experience neck pain over a 12 month period, and many are treated with manual therapy. Although evidence supports manual therapy treatment when combined with exercise, the dose is not defined. Up until now, there were few methods for objectively quantifying a manual technique to establish its optimal dose. This pilot randomised controlled trial will investigate two specific doses of posterior-to-anterior (PA) mobilisation, the most common manual technique therapists use when treating the cervical spine. Sixty patients will be randomised to receive either a high force or low force PA mobilisation, or sham treatment, with patients’ pressure pain threshold, resting pain, cervical range and stiffness measured before, immediately after and 3-5 days post-treatment. We will utilise innovative equipment we developed to standardise the manually applied forces, conducting the trial using demonstrable methods from our previous research. Determining dose-response relationships for manual therapy is essential for establishing optimal treatment strategies for patients with neck pain. The cost of neck pain is increasing, and many patients do not achieve symptom resolution. Therefore there is an urgent need for physiotherapists to provide effective treatment dosages with demonstrated patient outcomes, impacting spinal pain and advancing physiotherapy as the preferred treatment choice.

The purpose of this study is to assess the safety and tolerability of BMS-919373 in healthy subjects.

Otitis externa is a common ear condition. Also known as a ‘swimmer’s ear’, it often causes painful swelling of the external ear canal and may lead to sensation of blockage as well as hearing loss. It is primarily an inflammatory disease with infective component which can be bacterial or fungal in nature. Risk factors include compulsive scratching of the ear, swimming, hearing aid use and use of cotton buds. Otitis externa is typically treated with antibiotic/steroid ear drops but it is common for patients to experience symptoms of otitis externa such as pain for many days. Given that otitis externa is primarily inflammatory in nature, we propose that if patients are given a 3 day course of oral steroid tablets (anti-inflammtory drugs commonly used in many medical conditions) in addition to ear drops, it may speed up the recovery and reduce the total number of days during which patients would experience symptoms especially pain. This study would be a double-blinded and randomised-control trial in nature, meaning that both treating doctors and participating patients will not know which treatment has been given (i.e. treatment drug vs. placebo), thereby increasing the validity of the trial outcome.

Otitis externa causes swelling of the ear canal which makes visualisation of ear drum very difficult or often impossible. Primary care physicians regularly use ear drop known as Ciloxan or Ciproxin HC to treat otitis externa when ear drums are not visualised as these drops are indicated in the presence of actual or suspected ear drum perfortion. More broad spectrum, cheaper alternatives such as Sofradex, Otodex, Kenacomb/Otocomb Otic drops are not regularly used for the fear of introducing these to the middle ear space where these drugs can potentially be ototoxic. We, however, believe that by placing an otowick (self-expanding sponge) in the ear canal and then using these drops, they can be safely delivered to the external ear without risking the potential entry of these drops into the middle ear in presence of a perforated ear drum. By staining these drops with fluorescein, we will know if standard instillation (3 drops 3 times a day) of these drops will be limiting the drug presence within the external ear canal only when an otowick is placed in the ear canal by looking at whether staining of the ear drum occurs. If ear drums are stainined then we can assume that drugs can reach middle ear if ear drum is perforated even if there is a otowick in place.