ANZCTR search results

Trabeculectomy surgery for Glaucoma establishes a connection between the inside of the eye and the subconjunctival space which lies just below the surface of the eye. Flow of fluid through this connection forms a subconjunctival blister known as a bleb. Aqueous humor (fluid inside the front of the eye )is absorbed from the bleb into the blood stream. A significant casue of failure of trabeculectomy is scarring of the bleb. If the bleb develops an excessive amount of scar tissue then fluid is prevented from exiting and the eye pressure is increased. Cataract surgery has been shown in research trials to increase the risk of trabeculectomy failure. Control of postoperative scar formation after cataract surgery is a significant challenge in the surgical management of glaucoma in patients who have had previous Trabeculectomy surgery. Current practice is to use topical steroids and antiscarring agents such as 5-fluorouracil (5-FU). Although the use of 5-FU is widespread, scar tissue remains a problem in many patients and treatment is associated with side effects including wound leaks and disruption of the ocular surface. Active scarring is associated with inflammation. Triamcinolone is a synthetic corticosteroid that inhibits the inflammatory process and may therefore reduce scar formation. Injection of triamcinolone into the vitreous jelly of the eye has been widely used as a treatment for various diabetic and inflammatory conditions which are unresponsive to topical corticosteroids. It has been used as a mono-therapy and co-therapy for various back of eye conditions, and is also indicated for visualisation during vitrectomy.

Alcohol abuse continues to be a major contributor to injury related hospitalisations in Australia. The objective of the present study was to investigate the effectiveness of brief intervention in reducing harmful alcohol use in a group of patients admitted under the trauma service at a tertiary hospital. We conducted a randomised control trial of trauma patients who were screened with the AUDIT tool (Alcohol Use Disorders Identification Test) and deemed to be at risk drinkers. Groups were assigned to brief intervention or standard care. We compared AUDIT scores between groups and before and after intervention controlling for factors such as age, gender, injury severity and mechanism of injury.

The study will look at whether brief cognitive therapy is effective in helping individuals deal with food cravings.

This cluster randomised controlled trial (RCT) aims to provide evidence of the efficacy and sustainability of the 6-PACK program for preventing fall-related injuries in acute hospitals. Twenty-four acute medical and surgical wards from six to eight hospitals throughout Australia will be recruited. Wards will be matched by type and baseline fall-related injury rates then randomly allocated to either the 6-PACK intervention (12 wards) or the usual care control group (12 wards).The 6-PACK program includes completion of a nine-item falls risk assessment and six nursing interventions: ‘‘falls alert’’ sign above the patient’s bed; supervision of patients while in the bathroom; ensuring that the patient’s walking aid is within reach; establishment of a toileting regime; use of a low-low bed and use of bed/chair alarm. Intervention wards will receive 6-PACK equipment (falls alert signs, low-low beds and bed/chair alarms) and there will be a supported implementation (small group training and assignment of clinical leaders) and review strategy (audit, feedback and reminders). A cost effectiveness study of the 6-PACK program will also be conducted. The effectiveness of the 6-PACK implementation will also be examined using a structured mixed methods evaluation. Sustainability will be assessed in the year after the RCT when there will be a staged withdrawal of the research staff from the sites. The primary outcome measures are fall and fall-related injury rates in the 12 months after the 6-PACK is implemented. The cost-effectiveness outcome is “cost or saving per fall prevented” and “cost or saving per fall-related injury prevented” calculated from differences in mean costs and effects in the intervention and control groups to generate an incremental cost-effectiveness ratio. Outcome analyses will be undertaken on an intention to treat basis. Differences in fall and fall-related injury rates will be compared between groups using negative binomial regression where data are adjusted for clustering and pairing of wards. Primary analysis will be unadjusted. Secondary analyisis that adjusts for age and cognitive impairment will also be conducted. This study is planned to be the largest hospital falls prevention RCT to be undertaken and is the first to be powered to the important primary outcome of falls injuries.

The aim of this project is test the effects of an intervention we have designed that targets behavioural changes in relation to eating and physical activity as well as changes in psychological factors such as motivation, confidence, mood, and body image concerns, with the aim of maintaining healthy weight gain during pregnancy.

Pulmonary arterial hypertension (PAH) is a devastating condition with a poor prognosis. There are currently no widely available imaging modality to assess lung perfusion, which is decreased in PAH. Single photon emission computed tomography (SPECT) is a nuclear medicine technique which can assess three dimensional lung perfusion. We wish to evaluate the utility of SPECT in the assessment and early detection of PAH.

Doctors know that seizures occur more often in babies than older children. Seizures in babies may result in damage to their brain that may lead to epilepsy or affect their learning, thinking and memory. There is not a lot of research as to the best way to treat seizures in babies and to protect their brain function. The aim of this research project is to compare the treatment of seizures that are physically seen by doctors and nurses (standard clinical care) to when seizures are detected using an amplitude integrated electroencephalograph monitor (aEEG), to see which method is better at protecting brain function in the longer term. We hope a total of 630 babies will take part in this study. Half of the babies will receive standard treatment and half will be treated when a seizure is seen on the aEEG monitor. After the babies have been discharged from hospital we will follow them up at 2 years of age to assess their development. This research project is important because it may change the way doctors treat seizures in babies in the future, and we want to make sure that our treatment is protecting the babies brain.

Children’s sleep duration has been decreasing in recent decades, and the average Australian child is not getting enough sleep for optimal well-being, health and social function. This study will use a randomised controlled trial to test the effect of a comprehensive sleep intervention delivered in a school setting. It is hypothesised that the intervention will improve children’s attitudes and knowledge, mediating changes in sleep behaviour. In turn, this may affect alertness, quality of life, and use-of-time. This is the first sleep behaviour intervention delivered in a community setting. If successful, it could inform curriculum change, with the potential to address a wide range of cognitive, affective and physical outcomes.

A controlled clinical trial study design to study the efficacy, for smokers motivated to quit, of a cognitive and behavioural support program using mobile phones in addition to a traditional self-help quitting booklet to test the hypotheses that this intervention will increase short and long term smoking cessation.

The purpose of this project is to determine if a patient’s belief or views towards their medicines for heart attacks affects their decision on whether to take their medicines or not. This may help determine why some people choose not to take medications for their heart attack. Aim: To determine if patients’ belief towards medication for heart attacks is related to an optimised medication regimen as well as adherent behaviour, and whether this is influenced by review of their medication by a community pharmacist. Hypotheses: 1. Patients with good adherence will have different beliefs towards their medication than those with poor adherence 2. Patients receiving regular interviews with their community pharmacist are more likely to be on the appropriate medications for ACS at optimised doses and have better adherence than those who do not have this intervention. 3. Patients with beliefs in regards to their medicines that match good adherence are more likely to be taking evidence-based medicines for ACS at 12 months.