ANZCTR search results

Falls and movement disorders are both common and disabling in people with idiopathic Parkinson's disease (PD), which affects more than 80,000 Australians. Whereas one-third of community dwelling elders fall every year, the incidence in people with PD is as high as 50-68%. Many people with PD experience repeated falls and over 25% sustain a hip fracture (as the result of falling) within 10 years of diagnosis. Along with balance impairment, movements progressively become slower and scaled down in size. Anti-PD medications initially provide effective symptomatic relief although movement disorders and postural instability again become problematic with disease progression. Preliminary trials have shown that hospital based movement rehabilitation programs are an effective adjunct to pharamacological therapy in the short term. Nevertheless hospital inpatient and outpatient programs are costly and can be inconvenient for some people who do not have transport. This randomised controlled trial will compare the outcomes of home based “integrated rehabilitation” with a control intervention in a sample of 180 people with PD. Participants in the treatment group will receive a 6 week home-based rehabilitation program comprising movement strategy training, progressive strengthening and education regarding falls and mobility, delivered by an experienced physiotherapist. The control group will receive a “life-skills” home program delivered by an allied health professional (physiotherapist, PD nurse or occupational therapist). The life-skills program will provide participants with education on relevant topics including PD pathology, medications and relaxation techniques, without falls education, strategies or exercises. Participants will undertake all assessments and interventions associated with this trial within their own home.

This is a cluster randomized controlled trial, aiming to investigate both the feasibility of using this model and the impact of CVAR assessment and management on general practice clinical processes and patient care. This trial will be conducted in general practices in Sydney, involving GPs, other practice staff and patients aged 45-69 without existing CVD. 32 practices (40 GPs) and 1600 patients will be recruited. Randomization will be conducted at the practice level. The intervention group of GPs will be trained to use a CVAR implementation model while the control group of GPs will continue usual care. Study variables include clinical processes, patient risk, use of lifestyle intervention and prescribing of antihypertensive and lipid lowering medications. Data will be collected and analyzed using mixed methods. Study variables before and after the intervention will be compared, and the two groups be also compared after adjusting for baseline difference and clustering factors. Results of this study will help improve the primary prevention of CVD and inform guidelines for clinical practice and the implementation of other health initiatives.

The aim of this study is to assess the clinical applications of the proven diagnostic abilities of Computer Tomography Coronary Angiography (CTCA). Specifically, in patient groups with an intermediate probability of coronary artery disease is there a difference between computer tomography coronary angiography and myocardial perfusion imaging in ruling out significant coronary artery disease.

This study compares levels of skin self-examination behaviour for the early detection of melanoma in men 50 years or older who receive a video-delivered intervention compared to those who receive standard brochures only. You can join this study if you are male, aged 50 years and older and live in Queensland, Australia. Participants will be randomly divided into two groups. Participants in one group (the intervention group) will receive one video, which runs for approximately 12 minutes, recommending that participants conduct a whole-body skin self-examination (SSE) at least once a month. They will also receive a body pictogram that they can use to mark lesions while they are conducting a SSE. All participants will receive standard written educational materials from the Cancer Council Queensland entitled Take the time to spot the difference. This brochure displays photographs of benign and malignant lesions and explains the particulars. It recommends sun protection, and regular skin self-examination without giving details of how to do so. The number of whole-body skin self-examinations (SSE) in both groups will be assessed by independent telephone survey staff blind to the participants’ group assignment. This trial aims to measure the impact and cost-effectiveness of a video-delivered intervention.

The aim of the project is to determine the effect on Tai Chi training on exercise capacity in people with COPD. Hypothesis: On completion of an 12 week training program, subjects with COPD will demonstrate significant improvement in exercise capacity, compare with the control group with no Tai Chit raining. Significance: If Tai Chi improves exercise capacity in people with COPD this would provide an alternate form of exercise training which does not require exercise equipment thus making effective exercise training more accessible for the large numbers of people with COPD.

Although oesophageal cancer can be surgically removed, the cancer often comes back. A combination of chemotherapy and radiation before surgery might help, but standard treatment hasn’t been defined and new therapies are needed urgently. This study will test a novel combination of chemotherapy and radiation, with and without a new type of antibody treatment. Effectiveness will be assessed by the amount of tumour left at the time of surgery, the length of time before the tumour begins to grow again, and length of life.

Approximately 100 hip fracture cases are expected to be recruited over a 12 month period who are vitamin D insufficient, reside in the Perth metropolitan area, consent to inclusion in the trial and don’t fulfill any exclusion citeria. Vitamin D insufficiency will be defined as a 25 OHD < 50 nmol/L and initially measured using our current assay (Diasorin 25OHD radioimmunoassay). In a randomised fashion all vitamin D insufficient patients will be offered standard therapy with Ostelin 1000 I.U./day (ergocalciferol) or Vigantoletten 1000 I.U./day (Cholecalciferol obtained from Merck, Germany) in addition to matching placebo to prevent unblinding of study design. Those patients consenting to trial entry will have serum collected for intact PTH, whole PTH, ionised calcium, vitamin D binding protein and 1,25 dihydroxyvitamin D at baseline and following three months therapy.

The research aims to test the leading theory of chronic pain, and to develop and test interventions aimed to reduce chronic pain. We will measure attentional biases to pain-related stimuli, such as hypervigilance (selectively paying more attention) and difficulty disengaging, in a group of adults with acute low back pain. We will then compare the effect of an active and placebo attention retraining task on these attentional biases, and the subsequent effects on the development of chronic low back pain and associated disability and distress.

This study will determine the most effective way to administer bee venom desensitisation therapy for people with serious life threatening bee venom allergy

To compare the safety and efficacy of traditional surgical repair (anterior colporrhaphy) with mesh based prosthetic devices (transobturator mesh) in the clinical management of bladder prolapse.