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The Skin Centre Suite 5 AHC House 14 Carrara Street Benowa, Queensland 4217 Therapeutic Goods Administration CTN Number 2007/490

BACKGROUND: Upper limb dysfunction is one of the most important predictors of participation restriction in children with cerebral palsy. Modified constraint-induced therapy is an intervention designed to improve the function of the affected arm of children with hemiplegic cerebral palsy and maximise their participation in daily activities. This therapy involves constraining the unaffected hand with a mitt and providing concurrent and carefully targeted therapy during the period of constraint. It has been argued that the constraint of the unaffected side encourages the child to use the affected side, providing opportunity for the child to develop muscle control and strength and to reduce learned non-use. Modified constraint-induced therapy is already offered in Australian clinics even though it is an expensive and intensive intervention and there is little evidence of its effectiveness. This randomised controlled trial will evaluate the effects of modified constraint-induced therapy on children’s upper limb function and participation in daily activities. If the intervention is to be widely adopted it must first be shown to be substantially more effective than current best practices in paediatric service provision. HYPOTHESES: Children with spastic hemiplegic cerebral palsy participating in modified constraint-induced therapy will have better upper limb function and will be better able to complete important daily activities than a group receiving standard best practice occupational therapy. STUDY: Randomised controlled trial. Fifty children with spastic hemiplegic cerebral palsy, aged between 18 months and 8 years and meeting specified eligibility criteria will be recruited from The Children’s Hospital at Westmead, The Centre for Cerebral Palsy and The Spastic Centre of NSW. Consenting families will complete a baseline assessment and then be randomised to a modified constraint-induced therapy group or standard best practice occupational therapy group. Therapy (and constraint) will start 1 week later and continue for 8 weeks. Children will be reassessed at 8 weeks and 6 months. Intervention for the experimental group will consist of modified constraint-induced therapy. Constraint will be implemented by a custom-made mitt which prevents grasp and release with the unaffected hand. The mitt will be worn for a minimum of 2 hours per day, 7 days per week for 8 weeks. In addition, adjunct therapy (to improve motor ability of the affected upper limb) will be provided daily by carers whilst the constraint is in place and once per week by an occupational therapist. The adjunct therapy is a critical component of modified constraint-induced therapy. The control group will participate in standard best practice occupational therapy for 8 weeks. The provision of standard practice controls for frequency of provision of occupational therapy. More importantly, it allows us to establish if modified constraint-induced therapy is more effective than current best practice, which should be a pre-requisite for implementation of this therapy.

The Live, Eat and Play (LEAP2) study is trialing a family based behavioural intervention for use by General Practitioners (GPs), aimed at reducing overweight in Victorian primary school children.

The ambulance services are conducting a project to compare the pain killing qualities of two medications, ketamine and morphine in people with moderate to severe pain following a traumatic injury. We are hoping to determine which medication is best to use when the ambulance services attend a person with an injury and are in pain.

This study will compare Cognitive Behaviour Therapy (CBT) with Non-specific Supportive Clinical Management (NSCM), in a chronic anorexia nervosa (C-AN) sample. Subjects will include 90 females over the age of 18, meeting the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM IV) criteria for AN for more than seven years (even if there have been periods of recovery). Individuals will be randomly assigned to either CBT or NSCM and will receive 30 treatment sessions over 6 months. All patients will be monitored for six months after the end of treatment. Assessments will occur at the start of treatment, 15 weeks into treatment, end of treatment, and six months after treatment. Interpretation of Results This study aims to compare outcomes between individuals with chronic anorexia (C-AN) who receive CBT and those who receive NSCM. It is hypothesised that these treatments will influence an individual's quality of life, level of depression and social isolation. It is also thought that there will be changes in an individual's core eating disorder pathology, in their motivation for change and a reduction in the use of medical services. This innovative project will provide the world's first information about potentially effective treatments for chronic anorexia nervosa. It will be the largest study ever conducted on C-AN anywhere in the world.

Developing recurring mastitis is an area of research where there is little published work. Studying mastitis management after childbirth may lead to improved understanding of the outcomes for breastfeeding duration. We therefore wish to conduct a Randomised Control Trial (RCT) that will examine the outcomes of ‘Self-Management’ of mastitis versus ‘Usual Care’ in breastfeeding women following childbirth. The study intends to: Measure the prevalence of mastitis in a population of breastfeeding women. Measure breastfeeding duration and exclusivity in a population of breastfeeding women. Trial the ‘Self-Management’ of mastitis intervention. Measure women’s beastfeeding confidence. Hypotheses Self management of mastitis lowers the rate of GP visits Self management of mastitis increase breastfeeding confidence Self management of mastitis increase breastfeeding duration Self management of mastitis increase breastfeeding exclusivity

This study aimed to develop and pilot test a computer-based psychological treatment for co-occurring depression and alcohol/other drug use problems. Computer-based treatment was compared with a therapist-delivered treatment that was identical in content, and both of these treatments were compared with a brief treatment control group of one-session. It was hypothesised that people with co-occurring depression and alcohol/other drug use problems would attend and report benefits from a computer-based psychological treatment targeted at their conditions; that people in the therapist- and computer-delivered treatments would report similar reductions in depression and alcohol/other drug use over time, and that participants in both of these treatments would report superior reductions in depression and alcohol/other drug use problems than the brief intervention control group.