ANZCTR search results

Childhood eczema places an enormous burden on children and families. While good evidence for therapeutic interventions exists, ongoing non-compliance with treatment is common and presents a serious problem, increasing morbidity and impacting quality of life for children and families. Existing approaches have a record of failure in improving adherence. This study will improve clinical outcomes for children with eczema by integrating evidence-based support for parents who rely on existing eczema care services, to improve treatment adherence, reduce disease severity, and improve the quality of life for affected children. A randomised controlled trial will evaluate a brief parenting skills-training program for parents of children with eczema, comparing the intervention with usual care. We expect that this approach, which aims to enhance parental self-efficacy via application of practical parenting skills, will lead to improvements in adherence with medical treatment regimens and better disease control.

PURPOSE: To compare the efficacy of Bystander Intervention Model-informed suicide prevention material with standard existing material in promoting appropriate suicide risk assessment and protective action in the general community according to best-practice to suicide prevention. HYPOTHESES: 1. The experimental condition will have a significantly higher suicide risk assessment ability score than the standard condition. 2. The experimental condition will have a significantly higher suicide protective action ability score than the standard condition.

PURPOSE: The aim of the study is to evaluate whether a BIM-guided factsheet about suicide prevention can improve participants’ knowledge, confidence and intent to intervene more than a standard condition when presented with a peer at risk of suicide. HYPOTHESIS: A public suicide prevention strategy which addresses the BIM will be more effective at increasing knowledge, confidence and intent to intervene when presented with someone at risk of suicide than a standard condition which does not address the BIM.

Several factors link OSA and atherosclerosis, including metabolic abnormalities, activation of inflammatory and oxidative pathways, autonomic dysfunction and mechanical factors linked to snoring. However, the relationship between OSA and its treatment with the burden and progression of atherosclerotic plaque has not been systematically investigated. Advances in computed tomography (CT) imaging permit noninvasive high-resolution plaque imaging, enabling characterisation of the factors driving disease progression. This study is an observational study of 75 adults to determine the relationship between OSA and its treatment with plaque burden, composition and progression. Imaging of the coronary arteries will be performed on a CT scanner at a baseline and 12 month follow-up visit. The baseline phase permits evaluation of the relationship between OSA and its severity with the extent, distribution and composition of plaque. The serial phase permits a real-world assessment of the impact of changes in OSA severity on plaque progression.

Increasing evidence suggests that sleep apnoea is an important factor driving CVD risk. Beyond worsening blood pressure and diabetes, sleep apnoea has direct adverse effects on blood vessels. In this study, we propose to employ a molecular imaging approach to investigate the impact of OSA on plaque activity. This study is a cross-sectional, observational study with the objective to ascertain the presence and extent of inflammatory activity of atherosclerotic plaque in patients with sleep apnoea. We will enroll 50 adults with obstructive sleep apnoea (OSA), 25 with mild OSA and 25 with moderate to severe OSA commencing continuous positive airways pressure (CPAP) therapy with either established atherosclerotic cardiovascular disease (ASCVD) or risk factors for ASCVD. A combined computed tomography (CT) and positron emission tomography (PET) scan will be performed following intravenous administration of is 18F-fluorodeoxyglucose (18F-FDG) which will enable measurement of inflammatory plaque activity. The findings will provide important information that may lead to the development of an important new marker to monitor reductions in CVD risk in sleep apnoea.

Fifth metacarpal neck fracture is a condition commonly referred to hand therapists for management. The method of treatment provided, as well as the frequency and duration of treatment vary widely, due to a lack of conclusive research evidence. This project will determine which of two treatment methods commonly employed by hand therapists is the most effective for the management of fifth metacarpal neck fracture. The findings of this project will enable therapists to decide with confidence which treatment method will produce the most satisfactory functional outcome and is preferred by patients. The results are expected to have implications for decision making about the resources allocated to this condition in the future, both in terms of therapist’s time and expertise, as well as materials used.

For many diseases, researchers have been able to find ‘biomarkers’ that are in the blood and that can predict whether or not someone is at risk of getting the disease. Biomarkers are naturally occurring molecules, genes, or other characteristics that help us to identify diseases and disease processes. The purpose of the research project is to use blood and tissue from people with susceptibility or resilience to cardiovascular disease (CVD), and to try and find new biomarkers that can identify risk of CVD at an early stage. In addition, we will investigate the use of biomarkers that we have already identified, and their ability to predict events and outcomes. We hope that by doing this, we will be able to: 1. Find out more about how and why CVD occurs 2. Find out more about the way that CVD progresses and affects different people 3. Find new biomarkers that will help us to work out if someone is at risk of CVD earlier 4. Find new treatments for CVD

This is a randomised control trial to compare platelet-rich plasma (PRP) against placebo (normal saline) as a treatment for women with symptomatic vulval lichen sclerosus (LS). LS is an acute and often chronic inflammatory dermatosis with autoimmune pathogenesis (Neill et al., 2010). It is a debilitating condition with serious consequences for the patient’s physical, emotional and sexual health (Newman et al., 2015). The management of LS is aimed at controlling symptoms, mainly severe vulvo-vaginal pruritus. Some women with LS are either unresponsive to corticosteroids or hesitate to use them. There are small studies to demonstrate PRP can improve vulvar LS. Therefore, this study is to assess the efficacy of PRP for treatment of vulvar LS.

The OPtimisation of Perioperative Cardiovascular Management to Improve Surgical outcomE II trial (Optimise II) is a large multi-centre randomised trial, which seeks to establish whether increasing blood flow from the heart during major abdominal surgery reduces the risk of infection. Within this large study, blood samples from 200 patients will be collected. All samples will be analysed for evidence of heart injury and 50 samples will be analysed also for circulation injury. This blood sample analysis will try to identify patients who are at higher risk of complications after surgery.

Informed medical consent is often poorly done; it can be time consuming, there is no clear standard between different medical practitioners, and overwhelmingly, the literature provides support for standardised animations or video consent. Video animations have been shown to improve patient comprehension, take the same amount of time, or can even save time and in most cases there is an improvement in patient satisfaction and comprehension. Videos have been successfully used to consent for colonoscopy, knee arthroscopy, laparoscopic urological procedures, cataract surgery, intravenous fluorescent angiography, vascular procedures, coronary angiography, cardiac electrophysiology, urogynaecological surgery as well as for clinical trials. There are no studies evaluating video informed consent for orthopaedic procedures in Australia. Given the literature shows improvements in patient understanding and satisfaction, it is anticipated that the video informed consent will lead to enhanced clinical practice, including enhanced knowledge retention by patients, improved patient and physician satisfaction, improved recall of the procedure, as well as saving minutes per consultation. We aim to compare traditional doctor-patient informed consent to a video animation when consenting for orthopaedic procedures (e.g. total hip replacement, total knee replacement, shoulder reconstruction, joint arthroscopy, hallux valgus deformity and other procedures). We propose that the video consent will be superior to traditional doctor patient consent – patients will have better retention of information, comprehension and understanding and higher satisfaction.