Clinical Trials

Background: Incidents of aggression are increasing in healthcare. Students are at higher risk of being on the receiving end of client aggression due to their lack of experience. Students also do not feel prepared to manage these situations.Methods: Students of health professions in the School of Primary and Allied Health Care will be eligible and contacted within lectures/via the learning management system Moodle. A randomised controlled trial (RCT) will be conducted to evaluate a suite of online aggression management modules for health professions students prior to entering their clinical years of study. If students are able to undertake face to face simulations they will be assessed by academic staff members using the English modified de-escalating aggressive behaviour scale (EMDABS). Mock clients will assess the students using the consultation and relational empathy (CARE) measure. Students will complete a self-assessment using the confidence with coping with patient aggression i...

Background
The coronavirus disease-2019 (COVID-19) originated in China and was declared a pandemic by the World Health Organization
(WHO) on 11th March 2020. Since its emergence in December 2019, there have been challenges in developing drugs that are effective against the virus. Currently, COVID-19 is managed using symptomatic and supportive therapies, antiviral agents, cellular
and immunotherapy. Besides, most of the treatment modalities are still under investigation and treatment guidelines vary from
one country to another. Ivermectin is among the drugs that are being used as part of treatment guidelines in certain countries like
the Republic of Peru. However, the WHO recommends that ivermectin only be used in clinical trials.
Aim
The authors conducted this review to explore published studies on the possible therapeutic effects of ivermectin against active
infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a causative agent of COVID-19.
Methods
A literature search was conducted using Google Scholar, PubMed and EMBASE for articles published from 2016 to 2021. Search
words used included ivermectin, antiviral, COVID-19, efficacy, safety, dosing, lower mortality rate, hospitalised patients and the
Boolean operator ‘AND’.
Results
A few clinical trials have shown that ivermectin is safe for use in humans at specific doses and reduces the severity of the infection. Ivermectin was seen to reduce the signs and symptoms associated with COVID-19 in some studies while others showed no
significant reduction. However, more studies must be conducted to ascertain its use in treating COVID-19.
Conclusion
Since many clinical trials are being conducted on the use of ivermectin to treat COVID-19, full evidence will be used to support
its use in humans. Currently, some countries that are using ivermectin for treating COVID-19 have reported it to be effective and
reduces morbidity and mortality associated with the disease. Therefore, countries should collaborate and provide full evidence for
the use of ivermectin in humans to manage COVID-19.

Existing pharmaceuticalisation research denotes the salience of expectations in novel medicines and in the medical contexts through which these may be accessed. Specific processes of expectation such as hope and trust, alongside their shaping of patients' lifeworlds around pharmaceutical use, remain neglected however. Considering data from in-depth interviews and observations involving thirteen patients with advanced-stage cancer diagnoses who were or had recently been involved in clinical trials, we develop a phenomenological analysis of the influence of hope and trust upon the accessing of novel medicines through trials, illuminating the depth and texture of pharmaceuticalisation at the micro-level. Trust in clinicians

Background: Although orthodontic white spot lesions (WSLs) are one of the most often and most evident adverse effects of comprehensive fixed appliance treatment, the efficacy of interventions for WSLs has not yet been adequately assessed in an evidence-based manner. Objective: Aim of this systematic review was to assess the therapeutic and adverse effects of interventions to treat post-orthodontic WSLs from randomized trials in human patients. Search methods: An unrestricted electronic search of eight databases from inception to May 2016. Selection criteria: Randomized controlled trials assessing any interventions for post-orthodontic WSLs on human patients. Data collection and analysis: After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of mean differences (MDs), standardized mean differences (SMDs), and odds ratios (ORs), including their 95% confidence intervals (CIs) were performed, followed by subgroup and sensitivity analyses. Results: A total of 20 unique studies and a total of 942 (42 per cent male and 58% per cent female) patients were included, with an average age of 16.2 years and a mean number of 8.2 WSLs (range 2.2 to 45.4) per patient. These were allocated to adjunct treatment with casein phosphopeptide-stabilized amorphous calcium phosphate creams, external tooth bleaching, low-or high-concentration fluoride films, gels, mouthrinses or varnishes, resin infiltration, miswak chewing sticks, bioactive glass toothpastse, or to no adjunct treatment (i.e. conventional oral hygiene). The monthly use of fluoride varnish was the best supplement to improve WSLs in terms of lesion area (1 trial; MD = −0.80 mm 2 ; 95% CI = −1.10, −0.50 mm 2 ; P < 0.05; high quality) and enamel fluorescence (3 trials; SMD = −0.92; 95% CI = −1.32, −0.52; P < 0.05; high quality), followed by the use of fluoride film. WSL treatment did not provide a considerable improvement in their clinical evaluation (3 trials; OR = 0.97; 95% CI = 0.60, 1.56; P > 0.05; moderate quality), with imprecision due to small sample size being the main limitation of existing evidence. Conclusions: Based on the existing trials, interventions for post-orthodontic WSLs, mainly fluoride varnish, seem to be effective, but further research is needed to elucidate their clinical relevance. Registration: PROSPERO (CRD42016037538)