A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network
Funder
National Health and Medical Research Council
Funding Amount
$2,497,654.00
Summary
Arthritis and musculoskeletal conditions place an immense and growing burden on the world’s population. They affect 28% of Australians (>6.1 million people). With the support of CRE funding, the Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network will optimise musculoskeletal health through high quality, collaborative clinical research, building research capacity and effective transfer of research outcomes into clinical practice and health policy.
Treatment Of Acute Otitis Media (AOM) In Low Risk Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,640,326.00
Summary
A randomised clinical trial design will be used to compare two different approaches to the treatment of acute middle ear infections in Aboriginal children living in urban communities: initial observation or immediate antibiotic prescription. The relative acceptability and cost effectiveness of treatment options will be studied. The evidence will allow primary care clinicians to confidently recommend treatment that maximises health benefits and reduces complications such as hearing impairment.
Implementing Guidelines To Routinely Prevent Chronic Disease In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$764,446.00
Summary
High quality, evidence-based guidelines for preventive activities and for the implementation of prevention in general practice have been developed by the Royal Australian College of General Practitioners and other bodies, yet available information suggests that many patients miss out on evidence-based preventive care. This project aims to evaluate current practice and develop a model of practice aimed at improving the implementation of preventive guidelines in general practice.
Venesection Or Expectant Management For Moderate Iron Overload In HFE Related Hereditary Haemochromatosis
Funder
National Health and Medical Research Council
Funding Amount
$853,109.00
Summary
Haemochromatosis is a preventable genetic iron overload disorder. Untreated, it can shorten life due mainly to liver cirrhosis and cancer. It can be prevented by blood donation to maintain normal iron levels. It is unclear, however, whether treatment is necessary when individuals have moderate elevation of iron in the body. This research project will study the effects of treatment in this group by assessing a number of scans, questionnaires and blood tests in treated and untreated individuals.
The Centre for Research Excellence in Nursing Interventions for Hospitalised Patients will provide evidence to improve the nursing care of a broad range of hospitalised patients who are at risk of complications related to compromised skin integrity and poor pain/anxiety management. Systematic reviews and clinical trials will provide the basis for developing clinical practice guidelines to assist nurses in providing high quality care to the 3.5 million Australians admitted to hospital each year.
A Randomised Controlled Trial Of Caseload Midwifery Care
Funder
National Health and Medical Research Council
Funding Amount
$761,311.00
Summary
There is concern about the rising levels of caesarean section in Australia and some evidence that women may benefit from caseload midwifery care. This randomised control trial will determine whether caseload midwifery care can reduce interventions and is as safe as usual hospital maternity care. A Cochrane systematic review of midwifery led care versus routine care was designed to answer these questions.This will be the first randomised controlled trial to contribute to this review
Adequate nutrition is necessary for recovery from illness. 30-40% of hospitalised patients may be malnourished. The critically ill are at higher risk because of increased energy requirements yet often receive less than 50% of required nutritional intake. Adequate nutrition therapy is associated with improved patient outcomes, such as reduced mortality and reduced infectious complications. Robust strategies to implement of evidence-based recommendations for nutrition therapy are required.
Minimising Disability And Falls In Older People Through A Post-hospital Individualised Exercise Program.
Funder
National Health and Medical Research Council
Funding Amount
$536,435.00
Summary
This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of ....This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of and adherence to the exercise program and the cost effectiveness of the program will be established. We will recruit 350 older people in the first six months after an in-patient stay in aged care and rehabilitation wards at one of two large teaching hospitals. Participants randomised to the intervention group will be asked to complete an individualised home exercise program three times a week. In addition, they will be offered a choice between receiving monthly physiotherapy home visits or attending exercise classes. These weekly exercise classes will be conducted by physiotherapists and will be made up of 6-8 people. The control group will receive an education booklet about falls prevention and will be given the opportunity to join the program on a self-funding basis after their one-year control period is complete. Post-intervention between-group comparisons will be made using appropriate statistical techniques including regression models. Additional analyses will establish predictors for program adoption and adherence and cost-effectiveness (the incremental cost per fall prevented in the exercise group compared with the control group). This study addresses an increasingly important health care problem in a systematic manner and thus has the potential to substantially enhance the health of older people in Australia and internationally.Read moreRead less
Best Evidence To Best Practice: Implementing An Innovative Model Of Care For Nutritional Management Of Patients With Head And Neck Cancer
Funder
National Health and Medical Research Council
Funding Amount
$276,250.00
Summary
This project aims to implement and evaluate an innovative best-practice dietetic model of care (MOC) based on published Evidence Based Guidelines for Nutritional Management of Patients with Head and Neck Cancer. Through integration with the multidisciplinary team, the MOC will take a patient-centred approach to delivery of nutritional care to minimise the detrimental sequelae of malnutrition and improve outcomes in this complex patient group.