I am a nephrologist, triallist and health services researcher aiming to generate high-quality evidence regarding the prevention and management of chronic disease and to reduce disparities in indigenous health.
A Multi-centre Double-blind RCT On Community-acquired Pneumonia In Indigenous Children And A Developing Country: Improving Clinical Outcomes And Identifying Systemic Biomarkers
Funder
National Health and Medical Research Council
Funding Amount
$2,167,560.00
Summary
Young children of Indigenous communities and developing countries are often hospitalised for pneumonia and have high risk of subsequent chronic disease. Our international study will determine if a longer duration of antibiotics (compared to shorter duration) improves the short and long term clinical outcomes of children hospitalised for pneumonia. We will look for unique markers that may predict those who will develop chronic lung disease. Our study will influence future guidelines on pneumonia.
Povidine-iodine Ear Wash And Oral Cotrimoxazole For Chronic Suppurative Otitis Media In Aboriginal Children: A 2x2 Factorial Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,261,802.00
Summary
Many Aboriginal children in remote communities have severe ear infection. Acute infection with eardrum perforation often leads to long term discharge of pus (chronic suppurative otitis media) usually causing significant hearing loss. This trial will determine the benefit of antiseptic ear washes and a long course of oral antibiotics. We will assess the impact on ear health and hearing.
Azithromycin Versus Placebo In The Treatment Of Asymptomatic Acute Otitis Media In Young Aboriginal Children : A RCT
Funder
National Health and Medical Research Council
Funding Amount
$1,357,460.00
Summary
Remote Aboriginal children have the highest rates of severe ear infection reported in the medical literature. At any time, large numbers of children have a bulging eardrum (acute otitis media) but most are completely asymptomatic. In our previous antibiotic study, acute otitis media (AOM) persisted in 50% of children after 1 week of treatment. In terms of clinical success, it didn't make any difference whether azithromycin or amoxicillin was used (although azithromycin seemed to be better at red ....Remote Aboriginal children have the highest rates of severe ear infection reported in the medical literature. At any time, large numbers of children have a bulging eardrum (acute otitis media) but most are completely asymptomatic. In our previous antibiotic study, acute otitis media (AOM) persisted in 50% of children after 1 week of treatment. In terms of clinical success, it didn't make any difference whether azithromycin or amoxicillin was used (although azithromycin seemed to be better at reducing the level of infection). Currently local clinicians are: i) uncertain whether antibiotics make any difference at all; and ii) reluctant to devote resources to case-finding without good evidence of substantial benefit. In this randomised controlled trial, we will determine the benefits of 2 doses of azithromycin given 1 week apart in children with asymptomatic acute otitis media will improve health outcomes. The results of the trial will become the best available evidence to guide the medical management of asymptomatic AOM in high-risk children. We anticipate that it will make an important contribution in the shift toward more effective prevention and management of otitis media in Australian Aboriginal children. It will also have implications for all disadvantaged populations where adverse outcomes are common and compliance with recommended treatment is poor.Read moreRead less
Surgery For The Treatment Of Otitis Media In Indigenous Australian Children
Funder
National Health and Medical Research Council
Funding Amount
$1,870,120.00
Summary
Ear infection (otitis media) is a major problem amongst children living in remote Australian communities. Medical treatment often fails, and ear nose and throat surgeons are called upon to provide surgical care. This clinical trial will provide surgeons with evidence so that they can recommend the best possible operation for children living in desert and tropical regions, most of whom are indigenous, to improve hearing and reduce the prevalence of ear infection and discharging ears.
In the Northern Territory, about twenty per cent of Indigenous children have perforated ear drums. Menzies research already shows medical treatments in high-risk Indigenous settings to be less effective than in non-Indigenous settings. I will lead an interdisciplinary team to develop, pilot, design and evaluate the effect of a comprehensive intervention program including best use of vaccines, reducing risk factors and maximising hygiene to prevent early age of first infection.
Improving Timely Diagnosis And Provision Of Best Care For Aboriginal And Torres Strait Islander People Living With Dementia: A Cluster RCT
Funder
National Health and Medical Research Council
Funding Amount
$1,251,378.00
Summary
Dementia is 3-5 times more likely to occur amongst Aboriginal people. This study will examine the effectiveness of a multi-faceted intervention in helping Aboriginal Community Controlled Health Services improve identification and care of people with dementia. The intervention includes clinical education, tools to prompt identification of cognitive impairment and clinical monitoring, routine feedback, and strategies to prompt adherence to clinical practice guidelines.
Periodontal Disease And Chronic Kidney Disease Among Aboriginal Adults; An RCT
Funder
National Health and Medical Research Council
Funding Amount
$1,035,550.00
Summary
Chronic Kidney Disease is a growing public health concern in Australia, especially among Aboriginal populations. It is associated with progression to end stage kidney disease requiring dialysis, cardiovascular disease burden and high mortality. This study will use a randomised controlled trial design to determine if comprehensive periodontal therapy reduces progression of kidney disease among Aboriginal adults with chronic kidney disease residing in Central Australia.
Associations Between Diabetes And Periodontal Disease Among Indigenous Australian Adults
Funder
National Health and Medical Research Council
Funding Amount
$439,920.00
Summary
The relationship between diabetes and periodontal disease, both of which are high among Indigenous Australians, is established. This study seeks to explore the prevalence of periodontal disease among this population with diabetes, and to determine if implementation of a periodontal intervention leads to improved glycaemic control. There may be benefit in applying this model to other areas of Indigenous health research.
Improving The Understanding And Management Of Children Hospitalised With Bronchiolitis In Northern Australia
Funder
National Health and Medical Research Council
Funding Amount
$69,506.00
Summary
Acute bronchiolitis remains one of the most common serious lower respiratory tract infections. Children can be treated effectively at home; however many require hospitalisation and current treatment is essentially supportive with oxygen and fluid therapy. In Indigenous settings where high colonisation of bacteria and burden of respiratory disease exist, antibiotics such as azithromcyin may provide clinical improvement in the short term outcomes for those children hospitalised with bronchiolitis.