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Implications Of Bacterial Load For Vaccine Efficacy And Antibiotic Treatment Outcomes In High-risk Populations
Funder
National Health and Medical Research Council
Funding Amount
$345,000.00
Summary
Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in t ....Otitis media (middle ear disease) is a common childhood infection, and a major concern in remote Aboriginal communities of the Northern Territory. For these children, otitis media commences within the first few weeks of life and progresses to perforation of the ear drum in 60% of children by 12 months of age. Few children in remote Aboriginal communities have normal ear status or normal hearing and many have conductive hearing loss, affecting language development and education. Otitis media in these children results from infection with the bacteria Streptococcus pneumoniae, Haemophilus influenzae and-or Moraxella catarrhalis. Therefore the types of interventions we are using to combat the high prevalence of ear disease are antibiotic therapy, Streptococcus pneumoniae vaccination, and hygiene interventions. However we fear that the high load of bacteria carried by these children compromises the treatment and prevention strategies. The current proposal will test this hypothesis, and if found to be true, there will be implications for the management of otitis media. For example, dose, frequency and choice of antibiotic treatment, and vaccine schedule changes including an early dose or a booster dose.Read moreRead less
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
Improving Outcomes For People With Cancer: Consultation Skills Training With Oncologists
Funder
National Health and Medical Research Council
Funding Amount
$499,070.00
Summary
Each year approximately 30,000 Australians die from cancer and 65,000 new cancers are diagnosed. Despite much research for a cure for cancer, the incidence and mortality from cancer has not changed. New treatments now cause people with cancer to live longer with the disease, so we now need to focus on efforts to optimise the quality of life of these people. Although the emotional burden on patients and families is recognized, there is a sense that this is an inevitable by-product of the disease ....Each year approximately 30,000 Australians die from cancer and 65,000 new cancers are diagnosed. Despite much research for a cure for cancer, the incidence and mortality from cancer has not changed. New treatments now cause people with cancer to live longer with the disease, so we now need to focus on efforts to optimise the quality of life of these people. Although the emotional burden on patients and families is recognized, there is a sense that this is an inevitable by-product of the disease and its management in existing clinical systems. However, this does not need to be the case. There is now ample evidence that the way that doctors interact with their patients can effect the accuracy of diagnosis and prognosis, as well as patients' satisfaction, adherence with treatment instructions and quality of life after being diagnosed with cancer. Both patient advocate groups and clinicians have called for further training for doctors to effectively manage psychosocial aspects of cancer care, however, despite this support, there have been few opportunities for such training in Australia. We have developed an innovative consultation-skills program for oncologists. So that the effectiveness of the project can be evaluated, it will be implemented as a randomised controlled trial with oncologists from major Australian cancer clinics being randomly allocated to an intervention or control group. The training program will be delivered by videoconferencing, to overcome many of the barriers that have impeded busy clinicians from participating in previous training programs. This is the first international study to use videoconferencing between remote locations for this type of consultation skills training. A variety of measures will be used to evaluate the impact of the training, including patients' quality of life, anxiety, depression and perceived needs, and oncologists' burn-out.Read moreRead less
Communication Of Genetic Information In Families: A Randomised Controlled Trial Of A Genetic Counselling Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$359,728.00
Summary
The amount of genetic testing information available to Australians has exploded as a result of the human genome project. Our multi-disciplinary team will investigate the most acceptable and feasible way for important genetic information to be transmitted in families. This study will be a world first trial of a genetic counselling intervention which aims to help patients and health professionals communicate life-changing information in families where there is a serious genetic condition.