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 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
Ketamine Therapy Among Patients With Treatment-resistant Depression: A Randomised, Double-blind, Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,069,382.00
Summary
In the last decade, there have been reports of powerful antidepressant effects after a single injection of anaesthetic ketamine, with dramatic (though shortlasting) effects within 24 hours. This will be the first controlled study to test whether a course of repeated ketamine treatments, given over 4 weeks, is effective and safe in treating depression.
The effect of competition and doctor heterogeneity on prices charged by doctors. Prices charged by doctors can have important effects on health care costs, access to health care and health status. This research will examine the determinants of prices charged by doctors. The results will be important in understanding the pricing practices of doctors and their impact on health care costs.
The Kids in Communities Study: national investigation of community level effects on children's developmental outcomes. This project (a cross-disciplinary collaboration) will investigate community level factors influencing early childhood developmental outcomes using a mixed methods approach in up to 10 communities across Australia. This will result in a potential set of measures or indicators that reflect communities that are good for children.
Evaluating Cancer Screening: Context, Evidence, Values And Ethics
Funder
National Health and Medical Research Council
Funding Amount
$572,460.00
Summary
The research and clinical communities are divided over whether certain forms of cancer screening do more harm than good. This project asks: What is the right thing to do about cancer screening now? Using robust qualitative methodologies, we will study real cases of cancer screening and analyse their ethical implications. Drawing on this data and analysis, we will produce tools to help policy-makers, consumers and professionals make good decisions about cancer screening in future.
Integrated Kids Hubs - Ensuring Equity of Access for Children. The Integrated Kids Hubs - Ensuring Equity of Access for Children project aims to determine if integrated Hubs are effective in increasing access to child and family services for disadvantaged urban and regional families with children aged 3 years and under, thus improving early identification of developmental vulnerability, parental wellbeing and capacity, and addressing unmet psychosocial needs. If these issues are not identified a ....Integrated Kids Hubs - Ensuring Equity of Access for Children. The Integrated Kids Hubs - Ensuring Equity of Access for Children project aims to determine if integrated Hubs are effective in increasing access to child and family services for disadvantaged urban and regional families with children aged 3 years and under, thus improving early identification of developmental vulnerability, parental wellbeing and capacity, and addressing unmet psychosocial needs. If these issues are not identified and addressed early, these children will go on to struggle in school and life. We will use a pragmatic trial design (meaning the research is embedded in our usual practice), determine the social return on investment, and establish what is needed to scale up the Hubs across NSW and Australia.Read moreRead less
Reducing The Greatest Uncertainty In Radiotherapy.
Funder
National Health and Medical Research Council
Funding Amount
$594,197.00
Summary
The weakest link in radiotherapy is defining treatment volumes (contouring). Lack of accuracy and consistency in clinical trial contouring has been shown to result in reduced patient outcomes. Manual review of contouring is resource intensive, expensive and for advanced treatments unachievable in a timely fashion. We will assess an automated approach to contouring assessment using 4 clinical trial datasets, changing practice for future studies and enabling consistent assessment in the clinic.
A Telehealth Mediated Nursing Intervention (PRISMS) To Enable Patient Monitoring And Self-care In Haematological Cancer Patients: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$936,632.00
Summary
People with cancer are required to monitor and to initiate self care activities to manage side effects at home. In haematological cancer patients these side effects are often severe and life-threatening. Safe home care requires close communication with the health team. We will test if a mobile phone based system can: support patients to monitor their side effects; promote the delivery of evidence based self care advice in a timely manner; and mediate the role of nurses to effectively provide rea ....People with cancer are required to monitor and to initiate self care activities to manage side effects at home. In haematological cancer patients these side effects are often severe and life-threatening. Safe home care requires close communication with the health team. We will test if a mobile phone based system can: support patients to monitor their side effects; promote the delivery of evidence based self care advice in a timely manner; and mediate the role of nurses to effectively provide real-time patient support.Read moreRead less