A Community-based Cluster Randomized Controlled Trial In Rural Bangladesh To Evaluate The Impact Of The Use Of Iron/folic Acid Supplements Early In Pregnancy On The Risk Of Neonatal MortalityBACKGROUND An Effective Program Of Antenatal Iron/folic Ac
Funder
National Health and Medical Research Council
Funding Amount
$2,564,922.00
Summary
This community-based trial in rural Bangladesh will determine if iron/folic acid supplementation commencing in the first trimester of pregnancy significantly reduces newborn deaths, and whether this approach is cost-effective. This trial has the potential to inform international public health policy about the importance of starting antenatal iron/folic acid supplementation early to improve neonatal survival, and to help countries reach their child survival Millennium Development Goal
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.
Preventing Mental Health Problems In Children: A Population-based Cluster Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$431,133.00
Summary
14% of Australian children develop mental health problems. As treatment is time and cost intensive, prevention is the ideal model. This can be targeted to ‘at risk’ children, but may stigmatise families and have poor uptake. This project aims to trial whether a population targeted approach embedded in universal prevention performs better than targeted prevention alone, with each approach compared to ‘usual care’. The local and state government partners will ensure sustainability, policy relevanc ....14% of Australian children develop mental health problems. As treatment is time and cost intensive, prevention is the ideal model. This can be targeted to ‘at risk’ children, but may stigmatise families and have poor uptake. This project aims to trial whether a population targeted approach embedded in universal prevention performs better than targeted prevention alone, with each approach compared to ‘usual care’. The local and state government partners will ensure sustainability, policy relevance and uptake if effectiveRead moreRead less
Improving School Transition By Improving Child Sleep: A Translational Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$745,827.00
Summary
A successful transition to school sets a child on a path for life. A poor transition can lead to early drop out, poor peer relationships and poor emotional skills. In 2008/09, we found that a brief sleep intervention for children improved key determinants of a successful transition including social-emotional functioning and parent mental health. We now plan to see if the same intervention, delivered by school nurses, can have a similar effect.
Early Intervention For Amnestic Mild Cognitive Impairment : A Randomised Trial Of Memory Management
Funder
National Health and Medical Research Council
Funding Amount
$577,556.00
Summary
It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions ....It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions are low cost and, where effective, can provide a stand-alone intervention or add value to the pharmacological approach. The primary aim of this study is to evaluate whether an early intervention program of memory training is effective in improving use of memory strategies in everyday life, and whether this has psychological and emotional benefits for individuals with MCI and their families. We will evaluate through a randomised controlled trial the efficacy of a memory-group program which will involve the family and patient, rather than just the person with MCI, in developing increased awareness of memory issues and specific strategies to prevent memory failures. Over successive cohorts recruited from memory clinics, families will be randomly assigned to either an immediate intervention or a delayed intervention (waiting-list control) group. We will also recruit a sample of healthy older adults who will be similarly randomised into early and late intervention groups. Healthy older adults will provide a means of establishing whether any improvements in the MCI groups are (i) to the same extent as healthy older adults and (ii) to normative levels. Evaluation will be at pre- and post-intervention and at six months follow-up on tests of memory, questionnaires of knowledge and use of memory strategies in everyday life, and appraisal of level of wellbeing. Information about memory and systematic training in compensatory memory skills are expected to significantly improve the capacity of patients and families to cope with everyday memory difficulties. Through active participation in the management of memory impairment, it is expected that the level of wellbeing will increase, for both patient and families.Read moreRead less
An International Comparison Of Systems Of Care, Risk Stratification And Outcomes In TIA And Minor Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,189,790.00
Summary
Transient ischaemic attacks (TIAs: self-limited brief episodes of stroke symptoms) are high-risk events with an approximately 15% risk of stroke within 90-days. Current practice calls for specialist treatment within 1-7 days. But this recommendation (based on 20 year old overseas evidence) may not apply in contemporary Australia. We will conduct a study of patients with TIA that will document their interactions with Australian health systems and inform contemporary Australian practice.
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
Preventing Early Academic Problems By Improving Working Memory: Translational Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$831,085.00
Summary
Learning difficulties are common and can cause school failure and poor self-esteem. They are associated with specific problems with temporarily remembering and using information (‘working memory’). Research suggests that improving working memory might improve academic achievement. We will study this intervention in a large group of primary school children who have poor working memory. If successful, the intervention will provide a way to improve the learning skills of these high-risk children.
A Behavioural Intervention For The Adoption & Maintenance Of Physical Activity In Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$334,955.00
Summary
For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on ....For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person's motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.Read moreRead less