Judicious Use Of Antibiotics For Acute Otitis Media In Aboriginal Children: A Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$614,840.00
Summary
Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important ....Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important implications for their education. The aim of this study is to determine whether a new longer-acting antibiotic will be more effective in treating young Aboriginal children with new ear infections and therefore prevent the progression to chronic suppurative otitis media. The involvement of up to 20 Aboriginal communities in this well-designed clinical trial represents a major advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide training in ear examination and appropriate medical management. Swabs from the nose will be taken to monitor the effect of antibiotics on the rates of antibiotic resistance. The results from this study will be directly relevant to evidence-based guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.Read moreRead less
Evaluation Of The Effectiveness Of Mobile Preschool For Child Health And Development In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$456,369.00
Summary
This project is a retrospective study of the effectiveness of the NT Mobile Preschool Program using assessment data for children's emergent literacy, social and emotional competencies and health status. Effectiveness will be established by comparison with achievement and health status data for children not attending preschool and those in communities with no preschool service. The study will identify and describe the key factors influencing the health and learning outcomes of the three groups.
Development And Evaluation Of A Primary Health Care Model To Prevent Dental Decay In Aboriginal Pre-school Children
Funder
National Health and Medical Research Council
Funding Amount
$1,482,000.00
Summary
Dental decay has been described as the most common disease of childhood that is not self-limiting or responsive to short-term pharmacological management. Regrettably, Australian Aboriginal children have, on average, twice as many teeth affected by decay as other Australian children. The disease is a particular burden for pre-school children who do not routinely have access to dental care provided by the state-territory programs. The goal of this project is to develop, implement and evaluate the ....Dental decay has been described as the most common disease of childhood that is not self-limiting or responsive to short-term pharmacological management. Regrettably, Australian Aboriginal children have, on average, twice as many teeth affected by decay as other Australian children. The disease is a particular burden for pre-school children who do not routinely have access to dental care provided by the state-territory programs. The goal of this project is to develop, implement and evaluate the effectiveness of a community-oriented, primary health care intervention to prevent dental decay among pre-school children in Aboriginal communities in the Northern Territory. The cluster randomized design provides a practical approach to the problem of small numbers of children living in remote communities. The results obtained from this research proposal would make an important contribution to the health care of Australian Aboriginal children and other disadvantaged children throughout the world.Read moreRead less
Cluster Randomised Controlled Trial Of An Innovative Intervention To Increase Childrens Physical Activity
Funder
National Health and Medical Research Council
Funding Amount
$505,530.00
Summary
Rates of childhood obesity are increasing and outdoor free play is decreasing. Research suggests that these patterns are inter-related, and that adults perceive outdoor free play to be risky for children. In this study we will reprioritise play, reframe teachers' perceptions of risk and modify the playground environment to increase children's physical activity. We will assess the effectiveness of this simple, cost-effective intervention in a randomised controlled trial.
Efficacy Of Exercise Physiologist Counselling In Primary Care Patients: A RCT Of Two Pragmatic Approaches
Funder
National Health and Medical Research Council
Funding Amount
$940,925.00
Summary
Physical activity is one of the most powerful contributors to health, but population levels of activity are low. General practitioners (GPs) are well placed to provide physical activity counselling, but many are too busy. This project examines the effectiveness of referral of insufficiently active adults to an exercise physiologist (EP), using step counts from a pedometer as the outcome. We compare usual care from the GP with: (1) 5 EP visits, and (2) a single visit and telephone follow up.
Changing Decision-making Behaviour In General Practice By Providing Access To Online Evidence.
Funder
National Health and Medical Research Council
Funding Amount
$206,375.00
Summary
The case for a shift to evidence-based practice, and the substantial economic and health outcome benefits of that shift, have been repeatedly made. Despite the vision, significant barriers to evidence-based practice remain, and the demonstration of a positive role for on-line systems would result in a significant change in strategies for clinician behaviour change. This study will make a specific and significant contribution to our understanding of the efficacy and effectiveness of online eviden ....The case for a shift to evidence-based practice, and the substantial economic and health outcome benefits of that shift, have been repeatedly made. Despite the vision, significant barriers to evidence-based practice remain, and the demonstration of a positive role for on-line systems would result in a significant change in strategies for clinician behaviour change. This study will make a specific and significant contribution to our understanding of the efficacy and effectiveness of online evidence retrieval systems as a component in any evidence-based strategy, through a rigorous and controlled approach to the study of clinical behaviour change. It will also provide a powerful test of the value of search filters as a specific technology in support of evidence retrieval. The focus on prescribing patterns in NHMRC priority areas as an outcome measure will also provide a significant data set reflecting current practice in primary care.Read moreRead less
The Physiology Of Health Systems: Port Lincoln As A Case Study
Funder
National Health and Medical Research Council
Funding Amount
$2,228,073.00
Summary
No health system in Australia has a complete, population-wide view of how they are used, by whom, and with what effect on health. Our plan is to capture and describe comprehensively all health system activity relating to a sizeable and carefully-defined Australian population and to complement this with a population-wide census of health status. Such 'intelligence' is fundamental to evaluating the current performance of health systems and to planning changes to them.
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