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
A Study To Investigate Alternative Regimens For Pneumococcal Vaccination Of Infants In A Developing Country
Funder
National Health and Medical Research Council
Funding Amount
$1,622,210.00
Summary
Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver thi ....Streptococcus pneumoniae (Pnc) is the leading vaccine preventable cause of serious infection in infants. The current Pnc conjugate vaccine is very expensive (approximately USD $200-infant) so it is unlikely to be affordable for most developing countries. Moreover, as health care access in developing countries may be episodic and unreliable, many children do not receive either complete or timely vaccine courses. Therefore, it is important to investigate affordable and flexible ways to deliver this vaccine, which are safe and effective. A recent WHO-GAVI meeting to address impediments to the introduction of these vaccines in developing countries recognized the need to evaluate other regimens of Pnc conjugate vaccine as an important research priority. This study has been deliberately formulated with that need in mind. The site for this research is Fiji. Although health services are good, Pnc disease, particularly pneumonia, remains the commonest cause of childhood morbidity and mortality. Fiji has good vaccine coverage and was the first Pacific country to introduce Hib vaccine. The arrival of the new, expensive Pnc conjugate vaccine presents a dilemma for Fiji and many similar countries. The expense of this vaccine would consume a large portion of the health budget. This study has two components: 1. A Phase 2 immunogenicity study (involving 750 infants) to evaluate regimens using reduced numbers of doses of Pnc conjugate vaccine, and using timing of dosing and combinations with the Pnc polysaccharide (PS) vaccine that may be more suited to the epidemiology of Pnc disease in developing countries. 2. An epidemiological study will measure the burden of invasive Pnc disease and pneumonia in Fiji. This will be part of a global effort to address these issues, and will be used to develop rapid assessment tools for these diseases in developing countries. We will seek cofounding for this component.Read moreRead less
A Case-control Study Of Rotavirus Vaccine Effectiveness Against Gastroenteritis Hospitalisation Of Children In The NT
Funder
National Health and Medical Research Council
Funding Amount
$465,859.00
Summary
Almost 1 out of 5 children in remote Aboriginal communities are hospitalised with diarrhoea caused by rotavirus. This study will evaluate the impact of rotavirus vaccination in preventing these hospitalisations. In addition to making sure that vaccination works and that those at highest risk are receiving the benefits, it will assess the indirect impact against other causes of diarrhoea providing, critical information relevant to the vaccine's broader introduction in developing country settings.
Diseases caused by the pneumococcus represent the largest cause of vaccine preventable death in the world today, mainly pneumonia and meningitis. In 2011, 16 developing countries will introduce pneumococcal conjugate vaccines, none in east Asia. Lack of research has been a major barrier to their use in the region. We have established an international centre of excellence in the field and we seek support to extend the capacity of this group and to transfer the technology to Vietnam.
Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster
Funder
National Health and Medical Research Council
Funding Amount
$2,651,687.00
Summary
This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
About time; a new biology for the mineralocorticoid receptor . Temporal control of cell function aligns biological pathways with environmental cues and is critical for optimal heath in mammals. This project will shed light on how a hormone receptor, the MR, modulates time keeping of biological clock time in cells. We will bring together cutting edge genetic modals and bioinformatic approaches with a unique set of research models to define the interaction between the MR and the circadian clock a ....About time; a new biology for the mineralocorticoid receptor . Temporal control of cell function aligns biological pathways with environmental cues and is critical for optimal heath in mammals. This project will shed light on how a hormone receptor, the MR, modulates time keeping of biological clock time in cells. We will bring together cutting edge genetic modals and bioinformatic approaches with a unique set of research models to define the interaction between the MR and the circadian clock and its role in the normal biology of the heart. New data will significantly enhance our understanding of the biology of MR and cortisol for the circadian time keeping function in peripheral tissues, and gain a clearer understand how our heart cells adapt to environmental circadian disruptors such as shift work. Read moreRead less
Threats to the water quality and ecosystem of Coffin Bay, South Australia. Coffin Bay (South Australia) is experiencing worsening environmental conditions despite its major economic and ecological importance. Research is needed to understand the cause of this decline, particularly in light of a recent bacterial outbreak that impacted the aquaculture industry. This multidisciplinary project aims to deliver world-leading scientific advice based on novel field techniques and innovative models of th ....Threats to the water quality and ecosystem of Coffin Bay, South Australia. Coffin Bay (South Australia) is experiencing worsening environmental conditions despite its major economic and ecological importance. Research is needed to understand the cause of this decline, particularly in light of a recent bacterial outbreak that impacted the aquaculture industry. This multidisciplinary project aims to deliver world-leading scientific advice based on novel field techniques and innovative models of this complex inverse estuary system and its surrounding catchment. The new understanding of the sources, fluxes and fate of nutrients within the bay and the surrounding catchment, arising from this project, is expected to benefit management decision-making and establish a new standard in estuarine water quality investigation.Read moreRead less
Special Research Initiatives - Grant ID: SR200200605
Funder
Australian Research Council
Funding Amount
$247,683.00
Summary
Australian Boys: Beyond the Boy Problem. In Australia, most research on boys and boyhood is focused on risk-reduction, representing boys as problems at school, on the streets, or in relationships, with an ambivalent (if not oppositional) relation to feminism. At the same time, anti-feminist public discourse highlighting the experiences of boys and young men is used to justify violence towards women as well as call for the reversal of social changes that have expanded opportunities available to g ....Australian Boys: Beyond the Boy Problem. In Australia, most research on boys and boyhood is focused on risk-reduction, representing boys as problems at school, on the streets, or in relationships, with an ambivalent (if not oppositional) relation to feminism. At the same time, anti-feminist public discourse highlighting the experiences of boys and young men is used to justify violence towards women as well as call for the reversal of social changes that have expanded opportunities available to girls. This research project will develop a framework for interdisciplinary research that takes Australian boys and boyhood as the subjects of a more inclusive future, working to overcome ingrained oppositions between feminist scholarship and the lives and interests of boys. Read moreRead less
Improved Indigenous population projections for policy and planning. This project will use a range of methods to understand the population dynamics of the Australian Aboriginal and Torres Strait Islander (Indigenous) population. This information will allow policy makers to plan and target resources and help Indigenous organisations understand what is happening to the population in their communities.
Developing Robust Small Area Population Forecasts for Planning and Policy. This project aims to create more robust, detailed, and accurate small area population forecasts, and implement them in a sophisticated forecasting system for one jurisdiction in Australia, USA, UK and Canada. The project is significant as it expects to generate a suite of new and innovative methods, theory, and population forecasts that will be useful to researchers and planners both in Australia and overseas. Expected ou ....Developing Robust Small Area Population Forecasts for Planning and Policy. This project aims to create more robust, detailed, and accurate small area population forecasts, and implement them in a sophisticated forecasting system for one jurisdiction in Australia, USA, UK and Canada. The project is significant as it expects to generate a suite of new and innovative methods, theory, and population forecasts that will be useful to researchers and planners both in Australia and overseas. Expected outcomes include new forecasting methods, associated computer code, many open-access academic papers, and new international collaborations. More detailed and reliable population forecasts will bring substantial benefits to those planning our future infrastructure requirements (e.g. schools, hospitals, housing and transport).
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