A Clinical Trial To Determine The Optimal Timing Of Androgen Deprivation In Relapsed Or Non-curable Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$627,600.00
Summary
The aim of the study is to clarify when is the optimal time to start hormone treatment for men with certain stages of prostate cancer. It has long been known that testosterone removal impedes prostate cancer growth, although not permanently. The removal of testosterone, however, has side effects , including loss of libido, hot flushes, weight gain, and in the longer term osteoporosis, loss of muscle bulk and mental changes such as loss of memory. Any benefit to be gained for a patient must there ....The aim of the study is to clarify when is the optimal time to start hormone treatment for men with certain stages of prostate cancer. It has long been known that testosterone removal impedes prostate cancer growth, although not permanently. The removal of testosterone, however, has side effects , including loss of libido, hot flushes, weight gain, and in the longer term osteoporosis, loss of muscle bulk and mental changes such as loss of memory. Any benefit to be gained for a patient must therefore be weighed against these side effects. This is particularly relevant in situations in which cure is not possible, when the aim of treatment should be to manage symptoms (either by preventing or delaying them or treating them as they arise). There are two situations in which a man may be diagnosed as having active prostate cancer but be without symptoms requiring immediate treatment. The first is after the failure of curative treatment, shown by the presence of prostate specific antigen (PSA) in the blood, but without any other evidence of prostate cancer. The second is a man newly diagnosed with asymptomatic prostate cancer, but with other reasons (such as heart disease) which make an attempt at cure inappropriate. We do not know in either case whether or not men live longer if treatment is started immediately, or whether it is reasonable to wait until symptoms develop, thus potentially postponing the side effects of treatment. The trial will therefore include these two groups of men. Half the men will be randomised to receive immediate treatment, and half to treatment starting when symptoms develop, or when there is evidence of progressive disease. The main endpoint is overall survival, balanced against quality of life and side effects from the disease and treatment. The hypothesis is that early treatment will improve survival with acceptable effects on quality of life.Read moreRead less
This project will improve our understanding of how painkiller medicines work in very old and frail people which will improve the use of these medicines in pain management. This study will carefully examine pain control with two of the most commonly used pain killer medicines - paracetamol and oxycodone. By understanding all the factors that influence an older persons pain control we will be able to improve the safe and effective use of painkiller medicines in this special group of people.
Towards Reducing Resistance And Haematological Toxicity Of Linezolid
Funder
National Health and Medical Research Council
Funding Amount
$135,825.00
Summary
Multi-drug resistance in bacteria is increasing at an alarming rate. We have diminishing therapeutic options, and there are few antibiotics in the drug development pipeline that offer much hope. It is therefore important that we look towards ways of further optimising the use of antibiotics that we currently have available. An important last line of defense drug, linezolid, has been available in Australia for less than 2 years and already resistance is occuring. In addition, with broader use of ....Multi-drug resistance in bacteria is increasing at an alarming rate. We have diminishing therapeutic options, and there are few antibiotics in the drug development pipeline that offer much hope. It is therefore important that we look towards ways of further optimising the use of antibiotics that we currently have available. An important last line of defense drug, linezolid, has been available in Australia for less than 2 years and already resistance is occuring. In addition, with broader use of this drug outside clinical trials, there has been an increasing concern over its toxicity to important blood cells. We seek to better understand the determinants of linezolid resistance and toxicity, so that novel dosing strategies may be developed to optimise its use (reduce toxicity and enhance efficacy) thereby extending the usefulness of this last line of defense antibiotic.Read moreRead less
Nasal CPAP For Very Preterm Infants At Birth: Does It Improve Outcome? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$460,604.00
Summary
Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a ....Neonatal respiratory distress syndrome (RDS) is the major cause of morbidity and mortality in preterm infants. Many of these infants need ventilatory support to keep them alive. In 1996 and 1997, 10,471 infants in Australia and New Zealand needed ventilatory support for a total of 72,544 days. This treatment is a great physical burden for the infants and an enormous emotional stress for their parents. Each day of treatment costs about A$2000 so their hospital treatment costs about $72 million a year. Of infants born less than 29 weeks' gestational age, about 40% of the survivors subsequently developed chronic lung disease (CLD). This condition is defined as prolonged dependence on supplementary oxygen therapy. CLD is associated with further costs and increased lung problems and readmissions to hospital in the first year of life. Thus, CLD is an expensive and time-consuming condition that has a high social cost. This project will determine whether treating these very premature babies from birth simply by applying oxygen under a low continuous positive pressure (CPAP) into their nose rather than the present treatment of placing a tube in the windpipe (known as intubation) and ventilation will reduce the incidence and severity of neonatal respiratory distress syndrome and subsequent chronic lung disease. The project will involve 600 babies from different, high quality neonatal intensive care units. Babies who are born at less than 29 weeks' gestation and who show signs of breathing at birth will be randomly allocated to be treated with either nasal CPAP or intubation and ventilation. This project will determine whether CPAP treatment at birth improves survival and reduces the severity of the RDS and subsequent CLD, or has no long term beneficial effect. If the trial is successful, this will be one of the most useful new treatments in neonatal medicine because it is simple to use, easier for the babies, and cheaper than ventilation.Read moreRead less
The Ecstasy Check-Up: A Multi-site Trial Of A Brief Intervention For Ecstasy Use Among Regular Ecstasy Users
Funder
National Health and Medical Research Council
Funding Amount
$458,432.00
Summary
Rates of ecstasy use have continued to rise rapidly over the past 10-15 years, particularly among young people. This is of concern, as several studies indicate that ecstasy is associated with a range of short- and long-term harms. Although many users acknowledge risks associated with ecstasy use, few users seek treatment. Therefore, the current project will aim to reduce ecstasy use and harm by providing non-treatment seeking ecstasy users with a brief motivational intervention.
The Feasibility And Effectiveness Of A Family-based Intervention For Indigenous Australians With Alcohol Dependence.
Funder
National Health and Medical Research Council
Funding Amount
$218,291.00
Summary
This study aims to determine the feasibility of implementing a family-based intervention in an Indigenous community-controlled health service in rural NSW and it's level of acceptability to Indigenous patients. The expected main benefits of implementing the family-based intervention are increases in the percentage of Indigenous individuals with alcohol dependence entering and engaging in evidence-based treatment.
A Randomised Trial Assessing A Shade Development Intervention In Secondary Schools For Adolescent Skin Cancer Prevention
Funder
National Health and Medical Research Council
Funding Amount
$709,615.00
Summary
Skin cancer is a significant burden to health costs, and morbidity and mortality in Australia. Reduction of exposure to ultraviolet radiation (UVR) in sunlight, particularly during childhood and adolescence is an important strategy for preventing skin cancer in later life. Adolescents have been particularly resistant to skin cancer prevention messages. Despite a high knowledge of skin cancer, the majority of Australian adolescents report a reliance on sunscreen, a resistance to hat wearing, and ....Skin cancer is a significant burden to health costs, and morbidity and mortality in Australia. Reduction of exposure to ultraviolet radiation (UVR) in sunlight, particularly during childhood and adolescence is an important strategy for preventing skin cancer in later life. Adolescents have been particularly resistant to skin cancer prevention messages. Despite a high knowledge of skin cancer, the majority of Australian adolescents report a reliance on sunscreen, a resistance to hat wearing, and commonly experience sunburn, an important indicator of increased risk of skin cancer. Psycho-social interventions have shown limited influence on adolescents' sun protective behaviours to date. The current research proposal explores an alternative approach to psycho-social interventions for adolescents. The study will assess the effect of increasing available shade at secondary schools. In a randomised control trial study design, the change in the number of students using certain outdoor areas at intervention schools will be observed 'before' and 'after' the installation of built shade sail structures. Our main hypothesis states that the number of students using these newly shaded areas in intervention schools will increase compared with use of equivalent unshaded areas in control schools. Shade development is increasingly becoming an issue for secondary schools and given both the high cost of providing shade structures and adolescents' resistance to other forms of sun protection it is important to establish that adolescents will use this form of sun protection. This study will determine whether adolescents actively avoid or seek shade and so provide evidence for informing decisions about further investment in shade provision in schools.Read moreRead less
Evaluation Of An Instrument For Management Of Behavioural And Psychological Symptoms Of Dementia.
Funder
National Health and Medical Research Council
Funding Amount
$598,468.00
Summary
Behavioural and Psychological Symptoms of Dementia (BPSD) distress the patient and others. The behaviours, and not the underlying causes, are often treated with antipsychotics, despite side effects and low efficacy. An assessment instrument for care staff to determine and address causes of BPSD will be implemented. We predict training will reduce inappropriate prescribing and other reasons for distress. Where medication is required, detailed information will assist more targeted prescribing.
Comorbid Affective Disturbance In A Model Of Absence Epilepsy - Shared Causation Linked To Morphological Abnormality?
Funder
National Health and Medical Research Council
Funding Amount
$502,650.00
Summary
People with epilepsy commonly suffer from severe mood disorders, such as depression and anxiety. These disturbances are underdiagnosed and undertreated, and are often more debilitating than the epilepsy. This project will investigate whether treatment of psychiatric disturbance with antidepressants also results in reduced seizure incidence in an animal model of epilepsy. Results generated from the study will provide clinicians strong rationale for aggressive treatment of such mood complaints.