Life! Diabetes Prevention Program: A Randomised Cluster Control Trial Of Its Efficacy And Cost Effectiveness
Funder
National Health and Medical Research Council
Funding Amount
$866,066.00
Summary
Type 2 diabetes is a great and growing epidemic, and Australia's largest public health challenge. Life! is a diabetes prevention program for 25,000 Victorians. This proposal will look at its efficacy, effectiveness and cost effectiveness so that more improvements can be made.
A Trial Of A Multidisciplinary, Group Based Intervention To Meet The Needs Of Men With Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$524,285.00
Summary
This study will test an innovative approach to meeting the physical and psychosocial needs of men with early stage prostate cancer using a randomised controlled trial. This novel approach involves a combination of individual and group-based consultations which encourages peer-to-peer support, promotes self-care and enhances appropriate multidisciplinary referrals and communication. It provides a new model of care for patients with chronic diseases that can be translated into clinical practice.
Impact Of Genetic Testing For Breast Cancer Predisposition On Psychological Adjustment And Related Health Behaviours.
Funder
National Health and Medical Research Council
Funding Amount
$96,897.00
Summary
This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now ....This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now known to significantly reduce risk in women with a strong family history of breast cancer. Whether these potential benefits are realised in practice needs to be evaluated, as do potential psychological harms, if any. Predictive genetic testing for hereditary breast cancer has become technically possible before its impact on psychological outcomes has been evaluated. As yet there are no Australian data on the impact of predisposition testing in any potentially treatable adult onset conditions and only preliminary overseas data. Results from this study may therefore have application to other potentially treatable adult onset conditions. Changes before and after testing in psychological status will be studied (using established methodology) over a 2-year period to identify when negative outcomes are most likely to occur. In addition, this study aims to identify factors that facilitate or hinder psychological adjustment so as to inform clinical decisions about testing and to allow appropriate interventions to be devised. Assessment of individual's preferences for the amount of information they receive will allow tailoring of information to maximise the benefit of educational materials and potentially minimise distress. Factors which influence women's decisions to undertake prophylactic surgery and their satisfaction with those procedures will be assessed.Read moreRead less
Women's Evaluation Of A Randomised Controlled Trial For Abuse And Violence In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$679,718.00
Summary
Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief ....Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief counselling intervention for abused women in general practice using a randomised controlled trial. General practice staff (general practitioners and-or practice nurses) will be randomised either to be intensively trained to deliver the intervention and their practice systems improved for care of abused women or to be given information to ensure minimum safe practice and deliver 'usual care' to abused women. The primary aim of the intervention is to increase abused women's safety behaviours and planning and improve their mental health and quality of life. Secondary aims include increasing their readiness for change and action with regard to abuse, and their comfort to discuss abuse with general practitioners-practice nurses and general practitioners-practice nurses inquiry about safety. It is not expected that in a twelve month period that any intervention with women will be able to decrease the abuse women experience as women cannot control their partners' behaviour and to leave is not necessarily going to end the violence and abuse. Rather, the intervention and outcomes will look at women's pathway and decision making around seeking safety and non-violence. A cost effective analysis will also be undertaken using health service use by women and costs of the intervention.Read moreRead less
The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, ther ....The survival of a baby at birth is crtically dependent upon the ability of the lungs to successfully take over the role of exchanging oxygen and carbon dioxide between the air and blood. To perform this task, during fetal life the lung must have grown properly and near the end of gestation it must mature both structurally and biochemically. Thus, babies that are born early, before the expected time of birth, are born before the lungs have had the opportunity to mature. It is not surprising, therefore, that an inability to breathe is one of the primary problems faced by a prematurely born infant. During late gestation the lung changes dramatically in order to increase its ability to exchange gases. There is an increase in surface area and a reduction in the barrier thickness between the airspace and the blood stream. The molecular mechanisms involved in this remodelling are unknown, but it is known that the administration of corticosteroids to women at risk of preterm labour causes a large decrease in this barrier thickness and increases the distensibility of the lung. This project seeks to understand how the structure of the lung matures in late gestation and to determine whether corticosteroids regulate these changes by altering the structure of a specialised molecule, called versican. Versican resides in the tissue space outside of cells and has special properties that allow it to retain water and help organise the surrounding matrix. We propose that alterations in the structure of versican will reduce its ability to retain water, thereby reducing the tissue volume and contributing to a reduction in the air-blood tissue barrier within the lung.Read moreRead less
Lung Injury Following Resuscitation In Immature Lambs
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
The primary aim of this project is to identify techniques for resuscitating premature babies that cause little or no damage to their lungs. We also want to identify factors that enhance the clearance of liquid from the lungs so air can easily enter to deliver oxygen and remove carbon dioxide at birth. About 1% of babies are born very prematurely and many develop respiratory distress syndrome (RDS). This is the major cause of illness and death in infants born at less than 32 weeks' gestation. Mos ....The primary aim of this project is to identify techniques for resuscitating premature babies that cause little or no damage to their lungs. We also want to identify factors that enhance the clearance of liquid from the lungs so air can easily enter to deliver oxygen and remove carbon dioxide at birth. About 1% of babies are born very prematurely and many develop respiratory distress syndrome (RDS). This is the major cause of illness and death in infants born at less than 32 weeks' gestation. Most of the survivors required assisted ventilation during their first weeks of life. In 1995, 2381 premature infants were ventilated in Australia and New Zealand, requiring 36,407 days of ventilator care. Thus, this is a serious condition with a high financial and social cost. It is known that RDS is caused by damage to the very immature lung which starts an inflammatory reaction. We don't know what triggers the damage and inflammation but believe that the way babies are resuscitated may damage the lungs. Currently, babies are resuscitated with a resuscitation bag squeezed by hand, with 100% oxygen. There is no pressure to stop the lungs collapsing during expiration. As the volume of gas delivered with each breath is not measured, it is possible that the volumes are too large and damage the lungs. This project will investigate whether less damage occurs to the lungs of preterm lambs when resuscitation uses a modern neonatal ventilator where each inflation is limited to a known volume. A small distending pressure will be used to stop the lungs collapsing during expiration. We will also investigate factors that enhance the clearance of liquid from the lungs after the initiation of breathing. The failure to clear lung liquid greatly limits the ability of babies to breathe and exposes those parts of the lung that are cleared to a much greater risk of injury. The results of this study will be directly applicable to the treatment and care of prematurely born babies.Read moreRead less
Fetal Intrapartum Pulse Oximetry: A Multicentre Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$246,001.00
Summary
Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a ....Current methods of monitoring the well-being of the unborn baby during labour often result in concern about the unborn baby's health. This leads to delivery by caesarean section, forceps, or vacuum. These babies are usually found to be healthy once born, meaning that the operation was unnecessary. In this study, when an unborn baby appears to be distressed, half of the study participants will be allocated to continue with the current monitoring of the baby's heartbeat. The other half will have a new form of monitoring in labour, fetal oxygen saturation monitoring, added. We will then determine whether the new form of monitoring makes a difference in the number of times women need to have a caesarean section, forceps, or vacuum delivery. It is important to do this research BEFORE the new form of monitoring becomes used routinely. This Australian research is leading the world in letting the health consumer (women) know whether the now monitoring method is effective in practice and ensuring that there are no unforeseen adverse events.Read moreRead less