A Randomised Control Trial Of A Group-Based Intervention For Substance Abuse In Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,250.00
Summary
The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages ....The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages of their illness, and within a number of different treatment settings. The intervention will be informed by an enhanced understanding of the motivations for substance use in people with psychotic illnesses The specific aims are to: Refine, implement and evaluate, using a controlled experimental design, a novel group-based intervention for reducing substance abuse comorbidity in people with psychotic disorders; Determine reasons for substance use by these individuals, to inform the intervention procedures; Pilot the intervention in a series of different treatment settings, including early episode and rehabilitation programs, and non-government organisations dealing with people with psychotic disorders, to ensure generalisability, adaptability, and acceptability; Augment case managers' knowledge and skills in dealing with comorbid drug and alcohol use Enhance detection, motivation to change, ongoing monitoring and relapse prevention of substance misuse in clients with psychotic disorders. It will also be possible, once the treatment intervention is finalised and evaluated, to expand its use to patients with non-psychotic mental illnesses.Read moreRead less
Randomised Control Trial Of Three Treatments For Adolescent Stutterers
Funder
National Health and Medical Research Council
Funding Amount
$376,320.00
Summary
Effective communication is an essential of everyday life, and stuttering impairs this function. Those who stutter may find effective communication impossible, and severe cases may be rendered almost mute. Clinically significant anxiety figures prominently in the disorder with almost half of those seeking treatment warranting a comorbid diagnosis of social phobia. The adolescent years are generally regarded as a difficult time of life, at which time the potential effects of disfigured speech can ....Effective communication is an essential of everyday life, and stuttering impairs this function. Those who stutter may find effective communication impossible, and severe cases may be rendered almost mute. Clinically significant anxiety figures prominently in the disorder with almost half of those seeking treatment warranting a comorbid diagnosis of social phobia. The adolescent years are generally regarded as a difficult time of life, at which time the potential effects of disfigured speech can be devastating. There has been much research and development of treatments for children and adults who stutter, proven effective treatments are available for those age groups. However, little is known about how to treat adolescents who stutter, and there has been little research and development to find the best treatment-s for this age group. The present proposal is for a randomised, controlled trial of three treatments that have been shown recently to have promise as treatment methods for this age group of patients. The trial will compare (1) a treatment that involves biofeedback muscle activity during speech, (2) a treatment that involves biofeedback of voice box activity during speech, and (3) a variant of a standard treatment that trains the speaker in a new speech pattern. The control group will receive no treatment. The trial extends for a period of 12 months after the subjects are randomly allocated to a treatment group or a control group. The subjects' speech will be assessed in a variety of situations in the clinic and during everyday life. The prime outcome measure will be percentage of syllables stuttered, and secondary measures will be the time required for treatment and how natural the patients sound after treatment. At the conclusion of the trial, the subjects in the control group will be given the treatment that was shown to be most effective.Read moreRead less
Evaluating Flexible Delivery In The Get Healthy Information And Coaching Service–A Partnership Project Between The NSW Ministry Of Health, Healthways, Healthdirect, The University Of Sydney And The University Of Queensland
Funder
National Health and Medical Research Council
Funding Amount
$296,116.00
Summary
High rates of participant drop-out are a problem in many health promotion programs. This is the case for the Get Healthy Service (GHS), a telephone health coaching service to assist adults to be active, eat healthy and lose weight. This Partnership Project aims to improve GHS retention rates without compromising the effectiveness of the GHS. Retention strategies will be evaluated in a randomised controlled trial. Results will inform changes to service delivery.
RESTORE - Individualised Movement Rehabilitation And Movement Sensor Biofeedback For Chronic, Disabling Low Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$1,214,385.00
Summary
Low back pain is the leading cause of disability in Australia, with an enormous cost burden for society. Available treatments have resulted in only moderate improvements that typically do not last. We propose to investigate the clinical- and cost-effectiveness of two new treatments that have shown promising early results: i) an individualised movement and cognitive rehabilitation approach (‘Cognitive Functional Therapy’) and ii) biofeedback from wireless movement sensors worn on the spine
A Randomised Controlled Trial Of Normoglycaemia Versus Conventional Glycaemic Control In Intensive Care Unit Patients.
Funder
National Health and Medical Research Council
Funding Amount
$1,773,507.00
Summary
The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are u ....The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are unsure if the treatment would work in their patients because of differences in the types of patients found in intensive care units in Australia, and because of other treatment given to the patients in the Belgian study. In particular the doctors in the Belgian unit studied only patients who had had operations and gave large amounts of intravenous sugar to their patients. This is not normally done in Australian Intensive Care Units and the safety of giving high dose insulin to patients not receiving large amounts of intravenous sugar is not known. This is of particular interest as reducing blood glucose to abnormally low levels can cause serious side effects and even result in permanent brain damage. The Australian and New Zealand Intensive Care Society proposes to conduct a new study involving 4,000 patients from intensive care units in Australia and New Zealand and will study all patients regardless of whether or not they have had an operation. These patients will be randomly assigned to receive insulin to control blood sugar levels to normal or to slightly above normal levels as has been tradition in intensive care units around the world. Outcome and serious side effects will be closely monitored. The results will be available within three years of starting the study, and these are likely to influence the treatment of the majority of patients admitted to intensive care units both in Australia and worldwide.Read moreRead less
Intravascular Device Administration Sets: Replacement After Standard Versus Prolonged Use (The RSVP Trial)
Funder
National Health and Medical Research Council
Funding Amount
$1,611,239.00
Summary
Most hospital patients need an IV drip, a small plastic tube in a vein, often the hand/arm. 14 million/yr are used in Australia. IV drips are connected to plastic tubing through which fluid & medicine is given. IV tubing is needed for a week or more, but is only used for 3-4 days as it was thought this might prevent infection. It is now thought that IV tubing can be used for a week. This would save $1 billion/year & reduce nurses workload. The research will test the safety of this approach.
Peripherally InSerted CEntral Catheter Securement: The PISCES Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,101,717.00
Summary
Cancer treatment often requires a peripherally inserted central catheter (PICC) for chemotherapy, transfusions, medicines, fluids, nutrition and/or blood sampling. Current PICC dressing and securement products are not preventing the 30% of PICCs that develop infection, occlusion, thrombosis or dislodgement. New products are available that may reduce complications. This trial will test their effectiveness, costs, comfort and practicality, working closely with patients, nurses and doctors.
New Methods And Guidelines For The Design, Analysis And Reporting Of Cluster-crossover And Stepped Wedge Randomised Trials In Clinical And Public Health Research
Funder
National Health and Medical Research Council
Funding Amount
$391,258.00
Summary
Cluster crossover and stepped wedge designs have emerged recently as study designs used in clinical and public health research settings. However, despite their use there has been very little methodological assessment of the statistical analysis methods used in current practice. The proposed research will assess the correctness of current methods and will produce a toolkit of state-of-the art, defensible trial design, analysis and reporting methods for the clinical/health researcher.
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