Randomised Controlled Trials Of Laparoscopic Techniques For Antireflux Surgery
Funder
National Health and Medical Research Council
Funding Amount
$275,923.00
Summary
Gastro-oesophageal reflux is common, and over the last decade there has been an exponential rise in the usage of acid suppressing medication. Current trends suggest that the national cost of medical treatment of reflux will become unaffordable unless new management or preventative strategies can be developed. Presently, surgery is the only treatment which can cure reflux. Laparoscopic fundoplication has recently become an acceptable, low morbidity keyhole surgical treatment for this problem. How ....Gastro-oesophageal reflux is common, and over the last decade there has been an exponential rise in the usage of acid suppressing medication. Current trends suggest that the national cost of medical treatment of reflux will become unaffordable unless new management or preventative strategies can be developed. Presently, surgery is the only treatment which can cure reflux. Laparoscopic fundoplication has recently become an acceptable, low morbidity keyhole surgical treatment for this problem. However, research is essential to develop a procedure which optimizes the outcome for patients undergoing surgical management of reflux, and minimizes the risk of complications. This may provide a better alternative to long term management with acid suppressing medication, and could eventually achieve long term savings to the nation's health budget. Since 1994 research conducted at the Royal Adelaide Hospital has evaluated a range of different key hole operations aimed at improving the outcome for patients undergoing surgery for gastro-oesophageal reflux. Over 100 patients have been entered into each of the following clinical trials: total fundoplication with or without division of the short gastric vessels, total versus anterior partial fundoplication and posterior or anterior hiatal repair. Further trials will compare a lesser degree of anterior partial fundoplication with total fundoplication. A common research protocol has been developed and applied to all of these trials. This involves the use of double blind randomised methodology, with independent follow-up obtained by an independent investigator. These trials will determine the best surgical technique for the surgical correction of reflux, and this should lead to a more widely accepted surgical alternative to existing non-operative strategies for pathological reflux.Read moreRead less
Interdisciplinary Maternal Perinatal Action On Clinical Trials Collaboration
Funder
National Health and Medical Research Council
Funding Amount
$1,140,000.00
Summary
The aims of the Interdisciplinary Maternal Perinatal Action on Clinical Trials (IMPACT) Collaboration is to promote and support high quality clinical trials addressing important research questions to improve the health and well being of women and their children. These aims will be achieved by implementing the three objectives of the Collaboration: • Provision of high level support to researchers at a national and regional level; • Provision of ongoing education and training; and • Identification ....The aims of the Interdisciplinary Maternal Perinatal Action on Clinical Trials (IMPACT) Collaboration is to promote and support high quality clinical trials addressing important research questions to improve the health and well being of women and their children. These aims will be achieved by implementing the three objectives of the Collaboration: • Provision of high level support to researchers at a national and regional level; • Provision of ongoing education and training; and • Identification of national priority research areas and encouraging methodological trials.Read moreRead less
Improving Community Approaches For Common Childhood Conditions.
Funder
National Health and Medical Research Council
Funding Amount
$478,602.00
Summary
Melissa’s end goal is community-based strategies that effectively prevent or manage common childhood conditions, which she addresses via four distinct yet unified programs of research (language-literacy, hearing loss, obesity, and early mental health-behaviour). All four programs are guided by long-term strategic plans that include advocacy and translation as central tenets. A further focus is research capacity-building in these areas via her substantial doctoral-postdoctoral programs.
Effects Of Laterally Wedged Insoles On Symptoms And Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$480,850.00
Summary
Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow di ....Knee arthritis is a painful, disabling, costly condition particularly affecting the elderly. As there is presently no cure for knee arthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow disease progression in certain patients, in addition to managing symptoms. However, to date there has been little quality research investigating the effectiveness of insoles in knee arthritis. This study aims to see whether 12 months of wearing insoles can lead to improvements in knee pain and function and slow disease progression in 200 people with knee arthritis. It will use state-of-the-art technology, magnetic resonance imaging, to measure changes in the amount of knee cartilage. This research is timely and the findings will be of major significance as there is increasing world-wide attention on slowing progression of knee arthritis. Insoles are one of the few non-drug therapies with the potential to influence both symptoms and disease progression. If the results show that insoles are beneficial, then this research will: 1. Better inform clinical guidelines to firmly recommend insoles to manage knee arthritis 2. Provide the basis for developing education strategies for health care practitioners and patients about the benefits of insoles 3. Provide the impetus to make insoles more readily available directly to patients 4. Ultimately lead to better patient outcomesRead moreRead less
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less
A Randomised Trial Of Adjuvant Chemotherapies In Resectable Pancreatic Cancer: ESPAC-3
Funder
National Health and Medical Research Council
Funding Amount
$430,500.00
Summary
Over 1,650 Australians are diagnosed with pancreatic cancer each year. In most cases, surgery will remove the tumour but it is possible that the cancer will return as a result of undetectable disease (micrometastases). The cancer will return and be incurable in the majority of patients. More than 1600 Australians die of the disease every year. This study compares the impact of adding chemotherapy to surgery alone (the current standard of care). The study will also compare the effectiveness of tw ....Over 1,650 Australians are diagnosed with pancreatic cancer each year. In most cases, surgery will remove the tumour but it is possible that the cancer will return as a result of undetectable disease (micrometastases). The cancer will return and be incurable in the majority of patients. More than 1600 Australians die of the disease every year. This study compares the impact of adding chemotherapy to surgery alone (the current standard of care). The study will also compare the effectiveness of two different types of chemotherapy. Surgical resection of a pancreas tumour is the current standard of care for this disease. It is possible that people treated with chemotherapy after their tumour has been surgically removed may live longer before their disease returns and may liver longer overall. This has been shown to be true in other in cancers; eg. breast and bowel. The side effects of chemotherapy are important and can be severe in some people. Recent studies in advanced pancreatic cancer have suggested that the new drug gemcitabine may be more effective than other drugs. For this reason, the trial compares the outcomes in people treated with gemcitabine to those treated with an older drug 5FU, which has been shown to improve survival in an earlier study by a European group. This trial will determine if chemotherapy in addition to surgery increases the length of time before the disease comes back and survival. If it does, it should become standard practice. This study is an important international initiative that will provide unique information about effectiveness of these treatments and their impact on quality of life from the patient's perspective. This study and the previous European study are the largest of their type ever done. 900 people will take part. This study is being conducted in Australia by the Australasian Gastro-Intestinal Trials in collaboration with the Australian Hepatobilary Association and the NHMRC Clinical Trials Centre.Read moreRead less