A Comparative Clinical Efficacy Trial Of Treatments For Melancholia
Funder
National Health and Medical Research Council
Funding Amount
$309,711.00
Summary
This study seeks to improve treatment of melancholic depression by comparing three treatments, i) a selective serotonin reuptake inhibitor (SSRI), ii) cognitive behaviour therapy (CBT) and, iii) a broad-spectrum antidepressant sequencing treatment approach. We hypothesize that the latter will be superior to both i) SSRI monotherapy, and ii) CBT monotherapy, over a 12-week trial period. Comparisons will be made with the US-based Sequenced Treatment Alternatives to Relieve Depression trial.
INTERACT: A Randomised Trial Of Intensive Blood Pressure Lowering In Acute Intracerebral Haemorrhage
Funder
National Health and Medical Research Council
Funding Amount
$2,680,868.00
Summary
Intracerebral haemorrhage (ICH) is a serious type of stroke affecting thousands of Australians and 2-3 million people in the world each year, with most either dying or left disabled. There is no proven treatment for ICH, although surgery is sometimes used and early injection of a special clotting factor may improve outcome. One potential simple therapy is the rapid control of elevated blood pressure (BP) which occurs commonly and predicts a poor outcome in ICH, possibly by increasing bleeding an ....Intracerebral haemorrhage (ICH) is a serious type of stroke affecting thousands of Australians and 2-3 million people in the world each year, with most either dying or left disabled. There is no proven treatment for ICH, although surgery is sometimes used and early injection of a special clotting factor may improve outcome. One potential simple therapy is the rapid control of elevated blood pressure (BP) which occurs commonly and predicts a poor outcome in ICH, possibly by increasing bleeding and swelling in the brain. There is much uncertainty as to the optimal management of elevated BP in ICH. This study, called INTERACT, aims to determine the balance of benefits and risks of a management strategy of early rapid BP lowering in 2000 patients with ICH randomised from 100 clinical sites in Australia-Asia.Read moreRead less
Association Between Obesity, TGFb, Thrombospondin And Small Abdominal Aortic Aneurysm Progression.
Funder
National Health and Medical Research Council
Funding Amount
$514,777.00
Summary
Abdominal aortic aneurysm (AAA) is an important cause of mortality in middle aged and elderly Australians. The incidence of AAA continues to increase despite improvements in the medical management of atherosclerosis. We postulate that obesity is important in the progression of AAA. In a community screening study we found that waist-hip ratio was independently associated with AAA. In this project we investigate the mechanisms underlying this association between obesity and AAA.
Treatment Of Bacterial Vaginosis: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$265,757.00
Summary
The objective of this research project is to determine if the treatment of Bacterial Vaginosis (BV) can be improved. Bacterial vaginosis is one of the most common causes of vaginal discharge in women. It can also have serious consequences, such as premature labour and can also increase the risk of HIV transmission. These complication cost communities many millions of dollars; for example in the US it is estimated that premature labour caused by BV alone costs about 1 billion dollars a year. The ....The objective of this research project is to determine if the treatment of Bacterial Vaginosis (BV) can be improved. Bacterial vaginosis is one of the most common causes of vaginal discharge in women. It can also have serious consequences, such as premature labour and can also increase the risk of HIV transmission. These complication cost communities many millions of dollars; for example in the US it is estimated that premature labour caused by BV alone costs about 1 billion dollars a year. The currently recommended treatment for BV works well initially (first month about 80% respond) but by 12 months most (60%) have relapsed. This randomised clinical study is investigating new ways to treat BV. The currently recommended arm of treatment (antibiotic metronidazole) is being compared to two other treatments. The second arm of the study involves the use of two antibiotics at once (metronidazole and clindamycin) and the third arm involves the use of a bacterial (lactobacilli) and oestrogen. Lactobacilli are bacteria that may help maintain the normal bacterial (and there by prevent relapse of BV) and oestrogen may have a similar effect. If either of these treatments improved the longer term treatment of BV, very significant benefits would flow to affected women and the community as a whole.Read moreRead less
Evaluation Of Internet-Based Treatments For Comorbidity Of Alcohol Disorders And Depressive Mood
Funder
National Health and Medical Research Council
Funding Amount
$710,333.00
Summary
Depression and alcohol problems often co-occur and contribute significantly to non-fatal disease burden in Australia. Psychological treatment for these illnesses is effective, but many Australians lack access to appropriate services. This study addresses this problem by offering treatment via the internet. This randomised controlled trial will compare three online treatments for comorbid alcohol use and depression.
Risk Of Birth Defects In Children Born Following Infertility Treatment
Funder
National Health and Medical Research Council
Funding Amount
$191,962.00
Summary
The development of assisted reproductive technology (ART) for infertility treatment has advanced at a tremendous pace since late 1970's. The use of ART is becoming increasingly frequent, with Australia having one of the highest rates of use internationally. Over 4,000 births result from ART annually in Australia. At the same time, minimally invasive infertility treatment-ovulation induction and insemination, remains a main option for some infertile couples and also generates several thousand bir ....The development of assisted reproductive technology (ART) for infertility treatment has advanced at a tremendous pace since late 1970's. The use of ART is becoming increasingly frequent, with Australia having one of the highest rates of use internationally. Over 4,000 births result from ART annually in Australia. At the same time, minimally invasive infertility treatment-ovulation induction and insemination, remains a main option for some infertile couples and also generates several thousand births annually. A fundamental concern for those involved in infertility treatment is the health of the children born following the treatment. Evidence from many studies indicates that compared to the general population, ART babies are more likely to be a twin or triplet, have a low birth weight, be born premature, and suffer higher rates of perinatal death and cerebral palsy. These issues are gradually being addressed by transferring a single embryo in a cycle. Of greater concern is the recent reporting by a Western Australian team that the risk of major birth defects is doubled in ART children. This is a highly significant finding that has raised concern in patients and clinicians. It is imperative to verify the findings through replication in a larger study. It is equally important to identify whether the increased risk is due to potentially modifiable treatment factors or patient factors related to their infertility. This innovative study will therefore also separate patient characteristics and type of treatment, and partition the risk attributable to various factors. The health of children from infertility treatments is of fundamental concern and has become an important public health issue. This study will direct future basic research in embryology and clinical services where there is a continual need to balance technical innovation and efficacy with treatment safety. The long-term benefit will be improvement of the health status of Australian families.Read moreRead less
Improving Asthma Control: General Practice Strategies To Optimise Medication Adherence
Funder
National Health and Medical Research Council
Funding Amount
$460,820.00
Summary
Asthma is a major health problem for Australia. Many patients have frequent symptoms and need urgent health care because they do not use a preventer inhaler regularly. This may be intentional e.g. fear of side-effects, and-or unintentional e.g. forgetting. This real-life study will test two simple strategies for GPs to improve their patients' use of preventer medications, to improve asthma control. Innovative technology will allow GPs to tailor the approach to each patient during a normal visit.
The Australia And New Zealand Fontan Registry: A Growing Population Of Young Adults With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$129,103.00
Summary
The Fontan procedure is an operation performed for all children with heart defects who cannot be repaired with 2 pumping chambers like a normal heart. It is expected that after 2 or 3 decades, these patients will either die or need a heart transplantation. We want to establish a registry to evaluate the number and status of this increasing patient population. This study may foresee and even prevent a sudden burden on the health system caused by their needs.
Randomised Controlled Trial Of A New Intervention For Alcohol Craving
Funder
National Health and Medical Research Council
Funding Amount
$780,673.00
Summary
Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and lo ....Alcohol problems continue to pose a significant burden across many areas, including the physical and mental health of the individual, and the wider implications for families, health systems providing care, and society as a whole. Despite the existence of a variety of therapies including in- and outpatient programs and anti-craving medications, people continue to struggle with this problem. Increased craving for alcohol is a major factor in ability to adhere to treatment, rate of progress, and long-term maintenance of change. Whilst current medications target craving, they provide only short-term symptom relief, and not all people find them effective. Cravings are both distracting and distressing during treatment, and increased craving often predicts treatment drop-out and relapse. This project evaluates a new treatment for alcohol misuse: CARM - Craving for Alcohol: Reduction and Management. This 8-session enhanced Cognitive-Behaviour Treatment (CBT) focuses on teaching people new skills to manage and reduce cravings, and is based on a new theory of craving that has strong research support. The study compares 4 groups: CARM; a more traditional CBT treatment for alcohol problems [motivational interviewing, problem solving for high-risk situations, and relapse prevention]; plus two brief interventions [Motivational Interviewing plus Self-Monitoring, and Self-Monitoring alone] both followed by CARM after an 8 week delay. All participants are able to set their own goals of abstinence or reduced use. Expected outcomes: all participants will learn effective skills to manage their alcohol use, resulting in significant reductions in alcohol consumption and fewer problems from alcohol use; however, those receiving CARM will find it easier to manage cravings during treatment, and will make faster progress and show less treatment drop-out. It is also anticipated that participants in CARM will show better long-term maintenance of treatment gains.Read moreRead less
Health System Performance And Outcomes For Indigenous Australians With Cancer: A National Study.
Funder
National Health and Medical Research Council
Funding Amount
$412,354.00
Summary
Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained ab ....Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained about health system performance for Indigenous Australians from national administrative databases and registers. This project will assess health system performance and outcome for Indigenous people with cancer at a national level for the first time. It will compare Indigenous with non-Indigenous cancer survival rates for Australia as a whole, including regional (urban-rural-remote) variations and time trends. For those states where data on stage at diagnosis and hospital treatment are available, it will also investigate the performance of diagnostic and treatment services for Indigenous cancer patients by comparing their stage at diagnosis and surgical treatment with that for non-Indigenous patients. Time trends for each of these issues will be examined using data from those states with data of adequate quality and consistency over the past 10-15 years. This project will provide the methodological basis for regular reporting of Indigenous cancer survival and related statistics in the national cancer reporting system and demonstrate that national monitoring of the acute care system for Indigenous people is possible for other conditions. The results of this research will directly inform acute care policy and practice for Indigenous people with cancer (particularly the relative need for improvement in primary health or acute care services), and have implications for the performance of the acute care system system more generally for Indigenous Australians.Read moreRead less