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Long Term Follow-up Of Two Randomised Controlled Trials Of Treatment For Depression And Alcohol-other Drug Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$252,925.00
Summary
This study proposes the long term follow-up of participants in two of the first and largest studies of psychological treatment for people with co-occurring depression and alcohol-other drug use problems ever conducted. This is a crucial next step in research on the effectiveness of psychological treatment among this highly prevalent yet often neglected section of the community.
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.
Optimising Corticosteroid Injection For Lateral Epicondylalgia With Physiotherapy: A Randomised Placebo Control Trial.
Funder
National Health and Medical Research Council
Funding Amount
$373,393.00
Summary
Tennis elbow affects just under 1% of patients seeing a doctor and on average 10-30% need to take 12 weeks off work. Two popular treatments are physiotherapy and corticosteroid injections. We have recently shown that whilst injection is superior in the short term (3 weeks) compared to physiotherapy, it is responsible for 9 times more recurrences. We seek a solution for the downside to steroid injections, by studying the effects of adding physiotherapy; as such it will address a major problem.
A Multi-centre, Randomised, Controlled Trial Of BAL Directed Therapy In Young Children With Cystic Fibrosis.
Funder
National Health and Medical Research Council
Funding Amount
$571,750.00
Summary
The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated ....The management of children with cystic fibrosis (CF) aims to delay the inevitable progression of lung disease that results from chronic lower respiratory tract infection (LRTI) and inflammation. Flexible bronchoscopy (FB) and bronchoalveolar lavage (BAL) are increasingly used as research and clinical tools in the management of LRTI in CF infants and are integral to the monitoring of future drug trials and gene therapy. Early LRTI particularly with Pseudomonas aeruginosa (Pa) in CF is associated with a decline in pulmonary function and an increase in morbidity and mortality. Many CF centres internationally now treat young children with CF using aggressive antibiotic protocols in an attempt to eradicate infection. Most centres use oropharyngeal specimens to diagnose LRTI with a sensitivity of around 45% and specificity of around 90%. Thus many children miss out on treatment or are exposed unnecessarily to antibiotics. The use of antibiotics themselves may increase the risk of infection with resistant organisms thus complicating the design of drug trials in young children as monitoring for the emergence of resistant new organisms requires BAL. It is thus of key importance that the safety and value of FB and BAL is examined and long term outcomes are obtained. The financial costs of managing patients with CF in Australia may be estimated at more than $85 million-annum. Early intervention strategies may reduce health costs because of improved morbidity or may increase costs due to the intervention. This will be the first time an economic evaluation of early management and the cost effectiveness of an intervention in children with CF has been undertaken which will enable responsible health care planning for this important group of patients. This trial provides a unique opportunity to study the relationship between LRTI and inflammation and long term outcomes such as lung function and radiological scores and will provide key evidence for designing future trials.Read moreRead less
Metformin In Gestational Diabetes: Follow-up Of Mothers And Offspring: Body Composition, Insulin Resistance, Development
Funder
National Health and Medical Research Council
Funding Amount
$630,142.00
Summary
Children born to women with gestational diabetes are at increased risk of later obesity and diabetes. This study will help to assess if giving such women during their pregnancy the cheap oral diabetes drug metformin rather than insulin injections can safely reduce this risk, measuring growth, fatness and blood glucose-insulin in the children at 2 and 5 years of age, as well as assessing the mothers. If so, such treatment might help to reduce the worldwide burden of disease related to obesity.
Shared Team Approach Between Nurses And Doctors For Improved Risk Factor Management (STAND FIRM)
Funder
National Health and Medical Research Council
Funding Amount
$1,945,676.00
Summary
There are many proven treatments for preventing people with stroke from having a recurrent event, e.g. maintaining blood pressure at acceptable levels. However, uptake of therapies is poor. We will assess whether patients receiving individualised management plans, prepared and administered by both doctors and nurses will have risk factors controlled better than those receiving usual care. The plan includes education of patients to help them have more control over their own care.
Extended Follow Up Of The RENAL Study And Individual Patient Data Meta-analysis In Acute Kidney Injury
Funder
National Health and Medical Research Council
Funding Amount
$650,271.00
Summary
Acute kidney failure is increasingly common and associated with very high mortality. The long term consequences for patients and their kidney function are unknown. By extending follow up of the RENAL study, which explored how the dose of dialysis affected survival, and combining it with other trials from around the world, we will provide the strongest evidence regarding how dialysis treatment can reduce this mortality and define the long term consequences of this condition.
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
Excitatory Synaptic Circuitry And Plasticity In The Amygdala.
Funder
National Health and Medical Research Council
Funding Amount
$405,750.00
Summary
The amygdala is a key structure in the neuronal circuitry that underlies the analysis of emotional information. In particular this structure plays a major role in the processing of fear-related information. Disorders of the processing and storage of such information are thought to be the major underlying cause of mental disorders such as panic attacks, anxiety and post traumatic stress disorder. Understanding the physiology of this structure and the ways in which this can change in response to v ....The amygdala is a key structure in the neuronal circuitry that underlies the analysis of emotional information. In particular this structure plays a major role in the processing of fear-related information. Disorders of the processing and storage of such information are thought to be the major underlying cause of mental disorders such as panic attacks, anxiety and post traumatic stress disorder. Understanding the physiology of this structure and the ways in which this can change in response to various stimuli is necessary for the development of rational therapies that target the amygdala.Read moreRead less