Neural Changes Associated With Symptom Improvement In Posttraumatic Stress Disorder Following Exposure Treatment
Funder
National Health and Medical Research Council
Funding Amount
$223,855.00
Summary
Posttraumatic stress disorder (PTSD) is a chronic disorder with enormous psychological, social and economic consequences that affects approximately 10-15% of Australians. Recent international research is focused on identifying mechanisms underlying effective treatments of PTSD, in an attempt to understand both the processes that maintain PTSD, and to help target more precise interventions to prevent chronic PTSD, a disabling condition that creates an enormous economic burden on health and compen ....Posttraumatic stress disorder (PTSD) is a chronic disorder with enormous psychological, social and economic consequences that affects approximately 10-15% of Australians. Recent international research is focused on identifying mechanisms underlying effective treatments of PTSD, in an attempt to understand both the processes that maintain PTSD, and to help target more precise interventions to prevent chronic PTSD, a disabling condition that creates an enormous economic burden on health and compensation systems. This project will be the first study to identify the neural mechanisms underlying effective exposure-based treatment of PTSD. Exposure-based treatments are the current treatments of choice for PTSD, with several studies showing them to be highly effective in treating PTSD. Yet, the mechanisms and agents of change underlying this effective treatment remain unknown. Exploring the neural networks associated with effective treatment and symptom change will help identify and elucidate the mechanisms underlying exposure treatment. This has critical clinical implications, enabling insight into biological mechanisms underlying PTSD, more precise identification of populations that are less responsive to standard exposure-based treatments, and eventually will lead to better targeted and more effective treatment of chronic PTSD.Read moreRead less
An Intervention Trial To Prevent Cognitive Impairment And Depression In Older Men
Funder
National Health and Medical Research Council
Funding Amount
$286,018.00
Summary
A gradual decline in the thinking processes, dementia and depression are major health issues for older people. There is already some evidence that deficiency in certain vitamins may be contributing to these problems. This project seeks to evaluate an inexpensive and simple vitamin supplement which may provide a highly cost-effective method of preventing cognitive decline, dementia and depression in older people. This research will also allow the evaluation of the role of certain biological and g ....A gradual decline in the thinking processes, dementia and depression are major health issues for older people. There is already some evidence that deficiency in certain vitamins may be contributing to these problems. This project seeks to evaluate an inexpensive and simple vitamin supplement which may provide a highly cost-effective method of preventing cognitive decline, dementia and depression in older people. This research will also allow the evaluation of the role of certain biological and genetic risk factors which may also impact on these problems. This project seeks to do a trial of these vitamins in older men who are at particular risk for these problems. The men in this project will be monitored by simple tests of their thinking and evaluating any symptoms of depression.Read moreRead less
Evaluation Of Internet-based, Cognitive Behaviour Therapy For The Treatment Of Anxiety Disorders In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$570,750.00
Summary
Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary ....Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary to original beliefs, evidence shows that the internet can be used to deliver effective psychological therapies for a range of mental health problems, including anxiety disorders. So far this research has focused on adults, but adolescents may be in a particularly strong position to benefit from these forms of therapy, being experienced users of internet resources. This research investigates the effectiveness of internet-based cognitive-behaviour therapy (CBT) in the treatment for anxiety disorders in adolescents. Recently we have piloted CBT for anxious children that combines clinic and internet therapy, with half the therapy sessions in the clinic and half over the internet. Pilot data show that clinic + internet therapy produced significant reductions in anxiety and is almost as effective full clinic-based therapy. The proposed research builds on our pilot work by evaluating the effectiveness of a more extensive internet-based therapy in which all sessions are completed using the internet and with an older age group. The research also examines the factors that predict which young people will respond most positively to the intervention so that the treatment can be matched to those most likely to benefit from it in the future. The aim is to develop an effective internet-based treatment for adolescents with anxiety disorders that is easily accessed and suitable for use in rural and remote populations, requiring minimal face-to-face therapist contact.Read moreRead less
A RCT Of Power Training And Treadmill Training To Improve Walking Ability In Sub-acute Stroke Patients.
Funder
National Health and Medical Research Council
Funding Amount
$403,041.00
Summary
Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of trea ....Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of treadmill walking. However, this form of training does not address the weakness following stroke. Therefore we propose to demonstrate the efficacy of a relatively new modality 'treadmill training with power training', at higher intensity over a greater number of sessions than would be received currently with 'usual care' or treadmill training only. To ensure that persons continue to maintain the level of improvement from an intensive exercise program, we will also implement a behavioural change for long-term maintenance of exercise behaviour in a less supervised environment. A randomized, single-blinded, control trial will be used. Subjects will be randomly allocated to 'treadmill training + power training', 'treadmill training', or usual care (i.e. control). Subjects in the two training groups will also receive 'usual care'. Subjects in the treadmill and treadmill + power training groups will attend training sessions for 10 weeks, with 3 sessions per week. Subjects will then be provided with a home exercise package to continue with their exercises. The findings from this study are critical in identifying whether, by addressing the 3 major impairments following stroke at doses which are known to produce physiological change in other frail populations, the stroke patient can achieve independence in walking and walk sufficient distances, both of which are important to the stroke patient.Read moreRead less
Randomized Controlled Trial Of CPAP On Cardiac Function In Patients With Heart Failure And Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$140,906.00
Summary
Heart failure is a very common condition associated with disabling symptoms. The main symptoms are breathlessness, usually during sleep or upon exercise, and fatigue. Recent research has identified that sleep apnoea, a condition that occurs in about 50% of subjects with heart failure, is likely to be responsible for these symptoms. Moreover, treatment specifically aimed at sleep apnoea, namely continuous positive airway pressure (CPAP) delived via a small electric pump and nasal mask worn during ....Heart failure is a very common condition associated with disabling symptoms. The main symptoms are breathlessness, usually during sleep or upon exercise, and fatigue. Recent research has identified that sleep apnoea, a condition that occurs in about 50% of subjects with heart failure, is likely to be responsible for these symptoms. Moreover, treatment specifically aimed at sleep apnoea, namely continuous positive airway pressure (CPAP) delived via a small electric pump and nasal mask worn during sleep, may also improve the symptoms of heart failure. The study will involve subjects with stable heart failure on optimal drug treatment who have evidence of obstructive sleep apnea on an overnight sleep study. Obstructive sleep apnoea (OSA) is a condition in which the throat intermittently narrows or blocks during sleep (often associated with snoring) causing cessation of airflow or apnoeas. Associated with the apnoeas are vigorous efforts by the chest muscles to breathe (creating negative vacuum-like pressures within the chest - and around the heart) at a time of falling oxygen levels. Previous research has suggested that these obstructive apnoeas are detrimental to the heart. Volunteers will be randomized to either a control or a CPAP treated group for a three month period. The control and CPAP groups will receive intensive advice about good eating and sleeping habits as weight gain and sleep loss are factors known to aggravate heart failure and obstructive sleep apnoea. In addition to the lifestyle advice, the CPAP group will also be treated with nasal CPAP. The variables which we will measure include severity of sleep apnoea, exercise capacity, heart function at rest and symptoms. Symptoms will be measured using 4 very detailed and validated questionnaires.Read moreRead less
Early Intervention For Anxiety And Phobic Disorders In Young Children With Intellectual Disability
Funder
National Health and Medical Research Council
Funding Amount
$305,674.00
Summary
Children with intellectual disability (ID) are 2-3 times more likely to have behavioural and emotional disturbance, including anxiety and fears, than children of normal intellectual ability. Anxiety problems are a source of distress for the child, impair their ability to learn and are a cause of family burden and community cost. Therefore, effective interventions are urgently required. Research with non-disabled children has demonstrated the effectiveness of teaching parents to manage their chil ....Children with intellectual disability (ID) are 2-3 times more likely to have behavioural and emotional disturbance, including anxiety and fears, than children of normal intellectual ability. Anxiety problems are a source of distress for the child, impair their ability to learn and are a cause of family burden and community cost. Therefore, effective interventions are urgently required. Research with non-disabled children has demonstrated the effectiveness of teaching parents to manage their child's anxiety, however the effectiveness of this approach in children with ID has not yet been established. This project aims to compare the relative effectiveness of two intervention conditions compared to a waiting list group, for highly anxious children aged 4-7 years with ID. One intervention will teach parents to help their child deal with anxiety problems, and develop skills to overcome their own associated emotional upset and family and social problems. The other intervention will provide non-directive counselling and support to help the parents understand the nature and causes of ID, associated anxiety problems in the child, and parent and family stress. The long term outcome of these two interventions will be assessed by following the children and their families for two years. A manual of each treatment is produced. This project aims to provide evidence for a relatively inexpensive, feasible and effective early intervention program for young children with ID at risk for developing anxiety problems that can be easily taught to professionals and is acceptable to parents. Widespread use of this intervention has the potential to reduce the added burden and cost to families and the community of persistent severe anxiety in young people with ID.Read moreRead less
Health, Economic, Psychological And Social Impact Of Educating Carers Of Patients With Advanced Pulmonary Disease (APD)
Funder
National Health and Medical Research Council
Funding Amount
$605,452.00
Summary
Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified ....Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified difficulties experienced by caregivers of the elderly in general, very little research has been undertaken with carers of patients with APD. The study will compare the usual practice of educating patients with APD who commence home oxygen therapy (HOT), and their carers, against a more detailed and individually targeted education program that increases the skills of patients and carers. This study has the potential to reduce hospital-residential care readmission, reduce carer distress, improve patient outcomes, reduce adverse effects of oxygen therapy and medication use, and minimize inappropriate presentation to tertiary care emergency departments.Read moreRead less