A Multi-setting Intervention To Reduce Sedentary Behaviour, Promote Physical Activity And Improve Childrens Health
Funder
National Health and Medical Research Council
Funding Amount
$860,343.00
Summary
Sedentary behaviours and physical inactivity play a major role in the rising prevalence of obesity among children in Australia. This intervention study will take place in the school and family settings which play a critical role in shaping children's health behaviours. The objective is to determine whether a 2-year behavioural intervention reduces sedentary behaviour and promotes physical activity and results in improved health among 8-9 year old children.
Many older people who fracture their hip do not recover to their previous level of function. This study will test whether it is possible to help recovery of function, particularly walking, after hip fracture by using different and more intensive physiotherapy treatment. The treatment will concentrate on exercise when standing, will be provided twice daily and will continue after the person with hip fracture has returned home. Four months after the hip fracture it is expected that walking ability ....Many older people who fracture their hip do not recover to their previous level of function. This study will test whether it is possible to help recovery of function, particularly walking, after hip fracture by using different and more intensive physiotherapy treatment. The treatment will concentrate on exercise when standing, will be provided twice daily and will continue after the person with hip fracture has returned home. Four months after the hip fracture it is expected that walking ability, strength and balance will be improved by the new treatment methods.Read moreRead less
Exercise Self-management To Improve Long-term Functioning And Prevent Falls After Hip Fracture.
Funder
National Health and Medical Research Council
Funding Amount
$848,478.00
Summary
Up to 20,000 older Australians suffer hip fractures each year. Many people don't fully recover. We have designed a self-management training program which incorporates individualised exercise prescription. This novel program is designed for people who have completed usual treatment and rehabilitation for hip fracture. We will conduct a well-designed randomised controlled trial to test the effects of this program on disability, falls and hospital readmissions and to assess its cost-effectiveness.
Functional Genomic Analysis Of The Role Of P53 In Early Embryo Death After Assisted Reproductive Technologies (ART).
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
Assisted reproductive technologies (ART, such as IVF and related techniques) are successful treatments for most forms of infertility. ART are expensive therapies and much of this cost is related to the relative inefficiency of the technology. Much of this is due to the high mortality of the resulting embryos. Typically, 45-80% of embryos produced by ART do not survive the first week. Consequently the chance of any individual embryo resulting in a successful birth is not high. There has been only ....Assisted reproductive technologies (ART, such as IVF and related techniques) are successful treatments for most forms of infertility. ART are expensive therapies and much of this cost is related to the relative inefficiency of the technology. Much of this is due to the high mortality of the resulting embryos. Typically, 45-80% of embryos produced by ART do not survive the first week. Consequently the chance of any individual embryo resulting in a successful birth is not high. There has been only modest increments in embryo survival in recent years. The low cahnce of individual embryos resulting in a baby means that: (1) generally several treatment cycles are required; (2) superovulation is used to maximise the number of embryos produced giving an accumulation of unwanted cryopreserved embryos; (3) more than one embryo is generally transferred resulting in a significant incidence of multiple pregancies. The high mortality of the early embryo seems to be a general feature of IVF but its causes and effectors are not known. It has recently been established that it largely occurs due to a form of cell 'suicide' known as apoptosis. This form of cell death has important normal functions: its activation allows for cells that are no longer required to be removed, allowing the remodelling of tissues and it also serves to remove cells that are irreversibly damaged. p53 is a protein that has the ability to 'sense' cell stress and damage and to direct the cell to undergo apoptosis if the stress is severe. This project will examine if ART cause increased expression of p53 and whether this elevation of p53 causes embryonic cell death. We will examine the factirs that control p53 expression in the embryo. using mice with mutations that stop the function of p53 and several of its regulatory proteins. Experiments will determine the susceptibility of embryos possessing these mutations and will therefore allow us to define the proteins causing apoptosis after ART.Read moreRead less
Follow-up Of Women On A Randomised Clinical Trial Of Adjuvant Docetaxel And Doxorubicin For Node Positive Breast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$113,250.00
Summary
This project is testing the use of a drug docetaxel in the post-operative (adjuvant) treatment of women with breast cancer and involved lymph nodes (N+). Until recently the drug doxorubicin was the most active chemotherapy drug for breast cancer, but more recently a new group of chemotherapy drugs called taxanes were identified. One taxane called docetaxel may be even more effective than doxoubicin. Using available treatments that include doxorubicin based chemotherapy, approximately half the wo ....This project is testing the use of a drug docetaxel in the post-operative (adjuvant) treatment of women with breast cancer and involved lymph nodes (N+). Until recently the drug doxorubicin was the most active chemotherapy drug for breast cancer, but more recently a new group of chemotherapy drugs called taxanes were identified. One taxane called docetaxel may be even more effective than doxoubicin. Using available treatments that include doxorubicin based chemotherapy, approximately half the women with N+ breast cancer experience recurrence of their cancer. It is therefore important to test whether the inclusion of docetaxel in adjuvant therapy can reduce relapses. If docetaxel is to be included, it is also important to test whether it is best to combine it with doxorubicin at the same time (which for safety reasons requires the doses of each drug to be reduced), versus giving them sequentially at full dose. Currently, docetaxel is not approved nor funded for use in early breast cancer in Australia. There are several international trials testing the inclusion of taxanes in the adjuvant therapy of breast cancer. However this trial stands out, because all the women in the trial receive chemotherapy of at least 6 months. In some other trials, testing the possible benefit of adding a taxane, women in the control treatment group (who were randomised not to receive the taxane) received only 3 months of treatment, which makes it difficult to distinguish between longer treatment or addition of the taxane drug. This trial has completed international recruitment of 2890 women who will be carefully followed for 10 years. Australian and New Zealand centers recruited 20% of the women in the trial. After the women have been followed-up for 5 years the results of this trial will be analysed, presented and published and should provide reliable evidence about the potential benefit of adding docetaxel into adjuvant chemotherapy.Read moreRead less
Clinical Trial Of Adjuvant Docetaxel And Doxorubicin For Node Positive Breast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$185,135.00
Summary
This project is investigating the optimal use of docetaxel and doxorubicin in the treatment of women with breast cancer and involved lymph nodes (N+). Every year 3000 women in Australia, and over 400,000 worldwide are newly diagnosed with N+ breast cancer. Using available treatments more than 60% of these (5 per day in Australia, 4,500 each week worldwide) will die from breast cancer. The efficacy of adjuvant chemotherapy in early breast cancer is well established by the international overview c ....This project is investigating the optimal use of docetaxel and doxorubicin in the treatment of women with breast cancer and involved lymph nodes (N+). Every year 3000 women in Australia, and over 400,000 worldwide are newly diagnosed with N+ breast cancer. Using available treatments more than 60% of these (5 per day in Australia, 4,500 each week worldwide) will die from breast cancer. The efficacy of adjuvant chemotherapy in early breast cancer is well established by the international overview conducted by the Early Breast Cancer Trialist's Collaborative Group (EBCTCG). They have demonstrated the efficacy of adjuvant chemotherapy on reducing mortality and recurrence rates, but current regimens are far from optimal. Docetaxel (Taxotere), a new agent, has effectiveness and manageable side effects in the treatment of advanced breast cancer patients, and can plausibly improve outcomes for patients with early N+ breast cancer by optimal integration into current adjuvant chemotherapy regimens. This clinical trial is designed to compare whether it is advantageous to use docetaxel and-or doxorubicin in combination or sequentially with other currently available chemotherapy drugs.Read moreRead less
Discrimination Or Discretion? Factors Contributing To Discrimination Of People With Hepatitis C In Health Care Settings.
Funder
National Health and Medical Research Council
Funding Amount
$419,750.00
Summary
Hepatitis C is now the leading communicable disease in Australia and stigma and discrimination have been identified as major barriers to addressing this epidemic. This study builds on our previous work in which we have found evidence of discrimination against people with hepatitis C in health care settings. Discrimination, inappropriate and unfair treatment against people with hepatitis C, in health care settings is a major barrier to care, treatment and support. A key strategy for developing ef ....Hepatitis C is now the leading communicable disease in Australia and stigma and discrimination have been identified as major barriers to addressing this epidemic. This study builds on our previous work in which we have found evidence of discrimination against people with hepatitis C in health care settings. Discrimination, inappropriate and unfair treatment against people with hepatitis C, in health care settings is a major barrier to care, treatment and support. A key strategy for developing effective strategies to reduce both perceived and real discrimination of people with hepatitis C in health care settings is to gain a better understanding of the range of issues experienced by the health care providers themselves and factors in the broader health service context that impact on optimal care. The aim of this study is to identify these factors and the findings will influence policy and practice with the ultimate goal of removing barriers to equitable and appropriate health care for people with hepatitis C. The study will focus on both people (health care providers)- the knowledge, attitudes and practices among health care professionals in relation to infection control practices, hepatitis C and injecting drug use; and contexts (health care settings)- factors in the health care settings that contribute to discriminatory, inappropriate or unfair treatment of people with hepatitis C. The study will focus specifically on health care settings of general practice, dentistry, nursing and pharmacists. The outcomes will be used to develop practical and effective strategies for both improving health care for HCV positive individuals and improving the working relationships and environments for these health professionals working with this client population.Read moreRead less
Health Care Priorities: The Community's Preferences For Using Community Preferences
Funder
National Health and Medical Research Council
Funding Amount
$52,355.00
Summary
Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use ....Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use of their preferences in informing health care priorities needs to be investigated. Four specific questions will be addressed in this study: (i) do members of the general public feel that, as individuals, they have a legitimate role to play in informing priority decisions in health care? if so why? if not, why not? (ii) does the nature-level-setting of the decisions for which priorities are to be set affect whether individual members of the public would wish to participate in the priority setting process? (e.g. different health services, medical procedures-treatments, diseases) (iii) whose preferences should be used if not the community's? (iv) faced ex post with the preferences of the community and the preferences (possibly different) of health service decision makers (i.e. Oexperts'), does this knowledge affect preferences for having community preferences count? A number of health authorities are currently looking for ways of engaging local communities in health care decision making. This study will indicate the appropriate levels at which community preferences are to be elicited and the type of decisions and settings in which they are most relevant.Read moreRead less