The Role Of Pharmacotherapy In Prevention Of Relapse In Alcohol Dependence
Funder
National Health and Medical Research Council
Funding Amount
$422,310.00
Summary
The physical, psychological and social consequences of alcohol abuse remain a critical health problem. Every year in Australia, excessive consumption is responsible for 3,000-6,000 deaths and costs the community $6 billion. Approximately 15% of Australians abuse alcohol and 5% of men and 3% of women are alcohol dependent (addicted to alcohol). Young men are particularly affected, with 10% of all men aged 18-35 dependent on alcohol. Better treatment for alcohol dependence is urgently needed. Less ....The physical, psychological and social consequences of alcohol abuse remain a critical health problem. Every year in Australia, excessive consumption is responsible for 3,000-6,000 deaths and costs the community $6 billion. Approximately 15% of Australians abuse alcohol and 5% of men and 3% of women are alcohol dependent (addicted to alcohol). Young men are particularly affected, with 10% of all men aged 18-35 dependent on alcohol. Better treatment for alcohol dependence is urgently needed. Less severe forms of alcohol abuse frequently respond to brief screening and intervention programs. Treatment of alcohol dependence remains unsatisfactory. Most treatments lead to abstinence in only 1-3, and approximately 50% of these will relapse within 3 months of completing treatment. Two drugs (naltrexone and acamprosate) appear to interfere with the effects of alcohol on the brain that promote addiction. There is evidence that both drugs are beneficial in the treatment of alcohol dependence and both are now available in Australia. At present, no data have been reported comparing the effectiveness of these two drugs. The proposed project will compare naltrexone and acamprosate in a large carefully performed study. The study will help determine which subjects are likely to benefit from one or other of these agents. Compliance is a major problem with many medications, but is a particular problem with medications for substance abuse. The second aim of this study is to test a novel intervention to increase compliance with medications for alcohol dependent subjects. This intervention comprises 'compliance therapy', which resembles a short training course, a medication alarm, and an assertive reminder program for scheduled medical appointments. The present study will be the first to apply this type of therapy to subjects with alcohol dependence.Read moreRead less
Investigating Healing Outcomes In People With Venous Ulcers: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$340,834.00
Summary
Venous leg ulcers (VLU) are an extremely common, debilitating, costly problem and the burden is expected to rise with the ageing population, obesity and diabetes. Standard best practice treatment includes compression bandaging of the lower leg by tight bandaging. Application of 3 layer (3L) tubular bandage appears to be a promising new treatment according to a pilot study. We will conduct a randomised controlled trial to investigate improvement in healing with 3L and to measure cost-effectivenes ....Venous leg ulcers (VLU) are an extremely common, debilitating, costly problem and the burden is expected to rise with the ageing population, obesity and diabetes. Standard best practice treatment includes compression bandaging of the lower leg by tight bandaging. Application of 3 layer (3L) tubular bandage appears to be a promising new treatment according to a pilot study. We will conduct a randomised controlled trial to investigate improvement in healing with 3L and to measure cost-effectiveness when compared to standard compression.Read moreRead less
The Use Of A Multidrug Pill In Reducing Cardiovascular Events (UMPIRE) Trial
Funder
National Health and Medical Research Council
Funding Amount
$314,535.00
Summary
Patients who have cardiovascular disease are at very high risk of experiencing a heart attack or stroke, and current guidelines recommend the long-term use of aspirin, blood pressure lowering drugs and a cholesterol lowering drug in such patients to reduce their risks. The proposed research will investigate whether the availability of a polypill (a single pill containing all these drugs) will help ensure patients are appropriately prescribed these treatments, and keep taking them long-term. Aust ....Patients who have cardiovascular disease are at very high risk of experiencing a heart attack or stroke, and current guidelines recommend the long-term use of aspirin, blood pressure lowering drugs and a cholesterol lowering drug in such patients to reduce their risks. The proposed research will investigate whether the availability of a polypill (a single pill containing all these drugs) will help ensure patients are appropriately prescribed these treatments, and keep taking them long-term. Australian researchers will have a pivotal role in collecting and interpreting the data in this trial. In addition, Australian researchers will combine the findings of this study with results from similar trials being conducted in Australia (1600 patients, including 600 Aboriginal participants) and New Zealand (600 patients, including 600 Maori participants). This overview will provide very accurate information about the usefulness of the polypill, and how it should be used worldwide.Read moreRead less
Regulation Of Growth Hormone Action By Oestrogen And Selective Oestrogen Receptor Modulators
Funder
National Health and Medical Research Council
Funding Amount
$474,750.00
Summary
Growth hormone (GH) is essential for body growth and development. In adult life, it plays a key role in regulating the ratio of body fat to muscle, thus influencing health. Disruption of GH action decreases muscle mass and increases body fat. These changes lead to reduced muscle strength and fitness, and increase the risk of diabetes, hypertension and cardiovascular mortality. Our laboratory has reported that oestrogens taken orally blunt GH action and cause unfavourable changes in body fat and ....Growth hormone (GH) is essential for body growth and development. In adult life, it plays a key role in regulating the ratio of body fat to muscle, thus influencing health. Disruption of GH action decreases muscle mass and increases body fat. These changes lead to reduced muscle strength and fitness, and increase the risk of diabetes, hypertension and cardiovascular mortality. Our laboratory has reported that oestrogens taken orally blunt GH action and cause unfavourable changes in body fat and muscle. How this happens is not known. As oral oestrogens are widely used in our society, it is important to understand the basis of their impact on GH action. SERMs, or selective oestrogen receptor modulators, are a group of drugs used in the treatment of breast cancer and osteoporosis. These substances mimic oestrogen action in some tissues, and block oestrogen action in others. Whether SERMs interfere with GH action as oestrogens do have not been studied, but such knowledge would have therapeutic significance because of their widespread and long-term use. GH action is mediated by a protein, called the GH receptor, located on the surface of target tissues. We propose that oestrogens and SERMs alter the production and function of this protein to control GH action. Thereby, this project is designed to test, in cultured cells of human origin, how oestrogens and SERMs modulate abundance of the GH receptor and its ability to mediate GH action. This work is anticipated to gain novel insights into the interaction of GH with oestrogens and SERMs. This information may also be useful for the design of new drugs devoid of adverse effects on GH action, and hence would have potentially significant implications in women s health and disease.Read moreRead less
Improving Adherence With The Use Of Hip Protectors, In Community, Residential Aged Care And Hospital Settings
Funder
National Health and Medical Research Council
Funding Amount
$405,250.00
Summary
Hip protectors are plastic shields or foam pads worn over the hip in specially adapted underwear. A number of studies in older people have shown that hip protectors are very effective if worn when a fall occurs and these have been available for the last few years in Australia. Unfortunately it has been difficult for older people to wear the hip protectors reliably and because of limited compliance with their use they have not been fully effective. This study will compare provision of a brochure, ....Hip protectors are plastic shields or foam pads worn over the hip in specially adapted underwear. A number of studies in older people have shown that hip protectors are very effective if worn when a fall occurs and these have been available for the last few years in Australia. Unfortunately it has been difficult for older people to wear the hip protectors reliably and because of limited compliance with their use they have not been fully effective. This study will compare provision of a brochure, with supply of the older person's choice of hip protectors , with or without cost, and with or without contact with a nurse who will assist with use of the hip protector. After six months the level of use of the hip protectors will be checked. The new strategies tested in this study may increase compliance with hip protectors to a level where they will be effective if used at home in the community, in residential aged care facilities, and in hospitals.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.
Optimising The Efficiency Of Enforcement In Commercial Fisheries
Funder
Fisheries Research and Development Corporation
Funding Amount
$233,474.55
Summary
The cost of enforcement in most fisheries is substantial. There has been little research on the effectiveness of enforcement measures or the investigation of alternate enforcement strategies. An understanding of the fisher’s perception of the enforcement program, particularly the perceived level of inspections, and how they will respond to changes in enforcement is required to more effectively and efficiently maintain compliance with the regulations.
Similarly the relationship between ....The cost of enforcement in most fisheries is substantial. There has been little research on the effectiveness of enforcement measures or the investigation of alternate enforcement strategies. An understanding of the fisher’s perception of the enforcement program, particularly the perceived level of inspections, and how they will respond to changes in enforcement is required to more effectively and efficiently maintain compliance with the regulations.
Similarly the relationship between the extent of enforcement effort and the level of compliance is not understood for most fisheries. If the rate of compliance is not overly sensitive to the amount or type of enforcement it may be possible to reduce some elements of the enforcement effort and cost while maintaining an acceptable level of compliance. On the other hand if the rate of compliance is highly sensitive to the amount of enforcement effort it will be possible to determine the amount of effort required to obtain the required level of compliance.
The true nature and extent of non-compliance is required to better direct enforcement effort. Spatial and temporal patterns of non-compliance need to be investigated. A better understanding of the motivation for non-compliance, whether the incentive is financial or otherwise, will be gained by comparing expected gains against the likely penalties and probability of detection. This will enable the effectiveness of penalties as a deterrent to be assessed. This information is needed in a form that will enable managers responsible for enforcement activities to explore the effect of the location, timing and type of enforcement activity on the level of compliance. Objectives: 1. Estimate the level of non-compliance in the Western Australian rock lobster industry. 2. Determine factors such as seasonal, regional and factory, which may affect the level of non-compliance in order to better target the timing of enforcement effort. 3. Develop relationships between enforcement and compliance with the regulations to enable an assessment of increasing or decreasing the level of enforcement on the level of compliance. 4. Determine the reasons and motivations for the non-compliance of commercial fishers with the regulations in terms of the expected gains versus the probability of detection. 5. Ascertain the perceptions of the fishing regulations and enforcement measures including the perceived probability of detection for commercial fishers. 6. Ascertain whether commercial fishers are aware of the full extent and frequency of inspections. Read moreRead less
Impact Of Co-morbidities On Screening, Diagnosis, Treatment And Survival Of Cervical Cancer Amongst Australian Indigenous And Non-Indigenous Women: 1997-2009
Funder
National Health and Medical Research Council
Funding Amount
$98,236.00
Summary
Indigenous women are more likely than non-Indigenous Australian women to be diagnosed with cervical cancer and are less likely to survive it. This study will investigate the impact of co-exisiting chronic diseases (co-morbidities) on cervical cancer screening, diagnosis, treatment and survival outcomes for Indigenous compared to non-Indigenous women. Results from this study will assist in directing future public health initiatives that aim to improve outcomes for women with cervical cancer.