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Novel Point-of-care Screening And Treatment Interventions To Improve Pregnancy Outcomes And To Prevent Cervical Cancer In High-burden, Low-income Settings
Funder
National Health and Medical Research Council
Funding Amount
$470,144.00
Summary
I lead newly-funded research grants worth nearly $10 million to conduct novel intervention trials in sexual and reproductive health. These projects build on the extensive collaborations and the robust nationwide network of clinical field sites that I have established in Papua New Guinea during the past five years. My research will lead to improved maternal and neonatal health outcomes, and prevent premature deaths due to cervical cancer, in high-burden, low-income settings worldwide.
The Influence Of Acupuncture On Reducing Women's Pain From Primary Dysmenorrhoea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$310,875.00
Summary
Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion o ....Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. It has been indicated in several non-clinical studies and two small clinical trials to be effective with treating dysmenorrhoea. Evidence from the Cochrane systematic review of acupuncture to treat primary dysmenorrhoea concluded acupuncture may be helpful. This study assesses whether women with dysmenorrhoea can be successfully treated using acupuncture. Women experiencing dysmenorrhoea with no underlying pelvic pathology will be offered the opportunity to take part in the trial. Women interested in taking part will be randomly allocated into one of two groups. One group of women will receive acupuncture, a second group will receive control (sham) acupuncture. The second study group involves the insertion of needles away from acupuncture points. Women will receive the treatment intervention for three menstrual cycles and then followed up for a further six months. Women will be asked to report on the pain they experience during menses and to report any time taken off from work or school, disruption with day to day activities, or the need for additional pain relief. In 2005 we expect to report on the effectiveness of this treatment on dysmenorrhoea and whether this treatment is acceptable to women. If the results are positive, it is hoped this will become an option available to women for the management of their dysmenorrhoea.Read moreRead less
The Evidence-based Consumer: Making Informed Decisions About Menopause, Hormone Replacement And Complementary Therapies
Funder
National Health and Medical Research Council
Funding Amount
$97,750.00
Summary
This project aims to find out whether providing women with information about menopause, and therapies to treat the symptoms and effects of menopause will change their use of hormone replacement therapy (HRT) or complementary therapies. A menopause information kit or brochure(s) with information about the risks and benefits of therapies and treatments for the symptoms and effects of menopause, will be provided to a group of women between the ages of 40 and 64 years. The information will be based ....This project aims to find out whether providing women with information about menopause, and therapies to treat the symptoms and effects of menopause will change their use of hormone replacement therapy (HRT) or complementary therapies. A menopause information kit or brochure(s) with information about the risks and benefits of therapies and treatments for the symptoms and effects of menopause, will be provided to a group of women between the ages of 40 and 64 years. The information will be based on up-to-date medical evidence about conventional HRT along with evidence about complementary therapies such as wild yam cream and herbal medicines. The information will outline the risks and benefits of these and other therapies as well as the proper use of HRT to control symptoms and effects of menopause. Current knowledge about reduction in heart disease risk and prevention of osteoporosis with the use of HRT, and the current knowledge about risk of ovarian, breast and uterine cancer will also be included in the information kit or brochure(s). The sample of women living in the Southern metropolitan region of South Australia will be included in the trial. They will be asked to complete a questionnaire and then some of the women will be asked to study the information about menopause and HRT. All participants will be asked to complete further questionnaires 3 months and 12 months later. The results will show whether providing women with information about menopause, HRT and complementary therapy will result in: 1. the women being more informed and better equipped to make the right decisions about treatment of the symptoms and effects of menopause, and 2. a more appropriate use of hormone replacement and complementary therapies to meet the individual needs of the women.Read moreRead less
MOSAIC: A GP Cluster Randomised Trial To Reduce Partner Violence Among Pregnant Women And Women With Pre-school Children
Funder
National Health and Medical Research Council
Funding Amount
$432,250.00
Summary
Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is ....Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is vital to inform both GP training and clinical practice. There is sound evidence that home visiting or support by peers improves the health of disadvantaged mothers and children. Similarly, advocacy improves the health and wellbeing of abused women. The MOSAIC community intervention trial combines these two elements: home visiting-peer support and domestic violence advocacy and this strategy will be evaluated in a randomised trial. The trial aims to reduce partner abuse and depression among women pregnant or with children under 5 attending GPs. It also aims to strengthen mother-child bonds. Trained and supported GPs from 40 participating practices will identify 700 abused or at risk women over a 40 week period. Women in the intervention arm of the trial, identified as abused or at risk by their GPs will be offered the support of trained para-professional 'mentor mothers' for up to a year, while the comparison arm will be offered standard GP care. Recent funding allows a pilot study of mentor mother recruitment and training to be undertaken in 2003. The study will strengthen GP support for this difficult issue and build a 'critical mass' of GPs interested in partner abuse management in the 5 participating divisions. The MOSAIC study will assess the value to GPs and women of an enhanced support system for victims' care and provide much needed evidence of an intervention embedded in general practice to reduce partner abuse of pregnant women and women with young children.Read moreRead less
Women's Evaluation Of A Randomised Controlled Trial For Abuse And Violence In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$679,718.00
Summary
Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief ....Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief counselling intervention for abused women in general practice using a randomised controlled trial. General practice staff (general practitioners and-or practice nurses) will be randomised either to be intensively trained to deliver the intervention and their practice systems improved for care of abused women or to be given information to ensure minimum safe practice and deliver 'usual care' to abused women. The primary aim of the intervention is to increase abused women's safety behaviours and planning and improve their mental health and quality of life. Secondary aims include increasing their readiness for change and action with regard to abuse, and their comfort to discuss abuse with general practitioners-practice nurses and general practitioners-practice nurses inquiry about safety. It is not expected that in a twelve month period that any intervention with women will be able to decrease the abuse women experience as women cannot control their partners' behaviour and to leave is not necessarily going to end the violence and abuse. Rather, the intervention and outcomes will look at women's pathway and decision making around seeking safety and non-violence. A cost effective analysis will also be undertaken using health service use by women and costs of the intervention.Read moreRead less
Women's Evaluation Of Abuse And Violence Care Randomised Controlled Trial- Long Term Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$284,391.00
Summary
Domestic violence has major health consequences and is a common hidden problem for women attending general practice. The project evaluates if a general practice intervention involving screening women for partner abuse, health provider education and brief counselling for women decreases partner abuse experienced and improves women's mental, physical health, parenting skills & quality of life long term (2 & 3 years after intervention). Further, to understand long term whether it is cost effective.
Exercise: An Examination Of Dose-response Relationships For Women Aged 65-74 Yr.
Funder
National Health and Medical Research Council
Funding Amount
$696,249.00
Summary
The increasing number of older women in Australia presents a significant challenge to our health system. Preventative and health promotion strategies must be developed for this important group of Australian's if chronic disease and disability are to be contained and the decline in functional capacity attenuated. One potential intervention strategy is regular exercise. However, if exercise is to have multi-systems benefits, the dose of the exercise must be known. We do not know the exercise presc ....The increasing number of older women in Australia presents a significant challenge to our health system. Preventative and health promotion strategies must be developed for this important group of Australian's if chronic disease and disability are to be contained and the decline in functional capacity attenuated. One potential intervention strategy is regular exercise. However, if exercise is to have multi-systems benefits, the dose of the exercise must be known. We do not know the exercise prescription that will maximize those health benefits required for this group of Australian's. We propose to resolve this situation via two related experiments involving women aged 65-74 yr. Experiment 1 will select moderate-intensity treadmill walking for 30 min-session with the weekly exercise frequency varied from 1 to 5 session-wk for 64 sessions. Experiment 2 will also select moderate-intensity treadmill walking with the total exercise time per week (120 min-wk) and the number of weeks of training (24 wk) fixed but varying the exercise duration per session (24 to 120 min-session) and the exercise frequency per week; 5 (x 24 min) to 1 (x 120 min) session-wk. Each subject will undergo lung function tests, body fat test, fitness tests and blood tests at selected time intervals throughout each experiment. A separate fitness test will be conducted on the subjects' leg muscle to help us understand what is happening directly in the muscle. We will also conduct a tilt test to help us understand how regular exercise might lessen the likelihood of 'falls' in older individuals. We expect to determine the optimum exercise prescription to improve health and minimize injury and misadventure. It is essential that GP's who have the main responsibility for prescribing exercise for their older patients, have access to knowledge on the optimum exercise prescription to maximize the beneficial changes in health and functional capacity in females aged 65-74 yr.Read moreRead less
Improving the physical and oral health of people with severe mental illness: using Normalisation Process Theory to support new practices. The physical health of people with severe mental illness is extremely poor, often due to inadequate attention to their health needs by health professionals in primary care and the public mental health system. This project will focus on how practices can be changed to improve the health of this population and increase their access to preventative healthcare.
Enhancing health literacy to optimise health equality across Victorian communities. Health literacy—the ability to seek, understand and use health information—is a major influence on equitable health outcomes for Australians. This project will take a fresh approach to health literacy to understand vulnerable members of our community and develop supports and interventions that aim to assist services to reduce health inequalities.
A randomised controlled trial assessing the effects of a school-based sleep intervention in Year 6 and 7 students. Inadequate sleep is associated with a wide range of health problems in children, including obesity and poor performance at school. Children are sleeping less than ever before, and there is an increasing pattern of “yo yo sleeping” (sleep deprivation on school days followed by catch up sleeps on weekends). This study will trial a school-based program designed to improve the sleeping ....A randomised controlled trial assessing the effects of a school-based sleep intervention in Year 6 and 7 students. Inadequate sleep is associated with a wide range of health problems in children, including obesity and poor performance at school. Children are sleeping less than ever before, and there is an increasing pattern of “yo yo sleeping” (sleep deprivation on school days followed by catch up sleeps on weekends). This study will trial a school-based program designed to improve the sleeping habits of children. Better sleep is expected to result in improved alertness, better life satisfaction, and improved weight status.Read moreRead less