Judicious Use Of Antibiotics For Acute Otitis Media In Aboriginal Children: A Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$614,840.00
Summary
Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important ....Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important implications for their education. The aim of this study is to determine whether a new longer-acting antibiotic will be more effective in treating young Aboriginal children with new ear infections and therefore prevent the progression to chronic suppurative otitis media. The involvement of up to 20 Aboriginal communities in this well-designed clinical trial represents a major advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide training in ear examination and appropriate medical management. Swabs from the nose will be taken to monitor the effect of antibiotics on the rates of antibiotic resistance. The results from this study will be directly relevant to evidence-based guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.Read moreRead less
Development And Evaluation Of A Primary Health Care Model To Prevent Dental Decay In Aboriginal Pre-school Children
Funder
National Health and Medical Research Council
Funding Amount
$1,482,000.00
Summary
Dental decay has been described as the most common disease of childhood that is not self-limiting or responsive to short-term pharmacological management. Regrettably, Australian Aboriginal children have, on average, twice as many teeth affected by decay as other Australian children. The disease is a particular burden for pre-school children who do not routinely have access to dental care provided by the state-territory programs. The goal of this project is to develop, implement and evaluate the ....Dental decay has been described as the most common disease of childhood that is not self-limiting or responsive to short-term pharmacological management. Regrettably, Australian Aboriginal children have, on average, twice as many teeth affected by decay as other Australian children. The disease is a particular burden for pre-school children who do not routinely have access to dental care provided by the state-territory programs. The goal of this project is to develop, implement and evaluate the effectiveness of a community-oriented, primary health care intervention to prevent dental decay among pre-school children in Aboriginal communities in the Northern Territory. The cluster randomized design provides a practical approach to the problem of small numbers of children living in remote communities. The results obtained from this research proposal would make an important contribution to the health care of Australian Aboriginal children and other disadvantaged children throughout the world.Read moreRead less
A Randomised Controlled Trial Of Caseload Midwifery Care
Funder
National Health and Medical Research Council
Funding Amount
$761,311.00
Summary
There is concern about the rising levels of caesarean section in Australia and some evidence that women may benefit from caseload midwifery care. This randomised control trial will determine whether caseload midwifery care can reduce interventions and is as safe as usual hospital maternity care. A Cochrane systematic review of midwifery led care versus routine care was designed to answer these questions.This will be the first randomised controlled trial to contribute to this review
Efficacy Of Exercise Physiologist Counselling In Primary Care Patients: A RCT Of Two Pragmatic Approaches
Funder
National Health and Medical Research Council
Funding Amount
$940,925.00
Summary
Physical activity is one of the most powerful contributors to health, but population levels of activity are low. General practitioners (GPs) are well placed to provide physical activity counselling, but many are too busy. This project examines the effectiveness of referral of insufficiently active adults to an exercise physiologist (EP), using step counts from a pedometer as the outcome. We compare usual care from the GP with: (1) 5 EP visits, and (2) a single visit and telephone follow up.
Efficacy And Cost-effectiveness Of Physiotherapy For Chronic Rotator Cuff Pathology
Funder
National Health and Medical Research Council
Funding Amount
$384,675.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty per ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty percent of sufferers will continue to have symptoms beyond 3 years and 15% will have persistent disability which may require surgical intervention. Because this disorder is prevalent, it imposes a considerable burden on the Australian health care system. Physiotherapy is a common conservative treatment option but its efficacy has not been well established. A recent Cochrane review of the literature revealed several problems with many of the existing studies: (i) the populations have included a mix of shoulder diagnostic categories; (ii) the research designs have major flaws and (iii) a single physiotherapy modality has been evaluated rather than a combined program as is current clinical practice. Thus, this novel research project involving 200 participants will answer important questions about the efficacy of a physiotherapy program for chronic rotator cuff pathology and whether benefits can be maintained. In addition it will determine whether the costs of physiotherapy represent good value for money which is important in today's economic climate. The results of this project can be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy and to funding and compensable bodies.Read moreRead less
Efficacy Of Physiotherapy After Hydrodilatation For The Painful Stiff Shoulder: A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$269,020.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements beyond 3 years and 15% will have persistent disability. Because this disease is prevalent, it imposes a considerable burden on the Australian health care system. Shoulder hydrodilatation is a common conservative treatment option that has been shown by our research group to have short-term but not long-term benefits. Physiotherapy may be prescribed following hydrodilatation on the basis that it may maintain the initial benefits seen with hydrodilatation. However, there are no studies to either support or refute this hypothesis. Thus, this novel research project will answer important questions about the efficacy of a physiotherapy program in addition to hydrodilatation for the stiff painful shoulder. We will determine whether physiotherapy offers a benefit over hydrodilatation alone and if so, whether this benefit is sustained. In addition we will determine whether the additional costs of physiotherapy represent good value for money. The results of this project can then be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy.Read moreRead less
Efficacy Of A Physiotherapy Treatment For Knee Joint Osteoarthritis: A Randomised, Double-blind, Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$156,743.00
Summary
Osteoarthritis of the knee is a disabling condition affecting the lining of the joints giving rise to pain and stiffness. It is common in older individuals and is a major cause of disability. Physiotherapy is often used to decrease pain and improve muscle strength and functional ability. However, there are few well controlled scientific studies which prove the efficacy of physiotherapy as a form of treatment in this condition. This project aims to establish whether a 12 week course of physiother ....Osteoarthritis of the knee is a disabling condition affecting the lining of the joints giving rise to pain and stiffness. It is common in older individuals and is a major cause of disability. Physiotherapy is often used to decrease pain and improve muscle strength and functional ability. However, there are few well controlled scientific studies which prove the efficacy of physiotherapy as a form of treatment in this condition. This project aims to establish whether a 12 week course of physiotherapy treatment is effective in reducing pain and improving function in 50-80 year old individuals diagnosed with osteoarthritis of the knee joint. It will also assess whether any improvements seen after treatment can be maintained with a home program. This will provide scientific evidence to justify the role of physiotherapy management in this condition.Read moreRead less
Child Health At Two Years Corrected Age After Antenatal Exposure To Dexamethasone Or Betamethasone; A Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,777,593.00
Summary
Both dexamethasone or betamethasone, given to women at risk of preterm birth substantially improve neonatal and child health. There are conflicting reports as to whether dexamethasone is better than betamethasone? This randomised trial will assess this. If dexamethasone is more beneficial, there will be fewer deaths and fewer disabled children. This will be of great importance for the care of women at risk of preterm birth, their children and health services in Australia and internationally.
Multicentre Evaluation Of A Clinical Pathway For Chronic Cough In Children- Can Its Use Improve Clinical Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$971,362.00
Summary
Chronic cough is a common presenting symptom to doctors. It is associated with significant morbidity and may be a symptom of a serious underlying problem. This is especially pertinent to Aboriginal children. In this study we will examine the utility and efficacy of an evidence based clinical pathway for the management of chronic cough in Aboriginal and non-Aboriginal children. This study will contribute to clinical policy and improve clinical outcomes and early diagnosis of respiratory illnesses