Amoxycillin For Persistent Nasal Discharge In Rural And Remote Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$226,738.00
Summary
Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical tri ....Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical trial will measure the impact of antibiotic treatment on persistent nasal discharge and rates of transmission of bacterial respiratory pathogens. An innovative study design will test the efficacy of twice daily doses of amoxycillin on newly developed clinical and bacteriological outcome measures. Both the investigators and the Aboriginal community have considerable experience in conducting this type of research and are committed to using a cooperative model of clinical research to reduce disease burden. Ongoing training of Aboriginal health workers in the principles of clinical epidemiology is an essential component of this process. This study will make an important contribution to the medical literature. Despite the deaths of around 10,000 children children from acute respiratory infections each day, very little is known about how antibiotics affect the transmission of some of the principal causative organisms. This project will greatly assist the development of appropriate antibiotic prescribing practices in high-risk populations.Read moreRead less
Asthma is a common problem for women during pregnancy. There is concern about how asthma and its treatment may effect the baby, and also concern that asthma may deteriorate during pregnancy. Variable adherence to treatment compounds this situation. Current clinical measures are not very accurate in determining the correct dose of inhaled therapy to be used for asthma. However, there is now good evidence from clinical trials in nonpregnant adults and children that this situation can be improved b ....Asthma is a common problem for women during pregnancy. There is concern about how asthma and its treatment may effect the baby, and also concern that asthma may deteriorate during pregnancy. Variable adherence to treatment compounds this situation. Current clinical measures are not very accurate in determining the correct dose of inhaled therapy to be used for asthma. However, there is now good evidence from clinical trials in nonpregnant adults and children that this situation can be improved by using markers of inflammation to guide therapy. One of the promising tests of inflammation is exhaled nitric oxide. We wish to determine whether asthma can be better managed during pregnancy by using nitric oxide to guide therapy. We will examine whether this approach leads to fewer asthma exacerbations, lower doses of corticosteroid, better asthma control, and better outcomes for the baby. To do this we have put together a team with expertise across each of the important areas of asthma, pregnancy, and research methods. This will enable the study to provide a clear indication of which treatment approach is better, and this can then be offered to pregnant women and their health care team.Read moreRead less
Selective Use Of Long-term Antibiotics For Chronic Lung Obstructive Disease In Aboriginal Adults: A Multi-centre Trial
Funder
National Health and Medical Research Council
Funding Amount
$446,800.00
Summary
Indigenous Australians suffer from well-documented health disadvantage. This is demonstrated particularly for chronic obstructive lung disease (COPD-COAD). In remote communities nearly 15% of Aboriginal Australians suffer from COPD. This is reflected in death rates that show Aboriginal Australians as 6 times more likely to die from COPD and to be hospitalised much more frequently for this condition. Treatment options for COPD once it is established are however limited. Although smoking is a well ....Indigenous Australians suffer from well-documented health disadvantage. This is demonstrated particularly for chronic obstructive lung disease (COPD-COAD). In remote communities nearly 15% of Aboriginal Australians suffer from COPD. This is reflected in death rates that show Aboriginal Australians as 6 times more likely to die from COPD and to be hospitalised much more frequently for this condition. Treatment options for COPD once it is established are however limited. Although smoking is a well recognised cause of COPD it is becoming clear that in Aboriginal Australians additional factors are likely to be important. Aboriginal Australians have higher rates of bacterial respiratory infections compared non-Indigenous Australians and it is likely that this is an important preventable factor in the establishment and progression of COPD. The aim of this study is thus to determine if the judicious use of regular antibiotics will be effective in treating Aboriginal adults with COPD. Particularly we aim to determine if this treatment can prevent acute exacerbations, which are associated with hospitalisation and death, and reduce inflammation in the airways, which is associated with continuing damage to the lungs and progressive disability. The involvement of 4 Aboriginal communities in this well-designed clinical trial is an important advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide local training and equipment to improve the assessment and management of respiratory disease in remote Aboriginal communities. Finally the results of this study will be directly relevant to evidence-based guidelines that are currently utilised for the management of COPD in Aboriginal and Torres Strait Islander populations.Read moreRead less
Centre For Research Excellence In Pulmonary Fibrosis
Funder
National Health and Medical Research Council
Funding Amount
$2,498,607.00
Summary
The Centre for Research excellence in Pulmonary Fibrosis (CRE-PF) aims to develop a sustainable nation-wide network, consisting of world recognized experts. The group will enable an integrative approach to solving PF through a layered strategy extending from molecules germane to disease pathogenesis, to human studies. With this approach the CRE-PF will set a new paradigm for synergy between academia, health care, health policy and the public, placing Australia at the forefront of innovation.
Prevention Of Asthma In Young Children Via Immunostimulation
Funder
National Health and Medical Research Council
Funding Amount
$679,683.00
Summary
Persistent asthma is a major problem for Australia yet none of the current therapies do more that control the condition. The long-term solution is to prevent asthma from progressing to the persistent form. The major risk factors are: family history, early allergy and recurrent severe lower respiratory infections (sLRI) in the early life. We will conduct a randomized clinical trial to prevent sLRI using a novel bacterial-derived immunostimulant in infants at high risk of developing asthma.
Gabapentin In The Treatment Of Idiopathic Chronic Cough: A Randomised Double-blind Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$331,229.00
Summary
Better treatment approaches are needed to address the significant quality of life impairment associated with chronic cough. We propose to conduct a double-blind, placebo controlled study comparing the efficacy (and safety) of oral gabapentin therapy on cough reflex severity and cough-specific quality of life in people with idiopathic cough. The advantages are a strong design, use of objective assessment techniques, and investigation of a new treatment modality for cough.
Multi-centre RDBC Trial Of Oxygen Vs Air For Relief Of Breathlessness In Terminally-ill Patients With Intractable Dyspno
Funder
National Health and Medical Research Council
Funding Amount
$149,701.00
Summary
This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects exp ....This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects experienced.Read moreRead less
Effect Of Anti-IgE Antibody On Immune System Responses And Short-term Outcome In Acute Asthma In Children
Funder
National Health and Medical Research Council
Funding Amount
$571,752.00
Summary
We plan to undertake a randomised, double-blind, placebo-controlled, clinical trial of anti-IgE antibody given at the time of an acute attack of asthma in children aged 6-12 years. The idea for this arose from our own novel data – IgE levels increase with the most common infection causing acute asthma. Given evidence the virus uses IgE to cause inflammation, giving anti-IgE during the attack should reduce the severity of the attack and produce a new, effective treatment for acute asthma.