A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
A framework for adapting child interview protocols in complex cases. This project aims to develop–in collaboration with Aboriginal and other industry co-researchers–a ‘how to’ framework for effectively adapting standard child abuse interview protocols to accommodate the complexities that create barriers to disclosure. Complex cases necessitate interview adaption, but it requires systematic guidance and an interdisciplinary, practitioner-driven approach to be effective. This innovative framework ....A framework for adapting child interview protocols in complex cases. This project aims to develop–in collaboration with Aboriginal and other industry co-researchers–a ‘how to’ framework for effectively adapting standard child abuse interview protocols to accommodate the complexities that create barriers to disclosure. Complex cases necessitate interview adaption, but it requires systematic guidance and an interdisciplinary, practitioner-driven approach to be effective. This innovative framework is expected to have long-term benefits for services that support children’s well-being, through improvements in the quality of evidence underpinning decisions. By enhancing interviewer capability, there will also be fewer cases prematurely exiting the justice system before forensic interview or investigation.Read moreRead less
Evaluation Of The Effectiveness Of Mobile Preschool For Child Health And Development In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$456,369.00
Summary
This project is a retrospective study of the effectiveness of the NT Mobile Preschool Program using assessment data for children's emergent literacy, social and emotional competencies and health status. Effectiveness will be established by comparison with achievement and health status data for children not attending preschool and those in communities with no preschool service. The study will identify and describe the key factors influencing the health and learning outcomes of the three groups.
Australian Partnership (for) Preparedness Research On InfectiouS (disease) Emergencies (APPRISE)
Funder
National Health and Medical Research Council
Funding Amount
$4,996,416.00
Summary
We have assembled national experts in clinical, laboratory and public health research to ensure Australia is equipped for a coordinated, effective and evidence based response to infectious diseases. This multidisciplinary team will create and share new knowledge to detect, prevent and manage emerging infection threats. We will train a robust cross-sectoral work force and develop sustainable research capacity integrated within the health system to ensure national and regional health security.
Intermittent Preventive Treatment In Pregnancy With Sulphadoxine-pyrimethamine Plus Dihydroartemisinin-piperaquine To Reduce Adverse Pregnancy Outcomes And Prevent Malaria In Papua New Guinea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,938,453.00
Summary
Millions of pregnancies are complicated by malaria worldwide. Monthly sulphadoxine-pyrimethamine (SP) treatments, the current treatment strategy, no longer protects from malaria but improves birth outcomes through non-malarial effects. Dihydroartemisinin-piperaquine clears malaria but babies are smaller compared to women who received SP. A clinical trial of their combination has potential to substantially improve health outcomes for women and babies in Papua New Guinea and beyond.
A Behavioural Intervention For The Adoption & Maintenance Of Physical Activity In Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$334,955.00
Summary
For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on ....For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person's motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.Read moreRead less
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
Impact Of DTP Schedules On The Immunogenicity Of 2 Doses Of 13v-PCV Followed By An Early Booster
Funder
National Health and Medical Research Council
Funding Amount
$2,651,687.00
Summary
This project aims to come up with a vaccination schedule to make pneumococcal vaccines more effective and affordable for Fiji and other developing countries. We will evaluate schedules involving a 2 dose primary series in early infancy with a booster at 9 months of age. We will compare the immune responses to 3 different primary series and 2 booster options. The results of this project will be used to provide advice, at global and country levels, regarding introduction of pneumococcal vaccines.
Impact Of An Ivermectin Mass Drug Administration Program Against Endemic Scabies And Strongyloidiasis
Funder
National Health and Medical Research Council
Funding Amount
$1,289,786.00
Summary
Overseas studies suggest sustainable and long term benefits can be obtained through the use of ivermectin in mass drug administration programs to control parasitic infections. Our study will be a critical first step in establishing if such a program can be successful in a remote Indigenous community setting, where the disease burden from scabies and strongyloidiasis (threadworm infections) is very high.