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
Reducing young women’s offending through improved service delivery . Young women’s contact with justice and welfare agencies has increased rapidly across Australia and the world, creating a crisis that is costly and harmful, especially for young Indigenous women. Pathways into these systems are gendered; but the systems were designed to address the needs of young male offenders. This project therefore aims to discover how these systems could be better designed to improve outcomes for young women ....Reducing young women’s offending through improved service delivery . Young women’s contact with justice and welfare agencies has increased rapidly across Australia and the world, creating a crisis that is costly and harmful, especially for young Indigenous women. Pathways into these systems are gendered; but the systems were designed to address the needs of young male offenders. This project therefore aims to discover how these systems could be better designed to improve outcomes for young women. The project uses a novel approach that gives young women a voice in how five Anglicare end-users (the research partners) and other end-users can enhance their service provision in the welfare and justice sectors and become models of best practice.Read moreRead less
The Macroderma initiative: conserving ghost bats and informing development. This project aims to improve methods for capturing biological information required for environmental assessments of highly mobile species and enable strategic environmental planning in Northern Australia. Using Australia’s iconic ghost bat as a focus, the project will test and apply emerging technologies to obtain key information on a species’ population status and its critical resources to inform assessments of ecologic ....The Macroderma initiative: conserving ghost bats and informing development. This project aims to improve methods for capturing biological information required for environmental assessments of highly mobile species and enable strategic environmental planning in Northern Australia. Using Australia’s iconic ghost bat as a focus, the project will test and apply emerging technologies to obtain key information on a species’ population status and its critical resources to inform assessments of ecological impacts of industry development. Important benefits of the project include information and tools for streamlining development approvals and accurately assessing risks to threatened species to improve outcomes for both our economy and our natural environment.Read moreRead less
A Structured Systems Approach For Improving Health Promotion Practice For Chronic Diseases In Indigenous Communities
Funder
National Health and Medical Research Council
Funding Amount
$666,592.00
Summary
This project will trial a model for continuous improvement, with the aim of assisting health services and community based organisations to improve the services they deliver to promote health and prevent chronic disease in Indigenous communities.
A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. Th ....A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. The findings will inform effective multidisciplinary collaboration and service integration, address service gaps and duplication and lead to increased access to services. This study will generate new knowledge about characteristics of organisations, service delivery and professions that facilitate or hinder innovation.Read moreRead less
The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the co ....The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the country. The project aims to inform consumers, health practitioners, health service planners and policy-makers about the impact of FIFO, as well as to contribute to the development of strategies designed to stabilise the remote health workforce.Read moreRead less
Staffing practices in Aboriginal primary health care services. This project aims to generate new knowledge about the impact of short-term staffing in remote Aboriginal Community Controlled Health Services on service acceptability to patients, workload and attitudes of long-term staff and the effectiveness and cost of services. The project intends to compare these results to recent findings about the impact of short-term staffing in government-run clinics, in order to quantify and describe the po ....Staffing practices in Aboriginal primary health care services. This project aims to generate new knowledge about the impact of short-term staffing in remote Aboriginal Community Controlled Health Services on service acceptability to patients, workload and attitudes of long-term staff and the effectiveness and cost of services. The project intends to compare these results to recent findings about the impact of short-term staffing in government-run clinics, in order to quantify and describe the potential positive effect of community control. Expected outcomes include rigorous evidence about the 'fly in/fly out' workforce and the impact of community control which can inform new policy that will stabilise the remote health workforce, save money and contribute to 'closing the gap' in health outcomes.Read moreRead less
Assessing supportive care needs of Indigenous cancer survivors' caregivers. This project aims to gather data about the needs of partners and caregivers of Aboriginal and Torres Strait Islander cancer survivors. The project will undertake a comprehensive exploration of the experiences of caregivers and develop a psychometrically tested tool to assist in identifying unmet needs. The project expects to provide new knowledge about the needs of this population and a validated tool to better assess th ....Assessing supportive care needs of Indigenous cancer survivors' caregivers. This project aims to gather data about the needs of partners and caregivers of Aboriginal and Torres Strait Islander cancer survivors. The project will undertake a comprehensive exploration of the experiences of caregivers and develop a psychometrically tested tool to assist in identifying unmet needs. The project expects to provide new knowledge about the needs of this population and a validated tool to better assess these needs. The project will result in improvements in the assessment of unmet supportive care needs in caregivers of Indigenous cancer survivors, leading to more timely interventions, and a better quality of life for patients and caregivers.Read moreRead less
Excessive sitting and population health: strengthening the science and the relevance to policy and practice. The majority of Australian adults spend most of their waking hours sitting; this increases the likelihood of developing diseases of inactivity, including diabetes, heart disease and some cancers. New research will investigate what factors encourage excessive sitting and what the health benefits are for people who deliberately do less sitting.
Enhancing linkage and exchange in a national research partnership to improve primary health care performance and outcomes for Indigenous peoples. This project will enhance current efforts to make high-quality primary health care services accessible to all Indigenous Australians. The work will result in widespread application of systematic and cutting-edge methods to enable health service staff and managers to review and continually work to improve the quality of their service.