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
The Management To Optimise Diabetes And MEtabolic Syndrome Risk Reduction Via Nurse-led Intervention (MODERN) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,445,861.00
Summary
There is increasing recognition of society’s responsibility to provide effective and sustainable health care to the entire population and not just selected parts. This practical study will test the impact of a nurse-led, multidisciplinary prevention program to reduce the risk of future cardiovascular events in middle-aged individuals at a high risk of developing cardiovascular disease (CVD) living in regional Australia.
Incentivising On Country Aboriginal Employment: Anangu Futures. . This project aims to investigate the changing face of cultural tourism in central Australia and examine pathways towards sustainable aboriginal employment in and around Uluru-Kata Tjuta National Park. The project is significant because it brings together Aboriginal community members, industry and government stakeholders to identify micro-business opportunities, youth training initiatives, better relations across cultural divides, ....Incentivising On Country Aboriginal Employment: Anangu Futures. . This project aims to investigate the changing face of cultural tourism in central Australia and examine pathways towards sustainable aboriginal employment in and around Uluru-Kata Tjuta National Park. The project is significant because it brings together Aboriginal community members, industry and government stakeholders to identify micro-business opportunities, youth training initiatives, better relations across cultural divides, and the economic value of Aboriginal knowledge. Outcomes include a model for sustainable Aboriginal employment in remote and very remote contexts, and the development of culturally relevant and sustainable governing guidelines for regional investment. Benefits include more sustainable jobs for Aboriginal people.Read moreRead less
Beyond burial: redefining the blue carbon paradigm. This project aims to constrain the magnitude and drivers of alkalinity and greenhouse gas fluxes in mangroves. Mangroves cover less than 0.03 per cent of the Earth’s surface yet account for approximately 14 per cent of oceanic carbon burial. Mangroves also export alkalinity to the coastal ocean, and act as sources of methane and nitrous oxide. The effect of these fluxes on climate may exceed carbon burial by several-fold, but are unaccounted fo ....Beyond burial: redefining the blue carbon paradigm. This project aims to constrain the magnitude and drivers of alkalinity and greenhouse gas fluxes in mangroves. Mangroves cover less than 0.03 per cent of the Earth’s surface yet account for approximately 14 per cent of oceanic carbon burial. Mangroves also export alkalinity to the coastal ocean, and act as sources of methane and nitrous oxide. The effect of these fluxes on climate may exceed carbon burial by several-fold, but are unaccounted for in blue carbon budgets. This project will couple high-resolution radionuclide geochronology of soil carbon cycling with autonomous measurements of aquatic exports and greenhouse gas fluxes. This study will provide the detailed data required to refine the blue carbon paradigm.Read moreRead less
Local reoptimization for turbocharging heuristics. Theoretical computer science has up until now had little impact on the design of effective heuristics. While data sets may be large, significant structure is almost always present and important to take into account when designing algorithms. Parameterised complexity considers the underlying structure by parameterising not only on the size of the input but also on structural parameters. This project aims to take advantage of the many opportunitie ....Local reoptimization for turbocharging heuristics. Theoretical computer science has up until now had little impact on the design of effective heuristics. While data sets may be large, significant structure is almost always present and important to take into account when designing algorithms. Parameterised complexity considers the underlying structure by parameterising not only on the size of the input but also on structural parameters. This project aims to take advantage of the many opportunities for new theories in the design of new heuristics and in turbocharging existing heuristics for computationally hard problems.Read moreRead less
CENTRE OF RESEARCH EXCELLENCE TO REDUCE INEQUALITY IN HEART DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$2,607,253.00
Summary
There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health ....There is increasing recognition of a societal responsibility to provide effective and sustainable health care to the entire population and not just to selected parts. Indigenous and regional Australians are most affected by Australia's biggest killer - heart disease. In response, the CRE to Reduce Inequality in Heart Disease, is a national collaboration of researchers from a range of health disciplines. Together they aim to address this problem by developing sustainable and cost-effective health care services.Read moreRead less
Aboriginal place names and ethnobiology: enhancing interpretation of Indigenous culture and heritage. This project looks at how Indigenous people’s knowledge of place names and bush tucker can create opportunities for Indigenous communities in areas such as tourism. The project aims to do this by harnessing new advances in digital media which offer new ways of passing on this knowledge to both Indigenous and intercultural audiences.
Immunising Aboriginal Mothers With Pneumococcal Polysaccharide Vaccine To Prevent Infant Ear Disease And Carriage
Funder
National Health and Medical Research Council
Funding Amount
$1,131,530.00
Summary
Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are nee ....Aboriginal children experience the highest rates of acute and chronic ear infections in the world, with resultant permanent ear damage, hearing loss and educational disadvantage. These infections are mainly bacterial, and Streptococcus pneumoniae (pneumococcus) is the predominant pathogen. Pneumococcal colonisation and infection begins within days of birth, many months before any potential immunological protection from infant pneumococcal conjugate vaccine may be expected. New strategies are needed to eliminate, or at least delay, this early-onset pneumococcal colonisation. One such strategy is the administration to the mother of pneumococcal vaccine, which may protect the newborn infant by leading to higher titres of transplacental or breast milk pneumococcal antibodies and-or by reducing carriage (and transmission to the infant) of maternal pneumococci. Previous small studies using this strategy have been encouraging, but there have been no studies properly evaluating carriage or disease endpoints in infants. The polysaccharide pneumococcal vaccine is currently recommended for all Aboriginal and Torres Islander persons aged 15 years or more in the Northern Territory but uptake of the vaccine has been poor. We propose to conduct a pilot study to determine if maternal immunisation with this vaccine, either in the third trimester of pregancy of immediately following delivery, can reduce pneumococcal carriage and the prevalence of middle ear disease among Aboriginal infants at seven months of age. We aim to recruit 210 Aboriginal women who have uncomplicated pregnancies from Darwin and remote communities in the Top End of the Northern Territory. Each subject and their infant offspring will be followed-up after vaccination and at birth, one , two and seven months after birth.Read moreRead less
Skin Microbes and Animal Health: Understanding the Ecological Context. This project aims to understand the fundamental ecological relationships between animal hosts (frogs, geckos) and bacteria on their skin by separating host effects from environmental factors that determine skin microbiome composition. The research is significant because it will generate new knowledge needed to understand how skin microbes function in providing protection against disease. Expected outcomes include the provisio ....Skin Microbes and Animal Health: Understanding the Ecological Context. This project aims to understand the fundamental ecological relationships between animal hosts (frogs, geckos) and bacteria on their skin by separating host effects from environmental factors that determine skin microbiome composition. The research is significant because it will generate new knowledge needed to understand how skin microbes function in providing protection against disease. Expected outcomes include the provision of essential information that will guide future research efforts on the factors that determine a healthy skin microbial community (which is needed before skin diseases can be combated). The research will provide significant benefits, including more targeted conservation efforts to combat wildlife skin diseases.Read moreRead less
Defining the links between climate change, marine disease and food security. This project will deliver critical new knowledge on the causes of marine pathogen outbreaks that threaten Australia’s $1.6 billion aquaculture industry. Several members of the same genus of bacteria have been implicated in recent mass mortality events in aquaculture species, as well as human illness in consumers of seafood, yet the triggers for unprecedented outbreaks of these pathogens are unknown. By coupling a suite ....Defining the links between climate change, marine disease and food security. This project will deliver critical new knowledge on the causes of marine pathogen outbreaks that threaten Australia’s $1.6 billion aquaculture industry. Several members of the same genus of bacteria have been implicated in recent mass mortality events in aquaculture species, as well as human illness in consumers of seafood, yet the triggers for unprecedented outbreaks of these pathogens are unknown. By coupling a suite of sophisticated molecular biological tools and physiological measurements, this research will resolve the role of environmental disturbances including marine heat waves, floods and plastic pollution in stimulating marine pathogen outbreaks, thereby informing efforts to safeguard Australia’s food security and food safety.Read moreRead less