Pelvic organ prolapse in women is associated with poor quality of life. The standard treatment currently available for prolapse is surgery. The evidence for conservative management with physiotherapy is not clear. This randomised controlled trial will examine the effect of physiotherapy treatment, including pelvic floor muscle training, on prolapse symptoms and severity, compared with lifestyle advice only. Appropriate conservative management may reduce the need for surgery and associated costs.
Pelvic Floor Muscle Training For The Management Of Urinary Incontinence In Elderly Women: A Randomized Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$321,240.00
Summary
Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. P ....Urinary incontinence is associated with significant personal shame and social stigma and affects around 10% of Australians. one-third of women over 60 years of age. Incontinence limits physical activity and this in turn can lead to loss of independence and poorer general health. Fewer than one-third of those with regular incontinence seek assistance. Pelvic floor muscle re-education by physiotherapists is the most commonly recommended method of conservative management for urinary incontinence. Pelvic floor muscle training is safe and effective and should thus be offered as the first choice of treatment for stress urinary incontinence. However there is still no strong evidence for the effectiveness of this intervention in the elderly and because of a perception by medical practitioners that pelvic floor muscle re-education is only effective in younger women, relatively few elderly women are referred to physiotherapy for management of incontinence. Although in clinical practice it is customary to complement pelvic floor muscle training with other forms of conservative management of incontinence such as bladder training, a recent influential study suggested that pelvic floor muscle training and bladder training were equally effective in patients with stress urinary incontinence. It is important to distinguish the relative effectiveness of these interventions used in isolation in order to ensure that urinary incontinence is managed in the most effective and efficient way. This project will therefore investigate the effectiveness of two conservative interventions, pelvic floor muscle training and bladder-behavioural training in women with stress urinary incontinence over 70 years of age. Moreover, strong evidence that conservative intervention is effective for urinary incontinence in the elderly will result in appropriate intervention being offered routinely as the first choice of treatment in older women.Read moreRead less
Endometriosis: Defining Mechanisms For Novel Risk Loci On Chromosomes 7p15.2 And 1p36
Funder
National Health and Medical Research Council
Funding Amount
$613,124.00
Summary
We recently identified two novel genomic regions with robust evidence for associaiton with endometriosis. The result does not give immediate insights into the genes or pathways contributing to disese because the genes in each region assocaited with increased risk need to be clearly identified. This project aims to find the gene or genes responsible in each region to help develop reliable disease biomarkers and effective preventative and therapeutic strategies for this important disease.
A Computer Alert To Increase Chlamydia Testing Of High Risk Women In General Practice: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$182,575.00
Summary
Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose ....Chlamydia trachomatis infection is the most common notifiable sexually transmissible infection (STI) in Australia, with over 30,000 infections notified in 2003, rising by 20% each year. Infection with chlamydia can have considerable complications, particularly for women - it is a leading cause of pelvic inflammatory disease and tubal infertility. Unfortunately, as many as 85% of people with infection do not have any symptoms, so are unaware they have chlamydia; yet chlamydia is easy to diagnose with urine tests and easy to treat with single dose antibiotics. Over 65% of infections diagnosed in women are among those aged 16 to 24 years. Internationally, screening programs for chlamydia have reduced the number of people with the infection and have also reduced the rate of complications arising from infection. However, Australia does not have a screening program and only tests about 4% of 16 to 24 year old women, the largest group at risk of infection, each year. We propose to conduct a study which tests the effect of using a computer based alert. This alert is designed to prompt doctors to discuss chlamydia testing with sexually active women aged 16 to 24 years. A group of general practices will be selected. We will randomly allocate some practices to have the alert installed on their computers and the remaining practices will receive no intervention. We will observe both groups of general practices over 12 months and compare their chlamydia testing rates among women aged 16 to 24 years. We estimate that the alert will increase testing rates from the 4% currently tested to 10%. By testing and treating more women with the infection, we can reduce the number of people in the community with the infection. We will also be collecting information about the dollar cost of chlamydia infection to the community. This study will produce valuable information which can be used by government to inform the design of future chlamydia screening and control programs.Read moreRead less
MECHANISMS OF TRANSMITTER SECRETION AT SYMPATHETIC NERVE VARICOSITIES
Funder
National Health and Medical Research Council
Funding Amount
$438,707.00
Summary
The mechanism by which quantal packets of transmitter are secreted from release sites called varicosities on sympathetic nerve terminals can now be taken to the molecular level, given the new techniques which we have introduced to solve this problem. There are two main facets to the problem. The first of these involves the question of how proteins involved in controlling the regulated secretion or exocytosis of the quantal packets of transmitter carry out this function. These proteins (syntaxin, ....The mechanism by which quantal packets of transmitter are secreted from release sites called varicosities on sympathetic nerve terminals can now be taken to the molecular level, given the new techniques which we have introduced to solve this problem. There are two main facets to the problem. The first of these involves the question of how proteins involved in controlling the regulated secretion or exocytosis of the quantal packets of transmitter carry out this function. These proteins (syntaxin, synaptobrevin, SNAP25 and synaptotagmin) together with a calcium channel are complexed with a docked synaptic vesicle containing a quantum of transmitter in a module of secretion appropriately called a secretosome. The leading questions here are to determine if only a single secretosome participates in transmitter release on the arrival of a nerve impulse, whether the number of these secretosomes in a varicosity determines its probability for secretion of a quantum, and fundamentally, how do the proteins within the secretosome cooperate to trigger exocytosis when there is sufficient calcium influx through the secretosome-associated calcium channel following the impulse. The other problem concerns the mechanism of removal of calcium from the varicosity once it has entered through the channels, This calcium can have considerable affects on the extent to which secretosomes participate in secretion with subsequent impulses. Furthermore, this influx of calcium can be modulated for subsequent impulses by transmitter released by the first impulse. The present research will solve these problems, providing a molecular description of secretion from single sympathetic varicosities.Read moreRead less