Evaluation Of Multidisciplinary Care Plans For Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$83,500.00
Summary
Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans ....Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans and whether the care planning process is associated with improved provision and outcomes of care for a specific chronic illness. The chronic illness that has been chosen for this research project is diabetes because of its prevalence in the community, importance in general practice and because there are accepted standards of process and outcomes of care against which diabetes care contained in EPC care plans can be bench marked. Diabetes is estimated to affect 7.5% of the adult Australian population with more than 85% of those affected having type 2 or mature onset diabetes. Increasingly care of type 2 diabetes is provided in primary care under share care arrangements with specialist diabetes services and in a multidisciplinary team approach involving the patient and their carer as well as relevant health professionals. A recent review has shown that there is a lack of evidence on whether multidisciplinary care is associated with improved process and outcomes of diabetes care. The project will involve 50 general practitioners and 200 of their patients with diabetes in South West Sydney. The design of the project involves audit of the care plans to examine the extent and quality of the diabetes care contained in comparison to accepted benchmarks. The project will also audit the patients' medical records for the year of care before and after the care plan. This care will be compared to published guidelines for process of care and goals for outcomes.Read moreRead less
Exploring The Role Of The Bcl-2 Family In Haematopoiesis And Haematopoietic Malignancy
Funder
National Health and Medical Research Council
Funding Amount
$190,980.00
Summary
Chronic Lymphocytic Leukaemia and Non-Hodgkin Lymphoma comprise the majority of blood cancers and are both disease in which the cell death pathway plays a vital role in both the development of the cancer cell and the resistance to chemotherapy. This project aims to examine the mechanisms of cancer in these tumours focussing on lymphoid cancers, and examine the role of new treatments targeting this pathway.
Effect Of Oral Glutamine On GLP-1 And Insulin Secretion And Glycaemia In Humans.
Funder
National Health and Medical Research Council
Funding Amount
$397,444.00
Summary
Diabetes is an ever increasing problem with serious complications. We will investigate whether glutamine, one of the most common amino acids (protein building blocks) in the body, has a beneficial effect on blood glucose and insulin levels in the body in people who have type 2 (non-insulin dependent) diabetes. If so, glutamine supplementation may represent a novel, cheap and palatable way of improving outcomes and preventing the development of complications in people with type 2 diabetes.
Leptin And The Regulation Of Substrate Partitioning
Funder
National Health and Medical Research Council
Funding Amount
$349,876.00
Summary
The prevalence of obesity is increasing with currently 18% of adult Australians being classified as obese. Obesity, particularly abdominal obesity, is associated with high blood lipid levels and blood pressure, and type 2 diabetes. In Australia, the cost of obesity is estimated to be $830 million per year. The ultimate aim of any obesity treatment programme is to reduce body fatness by burning off fat and to prevent further fat storage and so studies which focus on developing strategies to achie ....The prevalence of obesity is increasing with currently 18% of adult Australians being classified as obese. Obesity, particularly abdominal obesity, is associated with high blood lipid levels and blood pressure, and type 2 diabetes. In Australia, the cost of obesity is estimated to be $830 million per year. The ultimate aim of any obesity treatment programme is to reduce body fatness by burning off fat and to prevent further fat storage and so studies which focus on developing strategies to achieve these goals are very important. We have found that subjects who fail to keep weight off after being on a weight-reducing diet are bad fat burners. These people also have low levels of leptin, a hormone made by fat cells which helps to regulate food intake. The first aim of this study is to show that leptin increases the burning of fat by regulating the production and activity of factors which decide whether fat is used for energy or is stored in the body. The second aim is to find ways in which leptin levels can be changed so that fat burning is increased. Some of the ways in which we will change leptin levels are by changing the fat content of the diet, or by drugs, or by giving leptin itself. These studies will be performed in animal models of obesity and will help us to develop strategies for the treatment and prevention of obesity in humans.Read moreRead less
Falls Prevention For Stroke Patients Following Discharge Home: Contributory Factors And A Randomised Trial Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$549,440.00
Summary
Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention ac ....Falls are common after stroke, with over 50% of people being discharged home from hospital after stroke experiencing one or more falls in the subsequent six months. Despite a large focus on falls prevention in the community generally, and increasing research that a range of activities (such as exercise, medication review, home hazard modification) are effective in reducing falls among older people generally, there have been no randomised trials evaluating the effectiveness of falls prevention activities for people with stroke. This research will evaluate whether a detailed assessment and program of falls prevention activities (exercise, falls prevention information, bone strength recommendations, and other activities based on the assessment findings) will reduce falls in stroke patients with increased risk of falling. Two additional issues associated with falls among people with stroke will also be investigated. Detailed analysis of walking and stepping over obstacles will be evaluated to determine long term problems which might increase the risk of falling, and the effect of the falls prevention program will also be evaluated on the walking and stepping over the obstacle tasks. A third study will investigate the development of fear of falling firstly as a result of the stroke and resultant walking difficulties, and then how this changes when a fall occurs. The interaction between falls, fear of falling, and reduced activity and walking will be explored. The outcomes of this project will improve the understanding by health professionals of key factors contributing to increased risk of falling following stroke, and provide clear direction and resources for general application of the program in other stroke rehabilitation programs nationally. The main anticipated outcome is 33% reduction in falls, and improved balance, walking, and confidence for people returning home after stroke.Read moreRead less
Personalised Care For Type 2 Diabetes In Primary Care: Empowering Patients And Clinicians To Treat To Target
Funder
National Health and Medical Research Council
Funding Amount
$177,197.00
Summary
This Fellowship program focuses on evidence based clinical care of people with type 2 diabetes (T2D) in general practice. In particular it seeks to translate evidence about progressive intensification of treatment of elevated glucose levels to achieve “target levels” into real world everyday general practice care of people with T2D. Doing so will play an important role in reducing the long term serious complications and could reduce the costs to the community of this condition.
High-order conservative multiscale computation of elliptic problems in composite materials and porous media. The proposed technology will improve the design and performance of a wide range of mechanisms and industrial processes involving heterogeneous media, from composite materials to water filtration and recycling. Our researchers in computational mechanics will gain further opportunities to extend the advances this project will make.
Direct simulation of composite microstructures in fluid and elastic media. The proposed innovative computational methodology will improve the design and performance of a wide range of mechanisms and industrial processes involving particulate inclusions, from engineering to biological applications. The resultant technology will make a contribution to maintain and enhance Australia's role in the development of advanced engineering materials through manipulating their composite microstructures. The ....Direct simulation of composite microstructures in fluid and elastic media. The proposed innovative computational methodology will improve the design and performance of a wide range of mechanisms and industrial processes involving particulate inclusions, from engineering to biological applications. The resultant technology will make a contribution to maintain and enhance Australia's role in the development of advanced engineering materials through manipulating their composite microstructures. The proposed computational method will also lead to new opportunities for Australian companies that develop computer simulation software. Our researchers in computational mechanics will gain further opportunities to extend the advances this project will make.Read moreRead less
COX-2 Inhibitors And The Development Of Unstable Angina And Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$171,450.00
Summary
Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are ....Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are the adverse effects of these drugs on the heart and the kidneys. The older fashioned members of this class of drug are rapidly being replaced by newer agents known as COX-2 inhibitors. Popular examples in Australia are celecoxib (trade name Celebrex) and rofecoxib (trade name Vioxx). These drugs are heavily promoted as being safer than the older NSAIDs. In the case of the stomach, this claim seems to be correct. However, the effects of the new COX-2 inhibitors on the circulation have not been fully assessed. Recently, claims have been made that these drugs may increase the risk of heart attacks. If this were true, it would be an effect that was unique to COX-2 inhibitors as it has not been reported with the older NSAIDs. We plan to carry out a 3 year study in Newcastle hospitals in which we compare the use of COX-2 inhibitors in a group of patients admitted to hospital with a heart attack or unstable angina with that of a control group of patients who were admitted to hospital around the same time, but not for heart problems. We are interested in whether COX-2 inhibitors are associated with an increased risk of heart attacks and whether use of small doses of aspirin protects against this effect. Depending on the results we may be able to improve the safety of these drugs in patients at risk of heart attacks.Read moreRead less