Improving Quality Of Care For People With Dementia In The Acute Care Setting
Funder
National Health and Medical Research Council
Funding Amount
$1,859,855.00
Summary
People with dementia are often undetected in hospital. This can result in problems which impact their long-term health and wellbeing. An electronic nursing assessment system for people admitted to hospital which reduces nursing admission documentation time, increases identification of patients with cognitive impairment and risk of delirium on admission, supports care planning and increases time for direct clinical care will improve the quality of care for patients with dementia in hospital.
Can Skin Infection With Group A Streptococcus Cause Acute Rheumatic Fever?
Funder
National Health and Medical Research Council
Funding Amount
$459,450.00
Summary
It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of ....It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of the cause of ARF, and have important implications for prevention of ARF around the world. Presently, these approaches focus on diagnosing and treating sore throat, but no country has proven that such a program can be successful in substantially reducing new cases of ARF. If it was known that skin infection could lead to ARF, then countries (including Australia) could emphasise the importance of skin health programs. A further benefit of this knowledge would be to influence GAS vaccine development, which presently is largely focused on the prevention of sore throat. A different possibility has recently been raised - that the cause of ARF may not always be GAS, but instead that the related bacteria GCS and GGS may have the potential to cause this disease. Proof of this hypothesis would even more dramatically alter our understanding of disease causation, prevention, and vaccine development. We propose to determine the cause of ARF in Aboriginal communities by regularly swabbing families of people with a history of ARF, and using genetic fingerprinting of the bacteria from the skin and throat swabs. When cases of ARF occur, we will be able to determine the site and type of infection that precipitated the attack. We will conduct a related study in more communities, in which we will swab family members of people with ARF and of control families (without ARF) to determine the bacteria most commonly isolated from ARF families.Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.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.