Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
An Examination Of The Relationship Between Alcohol-related Injury (ARI) And Licensed Premises
Funder
National Health and Medical Research Council
Funding Amount
$78,686.00
Summary
There is growing interest in acute alcohol-related problems, and especially injuries. These are often experienced by young people, frequently as a consequence of intoxication or drinking in unsafe settings. Little work has been undertaken in Australia to systematically examined alcohol-related injuries (ARIs). This study will examine ARIs, identify the frequency with which such problems present to a local hospital, record the nature of the injuries, details of the person sustaining it, and the d ....There is growing interest in acute alcohol-related problems, and especially injuries. These are often experienced by young people, frequently as a consequence of intoxication or drinking in unsafe settings. Little work has been undertaken in Australia to systematically examined alcohol-related injuries (ARIs). This study will examine ARIs, identify the frequency with which such problems present to a local hospital, record the nature of the injuries, details of the person sustaining it, and the drinking location. Characteristics of drinking locations and drinking settings, in particular licensed premises, will be examined to determine their association with ARIs. Then an intervention will be undertaken in conjunction with local police, to address the conditions of the drinking environment with the aim of reducing ARIs and other alcohol-related problems stemming from licensed premises. The intervention will form part of a randomised controlled trial where licensed premises, identified through monthly police data as hot spots, receive either an intervention or act as a control. In the following month, controls receive the intervention (a cross-over design). The intervention was established in 1998 by Gold Coast police and involves police, fire and liquor licensing officers undertaking an on-site inspection and taking prescribed actions. It is hypothesised that this action should result in a decreased level of ARIs being generated from premises which receive the intervention, compared to those that do not. This is an intersectoral, collaborative project aimed at improving community safety through a concerted effort by police, health and the licensees.Read moreRead less
Determination Of Irradiation Dose Efficacy For Use In Impaction Grafting At Revision Joint Replacement
Funder
National Health and Medical Research Council
Funding Amount
$411,517.00
Summary
Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence ....Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence of early complications of this procedure have included loss of fixation within the bone. Fracture of the bone around prostheses has also reported in some centres. These events require more surgery, putting the patient at higher risk greater complications and longer rehabilitations. Recent improvements in surgical technique and donor bone preparation have improved results. A current debate questions whether the dose of irradiation can be reduced from 25 kGy, while maintaining sterility of allografts. The risk of bacterial contamination in allografts is low, and irradiation reduces the mechanical strength of the graft, contributing to complications when irradiated bone is used. The benefits of decontaminating the bone may be outweighed by the higher risk for failure due to poor bone quality and resulting prosthesis instability. We will use ISO standards to test the validity of radiation dose for sterilising bone ex vivo. In the absence of controlled human studies, our aim is also to compare the results of impaction grafting with non-irradiated bone versus bone irradiated at current doses used by Australian bone banks, and lower doses indicated by ex vivo testing. We will use a large animal model of revision hip replacement, with precise measures of prosthesis stability. The results of this study will guide clinical decisions regarding the efficacy of current bone graft preparation procedures and the use of irradiated bone in human hip replacement surgery.Read moreRead less
The Risks And Benefits Of Contemporary Total Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$493,530.00
Summary
The number of hip replacements undertaken in Australia is steadily increasing. The most common complications of hip replacements are dislocation and loosening due to bone loss around the implant, requiring complex and expensive revision surgery. This study will investigate the incidence of dislocation and, using a new diagnostic imaging technique, the incidence and amount of bone loss around a relatively new prosthetic material, the outcomes of which are not known despite its increasing use.