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.
A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic ev ....A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic evaluation, improving the quality of life and wellbeing of older Australians, and will assist in determining the relative cost effectiveness of new and existing services.
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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.
Effectiveness of Intervention Strategies to Promote Physical Activity Among Insufficiently Active Adults. This project will determine the cost-effectiveness of 2 types of physical activity (PA) interventions based around the workplace. 480 participants will be randomly assigned to PA intervention groups or controls. Interventions are either a (1) self-regulated, pedometer-based program or a (2) semi-structured, 40-day initiation to more moderately-vigorous PA. Both are designed to increase self- ....Effectiveness of Intervention Strategies to Promote Physical Activity Among Insufficiently Active Adults. This project will determine the cost-effectiveness of 2 types of physical activity (PA) interventions based around the workplace. 480 participants will be randomly assigned to PA intervention groups or controls. Interventions are either a (1) self-regulated, pedometer-based program or a (2) semi-structured, 40-day initiation to more moderately-vigorous PA. Both are designed to increase self-efficacy and impact on positive PA behaviours. Long-term, behavioural change and job-related outcomes will be evaluated by following participants for 12 months after the interventions.Read moreRead less
The impacts of industry restructuring. This project aims to shed light on how Australia's workforce and communities will engage with the world of work in a future shaped by new business models and disruptive technologies. Using the closure of the automotive industry as a lens into this topic, the project will provide new insights into how displaced workers find work, use services, relate to others, and reshape their futures. It sheds light on the community-wide impacts of restructuring, providin ....The impacts of industry restructuring. This project aims to shed light on how Australia's workforce and communities will engage with the world of work in a future shaped by new business models and disruptive technologies. Using the closure of the automotive industry as a lens into this topic, the project will provide new insights into how displaced workers find work, use services, relate to others, and reshape their futures. It sheds light on the community-wide impacts of restructuring, providing new perspectives on how local resources and public policies best advance the process of adjustment.Read moreRead less
Putting death in its place. The project aims to link 890,000 population records to place of residence from 1838 to 1930, to examine the relationships between where people live, mortality, life expectancy and health. Where people live impacts their life-course outcomes. Using novel matching techniques, the project expects to identify intergenerational changes and the spatial dynamics of inequality and social mobility. Expected outcomes include the creation of a public resource of linked data and ....Putting death in its place. The project aims to link 890,000 population records to place of residence from 1838 to 1930, to examine the relationships between where people live, mortality, life expectancy and health. Where people live impacts their life-course outcomes. Using novel matching techniques, the project expects to identify intergenerational changes and the spatial dynamics of inequality and social mobility. Expected outcomes include the creation of a public resource of linked data and a better understanding of long-run health and inequality. These should provide economic and social benefits by informing policy aimed at contemporary social and health challenges, enhancing our understanding of Australian history, and developing public resources.Read moreRead less
Fostering school attendance for students in Out-of-Home Care. This project aims to investigate why children and young people in Out-Of-Home-Care in Australia are absent from school far more than their peers. The project expects to generate new knowledge about the reasons for their absences and to develop solutions to improve attendance through: children’s own voices; detailed absence data; policy audit; and case studies of promising practice. Expected outcomes include a comprehensive conceptuali ....Fostering school attendance for students in Out-of-Home Care. This project aims to investigate why children and young people in Out-Of-Home-Care in Australia are absent from school far more than their peers. The project expects to generate new knowledge about the reasons for their absences and to develop solutions to improve attendance through: children’s own voices; detailed absence data; policy audit; and case studies of promising practice. Expected outcomes include a comprehensive conceptualisation of absences including those triggered by schools or the care context; and an evidence-informed, child-centred framework to enable attendance and, thereby, improved educational outcomes. This should provide significant social and economic benefits both for children in care and for the community. Read moreRead less
Implementing guidelines to prevent chronic disease in the community. The burden of chronic disease in Australia has resulted in prevention of chronic disease being an important priority for the Australian health system. High quality evidence for preventing chronic disease exists; however the practice falls short of the evidence. Finding ways to implement the evidence for preventing chronic disease is an urgent national need. This study aims to apply the evidence for preventing chronic disease in ....Implementing guidelines to prevent chronic disease in the community. The burden of chronic disease in Australia has resulted in prevention of chronic disease being an important priority for the Australian health system. High quality evidence for preventing chronic disease exists; however the practice falls short of the evidence. Finding ways to implement the evidence for preventing chronic disease is an urgent national need. This study aims to apply the evidence for preventing chronic disease in practice. It will generate data and validate a model on how to effectively improve the uptake of guidelines by both practitioners and consumers. This project is of national and community benefit because it will enable the potential of preventing chronic disease to be realised.Read moreRead less
Early years languages learning in Australia. This project aims to investigate early year’s language programs in Australian schools. The project will explore and analyse successful programs in the three states of NSW, Queensland and Victoria, policy, curricula and resources for languages teaching and learning, key stakeholder perspectives, and student progress in new primary language teaching degrees. The project expects to generate new knowledge of linked best practice program types, pedagogies, ....Early years languages learning in Australia. This project aims to investigate early year’s language programs in Australian schools. The project will explore and analyse successful programs in the three states of NSW, Queensland and Victoria, policy, curricula and resources for languages teaching and learning, key stakeholder perspectives, and student progress in new primary language teaching degrees. The project expects to generate new knowledge of linked best practice program types, pedagogies, and teacher requirements, to provide new data and ongoing research opportunities. Intended benefits include the education of more linguistically and culturally competent young Australians who are able to effectively engage in a plurilingual, globalised world.Read moreRead less