A Randomised Controlled Trial Of A Nurse-led Intervention For Less Chronic Heart Failure: The NIL-CHF Study
Funder
National Health and Medical Research Council
Funding Amount
$1,166,160.00
Summary
The overall aim of the unique NIL-CHF Study is to examine the benefits of applying a specialist nurse-led, home and clinic-based intervention to optimise the care of recently discharged hospital patients with heart disease. Involving 950 patients, it will explore whether more flexible and individualised care to apply the best possible medical treatments is able to PREVENT the most deadly and disabling form of heart disease (chronic heart failure - CHF) and save money in the process.
The Effectiveness Of A Responsible Hospitality Audit And Feedback Intervention To Reduce Alcohol Related Harm
Funder
National Health and Medical Research Council
Funding Amount
$466,875.00
Summary
Alcohol is a major cause of death, injury and illness in Australia accounting for over 3,000 deaths and over 72,000 hospital admissions each year. Excessive drinking is estimated to cost the Australian community $7,560 million each year, representing 22% of all drug-related harm. Alcohol is a significant contributor to the occurrence of violence and crime. It is estimated that up to 70% of incidents attended by the police, and 77% of street offences such as assaults and malicious damage to prope ....Alcohol is a major cause of death, injury and illness in Australia accounting for over 3,000 deaths and over 72,000 hospital admissions each year. Excessive drinking is estimated to cost the Australian community $7,560 million each year, representing 22% of all drug-related harm. Alcohol is a significant contributor to the occurrence of violence and crime. It is estimated that up to 70% of incidents attended by the police, and 77% of street offences such as assaults and malicious damage to property, are alcohol-related. It is also estimated that 70% to 80% of night-time single-vehicle accidents are alcohol-related. A large proportion of assaults, offensive behaviour, malicious damage to property and drink driving occur following excessive drinking at licensed premises such as hotels and registered clubs. The risk of harm arising from the consumption of alcohol on licensed premises can be reduced by modifying such factors as service of alcohol to intoxicated patrons, service-supply of alcohol to underage patrons, management practices (eg. late closing) and environmental factors (eg. poor lighting). Auditing of licensed premises is an approach currently used by authorities to ensure compliance with licensing requirements. However, such audits do not focus on harm reduction and do not incorporate best practice audit and behaviour change features. No controlled studies have reported the effectiveness of such an audit approach in reducing the risk of violence and crime emanating from hotels and registered clubs. The proposed study aims to assess the effectiveness of a Responsible Hospitality Audit and feedback intervention in reducing service to intoxicated and underage patrons, and in reducing assaults-malicious damage to property following alcohol consumption on licensed premises. The outcomes of this study will be improved responsible service of alcohol actions and reduced alcohol-related crime associated with premises.Read moreRead less
Life! Diabetes Prevention Program: A Randomised Cluster Control Trial Of Its Efficacy And Cost Effectiveness
Funder
National Health and Medical Research Council
Funding Amount
$866,066.00
Summary
Type 2 diabetes is a great and growing epidemic, and Australia's largest public health challenge. Life! is a diabetes prevention program for 25,000 Victorians. This proposal will look at its efficacy, effectiveness and cost effectiveness so that more improvements can be made.
A Randomised Trial To Control Sexually Transmitted Infections In Remote Aboriginal Communities.
Funder
National Health and Medical Research Council
Funding Amount
$1,847,403.00
Summary
This project will trial strategies for attaining clinical best practice in sexual health with an overall objective of reducing the high rates of sexually transmitted infection in remote Aboriginal communities in central and northern Australia. The trial will take place in 21 communities of which seven will be randomly assigned in each of the three years of the trial. This trial will determine whether strengthening primary health services can reduce the level of these infections.
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
Systematic Expansion Of The Clinical Evidence Base In Opioid Prescribing For Refractory Dyspnoea At The End Of Life
Funder
National Health and Medical Research Council
Funding Amount
$414,535.00
Summary
Morphine can relieve breathlessness in the palliative setting. But many important questions remain. What is the best dose, should the dose change over time, do different medications provide the same relief, and how common is dyspnoea in the general population? This three part project will extend our knowledge to answer these questions. Population data will provide critical background to plan best care for future palliative patients distressed by breathlessness.
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.