Avian Influenza - National Perception Of Risks To Paramedics And Innovative Ambulance Service Population-based Models Of
Funder
National Health and Medical Research Council
Funding Amount
$297,909.00
Summary
This research addresses the important public health role of prehospital Emergency Medical Services (EMS) in containing and managing contagion should an influenza pandemic evolve in Australia. Paramedics are front line health staff and in the event of a pandemic will be among the first members of the community to face exposure to infection. This research will explore the attitudes and perceptions of paramedics and their families to working in epidemic conditions, provide prediction of behavioural ....This research addresses the important public health role of prehospital Emergency Medical Services (EMS) in containing and managing contagion should an influenza pandemic evolve in Australia. Paramedics are front line health staff and in the event of a pandemic will be among the first members of the community to face exposure to infection. This research will explore the attitudes and perceptions of paramedics and their families to working in epidemic conditions, provide prediction of behavioural responses to highly infectious environments, and a clear understanding of attitudes to infection control and use of Personal Protective Equipment (PPE). Knowledge of how to manage and support the responses of frontline health workers to an infectious disease outbreak is critical to the emergency system response. This project aims to mitigate the effects of perceived risk of infection on attitudes and behaviour of paramedics, by informing health promotion and infection-prevention messages to paramedics and their families. This research will also explore the emerging role of ambulance services as a key component of a public health surveillance system to provide an early warning of pandemic disease outbreaks and facilitate implementation of effective disease control strategies. Current triage systems, used for allocation of patients to appropriate treatment and-or quarantine, are not designed for epidemic environments, and may inadvertently facilitate disease spread and delay identification of victims requiring immediate care and-or quarantine. This project will explore the utility of a population-based triage tool to control an infectious disease outbreak by reducing patient-to-patient disease transmission. The project will facilitate expansion of current public health disease surveillance strategies and triage mechanisms for use during an epidemic, to effectively manage increased workloads within a highly infectious environment, whilst maintaining usual emergency medical services.Read moreRead less
In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states ....In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.Read moreRead less
A Computer Model Of Service Delivery For Behavioural And Psychological Symptoms Of Dementia: A Tool For Policy Makers An
Funder
National Health and Medical Research Council
Funding Amount
$400,108.00
Summary
Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementi ....Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementia and project associated costs of care into the future. It will also incorporate information about interventions for BPSD, and how they may affect prevalence and cost in the future.Read moreRead less
Models Of Care To Address Unmet Of Older Indigenous With Dementia Their Families And Communites Living In Remote WA
Funder
National Health and Medical Research Council
Funding Amount
$1,081,060.00
Summary
The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. O ....The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. Over the last 4 years the applicants of this project have started to address some of the health related problems faced by older Indigenous people, particularly the challenging area of dementia. The authors have developed a culturally appropriate assessment tool to help determine if an older Indigenous person has dementia. This has been very successful and is now frequently used by health professionals in remote and rural areas of Australia. A survey is in the final stages of completion to determine the estimated number of people in remote areas of the Kimberley who manifest signs and symptoms of dementia and associated old age diseases. Preliminary data sadly indicate that the frequency of dementia is higher than expected for people of this age group. The next phase of this project is to determine the unmet needs of this vulnerable group, by interviewing those with dementia and their families, communities and service providers in remote areas of Kimberley and Pilbara. This will determine culturally appropriate and practical ways to provide care to assist those with this condition and their families and communities.Read moreRead less
Determining Critical Points In The Potential Palliative Care Pathway In The Last Year Of Life
Funder
National Health and Medical Research Council
Funding Amount
$356,461.00
Summary
People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death ....People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death best introduced and how we can care for people from a diverse range of backgrounds and beliefs within our current health care system. We also need to identify and promote the best possible ways of supporting patients at the end of life and their families as they negotiate the often complex path towards a good death. With this kind of information, health care practitioners, particularly those involved in palliative care, can design better services that put in place pathways where assessment of patient and family needs, referral to the most appropriate services and coordination of all the aspects of care are easy to understand and access for all people. This kind of care can be expensive so we need to use the money allocated to palliative care wisely. This can be achieved with thoughtful research that identifies those most in need, at the time of most need and investigates the best approaches to alleviating pain in suffering in the weeks and months before death. A fair and equitable health care system is not just about keeping people healthy, but also about dealing humanely with the inevitability of deathRead moreRead less
Development And Implementation Of An Educational Program To Guide Palliative Care For People With Motor Neurone Disease
Funder
National Health and Medical Research Council
Funding Amount
$258,525.00
Summary
The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to peo ....The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to people with MND and their carers as a result of the implementation of the MND Education Program will be assessed and a national implementation plan will be developed.Read moreRead less
Validation Of A Competency Assessment Method For Persons With Dementia
Funder
National Health and Medical Research Council
Funding Amount
$580,451.00
Summary
Deciding what if any aspects of their financial affairs a person with dementia or suspected dementia can responsibly manage is a difficult process for health and legal professionals as well as for guardianship boards and tribunals. This process is often stressful for the older person, and families can find deciding when to “take over” stressful. Also, having family members manage the older person’s assets may result in family conflict. There is a small amount of overseas research examining this ....Deciding what if any aspects of their financial affairs a person with dementia or suspected dementia can responsibly manage is a difficult process for health and legal professionals as well as for guardianship boards and tribunals. This process is often stressful for the older person, and families can find deciding when to “take over” stressful. Also, having family members manage the older person’s assets may result in family conflict. There is a small amount of overseas research examining this issue. However, no comprehensive and validated method exists internationally or in Australia to determine competency in this context. We will test a methodology for assessing the capacity of individuals to manage their own financial affairs where dementia is an issue. This method involves the use of a number of reliable and well-validated instruments measuring the older person’s mental state, anxiety levels, depression, and social vulnerability combined with an interview exploring the personal circumstances of the older adult in relation to their financial affairs. We will work with the Office of the Adult Guardian in Queensland to recruit participants and to verify both the utility and usability of our methodology with stakeholders (e.g. solicitors, the Office of the Adult Guardian). A comparison will be made between the results obtained in approximately 200 financial competency cases with the competency opinions independently arrived at by the Office of the Adult Guardian in Queensland. As a result of this research, we will be able to ascertain the viability and utility of this assessment method, improve the method as per the data gathered, and ultimately seek future funding to trial the methods across multiple jurisdictions (e.g. other states) and contexts (e.g. various cultural contexts).Read moreRead less
Adouble-blind Placebo Contorolled Study Of Subcutaneous Ketamine In The Management Of Cancer Pain
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients ....Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients keep on their usual pain medicines. Participants are randomised to have ketamine or the placebo. The study looks at pain control, quality of life, ketamine side effects, and change in need for usual pain medicines. This is the first national clinical study of a new palliative care research network, the Palliative Care Clinical Trials Collaborative (PaCCSC). It is hoped that if ketamine is proven safe and effective in difficult cancer pain, it will be more easily available for cancer patients.Read moreRead less