Implementing Guidelines To Routinely Prevent Chronic Disease In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$764,446.00
Summary
High quality, evidence-based guidelines for preventive activities and for the implementation of prevention in general practice have been developed by the Royal Australian College of General Practitioners and other bodies, yet available information suggests that many patients miss out on evidence-based preventive care. This project aims to evaluate current practice and develop a model of practice aimed at improving the implementation of preventive guidelines in general practice.
The Centre for Research Excellence in Nursing Interventions for Hospitalised Patients will provide evidence to improve the nursing care of a broad range of hospitalised patients who are at risk of complications related to compromised skin integrity and poor pain/anxiety management. Systematic reviews and clinical trials will provide the basis for developing clinical practice guidelines to assist nurses in providing high quality care to the 3.5 million Australians admitted to hospital each year.
Venesection Or Expectant Management For Moderate Iron Overload In HFE Related Hereditary Haemochromatosis
Funder
National Health and Medical Research Council
Funding Amount
$853,109.00
Summary
Haemochromatosis is a preventable genetic iron overload disorder. Untreated, it can shorten life due mainly to liver cirrhosis and cancer. It can be prevented by blood donation to maintain normal iron levels. It is unclear, however, whether treatment is necessary when individuals have moderate elevation of iron in the body. This research project will study the effects of treatment in this group by assessing a number of scans, questionnaires and blood tests in treated and untreated individuals.
Early Intervention For Amnestic Mild Cognitive Impairment : A Randomised Trial Of Memory Management
Funder
National Health and Medical Research Council
Funding Amount
$577,556.00
Summary
It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions ....It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions are low cost and, where effective, can provide a stand-alone intervention or add value to the pharmacological approach. The primary aim of this study is to evaluate whether an early intervention program of memory training is effective in improving use of memory strategies in everyday life, and whether this has psychological and emotional benefits for individuals with MCI and their families. We will evaluate through a randomised controlled trial the efficacy of a memory-group program which will involve the family and patient, rather than just the person with MCI, in developing increased awareness of memory issues and specific strategies to prevent memory failures. Over successive cohorts recruited from memory clinics, families will be randomly assigned to either an immediate intervention or a delayed intervention (waiting-list control) group. We will also recruit a sample of healthy older adults who will be similarly randomised into early and late intervention groups. Healthy older adults will provide a means of establishing whether any improvements in the MCI groups are (i) to the same extent as healthy older adults and (ii) to normative levels. Evaluation will be at pre- and post-intervention and at six months follow-up on tests of memory, questionnaires of knowledge and use of memory strategies in everyday life, and appraisal of level of wellbeing. Information about memory and systematic training in compensatory memory skills are expected to significantly improve the capacity of patients and families to cope with everyday memory difficulties. Through active participation in the management of memory impairment, it is expected that the level of wellbeing will increase, for both patient and families.Read moreRead less
Improving Stroke Outcomes: Attenuating Progression And Recurrence
Funder
National Health and Medical Research Council
Funding Amount
$9,331,996.00
Summary
Stroke is the second most common cause of death and major cause disability. There are few proven interventions, so we need to introduce new ones. We developed a bench to bedside program to introduce new stroke therapies and its early secondary prevention. Our general goal is to provide evidence for their effectiveness and safety. We will use animal stroke models, markers in the blood to help diagnose and predict stroke outcome and imaging to help select patients for several clinical trials.
A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
Developing a Regulatory Framework for Mass DNA Screenings: A comparative study of public requests by crime investigators for bodily samples. The aim of the proposed study is to devise a principled model for regulating the performance of mass DNA screenings by Australian police. A ?mass DNA screening? is a public appeal by criminal investigators for bodily samples in order to test whether donors can be linked to a particular unsolved crime. Recent law reform inquires have recognised that the var ....Developing a Regulatory Framework for Mass DNA Screenings: A comparative study of public requests by crime investigators for bodily samples. The aim of the proposed study is to devise a principled model for regulating the performance of mass DNA screenings by Australian police. A ?mass DNA screening? is a public appeal by criminal investigators for bodily samples in order to test whether donors can be linked to a particular unsolved crime. Recent law reform inquires have recognised that the various legal regimes governing mass DNA screenings are inadequate in many respects. The study will develop a new regulatory framework suitable for implementation in all Australian jurisdictions through a principled consideration of laws and recent practice in Australian and comparative jurisdictions.Read moreRead less
Ontology-based collaboration in design. The design process of a building project establishes function, form and performance for the final building. When multiple participants from varying professions are involved there is a serious problem in coordinating, communicating, and locating information around each design decision. Establishing an ontology for this process, and using this ontology to structure all participant communication, will allow the requisite information from all participants to b ....Ontology-based collaboration in design. The design process of a building project establishes function, form and performance for the final building. When multiple participants from varying professions are involved there is a serious problem in coordinating, communicating, and locating information around each design decision. Establishing an ontology for this process, and using this ontology to structure all participant communication, will allow the requisite information from all participants to be considered for each design decision. This will greatly reduce rework and poor design decisions based on missed information. It will also ensure that participants are aware of all related information for their particular design tasks.Read moreRead less
Improving Ways Of Thinking And Ways Of Doing Aboriginal And Cross-cultural Health In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$948,465.00
Summary
Aboriginal community controlled health services and private general practice need to work together to close the gap. This practice-based cultural respect program and toolkit establishes a care partnership, with Aboriginal cultural mentors, to support strategies to embed cultural respect in general practices on an ongoing basis. Success indicators include a cultural quotient measure, performance of Aboriginal health checks and management of risk factors. The program may also benefit cross-cultura ....Aboriginal community controlled health services and private general practice need to work together to close the gap. This practice-based cultural respect program and toolkit establishes a care partnership, with Aboriginal cultural mentors, to support strategies to embed cultural respect in general practices on an ongoing basis. Success indicators include a cultural quotient measure, performance of Aboriginal health checks and management of risk factors. The program may also benefit cross-cultural health generally.Read moreRead less
Evaluating Cancer Screening: Context, Evidence, Values And Ethics
Funder
National Health and Medical Research Council
Funding Amount
$572,460.00
Summary
The research and clinical communities are divided over whether certain forms of cancer screening do more harm than good. This project asks: What is the right thing to do about cancer screening now? Using robust qualitative methodologies, we will study real cases of cancer screening and analyse their ethical implications. Drawing on this data and analysis, we will produce tools to help policy-makers, consumers and professionals make good decisions about cancer screening in future.