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Preventing Diabetes In Pregnancy From Progressing To Type 2 Diabetes: Macrolevel System Change In South Australia And Vic
Funder
National Health and Medical Research Council
Funding Amount
$1,338,281.00
Summary
The greatest predictor of the likelihood of developing diabetes is having diabetes during pregnancy. This project will invite women who have developed diabetes during pregnancy to be registered for recall every two years. They would go to their general practitioner to be tested for diabetes and to be advised on risk factors for diabetes. A lifestyle modification program will be developed for these women to reduce the risk of progressing to diabetes.
Social Aspects And Cultural Meanings Of Gynaecological Cancer Diagnosis, Treatment And Adjustment Of Victorian Women
Funder
National Health and Medical Research Council
Funding Amount
$158,500.00
Summary
Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social fact ....Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social factors that may influence their treatment decisions and care. The study will be conducted in metropolitan and rural Victoria. Women from a variety of ethnic, language and social backgrounds, who have been diagnosed with gynaecological cancer in the preceding three years, will be interviewed to gain insight into their understandings and experiences of the processes of disease, diagnosis and treatment procedures, the implications of for daily life, and the relationship of these events to their perceptions of their bodies, gender and sexuality. We will also interview oncologists and cancer support group facilitators, and participate in cancer support groups, to examine the role of such groups and to explore the experiences of health professionals providing care to women with these cancers. Research findings will be used to develop health educational information about gynaecological cancers, and to provide information to hospitals and clinicians to improve quality of clinical care and social support.Read moreRead less
Is Infection An Acute Trigger For Preeclampsia? A Case-crossover Study.
Funder
National Health and Medical Research Council
Funding Amount
$207,761.00
Summary
Preeclampsia is a multisystem hypertensive disease affecting up to 10% of pregnancies. It puts both mother and baby at increased risk of major illness and death. The cause is unknown but inflammation appears to play a key role. We will use an innovative design to determine whether recent maternal infection triggers the onset of preeclampsia. If preeclampsia is associated with infection, preventative strategies can be developed.
There is increasing evidence that regular physical activity contributes considerably to better physical fitness and good health of individuals and nations. Unfortunately, many individuals in Australia are not regularly active. A sedentary lifestyle is associated with a higher risk of coronary heart disease, obesity, diabetes, osteoporosis and some cancers. Physical activity guidelines encourage participation in at least 30 minutes of moderate-intensity physical activity on most, preferably all, ....There is increasing evidence that regular physical activity contributes considerably to better physical fitness and good health of individuals and nations. Unfortunately, many individuals in Australia are not regularly active. A sedentary lifestyle is associated with a higher risk of coronary heart disease, obesity, diabetes, osteoporosis and some cancers. Physical activity guidelines encourage participation in at least 30 minutes of moderate-intensity physical activity on most, preferably all, days of the week. Walking is one of the most common forms of physical activity undertaken by adults, however there is a relatively poor understanding of the physiological demands of this task. A better understanding of walking for people of different age, gender, size and shape would provide for improvements in the categorisation of intensity of physical activity for use in population measures of physical activity and exercise prescription for individuals who are obese. The aim of the proposed study is to assess the relationship between energy cost of walking and body composition of adults. The main purpose is to consider how people of different age, gender, size and shape manage self-paced walking relative to maximal capacity. The energy cost of walking is an important determinant of a person's functional capacity, physical fitness and health status. The main outcomes of the study: An increased knowledge and understanding of the energy expenditure of self-paced walking relative to maximal aerobic power; More reliable assessment of physical activity status using a variety of commonly employed indirect assessment techniques; A comprehensive understanding of the inter-individual differences in walking characteristics based on age, gender or body fatness; A better understanding of the energy cost of walking and the subsequent promotion of this form of physical activity has potential to impact on the health of Australians, particularly those who are sedentary and overweight or obese.Read moreRead less
Population-based Genetic Screening For Klinefelters Syndrome: A Critical Analysis
Funder
National Health and Medical Research Council
Funding Amount
$75,468.00
Summary
Klinefelter’s Syndrome (KS) is a common and important genetic condition affecting males, yet 70% are never diagnosed. Males with KS are always infertile and may have hormone imbalances, breast development, decreased facial and pubic hair, and varying levels of cognitive, social, behavioural and learning difficulties. Treatment and intervention options are available, if KS is diagnosed early enough. Screening for the condition is possible - but what would the advantages and disadvantages of this ....Klinefelter’s Syndrome (KS) is a common and important genetic condition affecting males, yet 70% are never diagnosed. Males with KS are always infertile and may have hormone imbalances, breast development, decreased facial and pubic hair, and varying levels of cognitive, social, behavioural and learning difficulties. Treatment and intervention options are available, if KS is diagnosed early enough. Screening for the condition is possible - but what would the advantages and disadvantages of this be?Read moreRead less
A Multi-level Study Of Socioeconomic Status And Healthy Food Purchasing Behaviour
Funder
National Health and Medical Research Council
Funding Amount
$173,492.00
Summary
Socioeconomically disadvantaged groups have the highest rates of death and ill-health for diet-related diseases (eg. coronary heart disease, some cancers). Our understanding of the dietary practices which may contribute to these outcomes, however, is limited. This project focuses on this issue by examining the relationship between socioeconomic status and food purchasing behaviour. Studies investigating this relationship have found that disadvantaged social groups are least likely to purchase fo ....Socioeconomically disadvantaged groups have the highest rates of death and ill-health for diet-related diseases (eg. coronary heart disease, some cancers). Our understanding of the dietary practices which may contribute to these outcomes, however, is limited. This project focuses on this issue by examining the relationship between socioeconomic status and food purchasing behaviour. Studies investigating this relationship have found that disadvantaged social groups are least likely to purchase foods which are important for long-term health. The reasons for this association, however, remain unclear. Research into the general determinants of food purchasing behaviour shows that food choices are influenced by the intra-personal characteristics of individuals (eg. knowledge and beliefs), interactions between individuals sharing the same context (eg. relations between parents and children), economic and material factors (eg. income, access to a car) and features of the wider physical environment (eg. availability of healthy food and public transport). What is clear from this evidence, is that food choice is influenced by factors which operate at multiple levels. This project aims to collect data simultaneously from each level, and determine whether (and to what extent) factors operating at each level differentially influence the food purchasing behaviours of socioeconomic groups. This study (i) will contribute to our understanding of why socioeconomic groups differ in their health status, (ii) is consistent with the goals and recommendations of numerous government reports, each of which calls for a a reduction in health inequalities, (iii) represents a methodological advance on previous research, and (iv) will generate the information necessary to develop innovative and appropriately targeted health promotion and health education campaigns.Read moreRead less
Health Services Research: A Randomised Controlled Trial To Evaluate A Model Of Comprehensive Stroke Care
Funder
National Health and Medical Research Council
Funding Amount
$519,150.00
Summary
This study compares the length of stay and patient outcomes between two stroke care models - co-located acute-rehabilitation and dislocated acute-rehabilitation stroke care. In participating hospitals, acute stroke patients admitted to the emergency department will be randomly allocated to either model of care. Length of hospital stay and clinical outcomes will be examined 90 days post-stroke. Study results will provide high level of evidence for future stroke care model development.
From Broome To Berrima: Building Australia-wide Research Capacity In Indigenous Offender Health And Health Care Delivery
Funder
National Health and Medical Research Council
Funding Amount
$3,018,575.00
Summary
Australia has the highest Indigenous incarceration rate in the OECD which impacts profoundly on Indigenous communities. Further, offender populations endure a greater health burden compared with the general community. This grant develops much needed capacity in offender health research, building a team of Indigenous researchers, and creating an Australia-wide network for sharing knowledge in this field. Outcomes will include better Indigenous offender health services and improved health and well ....Australia has the highest Indigenous incarceration rate in the OECD which impacts profoundly on Indigenous communities. Further, offender populations endure a greater health burden compared with the general community. This grant develops much needed capacity in offender health research, building a team of Indigenous researchers, and creating an Australia-wide network for sharing knowledge in this field. Outcomes will include better Indigenous offender health services and improved health and wellbeing for this marginalised population.Read moreRead less
MEDICAL EARLY RESPONSE INTERVENTION AND THERAPY (MERIT): A RANDOMISED CLINICAL TRIAL
Funder
National Health and Medical Research Council
Funding Amount
$530,500.00
Summary
Every year, between 12,000 and 23,000 deaths are associated with in-hospital adverse events, making them one of the leading causes of death in the general population. These adverse events lost Australia over three million bed-days per year, and cost the country up to $4.7 billion every year. Among the adverse events, death, cardiac arrest and unplanned admissions to intensive care unit (ICU) are the most serious occurrences. The majority of the events were preceded by serious clinical deteriorat ....Every year, between 12,000 and 23,000 deaths are associated with in-hospital adverse events, making them one of the leading causes of death in the general population. These adverse events lost Australia over three million bed-days per year, and cost the country up to $4.7 billion every year. Among the adverse events, death, cardiac arrest and unplanned admissions to intensive care unit (ICU) are the most serious occurrences. The majority of the events were preceded by serious clinical deterioration, which can be easily identified. Recognising these problems, a hospital-wide intervention system called the Medical Emergency Team (MET) has been developed in Australia over the last 10 years. Under this system, when a patient's clinical condition is unstable, a call is immediately placed to the MET for intervention. Preliminary data have shown that the MET can reduce in-hospital deaths, cardiac arrests and unplanned ICU admissions. However, past studies have been based on observational design and their results lack scientific credence due to uncontrolled confounders and biases. It is proposed to conduct a multi-centre randomised clinical trial to test the hypothesis that the implementation of the hospital-wide MET system will reduce the aggregate incidence of the following three adverse events: unplanned admissions to intensive care units, cardiopulmonary arrest, and in-hospital death. The study will involve 20 Australian and New Zealand hospitals, each with at least 20,000 admissions per year. This study will provide crucial scientific evidence for health managers and governments to make decision on the implementation of MET in Australian and New Zealand hospitals. If the MET system is shown to reduce adverse events as observed in preliminary studies, then the introduction of MET could save approximately 4000 lives, avoid 1500 cardiac arrests, and prevent 2500 unplanned ICU admissions every year.Read moreRead less
The Impact Of Hospital-based Aged Care And Dementia Services On Outcomes For People With Dementia Admitted To Hospital-a
Funder
National Health and Medical Research Council
Funding Amount
$1,308,580.00
Summary
This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence ....This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence that there are many hazards for people with dementia when they are hospitalized. The project will result in recommendations about the types of services and their features which produce better outcomes for people with dementia. Every stage of the research will be guided and informed by an Expert Panel comprising representatives of dementia service consumers, aged care providers, health service planning staff and key researchers. The Panel will provide contextual information about the service environment and how it affects people with dementia. Details of the patient's complete hospital stay can be investigated by linking existing administrative datasets. Data about hospital services will be gathered through a census of NSW hospitals, supplemented with in-depth interviews with key stakeholders and small group expert discussions with experts in each Area Health Service. The research team will also visit selected hospital sites. Multilevel modelling techniques will test for statistical associations between hospital based dementia services and care outcomes including admission rates to hospital, total length of hospital stay, mortality, admission rates to hospital, and the level of patient dependency on entry to residential aged care. The model will include the influence of regional variations in the provision of community aged care packages and residential aged care and the availability of informal care. The project will include a focus on the outcomes for people with co-morbidities and for people from different culturally and linguistically diverse backgrounds.Read moreRead less