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Often when people are sick they cannot communicate their wishes regarding medical decisions. This research will explore, through surveys and interviews, how older general practice patients understand these decisions and how their understanding compares with that of their loved ones and their general practitioner. We aim to provide an insight into the meaning people give to these decisions thereby assisting those who wish to plan for their future medical care and their doctors.
Primary Care Prevention Of Falls And Fractures In The Elderly By Annual Vitamin D Supplementation
Funder
National Health and Medical Research Council
Funding Amount
$305,750.00
Summary
While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vita ....While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vitamin D deficiency. Lower vitamin D levels following wintertime have now been reported in many populations including those living near the Mediterranean and in Geelong, Victoria. Vitamin D insufficiency is associated with an increased risk of falling through increased body sway and muscle weakness. Low levels of the vitamin also encourage the removal of calcium from bones and will predispose to bone fracture for two reasons - increased likelihood of falling and increased bone fragility and osteoporosis. Osteoporotic fractures are amongst the most important causes of ill-health among elderly people, causing an estimated 65,000 fractures in 2000-01. If nothing is done, fracture rates are estimated to increase from one every 8.1 minutes in 2001, to one every 3.7 minutes in 2021. Falls among the elderly are also a major health with about a third of people over 70years falling at least once every year. Almost 90% of all hip fractures result from the impact of a fall. This project will trial an annual dose of vitamin D to the elderly at high risk of vitamin D deficiency, falls and fractures. Fifteen hundred women will be supplemented with either vitamin D or a placebo dummy pill at the beginning of winter for five years. The supplementation will take place through their local doctor and researchers will expect to see fewer falls and bone fractures occurring in those receiving vitamin D than in the group receiving the placebo.Read moreRead less
Re-orientating General Practice Systems Toward Youth Friendly Care: A Cluster Randomized Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,387,497.00
Summary
This project aims to improve young people's health care by helping general practice become youth friendly and measuring the effects of this on: willingness to visit for mental health and risky behaviours such as tobacco, alcohol and other drug use and unprotected sex; parents' perceptions of the care received; the sense of competence staff have in dealing with young people's issues; the practice's effectiveness in responding to young people's health risks and on the cost of general practice.
The Effect Of Glucosamine Sulphate On Structural Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$1,250,214.00
Summary
Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommendi ....Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommending paracetamol as 'the preferred long term oral analgesic'. This recommendation is based on the increased risk of serious gastrointestinal, cardiovascular and renal diseases with long-term NSAIDs use in older people. However, NSAIDs appear to provide better pain relief for patients with more than mild joint pain. Amongst patients with OA, there is much demand for the dietary supplement glucosamine sulphate. Product marketing has led to the belief that glucosamine is able to slow the rate of joint destruction and cartilage loss and help ease joint pain with, in contrast to NSAIDs, little risk of side effects. However, the few trials conducted to date have been inconclusive. If the marketing claims are unjustified, many older people are wasting limited financial resources and due to unrealistic expectations of the benefit of glucosamine, placing a lower priority on lifestyle changes of proven effectiveness, such as regular exercise and weight loss. A total of 900 patients with knee OA will be randomly allocated to glucosamine sulphate or matching placebo capsules for two years. The main outcomes will be the rate of joint space narrowing, use of NSAIDs and physical disability. If glucosamine results in slowing disease progression or in reducing NSAIDs consumption, the widespread use of this product would effectively decrease pain, disability and NSAIDs-related illnesses amongst the increasing number of people with OA.Read moreRead less