Acute Vertigo In Emergency Departments: Distinguishing Between Central And Peripheral Causes By Objective Measure Of Oculomotor Examination (HINTS)
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
The goal of this work is to provide a quantitative objective measure of HINTS for developing an automatic diagnostic decision tool to differentiate vestibular neuritis (peripheral) and stroke (central) in patients presenting in emergency department for acute vestibular syndrome. Video oculography makes interpretation of the results more reliable. Video oculography goggles will be used as part of a systematic training program to enhance frontline clinician skills in eye movement examination.
Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses ....Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses in Australian hospitals. This project aims to address this need by providing nurses with wireless handheld access to such resources. This project is extremely significant, as the outcomes will provide nurses, in Australia and overseas, a set of guidelines for managing wireless handheld computers in clinical units, to enhance patient safety and quality of care.Read moreRead less
Most strokes are ischaemic due to occlusion of an artery producing rapid reduction in blood flow to the brain. Positioning a patient ‘lying flat’ (i.e. ‘head down’ to be level with the body, which increases the blood flow to the brain, may improve recovery and reduce disability. This study aims to determine whether ‘lying flat’ head positioning is beneficial in patients with acute stroke. The results could lead to a cheaper, safer and more effective stroke care in the world.
Mechanisms Of Glucocorticoid Resistance In Acute Lymphoblastic Leukaemia
Funder
National Health and Medical Research Council
Funding Amount
$547,970.00
Summary
Glucocorticoids are extremely active drugs used in the treatment of childhood acute lymphoblastic leukaemia (ALL), yet a proportion of patients respond poorly to therapy and exhibit resistance at relapse. Clinically relevant mechanisms of glucocorticoid resistance are poorly understood, principally due to lack of appropriate experimental models. This project will reveal novel mechanisms of drug resistance in childhood leukaemia and lead to novel therapeutic strategies to improve outcome.
Patient and nurse outcomes and the cost of nurses' turnover in Australian hospitals. An adequate supply of nurses is fundamental to all of the National Health Priority disease areas where quality care cannot be delivered without an adequate number of motivated nurses. Designing cost-effective methods of retaining nurses requires understanding reasons why they leave the workforce and the impact this has on patient care and system costs. The findings will assist policy makers and workforce planner ....Patient and nurse outcomes and the cost of nurses' turnover in Australian hospitals. An adequate supply of nurses is fundamental to all of the National Health Priority disease areas where quality care cannot be delivered without an adequate number of motivated nurses. Designing cost-effective methods of retaining nurses requires understanding reasons why they leave the workforce and the impact this has on patient care and system costs. The findings will assist policy makers and workforce planners at both local and national levels, to design strategies to effectively recruit and retain nurses as demands for health care and market competition for staff both increase.Read moreRead less
Listen to me, I really am sick! Understanding patient and family perspectives in triggering responses to medical emergencies. This project investigates whether patient and family perspectives are treated as evidence of a deteriorating health state whilst in hospital. Recommendations from this study will inform the development of patient centred strategies to reduce delays in clinician response to physiological deterioration and improve patient safety in hospitals.
Can Skin Infection With Group A Streptococcus Cause Acute Rheumatic Fever?
Funder
National Health and Medical Research Council
Funding Amount
$459,450.00
Summary
It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of ....It is traditionally taught that the cause of acute rheumatic fever (ARF) is always infection of the throat with the bacterium group A streptococcus (GAS). However, in Aboriginal communities of the Top End of the Northern Territory the incidence of ARF is the highest reported in the world, yet GAS is uncommonly isolated from the throat. There is further information to suggest that GAS skin sores may underlie many cases of ARF. If this were proven, it would completely alter the traditional view of the cause of ARF, and have important implications for prevention of ARF around the world. Presently, these approaches focus on diagnosing and treating sore throat, but no country has proven that such a program can be successful in substantially reducing new cases of ARF. If it was known that skin infection could lead to ARF, then countries (including Australia) could emphasise the importance of skin health programs. A further benefit of this knowledge would be to influence GAS vaccine development, which presently is largely focused on the prevention of sore throat. A different possibility has recently been raised - that the cause of ARF may not always be GAS, but instead that the related bacteria GCS and GGS may have the potential to cause this disease. Proof of this hypothesis would even more dramatically alter our understanding of disease causation, prevention, and vaccine development. We propose to determine the cause of ARF in Aboriginal communities by regularly swabbing families of people with a history of ARF, and using genetic fingerprinting of the bacteria from the skin and throat swabs. When cases of ARF occur, we will be able to determine the site and type of infection that precipitated the attack. We will conduct a related study in more communities, in which we will swab family members of people with ARF and of control families (without ARF) to determine the bacteria most commonly isolated from ARF families.Read moreRead less
A prospective evaluation of the impact of the nurse practitioner role on emergency department service and outcomes. The local hospital emergency department (ED) is a prominent and highly utilised service in Australian communities but demand on EDs is increasing, resulting in significant service delays. This project will study the composition of ED clinical teams around Australia and their impact on improving the timeliness and quality of emergency clinical care.
Targeting Drug-Resistance In Paediatric Acute Lymphoblastic Leukaemia
Funder
National Health and Medical Research Council
Funding Amount
$649,048.00
Summary
Leukaemia is the most common type of cancer in children but resistance to therapy continues to be a significant problem. This project will investigate the biology of drug-resistance and relapse using a mouse model that replicates the human disease. We hope to identify novel therapeutic targets that can be used in combination with existing therapies to improve outcomes in this disease, particularly for patients that develop drug-resistance such as those at the time of relapse.
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less