Discrimination Or Discretion? Factors Contributing To Discrimination Of People With Hepatitis C In Health Care Settings.
Funder
National Health and Medical Research Council
Funding Amount
$419,750.00
Summary
Hepatitis C is now the leading communicable disease in Australia and stigma and discrimination have been identified as major barriers to addressing this epidemic. This study builds on our previous work in which we have found evidence of discrimination against people with hepatitis C in health care settings. Discrimination, inappropriate and unfair treatment against people with hepatitis C, in health care settings is a major barrier to care, treatment and support. A key strategy for developing ef ....Hepatitis C is now the leading communicable disease in Australia and stigma and discrimination have been identified as major barriers to addressing this epidemic. This study builds on our previous work in which we have found evidence of discrimination against people with hepatitis C in health care settings. Discrimination, inappropriate and unfair treatment against people with hepatitis C, in health care settings is a major barrier to care, treatment and support. A key strategy for developing effective strategies to reduce both perceived and real discrimination of people with hepatitis C in health care settings is to gain a better understanding of the range of issues experienced by the health care providers themselves and factors in the broader health service context that impact on optimal care. The aim of this study is to identify these factors and the findings will influence policy and practice with the ultimate goal of removing barriers to equitable and appropriate health care for people with hepatitis C. The study will focus on both people (health care providers)- the knowledge, attitudes and practices among health care professionals in relation to infection control practices, hepatitis C and injecting drug use; and contexts (health care settings)- factors in the health care settings that contribute to discriminatory, inappropriate or unfair treatment of people with hepatitis C. The study will focus specifically on health care settings of general practice, dentistry, nursing and pharmacists. The outcomes will be used to develop practical and effective strategies for both improving health care for HCV positive individuals and improving the working relationships and environments for these health professionals working with this client population.Read moreRead less
A Clinical Trial Of The Effect Of Neuropsychological Treatments In Increasing Community Participation After Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$365,700.00
Summary
Traumatic brain injury is very common, with more than 2,000 people surviving serious brain injury in NSW each year. The survivors are most commonly young adult males and many are left with permanent brain damage, invariably affecting cognitive abilities. The impact of cognitive impairments on the person's capacity to resume their premorbid lifestyle is enormous. In one of our studies we found that 40% did not work but nor did they have any meaningful occupational activity to replace work. The cu ....Traumatic brain injury is very common, with more than 2,000 people surviving serious brain injury in NSW each year. The survivors are most commonly young adult males and many are left with permanent brain damage, invariably affecting cognitive abilities. The impact of cognitive impairments on the person's capacity to resume their premorbid lifestyle is enormous. In one of our studies we found that 40% did not work but nor did they have any meaningful occupational activity to replace work. The current project targets this large group of people in particular. The study aims to develop and test two alternative, intensive cognitive treatment programs that are geared to increasing community participation, everyday activities and psychological well-being. To date, no such therapies have been evaluated using powerful methodological designs. As a result of the study we will be able to incorporate the standardised interventions into a format that can be easily applied to Brain Injury Rehabilitation Services in Australia. The programs will not only improve the functioning of the individuals with brain injury, but will have a flow-on effect for their families and the community at large.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.
A Population Based Study Of The Use Of Acute Hospital Services By Elderly People Living In Residential Care.
Funder
National Health and Medical Research Council
Funding Amount
$127,000.00
Summary
This project will be the first population based Australian study to describe the pattern of utilisation of acute hospital services by elderly people living in residential care. It will provide much needed information on which to base health policy decisions relating to the acute care needs of the most frail elderly members of our community. Within a context of an ageing demographic profile of the Australian population, it is essential that the dynamic interplay between acute care services and th ....This project will be the first population based Australian study to describe the pattern of utilisation of acute hospital services by elderly people living in residential care. It will provide much needed information on which to base health policy decisions relating to the acute care needs of the most frail elderly members of our community. Within a context of an ageing demographic profile of the Australian population, it is essential that the dynamic interplay between acute care services and the residential aged-care sector be elucidated, both for current service provision and for better prediction of future service requirements. This study will make use of existing linked health data sources in WA to achieve the following aims: 1. To provide health service planners with information about the rates, patterns, causes, outcomes and costs of acute emergency department and in-patient hospital services for elderly persons living in residential care in Perth, Western Australia. 2. To develop a population model to determine future acute hospital requirements for elderly persons living in residential care. 3. To estimate the potential impact of alternate modes of integration of acute and long-term care on the utilisation of acute hospital services by hostel and nursing home residents.Read moreRead less
The Physiology Of Health Systems: Port Lincoln As A Case Study
Funder
National Health and Medical Research Council
Funding Amount
$2,228,073.00
Summary
No health system in Australia has a complete, population-wide view of how they are used, by whom, and with what effect on health. Our plan is to capture and describe comprehensively all health system activity relating to a sizeable and carefully-defined Australian population and to complement this with a population-wide census of health status. Such 'intelligence' is fundamental to evaluating the current performance of health systems and to planning changes to them.
Improving The Surgical Outcomes For Barretts-derived Oesophageal Adenocarcinoma Through Early Detection.
Funder
National Health and Medical Research Council
Funding Amount
$796,144.00
Summary
Some people with severe reflux develop Barrett's oesophagus, which puts them at high risk of developing cancer. Patients with Barrett's can be monitored by regular endoscopy to detect cancer early enough so that they can be treated successfully with surgery. The aim of this work is to identify patients who are at highest risk of cancer using molecular biomarkers. We will then determine the cost effectiveness of using biomarkers for surveillance of patients with Barrett's oesophagus.
Primary Health Care Errors Study: Qualification And Quantification Of Errors Occurring In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$191,000.00
Summary
The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of ....The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of GPs, or been able to quantify the frequency with which different types of errors occur. This study plans to ask a representative sample of GPs in both urban and rural areas to report their errors, so that we can try to quantify the incidence and prevalence of these different error types. No previous work has been done in Primary care which has attempted to determine the rate of recognized errors that occur in the community. In addition, since the last major work on this topic was done between 1993 and 1998, there have been many changes to General Practice, especially in the area of computerisation, and the types of problems that GPs face now may have changed significantly. Anonymous reporting is very important in order to encourage health professionals to admit to their mistakes, and in the past, projects have used paper based reporting forms, making it difficult to offer anonymity and requiring protection for participants under a Commonwealth Act of Parliament. However the GPES project will be the first major study of General Practice errors that uses an on-line anonymous reporting form, and high level encryption, located on a secure web-site, to encourage honest reporting. The reporting form was trialled in the 2001 pilot study. By analysing the types of errors occurring, and their contributing factors, we can target at-risk population groups and develop strategies to improve patient care and prevent future harm.Read moreRead less
Screening For Chlamydia Trachomatis With Routine Pap Smears In General Practice: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$350,500.00
Summary
Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertilit ....Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility. The economic costs of Chlamydial infection in Australia have been estimated to be as high as $160 million each year. In the ACT 73.8% of chlamydial infections occur in the 20-40 year old group. Between 60 and 70% of women in this age range participate in Pap screening every two years. While targeted screening for Chlamydia in women is effective in the US, there are few studies that investigate its value in an Australian setting. In this randomised controlled clinical trial we aim to test the novel hypothesis that the routine offer of chlamydia testing to women between 20 and 40 years who undergo Pap screening significantly increases the detection of Chlamydia in that population. This is the first randomised-controlled trial of its type and is an extension of a current non-randomised pilot study of linked Chlamydia-Pap screening in the primary care setting. The aim is to determine if the program can be incorporated more widely in the ACT. The study will: Measure the impact of linked chlamydia-Pap screening on chlamydia screening participation rates More accurately determine the epidemiology of genital chlamydial infection in this age group and social setting; Undertake an economic evaluation of this approach; Determine if promoting the Pap smear as an opportunity for chlamydial screening increases the uptake of Pap screening in younger women Aid in the development of a National Chlamydia Screening strategyRead moreRead less
What People With Aphasia Want: Towards Person-centred Goal-setting In Aphasia Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$427,702.00
Summary
Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech thera ....Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech therapy. The study will then seek the perspective of their treating speech pathologists about the goals of therapy and the challenges that speech pathologists face in practising person-centered goal setting. This study will not only provide a framework for aphasia services in Australia but also provide data that will inform professional educational programs about person-centered practice for speech pathologists and other health professionals. It will also contribute to current theories on collaborative goal setting in a rehabilitation context.Read moreRead less
Increasing Cardiovascular Risk Assessment In First Degree Relatives Of Patients With Premature Heart Disease: An RCT
Funder
National Health and Medical Research Council
Funding Amount
$113,972.00
Summary
Family history is a risk factor for ischaemic heart disease (IHD), especially if the history includes early onset disease. Families share both genetic and environmental risk factors, many of which can be modified to reduce the risk of heart disease. The aim of this project is to trial an intervention to promote heart disese risk assessment among the relatives of patients with premature heart disease. This is a first step toward prevention of heart disease in these families.