Computer-assisted Clinical Guidelines For The Management Of Manifestations Of Anxiety, Aggression And Depression
Funder
National Health and Medical Research Council
Funding Amount
$354,032.00
Summary
This project focuses on creating a new approach to integration of clinical guidelines and the development of a computer-assisted tool to support medical reasoning in psychogeriatrics. The primary focus of this research is on helping medical practitioners to better manage dementia patients with symptoms of anxiety, aggression and depression living in nursing homes. It has the potential to fundamentally improve the way guidelines are utilised in clinical practice
Hospital Admission, Cerebral Palsy, Intellectual Disability And Birth Defects In Assisted Conception Infants.
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
We have recently completed a study examining the prevalence of birth defects in assisted conception infants born in Western Australia from 1993-1997. Contrary to reassuring claims by other researchers in this area, we found that assisted conception infants have a two-fold increased risk of being diagnosed with a major birth defect by one year of age. We now propose to examine other long-term health outcomes in these children. This study involves record linkage between the WA Reproductive Technol ....We have recently completed a study examining the prevalence of birth defects in assisted conception infants born in Western Australia from 1993-1997. Contrary to reassuring claims by other researchers in this area, we found that assisted conception infants have a two-fold increased risk of being diagnosed with a major birth defect by one year of age. We now propose to examine other long-term health outcomes in these children. This study involves record linkage between the WA Reproductive Technology Register and four other population-based databases. The prevalence of cerebral palsy, intellectual disability, hospital admission and birth defects in assisted conception children born in WA between 1993 and 2001 will be compared to that seen in all other Western Australian children born over the same time period. The collection of information on risks associated with assisted conception treatment is vital to allow adequate counselling of couples considering fertility treatment. Cerebral palsy, intellectual disability, birth defects and hospital admission are all serious adverse health outcomes and, despite the introduction of IVF to most Western countries twenty years ago, there are limited data in the literature concerning the occurrence of these conditions in assisted conception infants. Quantifying the contribution of assisted conception treatment to neonatal, infant and childhood morbidity and mortality is also important for the planning of health service provision. Although assisted conception births represent only a small proportion of total births in Australia, these infants may require a disproportionate level of health care services, such as neonatal intensive care treatment due to complications associated with preterm or multiple birth. The wide application of assisted conception treatment in Australia and the increased number of pregnancies achieved by these means reinforce the urgent need for valid data on the health of children born after these procedures.Read moreRead less
Infrared Spectroscopic Imaging In The Diagnosis Of Cervical Cancer
Funder
National Health and Medical Research Council
Funding Amount
$291,600.00
Summary
In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to pro ....In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to probe smears shows promise in providing such an easily automated reliable method. We, and others have spent a number of years exploring this technique and have solved a number of the problems associated with it. Based on our work in the field and the work of others we now wish to develop a methodology using an infrared micro-imaging spectrometer combined with multivariate statistics that can be used to diagnose cervical cancer and the conditions that lead to cervical cancer.Read moreRead less
The Role Of Transcription Factors In Regulating The First Round Of Gene Expression In The Early Embryo.
Funder
National Health and Medical Research Council
Funding Amount
$348,931.00
Summary
Assisted reproductive technologies result in a high incidence of multiple births. This is and adverse outcome that requires correction. It stems from the common transfer of several embryos due to the low chance of an individual embryo made by IVF resulting in a baby. This project will determine the normal pattern of gene expression in the embryo and define: (1) how it is adversely changed as a consequence of IVF; and (2) the extent that these changes are a cause of the low embryo viability.
Mechanisms Of P53 Induced Embryopathy After In Vitro Fertilisation.
Funder
National Health and Medical Research Council
Funding Amount
$483,737.00
Summary
Assisted reproductive technologies (ART) cause many embryos not to survive to birth. We have shown that IVF causes increased expression of protein normally involved in stopping cells from dividing. This is a major cause of embryo death after IVF. This project will determine how this protein acts to cause embryonic death and assess strategies to prevent it.
Improving The Care For People With Acute Low Back Pain By Allied Health Professionals: Cluster RCT.
Funder
National Health and Medical Research Council
Funding Amount
$682,134.00
Summary
The project focuses on the NHMRC Clinical Practice Guidelines (CPG) for the management of acute low back pain, and more specifically the key messages of non-referral to x-ray and advising patients to stay active. A mixed design approach will be used in line with the framework for evaluating complex interventions (MRC 2000). A qualitative approach using semi-structured interviews with physiotherapists, chiropractors and the patients of both will be conducted to identify the barriers and enablers ....The project focuses on the NHMRC Clinical Practice Guidelines (CPG) for the management of acute low back pain, and more specifically the key messages of non-referral to x-ray and advising patients to stay active. A mixed design approach will be used in line with the framework for evaluating complex interventions (MRC 2000). A qualitative approach using semi-structured interviews with physiotherapists, chiropractors and the patients of both will be conducted to identify the barriers and enablers to implementation of the evidence-based clinical practice guideline. The interviews will be underpinned by a theoretical framework grounded in behavioural theory. Information from the interviews will be used to develop a survey to canvas views of a larger population of chiropractors and physiotherapists. The results of the interviews and survey will inform the development of a targeted implementation strategy suitable for use in private physiotherapy and chiropractic clinics. Potential interventions include educational strategies, patient and practitioner information via various media, reminder systems and peer leadership. A cluster randomised controlled trial (C-RCT) will then be conducted to determine the effects of the strategy. Practices will be randomised to receive either the developed implementation strategy, including strategies targeted at clinicians and patients, or to a control group receiving access to the guideline alone. The outcomes of the implementation strategy will be assessed at the level of the practitioner (did the strategy result in a change of practice?), and the patient (did the practice change result in improved patient outcomes?). Subgroup analyses will investigate effects specific to chiropractors and physiotherapists.Read moreRead less
The normal processes of development of the embryo require that the information encoded in chromosomes be reprogrammed soon after fertilization. This process is rather fragile and disturbance of the early embryo can upset it. Recent studies for the chief investigator's provide new understanding of the normal processes of reprogramming. The project will explore and validate the implications of these new discoveries and provide a basis for future alleviation of abnormalities to development.
People who have experienced a previous heart attack or stroke are at greatest risk of having another cardiovascular event. Drug treatment, with aspirin and medication to lower blood pressure and cholesterol, has been shown to substantially reduce this risk. Despite good evidence that these drugs are effective, and that their use is recommended in both Australian and international guidelines, many people who should be taking these medications on a long-term basis are not. This may partly be due t ....People who have experienced a previous heart attack or stroke are at greatest risk of having another cardiovascular event. Drug treatment, with aspirin and medication to lower blood pressure and cholesterol, has been shown to substantially reduce this risk. Despite good evidence that these drugs are effective, and that their use is recommended in both Australian and international guidelines, many people who should be taking these medications on a long-term basis are not. This may partly be due to under-prescribing by doctors, but it is also likely that asymptomatic patients are discouraged by the cost and inconvenience of taking many tablets. In the first study of its kind in this country, we will determine whether a strategy based on the provision of recommended treatments in a single pill (a polypill) will result in better use of these drugs, and as a consequence, will achieve optimum practice in patients with heart disease or stroke. Under the care of their general practitioner, 1000 such patients will be randomly allocated to the polypill, or to continuing their usual treatment. At the end of 2 years, both groups will be assessed for the proportion of people still prescribed and taking all recommended treatments. We will also collect information on the attitudes and experiences of those participating in the study of prescribing (by doctors), dispensing (by pharmacists) and taking (by patients) the polypill. As cardiovascular diseases are the leading causes of illness and death in Australia, finding new ways to ensure the maximum use of known, effective preventive treatments in patients with heart disease and stroke, particularly to those who have less access to health care, is of critical importance. The polypill represents a novel strategy with the potential to achieve this objective, and to improve the clinical care and well-being of many thousands of Australians.Read moreRead less