Integrating Evidence Intopolicy And Sustainableservice Delivery: The Wobbly Hub And Double Spokes Model
Funder
National Health and Medical Research Council
Funding Amount
$825,458.00
Summary
Vast distances and workforce shortages limit access to health services in rural and remote NSW. The University of Sydney, NSW Department of Ageing, Disability and Home Care (DADHC) and University of Technology Sydney, will explore current issues and develop, implement and evaluate evidence-based policies for workforce utilisation in service delivery. Expected outcomes include increased access to allied health services in Western NSW and a sustainable program of policy monitoring and development.
Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perfo ....Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perform poorly. Most people who fracture are not detected by BMD because their BMD is either normal or high, and many people with low BMD never fracture. The main aim of this grant application is to develop new tools to allow doctors and scientists worldwide to better estimate FN strength. To develop new methods to replace BMD, scientists need to make use of the 3D aspects of the bone such as size, shape and internal architecture. Presently, these 3D aspects (structure) have not been adequately studied and scientists incorrectly approximate them. As a result new methods are not any better. A good quantification of structure is needed. Another reason for the failure to accurately estimate the strength of bones is that estimates are based on a single parameter whereas the bone, like any architectural structure (e.g. building), comprises many components acting together to maintain its strength. To determine the strength based on density alone is incorrect; the size, the shape and things inside the structure need to be considered as a whole. After quantifying correctly the structure and components of bone strength, we will determine how they can be used individually and together to better estimate the strength of the FN in men and women. Tools generated will be used to better determine people likely to fracture and needing treatment; to better tailor and monitor treatments. A better understanding of the causes and epidemiology of fractures will ensue.Read moreRead less
RCT Of An Intervention To Improve The Health Of Adolescents With Intellectual Disability.
Funder
National Health and Medical Research Council
Funding Amount
$803,146.00
Summary
A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of ....A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of significant health information, negative social attitudes and inadequate training about disability for health service providers. This project is an attempt to minimise some of these barriers by examining the use of a Health Intervention Package. We want to give young people with intellectual disabilty the chance of similar health standards to the rest of the population. This package includes a comprehensive health review, a diary for collecting and storing health information, and advocacy training. We specifically want to examine if adolescents with intellectual disabilty using this package will receive better healthcare and improved health outcomes. We envisage that if successful, the intervention will establish good health practices for the rest of the young person's life. This group of young people is particularly at risk as they move from care provided by specialist paediatricians to accessing General Practitioners' services. To achieve this, the study will seek to recruit 1000 young people (and their parents and teachers) in Special Schools in Queensland. We have already shown that the comprehensive health review does improve health outcomes adults with intellectual disabilty, and the health information and advocacy training has received very positive evaluation. We now need to investigate the effect of both these processes in adolscence and establish if evidence exists to support wider implementation throughout the sector.Read moreRead less
Parent Education For The Treatment Of Severe Behaviour Problems In Children With Developmental Disabilities
Funder
National Health and Medical Research Council
Funding Amount
$116,220.00
Summary
Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the ef ....Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the effectiveness of FCT (Mirenda, 1997). Wacker et al. (1998) have shown that parents can be taught to use FCT, but these parents received individual consultations, which would seem to limit its practicality. Preliminary results from our current APEX grant suggest that parents can learn to implement this treatment in a group format, which is more practical from a public health perspective. However, it is currently unknown if group training is as effective as individual consultation. In the present application, we aim to compare these two ways of teaching parents how to use FCT. From a total sample of 36, the parents of 18 children will be randomly assigned to the group training format and 18 to the individual format. All parents will receive 12 hours of training on how to use FCT, either as part of a group of 3 families (mothers and-or fathers) in the clinic or on a one-to-one basis in the family home. Pre, post, and follow-up measures of problem behaviours will be used to address the research question: Is group training as effective as individual consultation? If so, we would have demonstrated a more practical way of teaching parents how to implement this evidence-based treatment for child behaviour problems.Read moreRead less
Involvement Of The Asciz Gene In Kidney Development And Disease
Funder
National Health and Medical Research Council
Funding Amount
$591,128.00
Summary
Congenital abnormalities of the kidney and urinary tract (CAKUT) affect more than 1/500 children. Urogenital development is primarily controlled by a small number of genes that regulate the timing and position of kidney formation. In this application we describe a novel gene involved in this process, establish where it acts, how it regulates gene expression and whether mutations in it cause CAKUT.
Understanding The Developmental Basis Of Kidney Disease
Funder
National Health and Medical Research Council
Funding Amount
$622,655.00
Summary
Kidney disease is a considerable burden on the health system and much of it derives from events that occur during organ development. In this grant I will investigate why human nephron number varies between people, how renal cysts form and what genes are mutated in patients with congenital kidney malformations.
Tissue-dependent Proregenerative Mechanisms In Adult Vertebrates
Funder
National Health and Medical Research Council
Funding Amount
$638,742.00
Summary
This proposal addresses how immune cells participate in regeneration of damaged organs in adult zebrafish. Unlike mammals, zebrafish have a remarkable capacity to regenerate their various body parts in adulthood, providing a model to understand how regeneration capacity might be induced in humans. The proposed study will define mechanisms of immune-mediated regeneration that could provide new cellular and molecular targets for stimulating replacement of damaged organs in the human injury setting
Epigenetic Regulation Of Male Fetal Germ Cell Development.
Funder
National Health and Medical Research Council
Funding Amount
$562,176.00
Summary
Men’s health has declined over recent decades, but the causes remain unknown. Non-genetic (epigenetic) mechanisms affecting formation and function of the male germ cells (which produce sperm) may play an important role. We will determine the role of a key epigenetic modifier on the formation and function of male germ cells, including germ cell tumours. This study will provide fundamental insights into male germ cell epigenetics, and significantly contribute to understanding men's health.
Identifying The Pathological Mechanism Of PCDH19-Girls Clustering Epilepsy
Funder
National Health and Medical Research Council
Funding Amount
$523,988.00
Summary
Changes in the PCDH19 gene are a relatively common cause of epilepsy. To better understand the basis of this disorder, we have developed unique mouse models that mimic the genetic changes and symptoms of this condition. We will perform careful analysis of brain development in these models to determine the primary cause of this condition. These experiments will create greater understanding of how changes in PCDH19 cause epilepsy in girls and facilitate the development of new treatments.