Supply, Demand And The Distribution Of Health Services In Australia
Funder
National Health and Medical Research Council
Funding Amount
$308,038.00
Summary
The distribution of medical services and its impact on access and equity is widely recognised as a key concern of the Australian community. Access and equity are key indicators to the public of the performance of a health system. These concerns have led to the adoption of major policy goals under Medicare relating to equitable access to medical services for the population as a whole. Furthermore, both the community and policy makers have expressed high levels of concern over the distribution of ....The distribution of medical services and its impact on access and equity is widely recognised as a key concern of the Australian community. Access and equity are key indicators to the public of the performance of a health system. These concerns have led to the adoption of major policy goals under Medicare relating to equitable access to medical services for the population as a whole. Furthermore, both the community and policy makers have expressed high levels of concern over the distribution of medical services between sub-markets and sub-populations, in particular, in the distribution of medical services between urban and rural-remote areas. This project, for the first time, comprehensively examines the performance of Medicare in terms of access to medical services over time. Australian data sets, largely untapped by economic modelling, will be used for analysis of the relationships between the distribution of, access to, and demand and fees for Australian medical services and their impact upon mortality over time. The study will result in the first comprehensive Australian description of access and supply of different medical services by social group and by geographic location over time. Furthermore it will provide evidence on the key determinants of distribution and changes in the distribution of medical services and estimates the likely effects of policy instruments designed to address the distribution of, and access to, medical services.Read moreRead less
Testing A Tailored, Evidence-based Education Intervention To Enhance Outcomes For Patients Commencing Chemotherapy
Funder
National Health and Medical Research Council
Funding Amount
$311,250.00
Summary
This project tests an innovative education program aimed at reducing the physical and psychosocial burden experienced during a course of cancer chemotherapy. The aim of the study is to reduce the burden and distress associated with cancer chemotherapy. Cancer chemotherapy is associated with physical (nausea, fatigue, hair loss, infection) and psychosocial (fear, anxiety, worry about family) effects that cause significant distress. Patients experience a highly level of pre-treatment anxiety and f ....This project tests an innovative education program aimed at reducing the physical and psychosocial burden experienced during a course of cancer chemotherapy. The aim of the study is to reduce the burden and distress associated with cancer chemotherapy. Cancer chemotherapy is associated with physical (nausea, fatigue, hair loss, infection) and psychosocial (fear, anxiety, worry about family) effects that cause significant distress. Patients experience a highly level of pre-treatment anxiety and for many this distress lasts across the course of treatment. Over the past decade there has been a dramatic shift in chemotherapy delivery to the outpatient setting. This means that patients are now responsibile for monitoring their own health at home and may need to use self-care strategies to deal with the many adverse effects of treatment. Pre-treatment education has usually focused on providing information about the facts of treatment, i.e. likelihood of nausea, rather than preparing the patient for the experience of treatment or helping them to manage the self-care demands associated with receiving treatment in the outpatient setting. The innovative education program tested here is the first of its type to draw on high level research evidence about preparing patients for potentially threatening medical procedures, tailoring this education to the individual situation of the patient and coaching the patient to implement evidence-based self-care behaviours and to use stress reduction techniques across the course of treatment.Read moreRead less
Determination Of Irradiation Dose Efficacy For Use In Impaction Grafting At Revision Joint Replacement
Funder
National Health and Medical Research Council
Funding Amount
$411,517.00
Summary
Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence ....Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence of early complications of this procedure have included loss of fixation within the bone. Fracture of the bone around prostheses has also reported in some centres. These events require more surgery, putting the patient at higher risk greater complications and longer rehabilitations. Recent improvements in surgical technique and donor bone preparation have improved results. A current debate questions whether the dose of irradiation can be reduced from 25 kGy, while maintaining sterility of allografts. The risk of bacterial contamination in allografts is low, and irradiation reduces the mechanical strength of the graft, contributing to complications when irradiated bone is used. The benefits of decontaminating the bone may be outweighed by the higher risk for failure due to poor bone quality and resulting prosthesis instability. We will use ISO standards to test the validity of radiation dose for sterilising bone ex vivo. In the absence of controlled human studies, our aim is also to compare the results of impaction grafting with non-irradiated bone versus bone irradiated at current doses used by Australian bone banks, and lower doses indicated by ex vivo testing. We will use a large animal model of revision hip replacement, with precise measures of prosthesis stability. The results of this study will guide clinical decisions regarding the efficacy of current bone graft preparation procedures and the use of irradiated bone in human hip replacement surgery.Read moreRead less
The Risks And Benefits Of Contemporary Total Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$493,530.00
Summary
The number of hip replacements undertaken in Australia is steadily increasing. The most common complications of hip replacements are dislocation and loosening due to bone loss around the implant, requiring complex and expensive revision surgery. This study will investigate the incidence of dislocation and, using a new diagnostic imaging technique, the incidence and amount of bone loss around a relatively new prosthetic material, the outcomes of which are not known despite its increasing use.
A Course Of Oxytocin Nasal Spray To Improve Social Communication In Young People With Autism
Funder
National Health and Medical Research Council
Funding Amount
$293,735.00
Summary
Autism is characterised by impairments in social behaviour and communication, and is a cause of major lifelong disability. A novel intervention, Oxytocin, enhances social communication in autism and non-clinical populations. This project will determine whether Oxytocin, taken twice daily over 8 weeks, improves social interaction skills in everyday life for young people with autism. This project represents a crucial step in developing a novel and effective new treatment for Autism.
The Effects Of Oxytocin Nasal Spray On Mechanisms Of Social-communication In Young People With Autism
Funder
National Health and Medical Research Council
Funding Amount
$191,400.00
Summary
Autism is charcterised by deficits in social behaviour and communication, and is a cause of major lifelong disability. A novel intervention, Oxytocin, enhances social communication in non-clinical populations. This project will determine whether OT improves social communication deficits characteristic of autism. This project is a critical first step towards treating a core deficit of autism.