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This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of t ....This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-off; how benefits weigh up against harms. This research is relevant to all partners in healthcare, (consumers, clinicians and policy-makers), who currently are being tested or using tests without being fully informed about the accuracy and effects of these tests.Read moreRead less
A Prospective Study To Examine The Effectiveness And Safety Of Antivirals Against Pandemic Influenza
Funder
National Health and Medical Research Council
Funding Amount
$142,394.00
Summary
Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifi ....Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifically the influenza neuraminidase inhibitors _NIs). As a consequence public health agencies around the world have been stockpiling these drugs and developing sophisticated plans for their use if an influenza pandemic was announced. However, there are no data indicating that the neuraminidase inhibitors (NIs) are safe and effective when used to manage pandemic influenza. Neither are there any data to support the use of these drugs on a population basis. Genetic resistance to NIS has been described but it is not clear if this has any relevance to public health. Our research will clarify this issue. This project will develop a number of clinical trials that could be implemented rapidly should pandemic influenza ever be announced by health authorities in Australia-Singapore or Hong Kong. Patients with suspected influenza infection will be asked to provide informed consent prior to commencing NI therapy. Clinical information will then be collected for a period of approximately one month along with some blood samples and swabs from the throat and nasal passages. Data will be analysed as quickly as possible to help inform the continued use of NI therapy as a cornerstone of the public health agency response to pandemic influenza. In addition, the study team will prepare clinical trials to be conducted in essential workers who are likely to receive long-term NI preventive treatment as well as the immediate contacts of people with presumed influenza infection who are likely to receive short-term prophylaxis with NIs.Read moreRead less
DCIS Management Since Publication Of Clinical Practice Recommendations: Surgeons' Practices And Women's Experiences
Funder
National Health and Medical Research Council
Funding Amount
$360,783.00
Summary
Ductal Carcinoma in Situ of the breast (DCIS) now represents 15% of all new cases of breast cancer. Although a benign disease, its diagnosis increases a woman's risk of developing invasive breast cancer and the goal of treatment is prevention of invasive disease. However the characteristics that predict this progression have not been clearly identified. Consequently women are confused about their diagnosis and both clinicians and women are faced with complex treatment decisions. The National Bre ....Ductal Carcinoma in Situ of the breast (DCIS) now represents 15% of all new cases of breast cancer. Although a benign disease, its diagnosis increases a woman's risk of developing invasive breast cancer and the goal of treatment is prevention of invasive disease. However the characteristics that predict this progression have not been clearly identified. Consequently women are confused about their diagnosis and both clinicians and women are faced with complex treatment decisions. The National Breast Cancer Centre (NBCC) published a set of eight clinical practice recommendations for the management of DCIS in September 2003 and a guide for consumers in 2004. Currently there is no information regarding how the treatment recommendations have been received by surgeons, the extent management of DCIS now follows these recommendations or the impact of the treatment recommendations on the medical experiences of women with DCIS. This project will fill this gap. The project aims to: 1. Examine the impact of clinical practice recommendations for the management of Ductal Carcinoma in Situ (DCIS) of the breast on clinical practice 2. Determine awareness of and attitudes towards the recommendations among surgeons treating DCIS and to examine the relationship between these attitudes and clinical practice 3. Examine women's experience of a DCIS diagnosis, their understanding of its prognosis and involvement in treatment decisions after release of a consumer guide in 2004 This research will determine whether the publication of the treatment recommendations in 2003 influenced the medical care women with DCIS recieve and identify the factors associated with surgeons and women that facilitate or prevent the uptake of these recommendations. This information will be used to develop strategies increase surgeons' adoption of the treatment recommendations in order to ensure that all women with DCIS have access to the best care possible.Read moreRead less
A Population-based Survey Of Recent Mothers In South Australia And Victoria
Funder
National Health and Medical Research Council
Funding Amount
$1,098,661.00
Summary
This study involves a postal survey of women giving birth in SA and Victoria in 2007. The survey will be mailed to around 7,000 women by hospitals and home birth practitioners in early 2008, five months after women have given birth. All Indigenous women who give birth in SA and Victoria during 2008, approx. 900 women, will be invited to participate in the survey by completing the survey by mail or by interview. The study will investigate the childbirth and early postnatal experiences, physical a ....This study involves a postal survey of women giving birth in SA and Victoria in 2007. The survey will be mailed to around 7,000 women by hospitals and home birth practitioners in early 2008, five months after women have given birth. All Indigenous women who give birth in SA and Victoria during 2008, approx. 900 women, will be invited to participate in the survey by completing the survey by mail or by interview. The study will investigate the childbirth and early postnatal experiences, physical and emotional health of representative samples of women giving birth in each state. Women living in metropolitan, regional and remote areas, and women having first and subsequent births will be included. A major aim of the study will be to monitor the impact of maternity services strategies implemented in each State, and determine whether the expansion of midwife care and other models providing continuity of care have resulted in improvements in women's overall experiences of maternity care. The study will also investigate women's experiences of psychosocial inquiry and support, explore women's views of universal postnatal home visiting programs and monitor the impact of the continuing trend towards shorter length of postnatal hospital stay on women's health after childbirth, breastfeeding and infant readmission. The impact of organisational and policy changes in maternity care has not been subject to careful or rigorous evaluation. The conduct of population-based surveys of recent mothers in Victoria provides a unique and important source of information for monitoring the impact of policy changes on maternal health and well-being, and women's experiences of maternity care. Repeating the survey, extending the survey to include women giving birth in SA and a representative sample of Indigenous women will provide valuable evidence regarding the responsiveness of maternity services and the extent to which policy changes have led to improvements in maternity care.Read moreRead less
Planned Vaginal Birth Or Planned Elective Repeat Caesarean For Women At Term With A Single Previous Caesarean Section
Funder
National Health and Medical Research Council
Funding Amount
$741,750.00
Summary
In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence fro ....In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence from which to develop health advice that will guide clinical practice, for the optimal care of women who have had a previous caesarean and their infants.Read moreRead less
A Cluster Randomised Controlled Trial Of Knowledge Translation Methods For Obesity Prevention
Funder
National Health and Medical Research Council
Funding Amount
$432,292.00
Summary
This study aims to increase the use of evidence in the development of programs for childhood obesity prevention by local government. There has been a lot of research to examine what works and what doesn't to increase healthy eating, physical activity and prevent childhood obesity, and programs conducted by local government have an important role to play. However, many who work in local government have not been trained in how to access research, nor do they have the time to search extensively for ....This study aims to increase the use of evidence in the development of programs for childhood obesity prevention by local government. There has been a lot of research to examine what works and what doesn't to increase healthy eating, physical activity and prevent childhood obesity, and programs conducted by local government have an important role to play. However, many who work in local government have not been trained in how to access research, nor do they have the time to search extensively for it, or interpret what the results from studies conducted elsewhere may mean for them in the local context. This study aims to examine what are the most effective and cost effective methods to increase access to evidence, and to increase the adoption of evidence by those working in local government (eg planners, maternal and child health nurses, family day care, environmental planners etc) to address environmental factors (playgrounds, walkability and active transport, policies for sporting events, community gardens, sporting events, street closures), health and social services (parent education, access to health promotion and prevention programs, education initiatives, environmental policies). Comparable research on what works for knowledge translation has only been conducted in the clinical context, for example, hospital clinics, and it is difficult to generalise these findings to the community based public health setting and relevant programs.Read moreRead less
Building Citizenship Capacity in Young Adults With and Without Cerebral Palsy. This project will investigate practical aspects of citizenship participation within the context of a young adult population, as different from frequently reported theoretical views on citizenship. Specifically, the aim is to identify strategies necessary for building citizenship capacities for young adults with cerebral palsy (CP), as they are now living longer, but not eligible for care at the same level as during sc ....Building Citizenship Capacity in Young Adults With and Without Cerebral Palsy. This project will investigate practical aspects of citizenship participation within the context of a young adult population, as different from frequently reported theoretical views on citizenship. Specifically, the aim is to identify strategies necessary for building citizenship capacities for young adults with cerebral palsy (CP), as they are now living longer, but not eligible for care at the same level as during school years. Gaining capacities for success as a participating community member, young adults with CP need opportunities to manage not only physical and economic demands, but also develop knowledge and competencies necessary to engage in civic and social reciprocity within the community.Read moreRead less