Proactive Specialist Diabetes Inpatient Team To Improve Outcomes In Hospitalised Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$124,761.00
Summary
Diabetes is a major epidemic in Australia. Current care of hospitalised patients with diabetes is complex, suboptimal and contributes to longer hospital stay, poor outcomes and strain on healthcare resources. This research aims to improve diabetes care in hospitalised patients by implementing a proactive specialist diabetes team that will autonomously identify and provide specialist care for these patients. The expected findings have potential to shape a new approach to hospital diabetes care.
Evaluation Of Nitrous Oxide In The Gas Mixture For Anaesthesia: A Randomised Controlled Trial (The ENIGMA Trial)
Funder
National Health and Medical Research Council
Funding Amount
$490,125.00
Summary
There are about 2 million anaesthetics given each year in Australia (1:10 Australians), with more than 1 million Australians being exposed to nitrous oxide (laughing gas). Despite being around for more than 150 years, there has yet to be a large trial of the safety and benefits of nitrous oxide, particularly when compared with newer (safer?) anaesthetic drugs. Nitrous oxide is not a particularly strong anaesthetic and so it must be mixed with other drugs. Current practice in Australia and around ....There are about 2 million anaesthetics given each year in Australia (1:10 Australians), with more than 1 million Australians being exposed to nitrous oxide (laughing gas). Despite being around for more than 150 years, there has yet to be a large trial of the safety and benefits of nitrous oxide, particularly when compared with newer (safer?) anaesthetic drugs. Nitrous oxide is not a particularly strong anaesthetic and so it must be mixed with other drugs. Current practice in Australia and around the world is to give 70% nitrous oxide in oxygen along with another anaesthetic gas in order to produce a depth of anaesthesia sufficient for surgery. This is despite knowledge that nitrous oxide interferes with the production of DNA. DNA is used to programme cell division and function - it is the building block of cell and tisue growth. It is known that nitrous oxide can impair some tissue functions, such that anaemia and, possibly birth defects can occur. Such effects are rare, but recent evidence suggests that milder abnormalities may occur more commonly than previously thought. There is also good evidence that nitrous oxide increases the risk of severe nausea and vomiting after surgery. The adverse effects on DNA production raises the possibility of nitrous oxide causing immune deficiency, heart ischaemia, (angina), nerve and spinal cord damage, and increased cancer risk in hospital staff chronically exposed to low levels of nitrous oxide. The prevailing view is that nitrous oxide is a cheap, relatively safe drug that can reduce the exposure to other anaesthetic drugs. However, the development of many new anaesthetic drugs demands a re-evaluation of the role of nitrous oxide in current anaesthetic practice.Read moreRead less
Dynamic Prediction Of Hospital Length Of Stay, Readmission, And Death
Funder
National Health and Medical Research Council
Funding Amount
$322,821.00
Summary
Healthcare systems are under increasing pressure to improve the appropriateness and effectiveness of current patterns of care. The aim of this project is to develop a dynamic predictive method that, at any time during hospitalisation, calculates days expected to be in hospital, days expected to live and days expected until next hospitalisation. Rapidly identifying patients at most risk has great potential to improve the quality of care and reduce avoidable harm and costs associated with admissio ....Healthcare systems are under increasing pressure to improve the appropriateness and effectiveness of current patterns of care. The aim of this project is to develop a dynamic predictive method that, at any time during hospitalisation, calculates days expected to be in hospital, days expected to live and days expected until next hospitalisation. Rapidly identifying patients at most risk has great potential to improve the quality of care and reduce avoidable harm and costs associated with admission.Read moreRead less
Minimising Disability And Falls In Older People Through A Post-hospital Individualised Exercise Program.
Funder
National Health and Medical Research Council
Funding Amount
$536,435.00
Summary
This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of ....This study aims to implement and evaluate the Functional Activities for Better Balance (FABB) program, a tailored exercise program which is designed to minimise disability and falls, among older adults who have recently had a hospital stay. A randomised controlled trial will be undertaken to determine the success of the program in minimising disability and falls and improving balance, muscle strength, and reaction time, quality of life and fear of falling. In addition, predictors of adoption of and adherence to the exercise program and the cost effectiveness of the program will be established. We will recruit 350 older people in the first six months after an in-patient stay in aged care and rehabilitation wards at one of two large teaching hospitals. Participants randomised to the intervention group will be asked to complete an individualised home exercise program three times a week. In addition, they will be offered a choice between receiving monthly physiotherapy home visits or attending exercise classes. These weekly exercise classes will be conducted by physiotherapists and will be made up of 6-8 people. The control group will receive an education booklet about falls prevention and will be given the opportunity to join the program on a self-funding basis after their one-year control period is complete. Post-intervention between-group comparisons will be made using appropriate statistical techniques including regression models. Additional analyses will establish predictors for program adoption and adherence and cost-effectiveness (the incremental cost per fall prevented in the exercise group compared with the control group). This study addresses an increasingly important health care problem in a systematic manner and thus has the potential to substantially enhance the health of older people in Australia and internationally.Read moreRead less
Prediction Of Clinical Radiosensitivity Caused By Ionising Radiation During Radiotherapy.
Funder
National Health and Medical Research Council
Funding Amount
$447,750.00
Summary
Around one to five percent of cancer patients suffer from significant side effects in normal tissue exposed to ionizing radiation during radiotherapy. Although radiotherapy is an effective therapy for cancer treatment, the amount of radiation is generally restricted to minimize the incidence of these severe side effects (radiosensitivity). This means that individuals who don't have radiosensitivity are not getting the dose of radiation that would be most beneficial. A major goal of radiation bio ....Around one to five percent of cancer patients suffer from significant side effects in normal tissue exposed to ionizing radiation during radiotherapy. Although radiotherapy is an effective therapy for cancer treatment, the amount of radiation is generally restricted to minimize the incidence of these severe side effects (radiosensitivity). This means that individuals who don't have radiosensitivity are not getting the dose of radiation that would be most beneficial. A major goal of radiation biology research is to develop efficient predictive measures that could identify radiosensitive individuals prior to treatment. This predictive ability would enable the individualisation of radiotherapy radiation doses, which should result in improvement of tumour control rates and a reduction in the incidence of side effects associated with radiotherapy. We aim to understand radiosensitivity at the molecular level using the powerful technology of microarrays. Using microarray technology, thousands of genes can be tested for expression activity simultaneously. We have a unique tissue bank established from many radiosensitive and non-sensitive control radiotherapy patients. The use of microarray technology on samples from this unique tissue bank may enable the gene expression pattern of individuals that display radiosensitivity to be distinguished from the rest of the population. In conjunction, two additional tests will be used to determine who is susceptible to radiosensitive reactions which include assessment of a DNA repair pathway and assessment of the length of the telomeres (Caps on the ends of the chromosomes), both of which have been shown to be involved with radiosensitivy. This experimentation will hopefully lead to the development of a predictive assay for use in the clinic for cancer patients prior to receiving radiotherapy.Read moreRead less
Trials To Prevent The Transmission And Complications Of Sexually Transmitted Infections, Including HIV
Funder
National Health and Medical Research Council
Funding Amount
$306,123.00
Summary
Sexually transmitted infections (STIs) are important causes of illness in some sectors of the community. Even though they can be effectively prevented and treated, many health services do not give them priority. This research project will study ways in which general practitioners can better diagnose and treat STIs. We will carry out trials that compare new approaches to supporting doctors in this area, that involve a mixture of training, reminders and technical support as needed.
Hume's Sceptical Materialism. The early modern period is the decisive period in shaping the modern outlook, but its major figures are not well understood in Australia. This project will enable a broader and more unified understanding of the intellectual movements of the period (showing Hume to be not an intellectual outsider but someone offering a sceptical version of the radical Enlightenment) - and so will enable a better understanding of our intellectual heritage.