Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
Understanding, measuring and managing the benefits of urban waterways. This project aims to improve understanding of the contribution of urban waterways to enhanced liveability in cities. Australia needs better water resource management and the rapid growth of Australia’s cities places increased importance on managing natural assets in metropolitan areas. The project focuses on clarifying the link between the benefits of waterways and the measurement techniques used by economists, which in turn ....Understanding, measuring and managing the benefits of urban waterways. This project aims to improve understanding of the contribution of urban waterways to enhanced liveability in cities. Australia needs better water resource management and the rapid growth of Australia’s cities places increased importance on managing natural assets in metropolitan areas. The project focuses on clarifying the link between the benefits of waterways and the measurement techniques used by economists, which in turn inform management choices. The project aims to fill an important gap between the psychology and economics disciplines and outputs should significantly improve the way waterways are valued and managed. This is intended to offer benefits for urban residents and to improve the methodologies used for environmental valuation.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
Family Violence Triage in Family Courts: Safety, Efficacy and Benefit. Domestic and family violence (DFV) risks are highest during relationship separation, elevated further for parents and children involved in Family Court disputes. Utilising the federal Family Courts’ Triage pilot program, this partnership project aims to examine risk pathways, burdens and costs of post-separation DFV, and the efficacy and cost-benefits of early DFV triage. The project intends to produce new knowledge about fam ....Family Violence Triage in Family Courts: Safety, Efficacy and Benefit. Domestic and family violence (DFV) risks are highest during relationship separation, elevated further for parents and children involved in Family Court disputes. Utilising the federal Family Courts’ Triage pilot program, this partnership project aims to examine risk pathways, burdens and costs of post-separation DFV, and the efficacy and cost-benefits of early DFV triage. The project intends to produce new knowledge about family and systemic drivers of safety, to advance evidence on the efficacy of DFV triage and to translate findings into new resources for preventing DFV harms. This world-first study aims to inform global family law policy and practice, with inter-generational benefit for vulnerable Australian families and for society. 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.