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Improving The Psychological Wellbeing Of Family Caregivers Of Home Based Palliative Care Patients: A Randomised Controll
Funder
National Health and Medical Research Council
Funding Amount
$300,000.00
Summary
Support for family caregivers during the care giving phase and into bereavement is a core element of palliative care philosophy and practice. The majority of people report a preference to be cared for at home yet only about a quarter of Australians receiving palliative care services have a home death. Family caregivers provide the bulk of support to patients receiving palliative care at home and without this contribution the well-being of patients and their capacity to remain at home would be co ....Support for family caregivers during the care giving phase and into bereavement is a core element of palliative care philosophy and practice. The majority of people report a preference to be cared for at home yet only about a quarter of Australians receiving palliative care services have a home death. Family caregivers provide the bulk of support to patients receiving palliative care at home and without this contribution the well-being of patients and their capacity to remain at home would be compromised. Many research studies have acknowledged the negative psychological, physical, social and financial impact experienced by family caregivers who care for a relative requiring palliative care at home. Family caregivers report a variety of unmet needs throughout the palliative care and bereavement process, despite input from health care services and have been referred to as �hidden patients�. Support for family caregivers is often crisis driven. Resource issues in rural areas add to the challenges of providing optimal family centred support. Hence, it is difficult to claim that palliative care services pro-actively provide effective targeted support for family caregivers and for the most part, family situations with unmet needs prevail. Family caregivers want information that prepares them for what is involved in supporting a dying relative, on how to provide patient comfort, practical care needs and strategies to minimise their own psychological burden. Our study specifically responds to these identified needs by evaluating a home based intervention that aims to enhance the psychological well-being of family caregivers. Family caregivers will receive two home visits from a palliative care nurse, written resources and phone support. A care plan will be developed in partnership with the local palliative care service.Read moreRead less
A Randomised Controlled Trial Of Immediate Delivery Versus Expectant Care In Women With Ruptured Membranes Close To Term
Funder
National Health and Medical Research Council
Funding Amount
$768,900.00
Summary
Preterm premature rupture of the membranes (PPROM) complicates 1-2% of all pregnancies and is the cause of 40% of all preterm births . At gestations remote from term expectant management is appropriate to allow fetal maturation. When PPROM complicates pregnancies closer to term the risks of prematurity are lower and the risk to the infant of sepsis becomes of greater significance. This trial will provide level 1 evidence from which to determine the optimum management of these women. If it can be ....Preterm premature rupture of the membranes (PPROM) complicates 1-2% of all pregnancies and is the cause of 40% of all preterm births . At gestations remote from term expectant management is appropriate to allow fetal maturation. When PPROM complicates pregnancies closer to term the risks of prematurity are lower and the risk to the infant of sepsis becomes of greater significance. This trial will provide level 1 evidence from which to determine the optimum management of these women. If it can be demonstrated that early planned delivery in this clinical situation is associated with less maternal and neonatal morbidity this will change current national practice. The findings of the study will also have significant resource implications as PPROM close to term is a frequent indication for antenatal admission. The study also allows for a detailed assessment of the costs associated with the care of the neonate from two different management strategies. Analysis of the clinical and economic sequelae of immediate delivery as opposed to expectant management will enable informed decisions and guidelines to be formulated.Read moreRead less
Electronic Portable Health File (PHF) To Promote Quality Of Care And Workflow Through Continuity Of Care
Funder
National Health and Medical Research Council
Funding Amount
$694,745.00
Summary
The medical of older individuals with chronicdiseases and with multiple doctors is complex and burdensome for the patient. We have done work where the patient is given charge of a portable personal health record that he-she can update as needed and care givers update at ofiice visits. The preliminary work is positive. Two types have been investigated, an electronic patient health file (on a data stick) and a wallet size booklet. Both have been found accceptable. The goal of this project is to se ....The medical of older individuals with chronicdiseases and with multiple doctors is complex and burdensome for the patient. We have done work where the patient is given charge of a portable personal health record that he-she can update as needed and care givers update at ofiice visits. The preliminary work is positive. Two types have been investigated, an electronic patient health file (on a data stick) and a wallet size booklet. Both have been found accceptable. The goal of this project is to see if short term acceptability and satisfaction will translate into later improved outcomes such as a reduced rate of hospitalizations.Read moreRead less
Tai Chi For Independent Living: RCT Of Efficacy Of Tai Chi In Delaying Disability Among Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,157,574.00
Summary
This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people ....This study addresses the issue of disability among our ageing population. Preservation of function among our older citizens, and their capacity to live independently, is of significant social, public health and economic benefit. The aims of this study are to (1) test the efficacy of Tai Chi in delaying disability among older people, prior to its onset, (2) investigate the mechanisms by which Tai Chi intervenes in the disability pathway, (3) determine the cost-benefits of Tai Chi for older people. The study will recruit 670 people over 70 years of age and randomly assign them to receive either Tai Chi, or a stretching and relaxation program, for a period of 48 weeks. The groups will then be compared to determine if there is any difference in the development of disability as well as a range of functional outcomes such as strength, balance, depression, arthritic symptoms, life satisfaction, and falls. This will be the first study world-wide to test the impact of any exercise program on delaying the manifestation of disability among older people. Robust evidence that Tai Chi can in fact delay disability will have immediate and significant implications for the maintenance of independence among older people at a critical time for our ageing population. Translation of these research results to practice will decrease demand for support services for community dwelling older people, and for places in supported accommodation facilities. Older people will have improved quality of life, and government and non-government agencies will experience reduced demand for limited resources. This internationally significant study will also contribute to understanding the mechanisms by which disability develops, and create the valuable opportunity for continuing research on attrition of effect and long term adherence to exercise programs.Read moreRead less
Understanding Health Professionals' Infection Control Practices In The Acute Care Setting
Funder
National Health and Medical Research Council
Funding Amount
$151,196.00
Summary
Health-care acquired infections have a considerable personal, social and economic impact in Australia, and better understanding of the causes of these infections is necessary. Failure by health professionals to follow infection control recommendations has important consequences in terms of the personal risk of acquiring an infection as well as the risk of infection transmission to patients. In Australia surgical site infections alone are estimated to cost as much as 268 million dollars a year. H ....Health-care acquired infections have a considerable personal, social and economic impact in Australia, and better understanding of the causes of these infections is necessary. Failure by health professionals to follow infection control recommendations has important consequences in terms of the personal risk of acquiring an infection as well as the risk of infection transmission to patients. In Australia surgical site infections alone are estimated to cost as much as 268 million dollars a year. Health-care acquired infections are associated with poorer health outcomes, a greater probability of prolonged hospital stays, greater re-hospitalisation rates, and significant reductions in health related quality of life. In this qualitative study we will use grounded theory and a comparative analysis strategy. We will initially identify participants sampled from health professionals employed in the acute care setting at a major teaching hospital in Perth, Western Australia. We will seek representation of a range of health professionals recruited from multiple occupational groups, including doctors, nurses and paramedical staff who have direct patient contact in the study sample. Sampling will also aim to recruit participants from a number of different acute care areas within the hospital, and staff with a range of individual characteristics, experiences and beliefs. We will interview a range of health care workers in order to explore their experiences of engagement in infection control practices and the factors influencing these experiences. We aim to develop a substantive theory that explains health professionals' engagement in high-risk infection control practices in the acute care setting. This will have implications for current understandings of the factors influencing adherence to recommended infection control practices, current theoretical perspectives which guide infection control practice, and strategies used to promote compliance with recommended practices.Read moreRead less
Can Lure And Kill Strategies Prevent Dengue Transmission In North Queensland, Australia
Funder
National Health and Medical Research Council
Funding Amount
$318,621.00
Summary
Dengue fever is a growing threat to human health in the tropics. In north Queensland, 11 dengue outbreaks have resulted in 985 confirmed cases since 2000. Furthermore, 2004 saw the emergence of severe disease, with 4 cases of dengue haemorrhagic fever resulting in at least one death in the Torres Strait. The current dengue managment plan employs methods to control larvae and adults of the mosquito vector, Aedes aegypti. Adult control consists of spraying dark, protected areas inside houses and b ....Dengue fever is a growing threat to human health in the tropics. In north Queensland, 11 dengue outbreaks have resulted in 985 confirmed cases since 2000. Furthermore, 2004 saw the emergence of severe disease, with 4 cases of dengue haemorrhagic fever resulting in at least one death in the Torres Strait. The current dengue managment plan employs methods to control larvae and adults of the mosquito vector, Aedes aegypti. Adult control consists of spraying dark, protected areas inside houses and buildings with a residual pyrethroid insectcide. However, this method is laborious and exposes residents and the environment to pesticide. Our research team, funded by NHMRC project grant no. 279401, has developed lure and kill methods to kill Ae. aegypti mosquitoes using traps. These traps are baited with chemicals that attract female dengue mosquitoes trying to bite (host-seeking traps; HSTs) or trying to lay eggs (lethal ovitraps; LOs). The use of traps to kill specific target insects is termed lure and kill strategy. This strategy reduces the amount of pesticide used by 1000X, and are twice as fast to employ than house spraying. We are seeking funding to conduct a series of field trials to provide proof of concept that the lure and kill strategy will rapidly reduce populations of Ae. aegypti and thus stop dengue transmission. These trials will be conducted in the Cairns area. We will also trial a biodegradable lethal ovitrap that could be put into yards without having to return to retrieve the trap. The trap would simply biodegrade after 4 weeks, and thus pose no threat to become a mosquito breeding site once the pesticide had become ineffective. A biodegradable trap would be especially useful in the Torres Strait where return visits are costly and time consuming. Finally, we propose to trial a new paper strip device that emits vapors of the pyrethriod insecticide metofluthrin, shown to repel mosquitoes for weeks, to set in dengue case houses.Read moreRead less
Protecting young people from harm and injury: investigating the utility of a risk and protective framework. Serious injuries due to transport, violence and alcohol associated risk-taking are the main cause of teenage death. An innovative school course will be taught and evaluated that increases protecting others from risk, helping injured friends and promoting a connected environment where teachers and peers reach out to provide support.