Inter-rater Reliability And Predictive Validity Of A New Functional Capacity Evaluation For Chronic Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$105,794.00
Summary
Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, c ....Back pain costs the Australian community tens of billions of dollars. Back pain is one of the main causes of work injury and lost time from work. The longer a person is off work, the harder it is to get them back to work. Workers' compensation systems around Australia aim at getting the injured worker with back pain back to work as soon as possible. One of the difficulties in this process is determining what the person with back pain can physically do in the workplace. An evaluation technique, called functional capacity evaluation (known as FCE), is one method used to find out what the person with back pain physically can and cannot do. In a FCE, a trained health professional such as an occupational therapist, observes the person performing a range of physical activities like the ones he or she may have to perform in a job. The therapist closely observes the person performing activities such as lifting, carrying, kneeling, crouching, balancing, and walking and notes any limitations in the person's ability to complete the activities. The therapist makes comments about what difficulties the person may have on the job and recommendations about how these could be reduced or eliminated. The information gained from these evaluations can be valuable for the treating doctor in deciding whether the person is ready to go back to work and what duties the person can and cannot do on the job. Because of such value they provide, FCE is commonly used in rehabilitation programs endorsed by workers' compensation systems around Australia. This widespread use and endorsement of FCE occurs despite limited research on the soundness of the ratings made from these evaluations. There is a need to see whether recommendations made from FCEs are consistent between therapists (i.e. reliable) and to see if the FCE accurately predicts the person's physical capacity for work. This research will examine these issues with injured workers with back pain.Read moreRead less
The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less
Effects Of Circadian Disruption And Sleep Deprivation In Respiratory Disorders
Funder
National Health and Medical Research Council
Funding Amount
$408,000.00
Summary
This project aims to determine the impact of reduced sleep hours and jet lag-sleep time shift in two very common breathing disorders; sleep apnea (snoring sickness) and asthma. We will also make measurements in healthy normal people as well. Reduced sleep hours are common in many sections of society due to a number of factors, including increased work hours, overtime, shiftwork, medical conditions (sleep and other medical disorders), caring for a new baby, and other family and social demands. In ....This project aims to determine the impact of reduced sleep hours and jet lag-sleep time shift in two very common breathing disorders; sleep apnea (snoring sickness) and asthma. We will also make measurements in healthy normal people as well. Reduced sleep hours are common in many sections of society due to a number of factors, including increased work hours, overtime, shiftwork, medical conditions (sleep and other medical disorders), caring for a new baby, and other family and social demands. In addition, body clock disruption due to shiftwork, transmeridien travel, circadian based sleep disorders and other factors that shift the timing of normal sleep-wake behaviour is also very prevalent in today's society. The effects of reduced sleep hours and jet lag-sleep time shift effect a number of body systems but have only been studied to a limited extent in the breathing system. Jet lag-sleep time shift changes are result of changes to the body clock rhythms - these rhythms effect coordinate activities of essentially all bodily functions, vigilance and thinking, heart, breathing, hormones, bowel function and the immune system that fights off infection and cancer. Together, this body clock system and sleep coordinate the majority of systems of the body and brain. This project will address a number of questions including whether reduced sleep hours worsen brain function in sleep apnea or whether shifting sleep (jet lag effect) can worsen airway function and increase risk of asthma. We will use two types of study - simulated jet lag and reduced sleep hours under complete laboratory supervision to test our theoriesRead moreRead less
Depression And Anxiety In Working Adults: The Costs And Outcomes Of Working While Ill
Funder
National Health and Medical Research Council
Funding Amount
$137,292.00
Summary
Depressive and anxiety disorders are common in the working population and costly. Individuals can continue working while ill or take an absence from work. This study will evaluate the economic cost and health outcomes of these two scenarios, using existing and published data to develop descriptive models. We consider who pays and who benefits from the perspective of the individual, their employer and society, to inform policy making, management practices, and clinical care.
A Case-control Study Of Environment And Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$808,948.00
Summary
Breast cancer is the most common cancer in Australian women and there have been a number of recent events which have raised public concern that occupational exposures are contributing to the increasing occurrence of this cancer. In this study, we will investigate occupational causes of breast cancer, particularly shift work, industrial solvent use and combustion products. We will compare occupations of 1000 women with breast cancer and 2000 women without cancer.
Psychosocial Disability And Return To Work In Younger Stroke Survivors
Funder
National Health and Medical Research Council
Funding Amount
$511,216.00
Summary
Each year about 12,000 Australians of working age survive a stroke. These younger survivors have responsibility for generating an income or providing care for families and state that their main objective is to return to work for financial reasons and to help rebuild confidence and independence. This observational 3 year study will determine thefactors are associated with returning to work, improving the wellbeing of thousands of stroke survivors and their families using multivariate regression.
Clinical Efficacy And Physiological Mechanisms Of Nerve And Tendon Gliding Exercises For Carpal Tunnel Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$370,068.00
Summary
Compression of one of the major nerves at the wrist (carpal tunnel syndrome) is a very common condition that significantly impacts on the well-being of the patient. To date, there is no good evidence that traditionally advocated interventions are effective in the long term. This project will evaluate the effects of a novel, active treatment strategy and will investigate the underlying mechanisms that may be associated with exercises that aim to mobilise the nerve and tendons at the wrist.
A Clinical Trial Of The Effect Of Neuropsychological Treatments In Increasing Community Participation After Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$365,700.00
Summary
Traumatic brain injury is very common, with more than 2,000 people surviving serious brain injury in NSW each year. The survivors are most commonly young adult males and many are left with permanent brain damage, invariably affecting cognitive abilities. The impact of cognitive impairments on the person's capacity to resume their premorbid lifestyle is enormous. In one of our studies we found that 40% did not work but nor did they have any meaningful occupational activity to replace work. The cu ....Traumatic brain injury is very common, with more than 2,000 people surviving serious brain injury in NSW each year. The survivors are most commonly young adult males and many are left with permanent brain damage, invariably affecting cognitive abilities. The impact of cognitive impairments on the person's capacity to resume their premorbid lifestyle is enormous. In one of our studies we found that 40% did not work but nor did they have any meaningful occupational activity to replace work. The current project targets this large group of people in particular. The study aims to develop and test two alternative, intensive cognitive treatment programs that are geared to increasing community participation, everyday activities and psychological well-being. To date, no such therapies have been evaluated using powerful methodological designs. As a result of the study we will be able to incorporate the standardised interventions into a format that can be easily applied to Brain Injury Rehabilitation Services in Australia. The programs will not only improve the functioning of the individuals with brain injury, but will have a flow-on effect for their families and the community at large.Read moreRead less
Cataract Surgery And Risk Of Age-related Macular Degeneration (AMD)
Funder
National Health and Medical Research Council
Funding Amount
$339,750.00
Summary
Cataract surgery currently ranks as one of the most frequently performed and successful surgical procedures in Australia (125,000 operations-year). Age-related macular degeneration (AMD) is the principal cause of moderate visual impairment and blindness, currently accounting for blindness in between 17,300 and 30,400 Australians. Past studies have not shown a definite relationship between cataract and AMD. Follow-up data from clinical case series and from two older population-based studies (the ....Cataract surgery currently ranks as one of the most frequently performed and successful surgical procedures in Australia (125,000 operations-year). Age-related macular degeneration (AMD) is the principal cause of moderate visual impairment and blindness, currently accounting for blindness in between 17,300 and 30,400 Australians. Past studies have not shown a definite relationship between cataract and AMD. Follow-up data from clinical case series and from two older population-based studies (the Beaver Dam and Blue Mountains Eye Studies) suggested that cataract surgery might increase the risk of subsequent development of AMD in operated eyes of older persons. Such an increased AMD risk in eyes after cataract surgery appears to be both short term (observation from clinical case series) and long term (evidence from population-based studies), and persists after taking into consideration age, sex, smoking, preexisting early stage lesions of the disease and correlation between both eyes. The proposed study is to follow a large number of older patients who are undergoing cataract surgery in Western Sydney Eye Hospital and in two ophthalmologists' private rooms. Rates of subsequent development of AMD will be compared between operated and non-operated eyes, and also between the surgical cohort and the Blue Mountains Eye Study cohort. We will document macular conditions carefully before and after surgery to exclude the possibility of confounding issues. We will also investigate whether the increased risk occurs in certain subgroups of patients at high risk of AMD. If an increased AMD risk from cataract surgery is confirmed in subgroups of patients, a modified clinical practice may be indicated, to maximize cataract surgery benefit and minimize the risk of vision loss from AMD after surgery. Changes may include additional patient information and consent about this risk, delayed cataract surgery within limits of visual function, and close postoperative follow up.Read moreRead less