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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
A Behavioural Intervention For The Adoption & Maintenance Of Physical Activity In Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$334,955.00
Summary
For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on ....For people with type 2 diabetes (T2DM) it is essential that blood glucose levels are managed well to reduce the risk of developing complications. Physical activity is essential for maintaining glucose levels because it helps make the muscles use glucose more effectively. In particular, being active through strength training not only improves blood glucose levels, but can be very effective for maintaining good physical functioning, which is known to be reduced by having T2DM. This study builds on our earlier research which demonstrated significantly improved blood glucose levels from a strength training program for older adults with T2DM. The strength training program is to be administered nationally in a research to practice trial (Lift for Life); however, the original research found that those who did not complete the program as it was intended (ie, poor adherence) did not show significant improvements in blood glucose levels. Furthermore, maintenance of strength training exercises after completion of the program was poor and resulted in return of blood glucose levels back to pre-starting levels. In people without diabetes, we have collected pilot data that shows that the use of behavioural strategies based on behavioural theories whereby each person's motivations and barriers are taken into consideration is more effective than the traditional one-treatment-fits-all approach. This study will evaluate the effectiveness of using behavioural strategies for improving adherence and maintenance to the Lift for Life strength training program (Enhanced L4L) for older adults with T2DM compared with the Standard L4L program. It will also follow-up participants 6 months later to determine the extent to which the changes in behaviour can be maintained. The study will provide information that will assist in the design, delivery and uptake of programs to improve treatment strategies in older adults with T2DM through the maintenance of healthier behaviours and lifestyles.Read moreRead less
Living high but healthy: impacts of access to nature on health, wellbeing and effective functioning of inner city highrise residents. Impacts on the health, wellbeing and effective functioning of inner city highrise residents, resulting from differing levels of access to natural environments, will be studied. Stratified random sampling will be used to select a sample of 600 residents in Melbourne and Sydney, including highrise apartment owner-occupiers and tenants of highrise public housing dev ....Living high but healthy: impacts of access to nature on health, wellbeing and effective functioning of inner city highrise residents. Impacts on the health, wellbeing and effective functioning of inner city highrise residents, resulting from differing levels of access to natural environments, will be studied. Stratified random sampling will be used to select a sample of 600 residents in Melbourne and Sydney, including highrise apartment owner-occupiers and tenants of highrise public housing developments. Both groups will include people with differing levels of access to green spaces. Questionnaires based on validated psychometric scales, and qualitative semi-structured interviews will be used to collect data, which will be analysed to assess the impacts of access to nature on health, wellbeing and effective functioning.Read moreRead less
Navigating the Carceral Interface. This project acknowledges the overrepresentation of young Indigenous people in child protection and incarceration rates. It aims to address the gap in knowledge of how young Indigenous people experience the carceral system and document how Indigenous community organisations support and provide vital contributions to building safer more supportive communities, which is one of the targets of the Closing the Gap policy framework. This project will develop a theore ....Navigating the Carceral Interface. This project acknowledges the overrepresentation of young Indigenous people in child protection and incarceration rates. It aims to address the gap in knowledge of how young Indigenous people experience the carceral system and document how Indigenous community organisations support and provide vital contributions to building safer more supportive communities, which is one of the targets of the Closing the Gap policy framework. This project will develop a theoretical model of a trauma- and culturally-informed response to improving experiences of young Indigenous people between the ages of 10–24 who come into contact with the carceral system, transferring the knowledge gained from the research back to Indigenous communities.Read moreRead less
Five Year Outcomes Of Care For Prostate Cancer In New South Wales
Funder
National Health and Medical Research Council
Funding Amount
$388,773.00
Summary
Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Stud ....Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Study is an already established research project that was established in 2000 with the aim of documenting the quality of life outcomes of 2000 men with prostate cancer to five years after diagnosis. The Department of Veterans Affairs funded the study between 2000 and 2005, to establish the cohort, collect patterns of care information from clinicians and quality of life information from participants to 3 years post diagnosis. We are now seeking funds to complete the quality of life follow up for each surviving participant at five years after diagnosis. We also will assess rate of recurrence of prostate cancer to five years and seek support to be able to undertake linkage with death certificate information to determine the vital status of each study subject and begin analysis of five-year survival rates. Five-year quality of life information will be the main endpoint for this part of the study. Initial analysis of the three-year data showed a continued improvement in outcomes related to urinary and sexual function. We wish to determine whether these improvements continue to five years and the extent of the difference, at that time, between men with prostate cancer and men without prostate cancer (controls), whom we are also studying. This information will be uniquely useful in helping men make decisions about treatment options when diagnosed with prostate cancer.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 Multilevel Study Of Socioeconomic Position And Physical Activity: Environmental And Individual-level Determinants
Funder
National Health and Medical Research Council
Funding Amount
$429,000.00
Summary
Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited ....Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited, and very little research has investigated this issue. This study will investigate why socioeconomic groups differ in their physical activity, by examining the influence of neighbourhood and individual-level factors. Neighbourhood factors include people's access to recreational facilities such as swimming pools, tennis courts, golf clubs, gyms, local parks, walking and bicycle paths; prices for entry to recreational facilities and opening hours; physical characteristics of the neighbourhood including public transport, presence of footpaths and street lighting, speed limits on local streets, availability of local services such as shops and schools, and; aesthetic characteristics, such as the presence and size of parks and green spaces, and traffic density. Individual factors include personal enjoyment, knowledge, confidence, type of occupation and hours worked, family responsibilities, age, health status, and whether other family member or friends engage in physical activity. A major aim of the study is to determine whether environmental or individual factors are more important in influencing participation in physical activity. The study will produce new knowledge to inform future public health strategies directed at increasing physical activity among socioeconomically disadvantaged groups, and these will have the potential to reduce socioeconomic health inequalities, as well as contribute to an overall reduction of the disease burden attributable to chronic conditions.Read moreRead less
Nurition Promotion And Population Health: A Program Addressing Behavioural, Social And Environmental Determinants
Funder
National Health and Medical Research Council
Funding Amount
$1,210,140.00
Summary
Good nutrition is important for health well-being by reducing the risk of diseases like heart disease, cancer and diabetes. However, a significant number of Australians do not eat diets that are consistent with existing health recommendations. While the health consequences of poor nutrition have been well-documented and there is a substantial body of research that describes this problem, much less research has focused on coming up with solutions. This research will explore the influences on Aust ....Good nutrition is important for health well-being by reducing the risk of diseases like heart disease, cancer and diabetes. However, a significant number of Australians do not eat diets that are consistent with existing health recommendations. While the health consequences of poor nutrition have been well-documented and there is a substantial body of research that describes this problem, much less research has focused on coming up with solutions. This research will explore the influences on Australian's eating patterns by examining the role of a range of personal, social and environmental factors in children and adults. The research will also test the effectiveness of innovative strategies to promote healthy eating.Read moreRead less
Meals on Wheels: building towards a new social experiment for our times. This project contributes directly to the National Research Priority, promoting and maintaining good health: ageing well, ageing productively, through developing evidence-based knowledge on which to build future volunteer business models. With the rapid ageing of the Australian population, it is imperative that volunteer-based organisations, such as Meals on Wheels, innovate to continue to deliver essential community service ....Meals on Wheels: building towards a new social experiment for our times. This project contributes directly to the National Research Priority, promoting and maintaining good health: ageing well, ageing productively, through developing evidence-based knowledge on which to build future volunteer business models. With the rapid ageing of the Australian population, it is imperative that volunteer-based organisations, such as Meals on Wheels, innovate to continue to deliver essential community services in a sustainable and cost-effective way. Meals on Wheels is integral within community care for frail, older people and those with disabilities, keeping people in their own homes and out of institutional care. Using national and international examples, the research has the potential to be adopted by the broad community services sector in Australia.Read moreRead less