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Safety and resiliency at home: voices of children who live with fear. Finding out what can help children feel safer who are currently living in households where there is family violence will enable early intervention for better outcomes for such children. This research is significant because it will focus on targeting appropriate responses by listening to the views of children themselves and hence finding out what is really helpful for them to build resiliency. This is important to the work of a ....Safety and resiliency at home: voices of children who live with fear. Finding out what can help children feel safer who are currently living in households where there is family violence will enable early intervention for better outcomes for such children. This research is significant because it will focus on targeting appropriate responses by listening to the views of children themselves and hence finding out what is really helpful for them to build resiliency. This is important to the work of a key family welfare agency (Berry St) but it also has benefit for health and welfare workers throughout Australia. Appropriate early intervention will not only help the families concerned but will strengthen Australia's economic and social fabric, a priority goal of the national research agenda.Read moreRead less
Evaluation Of Multidisciplinary Care Plans For Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$83,500.00
Summary
Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans ....Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans and whether the care planning process is associated with improved provision and outcomes of care for a specific chronic illness. The chronic illness that has been chosen for this research project is diabetes because of its prevalence in the community, importance in general practice and because there are accepted standards of process and outcomes of care against which diabetes care contained in EPC care plans can be bench marked. Diabetes is estimated to affect 7.5% of the adult Australian population with more than 85% of those affected having type 2 or mature onset diabetes. Increasingly care of type 2 diabetes is provided in primary care under share care arrangements with specialist diabetes services and in a multidisciplinary team approach involving the patient and their carer as well as relevant health professionals. A recent review has shown that there is a lack of evidence on whether multidisciplinary care is associated with improved process and outcomes of diabetes care. The project will involve 50 general practitioners and 200 of their patients with diabetes in South West Sydney. The design of the project involves audit of the care plans to examine the extent and quality of the diabetes care contained in comparison to accepted benchmarks. The project will also audit the patients' medical records for the year of care before and after the care plan. This care will be compared to published guidelines for process of care and goals for outcomes.Read moreRead less
A Model of Integrated Care for Dependant Older People Living in the Community. This research offers significant economic, health and social benefits. Promoting and maintaining good health and ageing well, ageing productively are national priority areas. Case management and telemedicine are both recognised strategies to support chronic disease self-management. Early intervention can offer significant benefits in morbidity and mortality. Enhanced service delivery using an integrated model encompas ....A Model of Integrated Care for Dependant Older People Living in the Community. This research offers significant economic, health and social benefits. Promoting and maintaining good health and ageing well, ageing productively are national priority areas. Case management and telemedicine are both recognised strategies to support chronic disease self-management. Early intervention can offer significant benefits in morbidity and mortality. Enhanced service delivery using an integrated model encompassing general practitioners, practice nurses and community carers, could improve chronic and complex disease management and reduce health costs.Read moreRead less
Acute Bronchitis In General Practice: What Factors Predict A Poor Outcome And Can Antibiotics Help?
Funder
National Health and Medical Research Council
Funding Amount
$393,750.00
Summary
In Australia acute bronchitis is one of the commonest reasons for patients to attend their general practitioner. It can have considerable impact on patients lives with patients coughing on average for two weeks, with a third spending some time in bed and a quarter not returning to their usual activities for many weeks. If they attend a general practitioner (GP) it is likely they will receive antibiotics. But researchers believe that antibiotics are over prescribed for this condition and the emer ....In Australia acute bronchitis is one of the commonest reasons for patients to attend their general practitioner. It can have considerable impact on patients lives with patients coughing on average for two weeks, with a third spending some time in bed and a quarter not returning to their usual activities for many weeks. If they attend a general practitioner (GP) it is likely they will receive antibiotics. But researchers believe that antibiotics are over prescribed for this condition and the emergence of bacterial resistance is a real concern to health authorities. GPs are therefore being urged to reduce the prescription of antibioics for this common condition. But surveys by the National Prescribing Service (NPS) indicate that this is one area where GPs find it difficult to meet national recommendations. In part this may be because GPs do not wish to undertreat or miss a serious respiratory illness. Also results from randomised controlled trials examining the effectiveness of antibiotics for acute bronchitis suggest some benefit from treatment, at least in some patients. However it is not clear who these patients are and how much benefit they would get from receiving antibiotics. This creates a great deal of uncertainity for GPs who then opt for a 'just in case prescription' for everyone presenting with acute bronchitis. Our study will re-examine the symptoms, and clinical findings of patients presenting to their GP with acute cough and explore the impact of this common illness on patients lives. We will determine who does and does not benefit from antibiotics, and give guidance to GPs about the symptoms, clinical findings and investigations that predict a poorer outcome. Evidence from this study will be incorporated into treatment guidelines for acute bronchitis leading to more rational and effective management of this common problem.Read moreRead less
This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professiona ....This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professionals in relatively small rural hospitals. Patients and rural doctors often have little choice but to manage urgent cases locally and in some cases experienced and skilled local teams are able to offer a wider range of services, including a limited number of elective procedures. Despite underlying assumptions that the quality of the services cannot match that of specialist care in larger hospitals, there is no agreement on what constitutes quality of rural procedural care and little evidence that the quality is different. This issue is important as substantial government funds are spent on recruiting, training and retaining a qualified rural medical workforce, and yet fewer rural doctors are providing these services and fewer rural hospitals have the facilities to support those rural doctors still providing the services. Further, measuring the quality of care is a complex issue on which different stakeholders may have different views. This study proposes a multi-perspective approach to assessing the quality of care through a number of case studies provided by rural doctors.Read moreRead less
A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. Th ....A study investigating the feasibility of implementing a national approach to child and family health services. Understanding and strengthening the way in which universal health services are provided to pregnant women, children and families has the potential to impact over a million Australian families annually. The findings of this study will have national application as federal, state and territory governments work towards implementing a national approach to child and family health services. The findings will inform effective multidisciplinary collaboration and service integration, address service gaps and duplication and lead to increased access to services. This study will generate new knowledge about characteristics of organisations, service delivery and professions that facilitate or hinder innovation.Read moreRead less
MOSAIC: A GP Cluster Randomised Trial To Reduce Partner Violence Among Pregnant Women And Women With Pre-school Children
Funder
National Health and Medical Research Council
Funding Amount
$432,250.00
Summary
Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is ....Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is vital to inform both GP training and clinical practice. There is sound evidence that home visiting or support by peers improves the health of disadvantaged mothers and children. Similarly, advocacy improves the health and wellbeing of abused women. The MOSAIC community intervention trial combines these two elements: home visiting-peer support and domestic violence advocacy and this strategy will be evaluated in a randomised trial. The trial aims to reduce partner abuse and depression among women pregnant or with children under 5 attending GPs. It also aims to strengthen mother-child bonds. Trained and supported GPs from 40 participating practices will identify 700 abused or at risk women over a 40 week period. Women in the intervention arm of the trial, identified as abused or at risk by their GPs will be offered the support of trained para-professional 'mentor mothers' for up to a year, while the comparison arm will be offered standard GP care. Recent funding allows a pilot study of mentor mother recruitment and training to be undertaken in 2003. The study will strengthen GP support for this difficult issue and build a 'critical mass' of GPs interested in partner abuse management in the 5 participating divisions. The MOSAIC study will assess the value to GPs and women of an enhanced support system for victims' care and provide much needed evidence of an intervention embedded in general practice to reduce partner abuse of pregnant women and women with young children.Read moreRead less