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THE DETECTION AND MANAGEMENT OF DEMENTIA IN GENERAL PRACTICE.
Funder
National Health and Medical Research Council
Funding Amount
$499,977.00
Summary
This research aims to examine a new method and practice guidelines for detection of early dementia. General practitioners will be screened on their ability to diagnose and manage dementia and to distinguish it from other diseases. Patient outcomes - including quality of life, depression, and satisfaction with care and referral indicators - will be examined.
Cognitive Outcome And Therapeutic Interventions For Coronary Artery Disease.
Funder
National Health and Medical Research Council
Funding Amount
$392,104.00
Summary
Dementia is recognized as an increasingly important factor affecting quality of life as people age. Deaths from heart disease are declining, in part due to improved surgical techniques and to the use of less invasive methods to keep arteries open such as coronary stenting. It is now well known that 20 to 60% of patients experience some degree of impairment in thinking ability (cognitive impairment) after cardiac surgery, that this will persist in some of these individuals for years and may incre ....Dementia is recognized as an increasingly important factor affecting quality of life as people age. Deaths from heart disease are declining, in part due to improved surgical techniques and to the use of less invasive methods to keep arteries open such as coronary stenting. It is now well known that 20 to 60% of patients experience some degree of impairment in thinking ability (cognitive impairment) after cardiac surgery, that this will persist in some of these individuals for years and may increase the risk of long-term problems. Cognitive impairment affects people in many ways. While it is not yet known whether the occurrence of cognitive impairment predisposes to dementia, it is thought that Mild Cognitive Impairment (MCI) may do so. We propose to explore the link between MCI and Post Procedural Cognitive Deficit (PPCD) in patients with coronary disease from before the first point of objective diagnosis, i.e. prior to the coronary angiogram, and over a 12-month period, through and subsequent to further treatment interventions such as stenting or cardiac surgery. Our Pilot data suggest that PPCD does indeed occur after angiography, and we propose to identify how long this lasts, whether MCI predisposes to it and whether it is better to wait until it resolves before further interventions are undertaken. In this way we hope to identify the safest treatment strategy for patients with coronary disease that will minimize the occurrence of Cognitive Deficit and possibly longer-term cognitive changes after investigation and treatment for their symptoms.Read moreRead less
Integrating Conventional Mesothelioma Therapies With Immuno- And Gene-therapies
Funder
National Health and Medical Research Council
Funding Amount
$804,916.00
Summary
Asbestos-induces cancers are some of the most aggressive cancers know to medicine. Unfortunately, treatments are not very effective and it is unusual for these cancers to be cured, particularly mesothelioma. Because recent scientific studies have suggested that combinations of therapy which include immunotherapy, ie treatments aimed at stimulating the bodies anti-cancer immune responses to attack the cancer, can be effective, we plan to develop this work in order to determine exactly which combi ....Asbestos-induces cancers are some of the most aggressive cancers know to medicine. Unfortunately, treatments are not very effective and it is unusual for these cancers to be cured, particularly mesothelioma. Because recent scientific studies have suggested that combinations of therapy which include immunotherapy, ie treatments aimed at stimulating the bodies anti-cancer immune responses to attack the cancer, can be effective, we plan to develop this work in order to determine exactly which combinations are likely to be the most effective and therefore the most suitable for clinical trial in patients.Read moreRead less
A RCT Of An Innocative Supportive Care Program Designed To Reduce Perceived Needs & Psychological Distress & Enhance
Funder
National Health and Medical Research Council
Funding Amount
$111,043.00
Summary
The diagnosis of incurable lung cancer is a very distressing event, and patients have a high level of psychological and informational needs. An innovative evidence-based program has been designed to address these unmet needs in an emotionally supportive environment at this critical time. This study tests whether the program meets the needs of these people, reduces their psychological distress and enhances their quality of life. If successful, it will be integrated into the standard care to impro ....The diagnosis of incurable lung cancer is a very distressing event, and patients have a high level of psychological and informational needs. An innovative evidence-based program has been designed to address these unmet needs in an emotionally supportive environment at this critical time. This study tests whether the program meets the needs of these people, reduces their psychological distress and enhances their quality of life. If successful, it will be integrated into the standard care to improve the experience of this large and under-supported group.Read moreRead less
An Exploration Of Functional Decline And The Potential For Rehab In Patients With Advanced Non-small Cell Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the ....Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the introduction of pulmonary rehabilitation, little research has been conducted to either map the functional status of lung cancer patients or to explore the application of pulmonary rehabilitation in this setting. This study seeks to begin a program of work in this area through first exploring the characteristics of functional decline in this group and then assessing the feasibility and acceptability of a rehabilitation program specifically addressing the functional status needs identified.Read moreRead less
Informing The Development Of A Model Of Care For Patients With End Stage COPD: What Are Their Needs And And They Being Met
Funder
National Health and Medical Research Council
Funding Amount
$49,425.00
Summary
Currently there is no specific model of care for people with end stage chronic obstructive pulmonary disease (COPD), despite growing evidence of the specific symptoms and issues of this patient group. Interviews with end stage COPD patients and their carers will be undertaken to explore the services currently being accessed, and how well patients’ needs are being met by these services. This project will conduct an audit of available services in South Australia and then examine how hospital, spec ....Currently there is no specific model of care for people with end stage chronic obstructive pulmonary disease (COPD), despite growing evidence of the specific symptoms and issues of this patient group. Interviews with end stage COPD patients and their carers will be undertaken to explore the services currently being accessed, and how well patients’ needs are being met by these services. This project will conduct an audit of available services in South Australia and then examine how hospital, specialist palliative care units and primary care services (including general practice) can interface to meet these identified patient and carer needs. The results from this study will be used to inform development of a distinct model (or models) of care that addresses the needs of patients with end stage COPD.Read moreRead less
Analysis Of The Effectiveness Of A Simple, Inexpensive, Saliva-based Caries-risk Test
Funder
National Health and Medical Research Council
Funding Amount
$29,688.00
Summary
The project aims to develop a test with the capacity to identify children at risk of developing caries (dental decay) so they can benefit from preventive care. The effectiveness of the test will be assessed by how well it correlates with currently available tests and whether it can predict caries development in children classified into risk groups on the basis of the test. The test promises to be predictive of caries-risk, inexpensive, easy to interpret and rapid when compared to those currently ....The project aims to develop a test with the capacity to identify children at risk of developing caries (dental decay) so they can benefit from preventive care. The effectiveness of the test will be assessed by how well it correlates with currently available tests and whether it can predict caries development in children classified into risk groups on the basis of the test. The test promises to be predictive of caries-risk, inexpensive, easy to interpret and rapid when compared to those currently available commercially.Read moreRead less
Validation Of A Competency Assessment Method For Persons With Dementia
Funder
National Health and Medical Research Council
Funding Amount
$580,451.00
Summary
Deciding what if any aspects of their financial affairs a person with dementia or suspected dementia can responsibly manage is a difficult process for health and legal professionals as well as for guardianship boards and tribunals. This process is often stressful for the older person, and families can find deciding when to “take over” stressful. Also, having family members manage the older person’s assets may result in family conflict. There is a small amount of overseas research examining this ....Deciding what if any aspects of their financial affairs a person with dementia or suspected dementia can responsibly manage is a difficult process for health and legal professionals as well as for guardianship boards and tribunals. This process is often stressful for the older person, and families can find deciding when to “take over” stressful. Also, having family members manage the older person’s assets may result in family conflict. There is a small amount of overseas research examining this issue. However, no comprehensive and validated method exists internationally or in Australia to determine competency in this context. We will test a methodology for assessing the capacity of individuals to manage their own financial affairs where dementia is an issue. This method involves the use of a number of reliable and well-validated instruments measuring the older person’s mental state, anxiety levels, depression, and social vulnerability combined with an interview exploring the personal circumstances of the older adult in relation to their financial affairs. We will work with the Office of the Adult Guardian in Queensland to recruit participants and to verify both the utility and usability of our methodology with stakeholders (e.g. solicitors, the Office of the Adult Guardian). A comparison will be made between the results obtained in approximately 200 financial competency cases with the competency opinions independently arrived at by the Office of the Adult Guardian in Queensland. As a result of this research, we will be able to ascertain the viability and utility of this assessment method, improve the method as per the data gathered, and ultimately seek future funding to trial the methods across multiple jurisdictions (e.g. other states) and contexts (e.g. various cultural contexts).Read moreRead less
Helping Family Caregivers Of Palliative Care Patients Manage Their Roles: Evaluation Of A Hospital Based Group Education
Funder
National Health and Medical Research Council
Funding Amount
$219,810.00
Summary
While most people would prefer to die at home, the reality is that about two thirds of people die in in-patient settings, such as palliative care units. A home death is more likely if family caregivers are well prepared and supported in their role. Palliative care services are expected to support family caregivers. Research shows, however, that many family caregivers lack the required information to effectively manage their role. They are also prone to suffer psychological distress while support ....While most people would prefer to die at home, the reality is that about two thirds of people die in in-patient settings, such as palliative care units. A home death is more likely if family caregivers are well prepared and supported in their role. Palliative care services are expected to support family caregivers. Research shows, however, that many family caregivers lack the required information to effectively manage their role. They are also prone to suffer psychological distress while supporting their dying relative. Caregivers have expressed a desire for structured information to better prepare them for their role, whether their dying relative is in hospital, a palliative care unit or at home. The aim of this project is to develop and evaluate an educational program offered to family caregivers who are supporting a relative who is receiving palliative care in an inpatient setting. The education program seeks to help family caregivers manage their role and to prepare them for the patient�s home care where appropriate. It is hoped that family caregivers who have attended the program will be more competent, better prepared and more informed about their caregiving role. An additional benefit from attending the program will be the opportunity for family caregivers to meet others in similar situations to themselves. Each education program will involve approximately six family caregivers; it will be conducted very soon after their relative has been admitted to the palliative care unit. The program will be of two hours duration (including time for data collection) and will be facilitated by a suitably qualified health professional. Written resources will be provided and caregivers will be given the opportunity to meet with staff from the multidisciplinary team. Referrals for scheduled consultations will be made where relevant. The program will be conducted in three sites (two in Victoria and one in Western Australia) and will be comprehensively evaluated. The caregivers who attend the program will be invited to provide feedback by completing several questionnaires designed to determine the effectiveness of the program. Group education programs of this kind have previously not been rigorously developed and tested. We seek to address this and hope to demonstrate that we can positively influence the family care giving experience.Read moreRead less