A Case Control Study Investigating Factors Contributing To The Risk Of Bleeding In Patients Receiving Warfarin Therapy
Funder
National Health and Medical Research Council
Funding Amount
$572,242.00
Summary
Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking dru ....Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking drugs that interact with warfarin, they may have problems with their liver or kidney which affects the body's ability to get rid of it, they may have suffered a fall, to name a few. Studies done overseas have suggested that people are more likely to have a bleed if they do not know how to properly manage their tablets, if they are depressed, if they have no helpers to support them or if their care is not well organised. In Australia, we do not know what impact the organisation of care has on whether a person's warfarin is well managed. We do not know the impact that depression has on their care, or whether people are more likely to have pooorly controlled warfarin if they have few community ties. These are importnat questions to answer, so that we can make significant inroads into preventing death and disability from warfarin.Read moreRead less
A Solution Based Approach Developing Child Health Research With A Focus On Preventive Interventions For Common Childhood
Funder
National Health and Medical Research Council
Funding Amount
$2,599,538.00
Summary
There is an increasing recognition that research into child health should focus not only on disease but also on common childhood disorders such as obesity, depression and poor literacy. In addition, such research should include solution-based activity. That is, child health research should have an active program of testing new interventions to prevent the onset of disorders, or to allow optimal early management. The Murdoch Childrens Research Institute, the largest Australian child health resear ....There is an increasing recognition that research into child health should focus not only on disease but also on common childhood disorders such as obesity, depression and poor literacy. In addition, such research should include solution-based activity. That is, child health research should have an active program of testing new interventions to prevent the onset of disorders, or to allow optimal early management. The Murdoch Childrens Research Institute, the largest Australian child health research institute, is in a very good position to develop Australia's capacity further with regard to a coordinated research program into preventative interventions in child health. This is because of: - the Institute's location at the Royal Children's Hospital, Melbourne, the largest paediatric health service provider in Australia - the many individual relevant research projects that are already occurring in MCRI - the strong existing teams of researchers with skills in many different fields of child health such as psychology, speech pathology, clinical-medical care, epidemiology and biostatistics, and laboratory science including genetics. This capacity building program will coordinate population health work to develop the knowledge and skills of eight population health researchers. This development will occur within the context of an internationally competitive research program with structured continuing education and training to promote public health leadership. The capacity building program will develop skills not only in study design, conduct and analysis, but also in collaboration and the translation of research findings into better health services, government policy and parental knowledge to prevent problems and improve the health and well being of children and their families. To care for children in the best way, parents, families, schools, health care providers, and government need the best evidence base possible on the prevention of common child disorders.Read moreRead less
Extending The Australian Arm Of The International Tobacco Control Policy Evaluation Study
Funder
National Health and Medical Research Council
Funding Amount
$881,295.00
Summary
This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These i ....This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These include the adoption of graphic health warnings on tobacco packaging, removal of misleading constituents levels information from packs, bans of misleading descriptors such as Light and Mild, and implementation of smoke-free bars. In addition it will advance our understanding of how policy effects persist over time, their equity, and the means by which they contribute to increased cessation and reduced relapse. We do this by following smokers every year in each of the countries and asking them about their thinking and actions with regard to smoking, as well as about their awareness of the policies. By comparing the responses of smokers exposed to policies with those from other countries that are not exposed, we can work out the contribution of the policies to changes in smoking. Understanding policy effects on smokers and smoking cessation will lead to improved policies in Australia and the likelihood of improved dissemination of policies that work here to other countries. Similarly policies found to work in other countries, can be best adapted to Australia if we understand how they work. Taken in total, it should advance our efforts to reduce the burden of smoking-related harm both in Australia and the rest of the world.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
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
Capacity Building In Childhood And Adolescent Obesity Prevention
Funder
National Health and Medical Research Council
Funding Amount
$2,080,191.00
Summary
As obesity prevalence in children and adolescents continues to climb, there is an urgent need to build Australia's ability to undertake solutions-orientated research across several fronts. This program covers the four areas of greatest need for building research capacity in obesity prevention.Whole-of-community intervention programs: These evaluate what works and what does not work in the real world of trying to get integrated action at the community level and how to get the maximum uptake by ch ....As obesity prevalence in children and adolescents continues to climb, there is an urgent need to build Australia's ability to undertake solutions-orientated research across several fronts. This program covers the four areas of greatest need for building research capacity in obesity prevention.Whole-of-community intervention programs: These evaluate what works and what does not work in the real world of trying to get integrated action at the community level and how to get the maximum uptake by children and adolescents, their families, schools and other community settings.Assessing the cost-effectiveness of interventions: This research combines existing and emerging evidence with new modeling techniques to estimate the costs, population impacts, and cost-effectiveness of a variety of interventions.Socio-cultural contexts for obesity prevention: This research seeks to understand the various attitudes, beliefs, perceptions and values relating to food, physical activity and body size perception so that social marketing messages and intervention programs are socially and culturally appropriate and resonate with the variety of communities involved.Analysing policy processes and interventions: Policy changes are important early and powerful drivers of creating environments where the health choices are the easy choices, and the evidence base for such changes in obesity prevention is urgently needed.The four Lead Applicants in the team are all highly experienced researchers across the range of disciplines involved and are already working on a number of combined projects which will provide the research platform for the seven Team Investigators to build their skills. The Team Investigators are at various stages in their research careers and are already contributing to a significant extent. This capacity building grant will substantially boost this critical area of research by developing a team of cross-disciplinary researchers of international standing.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