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1+1- A Healthy Start To Life:Targeting The Year Before And The Year After Birth In Aboriginal Children In Remote Areas
Funder
National Health and Medical Research Council
Funding Amount
$587,272.00
Summary
Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential ....Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential for promoting health and providing quality care. Evidence suggests redesigned models based on continuity of care, focused, proactive family support and workload reform will improve maternal and infant outcomes. New models need to be developed, costed, implemented and evaluated providing governments with the evidence base to initiate service improvement. Such models will have applicability elsewhere in Australia. Professor Lesley Barclay and her team of researchers from Charles Darwin University will conduct research into developing such a model. The project aims to improve the quality of care for remote dwelling Aboriginal women and infants in the year before, during and the year after birth by providing evidence for, and facilitating changes to, service delivery. This will enhance the potential for the development of resilience and well-being of their children. It will also test if service improvements can improve the health of women and reduce childhood disease and therefore reduce the impact of health conditions occurring in adulthood which have their origins in the early stages of life.Read moreRead less
PEACH Study- Patient Engagement And Coaching For Health: An Intensive Treatment Intervention For Patients With Type 2 Di
Funder
National Health and Medical Research Council
Funding Amount
$499,263.00
Summary
This study uses practice nurses integrated in existing general practice structures to implement telephone coaching for patients with type 2 diabetes (T2D) in a disadvantaged community. This is an evidence based patient empowerment strategy designed to increase patient self-management and engagement with the health care system to improve health outcomes.
Neuroscience On Barriers In Development (NEUROBID)
Funder
National Health and Medical Research Council
Funding Amount
$600,927.00
Summary
The program aims to understand normal and disturbed brain barrier function in development to devise ways of preventing or ameliorating neurological conditions in infants or adult neurological disorders with developmental origins. Unique features of transport mechanisms across brain barriers will be used to design novel methods of targeting therapeutic macromolecular and cellular agents to the brain barriers and transporting them into brain for treatment of neurological diseases in young and old.
Changing Patterns Of Work: Impacts On Physical And Mental Health And The Meditating Role Of Resiliency And Social Capital
Funder
National Health and Medical Research Council
Funding Amount
$1,140,342.00
Summary
This project will provide, for the first time in Australia, a detailed understanding of the impact of the changing forms of employment and unemployment on overall health. It will provide original insights into what aspects of the employment relation help or harm health, and on what enables some people to escape the harm that others experience. This will provide vital information to underpin policies designed to gain the benefits of a flexible workplace, with minimum harm to workers.
Outcomes Of Best Practice Diagnosis And Management Of Dementia In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$826,744.00
Summary
The outcome of this study will be new Australian data on what happens to people with dementia under the care of their GP, followed up for two years. In addition we will test the results for patients and carers of GP adherence to best practice for diagnosis and management of dementia. This is a 3-state randomised intervention trial in general practice which aims to add an extra year to an already funded study examining the outcomes for carers and patients of training GPs with extra skills in deme ....The outcome of this study will be new Australian data on what happens to people with dementia under the care of their GP, followed up for two years. In addition we will test the results for patients and carers of GP adherence to best practice for diagnosis and management of dementia. This is a 3-state randomised intervention trial in general practice which aims to add an extra year to an already funded study examining the outcomes for carers and patients of training GPs with extra skills in dementia screening and management guidelines. Outcomes for those GPs who adhere to the guidelines will be compared to outcomes for those GPs who do not. Patient and carer outcomes – include quality of life, depression, satisfaction with care and referral indicators, and patient pathways of care over the 24 month period will be recorded. In addition the study will examine barriers and enablers to GP best practice in dementia care.Read moreRead less
Intergeneration Growth And Risk Of Metaboloc Disorders
Funder
National Health and Medical Research Council
Funding Amount
$2,095,469.00
Summary
A compelling raft of studies has now shown that low birth weight predisposes to later, impaired glucose tolerance, diabetes, cardiovascular disease, hypertension and high cholesterol. The associations are clearly evident even after adjusting for important lifestyle factors, occupation, income, adult diet and socio-economic status. This has resulted in a new paradigm for understanding the transmission of disease risk from one generation to the next. A team of researchers based at the University o ....A compelling raft of studies has now shown that low birth weight predisposes to later, impaired glucose tolerance, diabetes, cardiovascular disease, hypertension and high cholesterol. The associations are clearly evident even after adjusting for important lifestyle factors, occupation, income, adult diet and socio-economic status. This has resulted in a new paradigm for understanding the transmission of disease risk from one generation to the next. A team of researchers based at the University of Adelaide led by Dr Davies has gained international recognition for being at the forefront of this research. Thirty years ago, the group established the Lucina cohort to study intergenerational health among women, and how conditions in pregnancy can affect the reproductive health of offspring in successive generations. Dr Davies and his team of researchers will expand this study in ways that were designed at the outset, but not commenced until now. This includes enrolling the traced mothers to study how their clinical experiences in pregnancy predict their own later risk of diabetes. We will also be seeking to enrol the siblings of the daughters so that we can identify events in pregnancies that predict which sibling is at increased risk of diabetes. Finally, the study will enrol the grandchildren and trace their birth records so that we can study the relationship between diabetes risk, intergenerational growth and how that risk can be substantially influenced by factors as basic as pre-pregnancy body weight and weight gain in pregnancy. The objective of this research is to grow healthier Australian babies, children and thereby healthier adults.Read moreRead less
The Development And Evaluation Of Management Strategies Designed To Address Poly-morbidity In Older People: Implications
Funder
National Health and Medical Research Council
Funding Amount
$2,150,705.00
Summary
Medicines are used to prevent or manage the symptoms of chronic disease, and thus their appropriate use impacts significantly on the quality of life of the elderly. Poly-morbidity, multiple chronic health problems affecting the one individual, is a common and increasing issue in our ageing population. In Australia, 60% of 65 year olds have 2 or more chronic conditions, while 80% of 85 year olds have 4 or more chronic conditions. As a result, medicine use is almost universal in the older populati ....Medicines are used to prevent or manage the symptoms of chronic disease, and thus their appropriate use impacts significantly on the quality of life of the elderly. Poly-morbidity, multiple chronic health problems affecting the one individual, is a common and increasing issue in our ageing population. In Australia, 60% of 65 year olds have 2 or more chronic conditions, while 80% of 85 year olds have 4 or more chronic conditions. As a result, medicine use is almost universal in the older population and it is common for older patients to take multiple medications concurrently. There are no studies which report on current patterns of care and their outcomes in these patients. The use of individual disease-specific management guidelines may be problematic for those with poly-morbidity. Disease specific treatment guidelines often fail to take into account complexities that arise when patients suffer from more than one chronic disease particularly when it is common for one treatment to be both beneficial and harmful in the same person. In addition, the evidence for medicine-based treatment often comes from studies on younger people. Consequently, older patients with lower tolerance are at a greater risk of adverse drug reactions and are admitted to hospital as a result of such reactions at a disproportionately high rate. The aim of this study is to establish a methodology, by examination of two health databases, for developing guidelines to achieve the best possible outcomes for older Australians with common combinations of chronic conditions. This research will provide a better understanding of the consequences of current patterns of care for older people with multiple chronic conditions, and enable the development of improved approaches to care. We will demonstrate the methodology using selected commonly occurring combinations of chronic conditions in older Australians. More realistic guidelines generated by undertaking this analysis in these major population databases will reduce the extent to which the elderly are placed at risk of adverse drug reactions, and better enable health care practitioners, in consultation with their elderly patients, to ensure the best possible health and quality of life outcomes for many older Australian patients who suffer from two or more chronic conditions.Read moreRead less
In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states ....In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.Read moreRead less
Which Heart Failure Intervention Is Most Cost-effective And Consumer Friendly In Reducing Hospital Care: The Which
Funder
National Health and Medical Research Council
Funding Amount
$921,640.00
Summary
Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. ....Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. We confirmed the results of pioneering Australian research that CHF-MPs dramatically improve health outcomes in CHF. CHF-MPs now form part of the recommended gold-standard management of CHF. However, we also have evidence that only a small proportion of patients are exposed to a CHF-MP in Australia. Residual issues such as consumer preference and the cost of applying these programs are hindering their wide-spread application. The WHICH? Study addresses this _road block� to implementing a potentially valuable health care service by tackling a number of critical issues: which form of CHF-MP (home or specialist clinic-based follow-up), will produce the best health outcomes, save the most money and meet the needs of consumers at the same time? To answer this question, we will undertake a randomised, head-to-head study of a home versus clinic-based CHF-MP, in 1000 recently hospitalised CHF patients recruited from SA, VIC, NSW and QLD. Patterns and of health care and consumer preferences and quality of life will then be compared for these two different forms of CHF-MP from a combined health economic, health policy and consumer perspective to determine the best form of CHF-MP to be applied. A _consensus� vision for applying an Australia-wide service will then be developed. The potential impact of the results of the study will then be modelled on the status of Australian CHF-MPs in the year 2010 and a blue-print for action devised.Read moreRead less