Background And Objectives: Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response.
Research Design And Methods: Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops.
Background: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse.
View Article and Find Full Text PDFImplement Sci Commun
November 2023
Background: Assessing the fidelity of intervention components enables researchers to make informed judgements about the influence of those components on the observed outcome. The 'Implementing work-related Mental health guidelines in general PRacticE' (IMPRovE) trial is a hybrid III trial aiming to increase adherence to the 'Clinical Guidelines for the diagnosis and management of work-related mental health conditions in general practice'. IMPRovE is a multifaceted intervention, with one of the central components being academic detailing (AD).
View Article and Find Full Text PDFObjectives: Resources to support dementia carers from ethnically diverse families are limited. We explored carers' and service providers' views on adapting the World Health Organization's iSupport Lite messages to meet their needs.
Methods: Six online workshops were conducted with ethnically diverse family carers and service providers ( = 21) from nine linguistic groups across Australia.
As Official Development Assistance (ODA) tops 180 billion USD per year, there is a need to understand the mechanisms underlying aid effectiveness. Over the past decade we have seen some low- and middle-income countries become developed nations with record economic growth. Others remain in development purgatory, unable to provide their citizens with access to essential services.
View Article and Find Full Text PDFAppl Health Econ Health Policy
March 2023
Objective: There is a paucity of papers synthesizing the cost-effectiveness (CE) of lifestyle interventions to support cancer patients, and the synthesis papers available have used analytic methods that do not permit easy comparison between studies. We therefore evaluated the CE of adjunctive lifestyle interventions compared with usual care.
Methods: A systematic literature search of Scopus, MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library databases was conducted from database inception until June 2021.
Background: Insomnia and fatigue symptoms are common in breast cancer. Active cancer treatment, such as chemotherapy, appears to be particularly disruptive to sleep. Yet, sleep complaints often go unrecognised and under treated within routine cancer care.
View Article and Find Full Text PDFPost-mortem magnetic resonance imaging (MRI) provides the opportunity to acquire high-resolution datasets to investigate neuroanatomy and validate the origins of image contrast through microscopy comparisons. We introduce the (open.win.
View Article and Find Full Text PDFBackground: Acute low back pain is a common condition, has high burden, and there are evidence-to-practice gaps in the chiropractic and physiotherapy setting for imaging and giving advice to stay active. The aim of this cluster randomised trial was to estimate the effects of a theory- and evidence-based implementation intervention to increase chiropractors' and physiotherapists' adherence to a guideline for acute low back pain compared with the comparator (passive dissemination of the guideline). In particular, the primary aim of the intervention was to reduce inappropriate imaging referral and improve patient low back pain outcomes, and to determine whether this intervention was cost-effective.
View Article and Find Full Text PDFBackground: The Clinical Guideline for the Diagnosis and Management of Work-related Mental Health Conditions in General Practice (the Guideline) was published in 2019. The objective of this trial is to implement the Guideline in general practice.
Trial Design: Implementing work-related Mental health conditions in general PRacticE is a hybrid III, parallel cluster randomised controlled trial undertaken in Australia.
Aim: In-vehicle telematics monitoring systems that provide driver feedback have been identified as a promising intervention to influence driver behaviours and reduce the growing burden of road injury. The current study was undertaken to assess the effect of driver feedback alone and feedback plus financial incentives on driving behaviours (speeding, hard acceleration and hard braking).
Method: A pragmatic randomised trial was undertaken over a 28-week observational period.
Background: Agitation is common in the early stages of recovery from traumatic brain injury (TBI), when patients are in post-traumatic amnesia (PTA). Agitation is associated with risk of harm to patients and caregivers. Recent guidelines recommend that agitation during PTA is managed using environmental modifications.
View Article and Find Full Text PDFBackground And Objectives: Blood services are tasked with efficiently maintaining a reliable blood supply, and there has been much debate over the use of incentives to motivate prosocial activities. Thus, it is important to understand the relative effectiveness of interventions for increasing donations.
Materials And Methods: This systematic review used a broad search strategy to identify randomized controlled trials comparing interventions for increasing blood donations.
For many populations at risk of social isolation, including Older Women Living Alone (OWLA), existing services to maintain independence and optimise well-being are difficult to access, unsuitable or unavailable. Co-creation is a strategy to develop 'person-centred' services that meet the needs of individuals. We adapted an existing framework for co-creation and used participatory action research methods, supported by an evidence base comprising a systematic review, analysis of routinely collected data and interviews, to develop person-centred services for OWLA.
View Article and Find Full Text PDFBackground: Navigating treatment pathways remains a challenge for populations with complex needs due to bottlenecks, service gaps and access barriers. The application of novel methods may be required to identify and remedy such problems.
Objective: To demonstrate a novel approach to identifying persistent service gaps, generating potential solutions and prioritizing action.
To test whether the Functional Independence Measure (FIM) could be mapped to the EQ-5D-3L to give researchers a viable but "second-best" option for calculating quality-adjusted life-years (QALYs) and conducting a cost-utility analysis when only clinical outcomes have been collected. Secondary analysis of repeated measures data collected during a randomized controlled trial ( = 3506 observations) at two inpatient rehabilitation centres. Participants had a mean age of 74 (SD 13) years, 63% were women and 58% were admitted with an orthopaedic diagnosis.
View Article and Find Full Text PDFBackground: Evidence-based guidelines for management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available; however, clinical practice remains inconsistent with these guidelines. A targeted, theory-informed implementation intervention (Neurotrauma Evidence Translation (NET) intervention) was designed to increase the uptake of three clinical practice recommendations regarding the management of patients who present to Australian EDs with mild head injuries. The intervention involved local stakeholder meetings, identification and training of nursing and medical local opinion leaders, train-the-trainer workshops and standardised education materials and interactive workshops delivered by the opinion leaders to others within their EDs during a 3 month period.
View Article and Find Full Text PDFRationale: Highly prevalent and severe sleep-disordered breathing caused by acute cervical spinal cord injury (quadriplegia) is associated with neurocognitive dysfunction and sleepiness and is likely to impair rehabilitation.
Objective: To determine whether 3 months of autotitrating CPAP would improve neurocognitive function, sleepiness, quality of life, anxiety and depression more than usual care in acute quadriplegia.
Methods And Measurements: Multinational, randomised controlled trial (11 centres) from July 2009 to October 2015.
Background: Evidence-based guidelines for the management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available, and yet, clinical practice remains inconsistent with the guidelines. The Neurotrauma Evidence Translation (NET) intervention was developed to increase the uptake of guideline recommendations and improve the management of minor head injury in Australian emergency departments (EDs). However, the adoption of this type of intervention typically entails an upfront investment that may or may not be fully offset by improvements in clinical practice, health outcomes and/or reductions in health service utilisation.
View Article and Find Full Text PDFObjectives: Debate regarding factors associated with persistent symptoms following mild traumatic brain injury continues. Nested within a trial aiming to change practice in emergency department management of mild traumatic brain injury, this study investigated the nature of persistent symptoms, work/study outcomes, anxiety and quality of life and factors associated with persistent symptoms following injury, including the impact of receiving information about mild traumatic brain injuries in the emergency department.
Methods: A total of 343 individuals with mild traumatic brain injury completed the Rivermead Post-Concussion Symptom Questionnaire, Hospital Anxiety Depression Scale - Anxiety Scale, and Quality of Life - Short Form in average 7 months post-injury.
Objective: To evaluate the cost-effectiveness of structured activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) plus treatment as usual (TAU) vs TAU alone for inpatient rehabilitation following severe traumatic brain injury (TBI).
Design: Trial-based economic evaluation from a health-system perspective.
Setting: Inpatient rehabilitation center.
Recent studies have demonstrated that financial incentives can improve driving behaviour but high-value incentives are unlikely to be cost-effective and attempts to amplify the impact of low-value incentives have so far proven disappointing. The present study provides experimental evidence to inform the design of 'smart' and potentially more cost-effective incentives for safe driving in novice drivers. Study participants (n = 78) were randomised to one of four financial incentives: high-value penalty; low-value penalty; high-value reward; low-value reward; allowing us to compare high-value versus low-value incentives, penalties versus rewards, and to test specific hypotheses regarding motivational crowding out and gain/loss asymmetry.
View Article and Find Full Text PDFObjectives: To compare the determinants of initial statin prescribing between New Zealand and Australia. New Zealand has a system-wide absolute risk-based approach to primary care cardiovascular disease (CVD) management, while Australia has multiple guidelines.
Method: Classification and Regression Tree (CART) analysis of two observational studies of primary care CVD management from New Zealand (PREDICT-CVD) and Australia (AusHeart).