Managing chronic back pain
Policy & Practice Report
Accountability for Informal Urban Equity (ARISE)
Background
Over half of the world’s population lives in cities, and one in three city-dwellers live in informal settlements in low- and middle-income countries (LMICs). Inadequate access to services, and limited opportunities to shape the environment, lead to a wide range of physical and mental health risks and overall well-being for persons living in informal urban settlements.
Accountability for Informal Urban Equity (ARISE) is a consortium of interconnected and interdisciplinary research hubs across Africa, South Asia, and the UK. The hub aims to address the intractable development challenges of ill-health, inequity, and insecurity in informal urban settlements in low- and middle-income countries in the context of complex and often dysfunctional governance arrangements.
The ARISE team comprises a diverse set of research organizations across Bangladesh, India, Kenya, Sierra Leone, United Kingdom, and an international federation of slum dweller organizations. By sharing experiences across these c
HEalth literacy in Low back Pain – the HELP media intervention study
BackgroundLow back pain (LBP) is one of the leading causes of disability worldwide, affecting approximately 80% of people over their lifetime, with estimates projecting an increase in prevalence in coming years. In addition, LBP places substantial economic strain on individuals and healthcare systems, with an estimated annual cost of AUD $4.8 billion annually to the healthcare system alone. While visits to a general practitioner (GP) contribute to these costs, many patients receive care that is not evidence-based, such as opioids and routine imaging.Waiting rooms present an opportunity to deliver health education-based multimedia interventions to improve the uptake of evidence-based care. Multimedia interventions delivered in GP waiting rooms have improved lifestyle habits, healthcare utilisation, and patients understanding of their condition in people with asthma, at risk of sexually transmitted diseases, and depression. Clinician-targeted, multifaceted interventions for LBP in emergency departments (EDs) ha
Strengthening clinical trials to provide high-quality evidence on health interventions and to improve research quality and coordination
Policy & Practice Report
Optimal Post Tpa-IV Monitoring in Ischaemic Stroke (OPTIMIST)
Aim: To establish that less-intense monitoring is at least as good as standard monitoring for patients who receive thrombolysis treatment for acute ischaemic stroke To establish that less-intense monitoring of patients is safe To establish that less-intense monitoring is cost-effective and allows more focussed nursing care.
Methodology:
An investigator-initiated and conducted, regionally coordinated, international, pragmatic, multicentre, prospective, stepped wedge, cluster randomised, blinded outcome assessed, clinical trial undertaken through a global network of investigators. The stepped wedge cluster (3 clusters, with 4 phases) will be undertaken at 120 hospitals, each recruiting average of 15 patient over a 4 month period per phase.
Ethical Considerations in Setting Health Research Priorities: A Philippine Case Study
Background
Research priority-setting (RPS) processes in the Philippines have applied a combination of principles and RPS frameworks such as the James Lind Alliance framework, Philippine National Health Research System Guidelines for Health Research Prioritization, bottom-up with top-down inputs approach, multi-criteria decision analysis, nominal group technique, and consensus-building. In a 2023 case study, the gaps identified highlight the need for ethical considerations and equity in RPS in the Philippine setting. Strengthening ethical considerations in health research is necessary to prevent perpetuation of inequities in global and national health systems
Aim
This project aims to:
Analyse ethical and equity considerations in health RPS exercises conducted by the Alliance for Improving Health Outcomes (AIHO) in the Philippines.
Develop recommendations for better integration of ethics and equity in future RPS activities by AIHO and in the Philippines.
Research
Fludrocortisone in ICU patients with aneurysmal subarachnoid haemorrhage (FLASH trial)
BackgroundAneurysmal subarachnoid haemorrhage (aSAH) is a severe and life-threatening form of stroke that affects approximately 2,000 Australians each year, with a mortality rate of around 30%. Survivors often experience long-term disability and reduced quality of life, contributing to the loss of 25,000 disability-adjusted life years annually. Despite advances in stroke care, no new treatments have emerged in the past 15 years to improve outcomes for these patients. Our research group, recognising this gap, formed a collaboration in 2017 to address the urgent need for improved clinical interventions in aSAH. Through a multicentre, binational study, we revealed that the case fatality rate of 29.2% has remained stagnant over the last decade, with patients requiring ICU admission facing a higher mortality rate and prolonged hospital stays compared to other neurological conditions.Further research into the long-term outcomes of aSAH patients identified significant functional impairment six months after their ICU
PReVENT-NEURO: PRophylaxis against VENTilator-associated infections in NEUROlogically injured ICU patients
Background
Ventilator-associated infections (VAI) represent a significant health burden among ICU patients, particularly those suffering from acute brain injuries. Conditions such as traumatic brain injury, subarachnoid haemorrhage, stroke, and status epilepticus often lead to reduced consciousness and impaired airway reflexes, which increase the risk of aspiration and subsequent lower respiratory tract infections, including pneumonia. These infections can exacerbate brain injury by causing hypoxia and increased intracranial pressure, both of which are linked to higher mortality rates and poor clinical outcomes. Globally, ventilator-associated pneumonia (VAP) is reported to affect between 9% and 27% of intubated patients, with particularly high mortality rates among those with neurological injuries.
In this vulnerable patient group, preventing infections is critical to reducing mortality and long-term disability. However, the use of prophylactic antibiotics remains contentious due to concerns
DAYARA: Developing and testing An intervention to promote psYchological wellbeing Among Scheduled TRibe communities in Andhra Pradesh
Background:
More than 104 million (approximately 8%) of India’s population belongs to Scheduled Tribe (ST) communities. About 35% of STs live below the poverty line and compared to other social groups, have poorer health and social indicators. Many live in remote areas or forest areas and have poor physical access to health facilities. ST communities have also been disproportionately affected by displacement and forced migration due to development projects. Although ST communities are exposed to a combination of social, economic and environmental factors that may affect their mental health and wellbeing, there is limited data related to mental health needs of tribal communities in India, with few mental health interventions involving tribal communities and limited evidence of appropriate mental health promotion interventions. Mental health promotion (MHP) is based on broader principles of health promotion in which the focus is not on disease or pathology but on promoting overall health and ps
INTErGenerational intervention to Reduce fraIlTY trial (INTEGRITY)
BackgroundIt is a huge achievement that we are living longer than before but sometimes older age also comes with poorer health. Frailty, defined as having an increased vulnerability, and dementia or cognitive decline are more common at older ages and often result in heightened care requirements and transition to aged care. Approximately 12-24 percent of older adults are identified as frail, while an additional 40 percent are categorized as 'prefrail' or mildly frail, and around 10% of adults over 65 have a diagnosis of dementia.But what if we could reduce the risk of becoming frail and help to protect our brain health and thinking or cognitive skills? We know that having greater physical activity, social engagement and using our brains in cognitive activities are linked to lowering the risk of developing frailty and cognitive decline. Increasing these aspects of our day to day life may help us. A fun way to do this can be through intergenerational practice.Intergenerational practice unites different generatio
8quity: Embedding Equity in our Research Processes
Background
Global health research reflects and can either perpetuate or challenge the complex power hierarchies and inequities that characterise our health systems and the societies in which they are situated. The imperative to embed equity in health research aligns with broader efforts globally to promote equitable partnerships among researchers, and between researchers and the communities potentially impacted by their research, or with whom knowledge is co-produced.
Aim
Our primary aim is to increase the capacity of public health researchers all over the globe to enhance equity integration across their research, regardless of their design, size or location. We want to improve conceptual understandings, know how and skills in application of ethical and equity-related principles, and contribute towards growing a culture of ethical praxis in global public health research.
Research Methodology
Case Study
We will develop case studies of research projects at The George
Factors influencing lung cancer outcomes in culturally and linguistically diverse (CALD) populations
Background
Lung cancer remains the leading cause of cancer-related mortality globally and in Australia, with 8,691 deaths recorded nationally in 2023. People from culturally and linguistically diverse (CALD) backgrounds experience disproportionately poorer outcomes, yet the reasons behind these disparities are not fully understood. Given that nearly one-third of Australia's population is born overseas, and a significant proportion come from CALD backgrounds, understanding and addressing these inequities is crucial.
CALD patients often face barriers such as language difficulties, cultural insensitivity, stigma, and limited health literacy, which can hinder access to timely diagnosis and treatment. About one-third of lung cancer patients in NSW present through emergency departments, often due to delays in care or lack of continuity. Bulk-billing practices, while more accessible, can be time-constrained and less conducive to preventive care discussions, particularly for patients requiring longer