Medical Research In Australia Research Articles

A mixed methods study protocol to identify research priorities for perioperative medicine in Australia

BackgroundClinical research in perioperative medicine requires the perspectives of patients and caregivers to increase its relevance and quality, benefiting both researchers and the community. Identifying these priorities will enable researchers, funders, and governing bodies to efficiently use scarce funding and resources. We aim to identify the top 10 research priorities in perioperative medical research in Australia. MethodsA mixed-methods, exploratory-sequential design will be conducted. The study will include five phases. Initially, a published open-ended survey gathered responses from the population (researchers, healthcare workers, and consumers) regarding uncertainties/questions relevant to the population about perioperative medical research. We collected 544 questions and quantitatively analysed and grouped them according to the Standardised Endpoints in Perioperative Medicine–Core Outcomes Measures in Perioperative and Anaesthetic Care (StEP–COMPAC) endpoints. Using multicriteria decision-making software, workshops combining the population will be conducted to determine the top 10 priorities for perioperative medicine research for the Australian population. Ethics and disseminationEthical approval to conduct the study was obtained from the Alfred Health (Australia) Human Research Ethics Committee (ID: 171/19). The findings will be disseminated in peer review publications, conferences, and dissemination across perioperative research networks. The top 10 priorities will be available to inform research funders, grant submissions, guidelines, and the population.

Principles for consumer involvement in health and medical research.

Principles for consumer involvement in health and medical research.

Aboriginal Human Research Ethics Committees ensuring culturally appropriate research

Abstract Aboriginal and Torres Strait Islander people, Australia's Indigenous peoples, make up three percent of the population of Australia. Like many other Indigenous peoples in colonised countries, they suffer the worst health and social status of any population group. Australian Indigenous people have a lower life expectancy (8.6 years lower for men and 7.8 years for women) compared with other Australians (ABS 2018a). The reasons for the poorer health outcomes are complex and include historical, political and social factors (AIHW 2015a). The health disparity has driven a high number of research projects with a focus on Australian Indigenous people or mainstream research projects where Australian Indigenous people are overrepresented. Given the uniqueness of Australian Indigenous cultures as well as the historical, political and social context, in 1998, the Aboriginal Health and Medical Research Council of New South Wales (AH&MRC) established an Australian Indigenous-specific human research ethics committee (HREC). The AH&MRC is the Indigenous peak health body of New South Wales. This presentation will outline the role and benefit of the AH&MRC HREC as a specialised HREC. The AH&MRC HREC is fully constituted and registered under the National Health and Medical Research Council (NHMRC). The NHMRC is the leading expert body in health and medical research in Australia and develops health research guidelines. The AH&MRC HREC is one of three AHRECs in Australia. The AH&MRC Ethics Committee not only guarantees that research is conducted ethically but also ensures research involving Indigenous people is undertaken in a culturally appropriate manner. One of the key elements required by the AH&MRC is that researchers consult Indigenous communities across all stages of the project from the design, implementation, analysis and write up. The AH&MRC HREC is essential, ensuring the research is of benefit to the Indigenous community in NSW and is conducted in a culturally safe manner. Key messages Specialised Indigenous human resarch ethics committees are vital to enuring research is culturally appropriate. Spscialised human resarch ethics committees can be of benefit for other disctinct populations.

Setting Medical Research Future Fund priorities: assessing the value of research.

In its 2014–2015 budget, the Australian Government announced the establishment of the $20 billion Medical Research Future Fund (MRFF).1 The MRFF aims to support health and medical research in Australia to drive innovation, improve delivery of health care, enhance the efficiency and effectiveness of the health system, and contribute to economic growth.1 In April 2016, the government announced the creation of the Australian Medical Research Advisory Board to determine the medical research strategy and priorities to guide the funding allocated through the MRFF. Although its mission is clear, the board faces the challenging task of identifying research priorities and allocating the available budget across topics and programs competing for funding. The criteria for identifying research priorities to guide the government decision making on program level funding, as set out in the MRFF legislation, focus on the ability of research programs to deliver the greatest value for as many Australians as possible.1 However, there is little mention of how the value of research programs would be objectively, transparently and practically assessed to inform research prioritisation and ensure efficient use of the MRFF budget.

A history of health and medical research in Australia.

Health and medical research has played an important role in improving the life of Australians since before the 20th century, with many Australian researchers contributing to important advances both locally and internationally. The establishment of the National Health and Medical Research Council (NHMRC) to support research and to work to achieve the benefits of research for the community was significant. The NHMRC has also provided guidance in research and health ethics. Australian research has broadened to include basic biomedical science, clinical medicine and science, public health and health services. In October 2002, the NHMRC adopted Indigenous health research as a strategic priority. In 2013, government expenditure through the NHMRC was $852.9 million. This article highlights some important milestones in the history of health and medical research in Australia.

Clinical research and leadership training program as a knowledge translation initiative across an Australian health care service

Health professionals need to be integrated more effectively in clinical research initiatives to ensure that research addresses key clinical needs and provides practical, implementable solutions at the coal face of care. The recent McKeon review of Health and Medical Research in Australia suggested that the best way to achieve practical and implementable solutions in healthcare is to involve the health-delivery workforce in research to ensure that research addresses key clinical needs [1]. Through a partnership with Monash Health and Monash University, goals of the Monash Centre for Health Research and Implementation (MCHRI) are to deliver clinical research and leadership training to build capacity in implementation and support clinical research at Monash Health. Here we describe the informative phase of a broader program to enable and support health professionals at Monash Health who do not have a research background, to engage in and lead research to improve healthcare outcomes. As one of the largest health services in Australia, comprising more than 40 community services and hospitals across Melbourne, Monash Health provides the ideal setting. The broader program is based on a framework that has been shown to lead to successful implementation and long-term sustainability and draws upon knowledge translation principles, as well as medical education frameworks. The study design incorporates mixed methods within a collaborative action research approach involving multidisciplinary researchers across MCHRI, Monash Health and Monash University. Ethics approval has been obtained and literature review completed. Within the informative phase, an online survey and semi-structured interviews are being conducted to explore knowledge, perceptions, experience and training preferences in clinical research methods, evidence based principles and research leadership. We anticipate information from a representative group of people working across different areas and at different levels at Monash Health. The findings will be used to develop a dedicated clinical research and leadership training program. The training program will support Monash Health staff to up-skill or enhance skills to conduct rigorous research; engage and lead multidisciplinary, collaborative teams; and to use research to guide practice, as well as identify and address gaps in clinical research.

Are the CAM professions engaging in high-level health and medical research? Trends in publicly funded complementary medicine research grants in Australia

Developing research capacity is an essential part of professional development in the health professions, as well as essential to improving health care delivery. CAM is one area in which the importance of research capacity has been previously highlighted. To determine whether academic and research CAM practitioners were actively engaged in high-level CAM research in Australia successful National Health and Medical Research Council grants data for projects starting between 2000 to present (2013) were collated and analyzed. CAM practitioners are not involved in most NHMRC-funded research, with non-clinical academics leading nearly half of all NHMRC-funded CAM grants. Conventional medical practitioners led the majority of CAM grants headed by clinicians. Only Chinese medicine and naturopathy practitioners appear to be building capacity, with NHMRC-funded CAM grants led by these practitioner groups increasing. University CAM faculties are for the most part not engaging in high level research, with most NHMRC-funded CAM projects being led by groups outside these faculties. Even the majority NHMRC-funded research led by CAM clinicians is administered outside university CAM faculties. The CAM professions have a low level of engagement with high-level health and medical research in Australia. Current levels of engagement appear to be dependent more on individual clinician involvement rather than professional strategy. Failure to engage with high-level health and medical research may pose challenges for the CAM professions, unless research engagement is improved. This requires an active and concerted effort from within CAM ranks to build research capacity in the CAM professions.

Better rural health through research?

Better rural health through research?

Causal pathways in cerebral palsy

Causal pathways in cerebral palsy

Early career medical research in Australia: looking to the future

[Extract] Australia has a proud history of successful medical research; however, the ageing of the medical research workforce threatens the continued success of these endeavours.

Collaborating with consumer and community representatives in health and medical research in Australia: results from an evaluation.

ObjectiveTo collaborate with consumer and community representatives in the Alcohol and Pregnancy Project from 2006-2008 http://www.ichr.uwa.edu.au/alcoholandpregnancy and evaluate researchers' and consumer and community representatives' perceptions of the process, context and impact of consumer and community participation in the project.MethodsWe formed two reference groups and sought consumer and community representatives' perspectives on all aspects of the project over a three year period. We developed an evaluation framework and asked consumer and community representatives and researchers to complete a self-administered questionnaire at the end of the project.ResultsFifteen researchers (93.8%) and seven (53.8%) consumer and community representatives completed a questionnaire. Most consumer and community representatives agreed that the process and context measures of their participation had been achieved. Both researchers and consumer and community representatives identified areas for improvement and offered suggestions how these could be improved for future research. Researchers thought consumer and community participation contributed to project outputs and outcomes by enhancing scientific and ethical standards, providing legitimacy and authority, and increasing the project's credibility and participation. They saw it was fundamental to the research process and acknowledged consumer and community representatives for their excellent contribution. Consumer and community representatives were able to directly influence decisions about the research. They thought that consumer and community participation had significant influence on the success of project outputs and outcomes.ConclusionsConsumer and community participation is an essential component of good research practice and contributed to the Alcohol and Pregnancy Project by enhancing research processes, outputs and outcomes, and this participation was valued by community and consumer representatives and researchers. The National Health and Medical Research Council in Australia expects researchers to work in partnership and involve consumer and community representatives in health and medical research, and to evaluate community and consumer participation. It is important to demonstrate whether consumer and community participation makes a difference to health and medical research.

Serpentine Science: Charles Kellaway and the Fluctuating Fortunes of Venom Research in Interwar Australia

Australian medical research before the Second World War is predominantly viewed as an anodyne precursor to its conspicuous postwar successes. However, the expanding intellectual appeal and state support for local research after 1945 built upon scientific practices, networks, facilities and finances established between 1919 and 1939. Arguably the most prominent medical scientist working in Australia during this period was Charles Kellaway (1889?1952), director of Melbourne's Walter and Eliza Hall Institute from 1923 until 1944. Facing both financial challenges and a profoundly unsupportive intellectual climate, Kellaway instigated a major research programme into Australian snake venoms. These investigations garnered local and international acclaim, allowing Kellaway to speak as a significant scientific actor while fostering productive laboratory collaborations. The venom work spurred basic research in tissue injury, anaphylaxis and leukotriene pharmacology, yet delivered pragmatic clinical outcomes, particularly an effective antivenene. By selecting a problem of continuing public interest, Kellaway also stimulated wider engagement with science and initiated a pioneering ad hoc Commonwealth grant for medical research. In tracing his training, mentors and practices within the interwar milieu, this article argues that Kellaway's venom studies contributed materially to global biomedical developments and to the broader viability of medical research in Australia.

Ethical dilemmas of a large national multi‐centre study in Australia: time for some consistency

To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits. However, in our clinical practice it is vital that clinical audits are undertaken for evaluation purposes. The findings of this study raise awareness of inconsistent ethical processes and highlight the need for expedient ethical review for clinical audits.

The Sylvia and Charles Viertel Charitable Foundation: a decade of support for medical research in Australia.

The Sylvia and Charles Viertel Charitable Foundation (http://www.alfredresearch.org/external/viertel.htm) recently celebrated its first decade of support for medical research in Australia. Its contribution to Australian medical research has centred on support of outstanding young people through Senior Medical Research Fellowships and a unique grant-in-aid programme for clinical investigators.

Towards an Australian Institute of Trauma Research: learning the lessons of history.

Although medical research in Australia in the 20th century has resulted in a reduction of approximately 95% in the death rate from the infectious and parasitic diseases, there has been no such beneficial outcome in road traffic accidents which, it is here suggested, were out of control from 1948 until 1970. In 1970 several concerned community groups (spearheaded by the Royal Australasian College of Surgeons) campaigned for the introduction of mandatory seat belt wearing. As a consequence of that initiative, and the virtual plethora of subsequent research activities, the road traffic accident rate has declined substantially in the last three decades. The death rate from drownings to toddlers (children under 5) was essentially unchanged until the 1970s when research into toddler pool deaths and the implementation of those research findings resulted in a downturn in toddler drownings in the last two decades. These two examples demonstrate the value of accident research and the implementation of research findings. By analogy with the contributions of the large medical research institutes, the creation of an Australian Institute of Trauma Research seems desirable and is here proposed.

A half-century of Australian health and medical research.

In 1951, the Journal published an overview of medical research in Australia since Federation. This concluded that, with a few notable exceptions, discoveries were few and research funding was paltry. In contrast, in 2001, Australia has become a significant contributor to international medical research. Three Australians have been awarded Nobel Prizes for research performed in Australia, and others have received international awards. Research growth has been driven by the development of the tertiary education sector and independent medical research institutes. Nevertheless, there is no room for complacency.

AN ASSESSMENT OF FUNDING TO SUPPORT RURAL AND REMOTE HEALTH RESEARCH IN AUSTRALIA

A systematic search was undertaken to ascertain the nature, source and extent of funding awarded to research projects that were directed specifically at aspects of rural health over the past decade. Comment is also made on the challenge of obtaining such information directly from databases. The sources investigated were the conventional research funding bodies, hospital trusts and foundations, university funding schemes and government sources. The results of these searches revealed a crude average of 3 million dollars per year from conventional research funding with the remaining sources adding a similar amount in total. Analysis of the data using a framework modified from the Strategic Review of Health and Medical Research in Australia shows that funding is concentrated in the health services and public health areas with a preponderance of funding being directed towards the description of conditions and interventions. Significant levels of funding have been directed towards the National Health Priority Areas.

An Assessment of Funding to Support Rural and Remote Health Research in Australia

A systematic search was undertaken to ascertain the nature, source and extent of funding awarded to research projects that were directed specifically at aspects of rural health over the past decade. Comment is also made on the challenge of obtaining such information directly from databases. The sources investigated were the conventional research funding bodies, hospital trusts and foundations, university funding schemes and government sources. The results of these searches revealed a crude average of 3 million dollars per year from conventional research funding with the remaining sources adding a similar amount in total. Analysis of the data using a framework modified from the Strategic Review of Health and Medical Research in Australia shows that funding is concentrated in the health services and public health areas with a preponderance of funding being directed towards the description of conditions and interventions. Significant levels of funding have been directed towards the National Health Priority Areas.

A review of the use of radio-isotopes in medicine and medical research in Australia (1947–73)

A review of the use of radio-isotopes in medicine and medical research in Australia (1947–73)

A review of the use of radio-isotopes in medicine and medical research in Australia (1947–73)

Recent reports in the Australian media have claimed that after the Second World War 'hundreds of (Australians) were injected with radioactive materials in medical experiments that continued in Australian hospitals until the 1960s'. These claims prompted a review of archival records of the Australian Radiation Laboratory (ARL) that are held by the Australian Archives pertaining to the medical uses of radio-isotopes during the period 1947-73. The material examined indicates that the procurement, distribution, and therapeutic and diagnostic uses of radio-isotopes were stringently controlled by the Radio-isotopes Standing committee (RSC) until 1973, when the responsibility of regulation of medical uses of radio-isotopes passed to the Therapeutic Goods Administration. On the basis of available information it appears that the claims made by the media that many Australians were subjected to unconscionable medical experiments are unjustified. A full report has been released by the Commonwealth Minister for Human Services and Health. The following is an abridged version of that report, detailing some of the more contentious uses of radio-isotopes for medical purposes in Australia during the period 1947-73.