NHMRC’s National Institute of Clinical Studies is pleased to announce the awarding of seven 2007 NICS Fellowships to help improve the use of evidence in key health areas.
NICS gratefully acknowledges the support of our funding partners:
Department of Veterans’ Affairs, Victoria’s Transport Accident Commission, and HCF (Hospitals Contribution Fund) Health and Medical Research Foundation.
Mr John Cannell
NICS Fellow
Rehabilitation Physiotherapy Supervisor, Launceston General Hospital, Tasmania
Project: Achieving optimal arm function in people rehabilitating following stroke
Ensuring best possible arm function in people rehabilitating from stroke is the goal of Mr Cannell's project. Stroke is the second highest cause of death in adult Australians. It is also one of the leading causes of disability, affecting over 345,000 people. While an average of 70 per cent of stroke survivors are able to walk, only a third of those who suffer arm weakness as a result of stroke recover functional usage of their arm.
Six evidence-based treatment strategies will be implemented to improve outcomes for people who have arm weakness following a stroke. These include Functional Electrical Stimulation, Constraint Induced Movement Therapy and Group Therapy. Training packages will be developed as part of this project and will be shared with other hospitals and rehabilitation providers around Australia.
Dr Bridget Hamilton
NICS Fellow
Lecturer, University of Melbourne, Victoria
Project: Reducing the use of seclusion in acute inpatient mental health care
Patients in acute psychiatric units identified by staff as being at risk of either harming themselves or others, are sometimes placed in a room which cannot be opened from the inside. This practice is known as seclusion and is an intervention of last resort as it can cause patient distress and result in injury to staff or patients. There is growing evidence that seclusion should be minimised but current rates in Victorian services suggests it is not always an action of last resort.
This project, undertaken at St Vincent's Hospital, Victoria, aims to reduce inappropriate seclusion by introducing a range of alternative strategies and a program of support to inpatient teams. The strategies have been successfully implemented overseas and include organisation leadership and support of the project, use of seclusion data, seclusion reduction tools, consumer involvement and staff training and debriefing.
- Bridget Hamilton Fellowship Profile (PDF, 74KB)
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Media Release 28.03.07 - Bridget Hamilton (PDF, 54KB)
Clinical Associate Professor Charles Inderjeeth 
NICS-Department of Veterans' Affairs Fellow
Geriatrician and Rheumatologist, Sir Charles Gairdner Hospital, Western Australia
Project: Improving awareness, investigation and management of osteoporosis in women presenting with a fracture
Osteoporosis costs the Australian health care system more than seven billion dollars annually, affecting one in two women and one in three men aged over 60 years. Osteoporosis resulting in fragility fracture is a common and increasing problem, especially amongst post-menopausal women.
The impact of osteoporosis can be significant. Fragility fractures that result are associated with disability, increased mortality and future fracture risk.
There are evidence-based Australian and International guidelines for the management of patients with osteoporosis with and without fracture. However, patients with previous fragility fracture remain untreated.
Improving awareness of osteoporotic fracture risk among patients with fracture and their clinicians is an important strategy. This project therefore targets patients presenting to hospital with a fracture. They are provided with an information sheet alerting them to their risk of osteoporosis and recommending review of their osteoporosis risk with their medical practitioner (improving patient awareness). In addition they are provided with an “Osteoporosis Management Guideline”which they are encouraged to take to their medical practitioner (improving GP awareness and management).Combined with this there will be a survey of medical practitioner attitudes and knowledge on osteoporosis and an education and awareness program through the local medical institution and the Divisions of General Practice.
Associate Professor Inderjeeth's fellowship is supported by the Department of Veterans' Affairs (DVA).
- Charles Inderjeeth Fellowship Profile (PDF, 90KB)
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Media Release 28.03.07 - Charles Inderjeeth (PDF, 55KB)
Mr Terry Marshall 
NICS-Transport Accident Commission Fellow
Clinical Support Officer, Metropolitan Ambulance Service, Victoria
Project: Improving the assessment and management of acute pain by ambulance services.
There is strong evidence as to the most effective means of measuring and treating pain after trauma, and an opportunity to improve in current practice in the pre-hospital setting.
Mr Marshall's fellowship is supported by the Transport Accident Commission (TAC).
Associate Professor Danielle Mazza 
NICS-HCF Foundation Fellow
Department of General Practice, Monash University, Victoria
Project: Promoting periconceptual folate supplementation in general practice in order to reduce neural tube defects
Despite evidence that folate supplementation can prevent 70 per cent of all cases of neural tube defects like spina bifida, less than 50 per cent of women take folate prior to and during the first three months of pregnancy (periconceptual period). This project will include research with general practitioners and women to identify barriers to improving the delivery and uptake of periconceptual care, including the increase of folate supplementation. The findings will be applied to improve maternal and neonatal outcomes.
Associate Professor Mazza's fellowship is supported by the HCF Health and Medical Research Foundation.
Dr Annie McCluskey
NICS-HCF Foundation Fellow
Senior Lecturer, University of Sydney, New South Wales
Project: Increasing outdoor journeys and the community participation of people with stroke
Many people with stroke are socially isolated and cannot easily get out into the community. These individuals may be isolated because of reduced mobility, an inability to drive and/or communication difficulties caused by their stroke. Evidence-based guidelines from the National Stroke Foundation suggest the provision of occupational therapy home and community visits can double the number of outdoor journeys taken by people with stroke. Therapy sessions can help people to gain confidence crossing roads, negotiate busy shopping centres, and in some cases, return to driving.
The aim of this project is to help two community stroke rehabilitation teams in Sydney South West to implement these visits and therapy sessions, as recommended in the national guidelines. These teams, in particular the occupational therapists, will provide a series of visits focussed on transport and community mobility to help people with stroke overcome social isolation and get out into the community.
Dr McCluskey's fellowship is supported by the HCF Health and Medical Research Foundation.
Ms Bhavini Patel
NICS-HCF Foundation Fellow
Director of Pharmacy, Royal Darwin Hospital, Northern Territory
Project: Improving management of chronic kidney disease in remote Indigenous communities
The incidence of chronic kidney disease is increasing in Australia, most significantly amongst Indigenous Australians, with rates in remote areas being 35 times higher than amongst non-Indigenous Australians. When the kidneys fail, a person must receive a transplant or their blood must be cleansed of waste artificially (dialysis). There is strong evidence that effectively managing high blood pressure can delay the need for dialysis, a treatment which in remote areas, can require long distance travel to access services and result in separation from family, social and cultural support. There is also strong evidence that an arteriovenous (AV) fistula is the most effective means of providing permanent access to veins in people starting dialysis. When best practice is not applied, there is a significant psychological and financial cost to the individuals and their community.
This project aims to implement and evaluate a care coordination model which uses quality improvement interventions to address both these issues. These improvements aim to provide sustainable solutions to the management of chronic kidney disease in remote communities.
Ms Patel's fellowship is supported by the HCF Health and Medical Research Foundation.