http://hdl.handle.net/2328/26053 2013-05-24T04:41:01Z http://hdl.handle.net/2328/26676 Title: How effective are programs at managing transition from hospital to home? A case study of the Australian transition care program Authors: Gray, Leonard C; Peel, Nancye M; Crotty, Maria; Kurrle, Susan E; Giles, Lynne Catherine; Cameron, Ian D Abstract: An increasing demand for acute care services due in part to rising proportions of older people and increasing rates of chronic diseases has led to new models of post-acute care for older people that offer coordinated discharge, ongoing support and often a focus on functional restoration. Overall, review of the literature suggests there is considerable uncertainty around the effectiveness and resource implications of the various model configurations and delivery approaches. In this paper, we review the current evidence on the efficacy of such programs, using the Australian Transition Care Program as a case study. Discussion: The Australian Transition Care Program was established at the interface of the acute and aged care sectors with particular emphasis on transitions between acute and community care. The program is intended to enable a significant proportion of care recipients to return home, rather than prematurely enter residential aged care, optimize their functional capacity, and reduce inappropriate extended lengths of hospital stay for older people. Broadly, the model is configured and targeted in accordance with programs reported in the international literature to be effective. Early evaluations suggest good acceptance of the program by hospitals, patients and staff. Ultimately, however, the program’s place in the array of post-acute services should be determined by its demonstrated efficacy relative to other services which cater for similar patient groups. Summary: Currently there is a lack of robust evaluation to provide convincing evidence of efficacy, either from a patient outcome or cost reduction perspective. As the program expands and matures, there will be opportunity to scrutinise the systematic effects, with lessons for both Australian and international policy makers and clinical leaders. 2012-03-14T00:00:00Z http://hdl.handle.net/2328/26673 Title: The relationship between quality of life, health and care transition: an empirical comparison in an older post-acute population Authors: Couzner, Leah; Ratcliffe, Julie; Crotty, Maria Abstract: The aim of this study was to explore, via empirical comparison, the relationship between quality of life, as measured by the ICECAP-O capability index (a new instrument designed to measure and value quality of life in older people), with both self-reported health status and the quality of care transition in adults aged 65 and over participating in two post-acute rehabilitation programs (outpatient day rehabilitation and the Australian National Transition Care residential program). 2012-06-15T00:00:00Z http://hdl.handle.net/2328/26330 Title: The FLASSH study: protocol for a randomised controlled trial evaluating falls prevention after stroke and two sub-studies Authors: Batchelor, Frances A; Hill, Keith D; Mackintosh, Shylie; Said, Catherine M; Whitehead, Craig Hamilton Abstract: This randomised controlled trial aims to evaluate the effectiveness of a multi-factorial falls prevention program for stroke survivors who are at high risk of falling when they return home after rehabilitation. Intervention will consist of a home exercise program as well as individualised falls prevention and injury minimisation strategies based on identified risk factors for falls. Additionally, two sub-studies will be implemented in order to explore other key areas related to falls in this population. The first of these is a longitudinal study evaluating the relationship between fear of falling, falls and function over twelve months, and the second evaluates residual impairment in gait stability and obstacle crossing twelve months after discharge from rehabilitation. 2009-01-01T00:00:00Z http://hdl.handle.net/2328/26054 Title: Dietary intervention to lower serum cholesterol Authors: Clifton, Peter; Colquhoun, David; Hewat, Claire; Jones, Peter; Litt, John Charles; Noakes, Manila; O'Brien, Richard; Shrapnel, Bill; Skeaff, Murray Abstract: Interventions that lower LDL-C lower the risk of cardiovascular disease. Comprehensive dietary intervention is indicated in all patients with an absolute 5 year risk for coronary disease of 10% or greater. Short term trials indicate that these interventions have the potential to lower LDL-C by approximately 20%. A year long trial has shown mean LDL-C lowering of 13%, with about one-third of subjects achieving a reduction greater than 20%, highlighting the importance of adherence to dietary advice. The most effective dietary strategies are replacing saturated and trans fatty acids with poly- and monounsaturated fats and increasing intake of plant sterols. Losing weight and increasing soluble fibre and soy protein intake can also lower serum cholesterol and may be considered when recommending a nutritionally balanced, cholesterol lowering diet. Motivational interviewing by general practitioners can improve the effectiveness of brief, behaviour orientated advice and dietary counselling to lower serum cholesterol. 2009-01-01T00:00:00Z