Health Outcomes Of Older Indigenous Australians- A 5 Year Follow Up Study Of A Population At Risk
Funder
National Health and Medical Research Council
Funding Amount
$833,759.00
Summary
The health of Indigenous people is poor and a number of risk factors contribute to lower life expectancy and the development of 'aged care syndromes' such as falls, incontinence, and dementia at a younger age. The research team has described high levels of dementia in a population survey completed in 2005 on 363 older people from the Kimberley. This population will be re-surveyed to document ageing syndromes and determine factors that may improve health for this population at risk
A New Model For The Pathogenesis Of Rheumatic Fever: Superantigen Priming Of The Immune Response To Group A Streptococci
Funder
National Health and Medical Research Council
Funding Amount
$248,820.00
Summary
Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, c ....Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, control of this ARF will partly depend on new and better treatment and prevention strategies. To achieve these goals a deeper understanding of the immune mechanisms underlying this disease is urgently needed. It is known that ARF is caused by an abnormal immune response following streptococcal infection. This leads to the production of cells called T cells that attack the body s own tissues rather than the bacteria itself. This autoimmune disease is responsible for the heart damage that underlies ARF. It is believed that this proces only occurs when susceptible individuals are infected with specific rheumatogenic strains of streptococci. However there are a number of deficiencies in this model and it is proposed that there is an additional factor responsible for the abnormal immune response in ARF. This project will explore the possibility that bacterial toxins called superantigens are the critical missing factor , by studying the immune response in ARF. Superantigens are produced by certain streptococci and staphylococci, and are potent in minute quantities causing widespread activation of the immune system. They have been found to play an important role in a number of autoimmune diseases and the type of immune response found in ARF fits well with that expected if superantigens were involved. If superantigens play an important role in causing the abnormal immune response in ARF then a number of new avenues would open for the treatment and prevention of this disease.Read moreRead less
The Feasibility And Effectiveness Of A Family-based Intervention For Indigenous Australians With Alcohol Dependence.
Funder
National Health and Medical Research Council
Funding Amount
$218,291.00
Summary
This study aims to determine the feasibility of implementing a family-based intervention in an Indigenous community-controlled health service in rural NSW and it's level of acceptability to Indigenous patients. The expected main benefits of implementing the family-based intervention are increases in the percentage of Indigenous individuals with alcohol dependence entering and engaging in evidence-based treatment.
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
Amoxycillin For Persistent Nasal Discharge In Rural And Remote Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$226,738.00
Summary
Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical tri ....Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical trial will measure the impact of antibiotic treatment on persistent nasal discharge and rates of transmission of bacterial respiratory pathogens. An innovative study design will test the efficacy of twice daily doses of amoxycillin on newly developed clinical and bacteriological outcome measures. Both the investigators and the Aboriginal community have considerable experience in conducting this type of research and are committed to using a cooperative model of clinical research to reduce disease burden. Ongoing training of Aboriginal health workers in the principles of clinical epidemiology is an essential component of this process. This study will make an important contribution to the medical literature. Despite the deaths of around 10,000 children children from acute respiratory infections each day, very little is known about how antibiotics affect the transmission of some of the principal causative organisms. This project will greatly assist the development of appropriate antibiotic prescribing practices in high-risk populations.Read moreRead less
Body Mass Index And Mortality In Aboriginal Australians In Northern Territory: A Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$136,220.00
Summary
The ultimate goal of this study is to define a healthy weight range for Aboriginal people. To fulfil this goal, we will investigate the health implications of body weight and weight change in Aboriginal communities. We will assess the association between body weight (as measured by body mass index) and the risk of death by examining how the death rate changes with body weight. The findings will have important implications for health professionals to provide adequate advice to Aboriginal Australi ....The ultimate goal of this study is to define a healthy weight range for Aboriginal people. To fulfil this goal, we will investigate the health implications of body weight and weight change in Aboriginal communities. We will assess the association between body weight (as measured by body mass index) and the risk of death by examining how the death rate changes with body weight. The findings will have important implications for health professionals to provide adequate advice to Aboriginal Australians, and for Aboriginal people to adopt a healthy life style in relation to body weight. Due to the differences in body shape and physiological and environmental factors between Aborigines and other populations, the optimal body weight obtained from other populations may not be applicable to Aboriginal communities. Do males and females have different optimal body weights? Do old and young people have different optimal body weights? This study will provide evidence for answering various questions like these. Individuals with different characteristics may have different optimal body weight values. Such information is useful for the development and modification of dietary guidelines for Aboriginal Australians. The results on the health impact of weight change are important for guiding weight control programs in Aboriginal communities.Read moreRead less
Judicious Use Of Antibiotics For Acute Otitis Media In Aboriginal Children: A Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$614,840.00
Summary
Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important ....Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important implications for their education. The aim of this study is to determine whether a new longer-acting antibiotic will be more effective in treating young Aboriginal children with new ear infections and therefore prevent the progression to chronic suppurative otitis media. The involvement of up to 20 Aboriginal communities in this well-designed clinical trial represents a major advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide training in ear examination and appropriate medical management. Swabs from the nose will be taken to monitor the effect of antibiotics on the rates of antibiotic resistance. The results from this study will be directly relevant to evidence-based guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.Read moreRead less