Incidence And Outcome Of Stroke In Rural South Australia
Funder
National Health and Medical Research Council
Funding Amount
$735,541.00
Summary
We propose to undertake a population-based study of the incidence, management and outcome of stroke (survival, disability, recurrent stroke) in geographically defined segments of rural South Australia and compare these with equivalent data, collected during the same period in a defined sector of metropolitan Adelaide. It is hard to over-state the value of this information for planning health services of many kinds for the next decade.
This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
The Real And Changing Atherothrombotic Disease Burden And Secondary Prevention
Funder
National Health and Medical Research Council
Funding Amount
$507,387.00
Summary
Absolute numbers of Australians with diseased narrowed blood vessels in the heart, brain or leg are increasing, dominating health priorities and expenditure. By linking Department of Health datasets, without identifying individual's, trends in hospital admissions, prescription of chronic protective medications and the cost consequences to the health system among and across conditions will be determined. The findings will provide quality measures of hospital care and inform quality improvement
Retinal Vascular Signs As Risk Markers For Incident Stroke Or Cerebrovascular Death: A Population-based Assessment
Funder
National Health and Medical Research Council
Funding Amount
$410,199.00
Summary
Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of ....Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of retinal photographs taken on people who attended the Eye Study during 1992-4 and 5-year follow-up exams during 1997-9. We will grade these photographs manually (using a stereo-viewer), and with computer assistance to measure changes in the diameter of small arteries in the retina and other signs. By closely matching our grading technique to that used in a large American Study, we hope to develop reliable grading for these signs and will be able to compare our findings internationally. Our aim is to assess the frequency of abnormal retinal vessel changes in people of different age groups as well as the development and progression of these signs over time. Their relationship to well known vascular risk factors like smoking, blood pressure, obesity, diabetes and cholesterol will also be investigated. We hope to be able to discriminate those changes associated with an increased stroke risk from those due to normal ageing. We expect that the increased stroke risk associated with abnormal retinal vessel changes may be greater than shown in our early data. If confirmed, then these findings may provide a more sensitive and objective measure of stroke risk than relying on traditional risk factors, which are difficult to quantify and change with time. We may be able to develop simple rules so that doctors using an ophthalmoscope or examining a retinal photograph could identify high risk patients. These people could benefit from interventions to reduce their risk.Read moreRead less
Trials To Prevent The Transmission And Complications Of Sexually Transmitted Infections, Including HIV
Funder
National Health and Medical Research Council
Funding Amount
$306,123.00
Summary
Sexually transmitted infections (STIs) are important causes of illness in some sectors of the community. Even though they can be effectively prevented and treated, many health services do not give them priority. This research project will study ways in which general practitioners can better diagnose and treat STIs. We will carry out trials that compare new approaches to supporting doctors in this area, that involve a mixture of training, reminders and technical support as needed.
Metabolic Syndrome, Inflammation And Non-alcoholic Fatty Liver Disease In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$351,300.00
Summary
The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic synd ....The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic syndrome and fatty liver disease may be on the increase and therefore so too could diabetes and heart disease which already consume significant health resources. Using the unique health data collection of the Busselton Health Study in Western Australia, this project will help to determine how common these conditions are in Australia and lead to a better understanding of the nature and causes of these conditions including the possible role of chronic inflammation. This important information will be used to provide opportunities for better risk assessment, disease prevention, and earlier intervention.Read moreRead less
Inter-relationships Between Life-stage Transitions, Depression And Cardio-metabolic Health In Young Adults
Funder
National Health and Medical Research Council
Funding Amount
$360,325.00
Summary
This study will investigate how social transitions and depression in young Australian adults affect the development of obesity and the adoption or persistence of behaviours that are associated with the risk of heart disease and diabetes. These behaviours include smoking, poor diet, physical inactivity and alcohol consumption. A better understanding of how psychosocial factors influence risk factors for heart disease and diabetes is needed to improve prevention strategies.
Adaptations Of Methods For Estimation Of Familial Correlation In Age At Onset Of Disease
Funder
National Health and Medical Research Council
Funding Amount
$146,250.00
Summary
Chronic diseases such as coronary heart disease, breast cancer, prostate cancer and non-insulin dependent diabetes are responsible for a significant burden of ill-health in society. Studies of familial aggregation are important in determining the relative magnitude of genetic and lifestyle-environment factors associated with chronic diseases, and in identifying individuals and families at high risk, even in the absence of conventional risk factors. The findings have implications for health promo ....Chronic diseases such as coronary heart disease, breast cancer, prostate cancer and non-insulin dependent diabetes are responsible for a significant burden of ill-health in society. Studies of familial aggregation are important in determining the relative magnitude of genetic and lifestyle-environment factors associated with chronic diseases, and in identifying individuals and families at high risk, even in the absence of conventional risk factors. The findings have implications for health promotion in the general population and disease prevention in those identified to be at high risk. An outstanding characteristics of these studies is that many participants had an event at some unknown time before the entry. This project aims at adapting current methods to properly account for events before entry and to provide estimates of familial aggregation between parents, between children and between parents and children in the same model. Furthermore, it provides freely available software for proper familial analyses which have not had any feasible numerical methods (or software). In addition, it provides estimates of familial aggregation of coronary heart disease in Busselton families which has longer follow-up than most other studies. This project is very cost effective as the Busselton Health Study consists of a series of cross-sectional surveys since 1968 and currently has hospital morbidity and death follow-up from medical record linkage until the end of 1997.Read moreRead less