Confirming The Burden Of Disease Associated With Dementia Using New Empirically Driven Australian Based Disability Rati
Funder
National Health and Medical Research Council
Funding Amount
$138,084.00
Summary
The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden e ....The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden estimates. First, the dementia calculations currently use a “disability weight” metric derived from a Dutch study. This is problematic in that the weights do not reflect an Australian experience of dementia, nor do they reflect the preferences of people closely affected by the disease (e.g. carers). Second, the dementia estimates do not include cases of mild cognitive impairment (considered a precursor state of dementia). Hence the dementia estimates may not estimate the full impact of dementia in Australia. Finally, there is no evidence that the method used by the Burden of Disease study to account for the impact of disease comorbidity adequately deals with the comorbidity associated with dementia. Consequently, there is need to develop a new and comprehensive set of disability weights for dementia that are Australian-based, include all stages of dementia severity and account for comorbidity. The proposed project aims to develop a new set of empirically derived Australian-based disability weights for dementia. The project will entail three studies. The first study will generate empirically based case vignettes that describe a range of dementia case scenarios. These descriptions will then be used in rating exercises (Study 2) to develop new disability weights. The second study involves Australian health practitioners, carers and lay persons reading case vignettes and completing health valuation rating exercises to generate new disability weights for dementia. The third study uses the new disability weights to re-calculate the burden of disease estimates for dementia. The new estimates will be compared to those reported by the 2007 Australian Burden of Disease project. In knowing the accuracy of the estimates, policy makers can use the burden data for dementia with confidence when engaging in service planning for the future.Read moreRead less
Palliative Care Constituency, Utilisation & Impact On Health Care: A Western Australia Based Epidemiology & Sociological
Funder
National Health and Medical Research Council
Funding Amount
$150,000.00
Summary
Using the Western Australian linked database and in consultation with palliative care service providers, the study will: 1. Study patterns of palliative care delivery during the last 12 months of life, comparing utilisation between different socio-demographic groups and cause of death. 2. Study the relationships between the services provided and the terminally ill. 3. Develop a definition of those who utilise designated palliative care programs and apply it to ....Using the Western Australian linked database and in consultation with palliative care service providers, the study will: 1. Study patterns of palliative care delivery during the last 12 months of life, comparing utilisation between different socio-demographic groups and cause of death. 2. Study the relationships between the services provided and the terminally ill. 3. Develop a definition of those who utilise designated palliative care programs and apply it to the population of Western Australia in 1994-1999. 4. Develop a forecasting model to optimise the planning and delivery of palliative care service in Australia.Read moreRead less
A Computer Model Of Service Delivery For Behavioural And Psychological Symptoms Of Dementia: A Tool For Policy Makers An
Funder
National Health and Medical Research Council
Funding Amount
$400,108.00
Summary
Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementi ....Behavioural and psychological symptoms of dementia (BPSD) affect approximate 90% of persons with dementia. BPSD include depression, aggression and psychosis and have negative effects on persons with dementia and carers. Management of BPSD is costly. This project will update and enhance our theoretical model of service delivery for BPSD by turning it into a computer-based model to assist health managers and policy makers. This model will incorporate the projected increase in prevalence of dementia and project associated costs of care into the future. It will also incorporate information about interventions for BPSD, and how they may affect prevalence and cost in the future.Read moreRead less
Models Of Care To Address Unmet Of Older Indigenous With Dementia Their Families And Communites Living In Remote WA
Funder
National Health and Medical Research Council
Funding Amount
$1,081,060.00
Summary
The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. O ....The health and unmet needs of older Indigenous people, particularly in remote and rural areas is generally under researched. It is well known that the life expectancy of indigenous people is approximately 20 years younger than non-Indigenous counterparts. Many illnesses generally experienced by non Indigenous people in older ages (e.g. 75 years) are seen at a much younger age in Indigenous populations. These conditions include dementia, falls, incontinence, premature heart disease and strokes. Over the last 4 years the applicants of this project have started to address some of the health related problems faced by older Indigenous people, particularly the challenging area of dementia. The authors have developed a culturally appropriate assessment tool to help determine if an older Indigenous person has dementia. This has been very successful and is now frequently used by health professionals in remote and rural areas of Australia. A survey is in the final stages of completion to determine the estimated number of people in remote areas of the Kimberley who manifest signs and symptoms of dementia and associated old age diseases. Preliminary data sadly indicate that the frequency of dementia is higher than expected for people of this age group. The next phase of this project is to determine the unmet needs of this vulnerable group, by interviewing those with dementia and their families, communities and service providers in remote areas of Kimberley and Pilbara. This will determine culturally appropriate and practical ways to provide care to assist those with this condition and their families and communities.Read moreRead less
Statistical Methods And Algorithms For Analysis Of High-throughput Genetics And Genomics Platforms
Funder
National Health and Medical Research Council
Funding Amount
$1,557,500.00
Summary
Through rapid advances in high-throughput -omics technologies, the number of phenotypes and the number of genotypes in gene mapping studies are or will be orders of magnitudes larger than in previous studies. Current algorithms and analysis methods have not kept up with the speed of data collection, nor has the training of qualified researchers. We will develop quantitative trait loci (fine) mapping analysis methods and bioinformatics algorithms and train (post)graduates in these research areas.
Roots Of Resilience: Transformations Of Identity And Community In Indigenous Mental Health
Funder
National Health and Medical Research Council
Funding Amount
$15,000.00
Summary
We propose to develop a cross-country interdisciplinary research program on factors and processes that promote resilience in mental health among indigenous peoples across the lifespan, with an emphasis on early childhood, school age children, adolescence and young adulthood. We will carry out a set of linked projects to identify the distinctive characteristics of individual and collective resilience among indigenous peoples in the three countries. This linkage of studies will occur in three ways ....We propose to develop a cross-country interdisciplinary research program on factors and processes that promote resilience in mental health among indigenous peoples across the lifespan, with an emphasis on early childhood, school age children, adolescence and young adulthood. We will carry out a set of linked projects to identify the distinctive characteristics of individual and collective resilience among indigenous peoples in the three countries. This linkage of studies will occur in three ways: (1) developing a comprehensive model of resilience at individual, family, community and societal levels that can be applied across the three countries; (2) designing multi-method studies of the same population so that results can be triangulated for greater validity of interpretation of results; (3) using cross-national comparisons to examine potential social structural, cultural and historical differences in the processes of resilience. The projects will include clinical, community and population-based studies of resilience using both qualitative life history and ethnographic methods and quantitative analysis of epidemiological data. The collaborating investigators have developed specific methods for studies of resilience in different age groups, including: parenting and family environment during infancy and early childhood; school-based research on outcomes of performance and retention; community-based ethnographic research on individual life trajectories; social historical research on community responses to adversity; and population-based research on longitudinal datasets. Throughout these studies our emphasis will be on identifying what may be distinctive about the experience of indigenous peoples so that research on resilience can be appropriately interpreted and applied to improve the health of these populations.Read moreRead less
Research has shown that psychosocial and behavioural processes of networks can result in better health status among and between non-Indigenous populations. In Australia, Canada and New Zealand Indigenous health organizations and networks have formed to combat health disparities and advance opportunities for Indigenous populations. Little is know about the social, economic, cultural and political life-course of such networks in a �post-colonial� environment, or whether these contribute to �resili ....Research has shown that psychosocial and behavioural processes of networks can result in better health status among and between non-Indigenous populations. In Australia, Canada and New Zealand Indigenous health organizations and networks have formed to combat health disparities and advance opportunities for Indigenous populations. Little is know about the social, economic, cultural and political life-course of such networks in a �post-colonial� environment, or whether these contribute to �resiliency� in health workers, researchers and policy developers that is translated into improved health for Indigenous populations. Historically the resiliency literature has viewed resilience as a fixed attribute of individuals. Some inroads have been made in defining resilience relative to social and cultural collective contexts. However, no study defines resiliency from an Indigenous perspective or within the context of networks and resilience generally. This study will develop Indigenous constructs of �resiliency� from a decolonized and non-deficit perspective for Indigenous health workers, researchers and policy developers, and will examine how networks and �resiliency� intersect. It will further explore whether Indigenous health worker, researcher and policy developer networks may be important mediators in laying a foundation for good health throughout life for Indigenous peoples. Constructs of �resiliency� specific to each country and across countries will be identified from themes that arise from key informant interviews. Comparative projects in each country will be designed to evaluate the impact of these networks on improving health status and combating health problems such as diabetes mellitus. These Indigenous constructs of �resiliency� will inform the ICIHRP research program intended to improve Indigenous health status.Read moreRead less