THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
The Construction And Validation Of The Assessment Of Mental Health Related Quality Of Life (PsyQoL) Instrument
Funder
National Health and Medical Research Council
Funding Amount
$539,450.00
Summary
Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the ....Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the measurement of 'utility' or 'quality of life'. The small number of 'generic' 'quality of life instruments' developed to date vary significantly in their 'sensitivity' to different illnesses-their ability to detect change-and none is very sensitive to changes in mental health states. The present project is to overcome this deficit. This will be achieved by refining and expanding an instrument developed in Australia, the Assessment of Quality of Life (AQoL) instrument. This is the only instrument to date which was both constructed using correct psychometric principles of instrument construction and which describes health states in terms of the effect upon a patient's ability to function in a social environment. The new instrument called the PsyQoL will increase instrument sensitivity by including a mental health 'module' to the existing instrument and revising existing items. The methods used will include several methodological innovations in the description of health states and the derivation of utility scores. The project will include a large scale 'validation' study which will include the construction of population 'norms' and also the creation of 'exchange rates' between the PsyQoL and other instrument scores. The significance of the project is that the PsyQoL will allow valid and reliable measurement of health states in a way that creates a 'level playing field' between mental and other health related interventions.Read moreRead less
Smoking Cessation For Youth Project Booster And Cohort Tracking Study
Funder
National Health and Medical Research Council
Funding Amount
$135,550.00
Summary
Adolescence is a critical period for the establishment of adult drug use behaviours. If smoking does not commence in teenage years it is unlikely to occur. This innovative project not only continues to address tobacco control with this important age group but also builds on evidence from a randomised intervention trial involving over 4,000 Year 9 students tracked over two years. This project was called the Smoking Cessation for Youth Project (SCYP). Preliminary longitudinal analyses of the SCYP ....Adolescence is a critical period for the establishment of adult drug use behaviours. If smoking does not commence in teenage years it is unlikely to occur. This innovative project not only continues to address tobacco control with this important age group but also builds on evidence from a randomised intervention trial involving over 4,000 Year 9 students tracked over two years. This project was called the Smoking Cessation for Youth Project (SCYP). Preliminary longitudinal analyses of the SCYP data indicate that the intervention students were significantly less likely to smoke heavily (smoking five or more days per week) than the control group and that intervention students were also significantly less likely to have tried smoking than the control group. These results represent a world first in evidence that population-based smoking cessation interventions among teenagers can be successful. The proposed project will determine the extent to which these positive intervention effects are sustainable, two years post intervention, as our cohort moves into Year 12. In addition to tracking the possible decay of SCYP intervention effects, the proposed project will also measure the effects of a booster intervention delivered students when they are in Year 12 (2002). The Year 12 intervention will comprise an innovative self-help 'magazine style' booster and a supportive environmental intervention involving school nurses and local GPs. This proposal represents a cost-effective opportunity to measure the effectiveness of a Year 12 tobacco cessation booster intervention. Further data on tobacco smoking behaviour in 2002 will also enable us to determine how long the SCYP intervention appears to affect behaviour and whether 'boosters' are needed in later secondary school years to maintain the benefits.Read moreRead less
Antimalarial Drugs In Pregnancy: Preclinical And Clinical Studies Of Conventional And Novel Agents
Funder
National Health and Medical Research Council
Funding Amount
$470,115.00
Summary
Women in malaria-endemic areas such as coastal PNG are at high risk of malaria in pregnancy. To prevent the substantially increased malaria-associated morbidity and mortality in mother and child, and because even asymptomatic infections can be deleterious, there has been a move to giving antimalarial drugs regularly during pregnancy regardless of the mother's clinical or parasitological status. In poor tropical countries, such treatment usually comprises safe and inexpensive agents such as chlor ....Women in malaria-endemic areas such as coastal PNG are at high risk of malaria in pregnancy. To prevent the substantially increased malaria-associated morbidity and mortality in mother and child, and because even asymptomatic infections can be deleterious, there has been a move to giving antimalarial drugs regularly during pregnancy regardless of the mother's clinical or parasitological status. In poor tropical countries, such treatment usually comprises safe and inexpensive agents such as chloroquine and Fansidar. There are two main issues with this approach. First, the efficacy of such conventional agents is waning and this increases the risk of break-through malaria. Second, there are few data on how the drugs are handled in pregnancy on which to base recommendations for treatment. We plan to collect information on the disposition and effectiveness of chloroquine and Fansidar in women with malaria in pregnancy in PNG that should allow a critical appraisal of the usefulness of current regimens in PNG and in other tropical countries where parasite resistance to these agents is emerging. Artemisinin combination therapy (ACT) in the form of a novel artemisinin drug and a longer-acting partner has been suggested as the most promising alternative therapy for malaria in pregnancy if conventional drugs fail. We plan to assess the safety of a leading ACT formulation, namely dihydroartemisinin and the chloroquine-like drug piperaquine (DHA-PQ), in animals before extending our studies to women with malaria in PNG. These latter studies will allow an evaluation of the safety and efficacy of DHA-PQ as novel therapy for malaria in pregnancy in PNG and other tropical countries.Read moreRead less
An RCT To Promote Healthy Lifestyle Behaviours From Infancy: An Intervention To Prevent Childhood Overweight
Funder
National Health and Medical Research Council
Funding Amount
$578,631.00
Summary
In Australia, one in four school-aged children is currently overweight and childhood obesity rates are continuing to rise. In the last five years it has become clear that rates of overweight and obesity are also rapidly increasing in pre-school age children. These are issues that are of concern to health officials as well as to parents. We understand that these rising rates in fatness relate to children's diet and activity patterns, and that these patterns, once established are likely to be patt ....In Australia, one in four school-aged children is currently overweight and childhood obesity rates are continuing to rise. In the last five years it has become clear that rates of overweight and obesity are also rapidly increasing in pre-school age children. These are issues that are of concern to health officials as well as to parents. We understand that these rising rates in fatness relate to children's diet and activity patterns, and that these patterns, once established are likely to be patterns for life. To date, there has been relatively little research regarding the chance to support parents to establish the eating and activity patterns that will protect their children from the very beginning of life. This project seeks to support first-time parents to establish healthy eating and activity behaviours in their children using the highly utilised Maternal and Child Health Centres first time parents' groups. We believe that these groups will provide a strongly supportive environment in which to provide parents with strategies and knowledge for promoting healthy eating and activity patterns for their children, and in turn, promote healthy weight gain. This project will assess the effectiveness of this intervention.Read moreRead less
Pandemic Influenza Containment Strategies In Aboriginal Communities: What Is Acceptable And Feasible?
Funder
National Health and Medical Research Council
Funding Amount
$1,056,688.00
Summary
Influenza is a serious disease with a much greater impact in Indigenous communities. This project will work with Aboriginal communities in NSW, north Qld and WA on modifying the national pandemic influenza plan to develop control strategies that are acceptable to the culture and circumstances of those communities. A template and acceptable process will then be offered to other Indigenous communities, finally leading to negotiation to modify implementation of pandemic influenza plans.
RCT Of The Impact Of Electronic Game Use By Children On Physical Activity And Energy Expenditure
Funder
National Health and Medical Research Council
Funding Amount
$538,135.00
Summary
Increasing childhood obesity and reduced physical activity are major health issues in Australia. Three quarters of Australian children play electronic games and this is widely thought to reduce their physical activity. Whilst the effect of TV viewing is well understood, the impact of electronic games is not. This study will test whether access to electronic games results in decreased physical activity in children. We need to understand the impact this popular activity is having on child health.
Pathways To Mental Health And Obesity In Young Adults: A Longitudinal Study
Funder
National Health and Medical Research Council
Funding Amount
$698,510.00
Summary
While the health of the population has been gradually improving, there are some health problems which are increasing. The mental health of young people is one such area. Based on data relating to youth suicide, substance abuse, cigarette smoking by females and behavioural or mental health problems in the young, there has been evidence of a marked increase in some important health problems faced by the young. Little is known about the causes of these problems and even less is known about the reas ....While the health of the population has been gradually improving, there are some health problems which are increasing. The mental health of young people is one such area. Based on data relating to youth suicide, substance abuse, cigarette smoking by females and behavioural or mental health problems in the young, there has been evidence of a marked increase in some important health problems faced by the young. Little is known about the causes of these problems and even less is known about the reasons for the increase. Based on the available evidence, 20-25% of young persons manifest a mental health problem. A second area of marked health deterioration concerns youth (and adult) obesity. Existing research points to the accumulation of cardiovascular risk factors associated with obesity from a very early age. Over 10% of youth are obese and a substantially higher proportion are overweight. There is evidence that the rate of obesity has been substantially increasing. Again little is known about the factors that contribute to obesity or the causes of the increase in the rates of obesity in the population. This proposal is for a 21-year follow-up of a sample of youth first enrolled when their mothers attended for their first obstetrical visit. Using a substantial body of existing data, we propose to examine the changes in levels of mental health and obesity and to identify the factors which contribute to these changes. This study involves the largest Australian cohort ever assembled for such research. The main questions asked in this study concern the impact of the mother's social and economic circumstances, her physical health and well-being, her use of addictive substances (including alcohol, cigarettes, illicit drugs) on the youth's health. We will also examine the association between early indicators of mental health and well-being and subsequent youth health and development.Read moreRead less
Geelong Osteoporosis Study: Fracture Risk Prediction Based On Twenty Years Of Prospective Data.
Funder
National Health and Medical Research Council
Funding Amount
$1,107,758.00
Summary
In this population-based study we will generate evidence, both environmental and genetic, for defining fracture risk in Australian men and women. This will help identify individuals likely to sustain fragility fractures so that suitable therapies can be recommended. The data will be useful for developing prognostic models in both a clinical setting and for genetic screening programmes.