Effective Management Of Acute Whiplash Injuries Requires A Pragmatic Approach: An RCT With Stratified Treatments
Funder
National Health and Medical Research Council
Funding Amount
$382,550.00
Summary
Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. ....Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. Transition from an acute to a chronic condition must be prevented. A new direction in management in the acute stage is urgently required as once the pain has become chronic, it is difficult to help. This research will conduct a novel randomised controlled trial for acute whiplash. It will test individually prescribed multi-professional management against usual care with the aim to lessen the numbers who go on to develop chronic pain. It will be the first clinical trial that acknowledges from the outset that the whiplash injuries and affects people in different ways. Our previous research with acute whiplash patients has documented the variations in presentation from physical, physiological and psychological perspectives. In this trial, management will be prescribed as directed by measurable pain, muscle and psychological impairments in the individual, rather than regard all patients as the same as in other trials. This trial will offer individualised treatments; medical, physiotherapy and-or psychological using an empirically derived treatment algorithm. Cost-effectiveness of the program will be evaluated against that incurred during usual care. It is predicted that early multi-professional management will be less expensive in the long term than existing approaches. This RCT stands to extend knowledge in the management of whiplash associated disorders (WAD).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.
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.
Hedgehog Signalling In Limb And Craniofacial Development And Disease
Funder
National Health and Medical Research Council
Funding Amount
$494,544.00
Summary
Anomalies of the face and limbs are amongst the most common features of human birth defects, and their frequent association suggests that the same genes are involved in governing the development of the limbs and face during embryogenesis. We have used a genomics-based approach to identify genes involved in limb development based on their alteration in a mouse model which develops extra fingers and toes. Defects in this mouse result from changes in Gli3, a gene which is known to be important in b ....Anomalies of the face and limbs are amongst the most common features of human birth defects, and their frequent association suggests that the same genes are involved in governing the development of the limbs and face during embryogenesis. We have used a genomics-based approach to identify genes involved in limb development based on their alteration in a mouse model which develops extra fingers and toes. Defects in this mouse result from changes in Gli3, a gene which is known to be important in both limb and face development. Based on the organs in which our genes of interest are active, we believe that they will also play key roles in embryonic development of the limbs, face and other organs. We now plan to investigate the regulation of a subset of these genes based on analysis in mouse models of limb and face development. In addition, we have chosen to further analyse the function of a completely novel gene we have identified which our preliminary studies suggest may play a role in the normal development of the lip and palate. These studies have the potential to shed light on the processes governing how organs develop, as well as on the molecular basis of common birth defects such as polydactyly (extra fingers and toes) and cleft palate.Read moreRead less
Implementation And Evaluation Of A Diabetes Intervention Program In Indigenous Australian Communities.
Funder
National Health and Medical Research Council
Funding Amount
$173,625.00
Summary
Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle ....Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle modification and tight control of the blood sugar levels, blood pressure and cholesterol are the keys to preventing the complications of diabetes. Self-management is central to success, and education, support and encouragement play an important role. This research project incorporates an education program that has been developed in partnership with the indigenous health team at Cherbourg. Particular strengths include the emphasis on family involvement and community support. The central role of the indigenous health team will ensure continuity of benefit to the community. If proven to be effective, the program could be used as a model for interventions in other community settings to reduce the burden from type 2 diabetes in the indigenous Australian population.Read moreRead less
A Supervised Exercise Programme Following Hospitalisation For Heart Failure: Does It Add To Disease Management?
Funder
National Health and Medical Research Council
Funding Amount
$730,966.00
Summary
Congestive heart failure (CHF) is a common, disabling condition. Outcomes are improved by a post-hospital disease management programme (DMP) including education, support and followup from a team of nurses, doctors and other health professionals. This study looks at whether adding a supervised exercise programme to a DMP can reduce death rates and hospital stays, and improve physical function and depression in patients with a recent hospital stay for CHF.
A reduced capacity to recover balance following an imbalance episode contributes to the high incidence of falls in older adults. The goal of the present study is to determine how age-related differences in lower extremity neuromuscular and biomechanical properties are related to balance recovery capacity and falls incidence. A detailed understanding of this relationship is necessary for the development of efficacious exercise-based interventions for the prevention of falls.
Molecular Epidemiology Of Melioidosis In Australia
Funder
National Health and Medical Research Council
Funding Amount
$357,875.00
Summary
Melioidosis is an important infection in northern Australia. It is a common cause of fatal pneumonia and blood infection in the region. Two outbreaks of melioidosis with fatalities occurring in remote Aboriginal communities have been linked to contamination of the community water supply with the melioidosis bacteria, Burkholderia pseudomallei. In addition, a rare form of melioidosis affecting the brain and spinal cord has resulted in a number of deaths in healthy Aboriginal people and also a num ....Melioidosis is an important infection in northern Australia. It is a common cause of fatal pneumonia and blood infection in the region. Two outbreaks of melioidosis with fatalities occurring in remote Aboriginal communities have been linked to contamination of the community water supply with the melioidosis bacteria, Burkholderia pseudomallei. In addition, a rare form of melioidosis affecting the brain and spinal cord has resulted in a number of deaths in healthy Aboriginal people and also a number left living in remote communities with severe disabilities such as complete paralysis of both legs. Melioidosis has also been identified in two outbreaks occurring over many years in separate locations in southern Australia. It is thought that it may have been introduced to these regions by imported animals, eg via cattle drives, and human fatalities have occurred after local flooding in these temperate locations. This project is built on the ongoing melioidosis collaboration between researchers in Western Australia, the Northern Territory and Queensland. The aim is to use new DNA fingerprinting methods developed specifically for the melioidosis bacteria to understand better why melioidosis can be such a severe disease and how it spreads from the environment to humans and animals and also how it has possibly spread within Australia and overseas. Better recognition and treatment of melioidosis has resulted in a halving of the death rate from this disease in northern Australia (mortality decreased from 40%-18%). This study aims to give us a better understanding of how this soil and water bacteria interacts with humans to cause such severe disease and will hopefully result in new primary preventative measures to complement the improved diagnosis and treatment.Read moreRead less
20 Year Study Of Skin Cancer In A Queensland Community
Funder
National Health and Medical Research Council
Funding Amount
$396,415.00
Summary
Skin cancers are by far the commonest cancers diagnosed in Australia. Even though it is known that sun exposure in excess causes skin cancers there are complexities about the causes, especially of basal cell carcinoma (BCC) -the major type of skin cancer- that are still not understood. Relative intensity of sun exposure and perhaps its timing with respect to age in life may well be critical factors. We aim to study these causes in very great detail by collating information that has been gathered ....Skin cancers are by far the commonest cancers diagnosed in Australia. Even though it is known that sun exposure in excess causes skin cancers there are complexities about the causes, especially of basal cell carcinoma (BCC) -the major type of skin cancer- that are still not understood. Relative intensity of sun exposure and perhaps its timing with respect to age in life may well be critical factors. We aim to study these causes in very great detail by collating information that has been gathered over a 20 year period in a community-based skin cancer study in Nambour, Qld as well as performing some laboratory tests on skin cancer tissue collected from participants. This 3-year project will enable the full realisation of the potential of this esource-20 years in the making- with its wealth of information for answering questions about skin cancer decelopment and preventability. It should finally provide us with a clearer rationale for 'prevention of skin cancer' than is currently available. In addition we shall assess the costs of treatment of skin cancer in general and for the individual, and how much preventive practices for skin cancer might save the health budget, by using the releavnt data collected from this community sample.Read moreRead less