A Community-based Cluster Randomized Controlled Trial In Rural Bangladesh To Evaluate The Impact Of The Use Of Iron/folic Acid Supplements Early In Pregnancy On The Risk Of Neonatal MortalityBACKGROUND An Effective Program Of Antenatal Iron/folic Ac
Funder
National Health and Medical Research Council
Funding Amount
$2,564,922.00
Summary
This community-based trial in rural Bangladesh will determine if iron/folic acid supplementation commencing in the first trimester of pregnancy significantly reduces newborn deaths, and whether this approach is cost-effective. This trial has the potential to inform international public health policy about the importance of starting antenatal iron/folic acid supplementation early to improve neonatal survival, and to help countries reach their child survival Millennium Development Goal
Epidemiology Of Unexplained Antepartum Fetal Death In Australia
Funder
National Health and Medical Research Council
Funding Amount
$450,350.00
Summary
The death of a baby before birth is a devastating event for the parents and families. In the vast number of these deaths, no cause can be found leaving no clues for parents and care providers struggling with decisions about future pregnancies and how the risk may be reduced for all women in pregnancy. Fetal death before the onset of labour without an apparent cause (Unexplained Antepartum Fetal Death (UAFD) constitutes the most common cause of fetal death. In Australia, the rate of UAFD is appro ....The death of a baby before birth is a devastating event for the parents and families. In the vast number of these deaths, no cause can be found leaving no clues for parents and care providers struggling with decisions about future pregnancies and how the risk may be reduced for all women in pregnancy. Fetal death before the onset of labour without an apparent cause (Unexplained Antepartum Fetal Death (UAFD) constitutes the most common cause of fetal death. In Australia, the rate of UAFD is approximately 2 per 1 000 births, contributing 30% to all fetal deaths. The rate of UAFD is over three times the current rate of Sudden Infant Death Syndrome (SIDS) in Australia. Despite this, little research has been undertaken in this area. The research which has been undertaken suggests that factors which are present during pregnancy may identify women who are at risk. However, the results of these studies are not consistent, largely due to the problems with study design, and therefore the available information is not sufficiently reliable to assist in identification of women at risk. Well designed, large scale studies are urgently needed to determine, from the reported list of risk factors, those factors which truly identify a woman at increased risk in the antenatal period where appropriate care can be provided to decrease the likelihood of fetal death. Recently, a collaborative effort involving clinicians and consumers in Australia has commenced to support and undertake research and related activities and to collaborate with international groups in reducing the risk of UAFD (ANZ Fetal Death Collaborative Group). This study forms the basis for this work within Australia. This study is designed to identify women who are at risk of unexplained antepartum fetal death. The study involves a review of 800 unexplained antepartum fetal deaths in three States of Australia and an analysis of information on all births in Australia which is routinely collected by Health Departments.Read moreRead less
Mortality Among Opioid Dependent Persons In Pharmacotherapy, NSW 1985-2006
Funder
National Health and Medical Research Council
Funding Amount
$148,757.00
Summary
Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabil ....Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabilise a chaotic heroin-using lifestyle by providing a regular dose of a legal, high quality opioid under medical supervision. Maintenance treatment uses long-acting opioids such as methadone and buprenorphine to provide consistent blood opioid levels so the client avoids the constant and disruptive cycles of opioid intoxication and withdrawal. Clients in regular maintenance treatments have lower death rates than untreated heroin dependent people and better outcomes with regards to drug use. However, death still occurs in methadone and buprenorphine treatment and minimising death rates is an important goal of treatment programs. This is a large longitudinal study looking at all NSW methadone and buprenorphine clients between 1985 and 2006, an estimated 44,000 people. In particular, the study looks at their mortality. It is a data linkage project, in that it uses two existing databases (a treatment database and a mortality database) and combines the information for each subject to get a better picture of how long methadone and buprenorphine clients survive, how much maintenance treatment they have received, and what the clients die of. This is the first time the mortality of all NSW methadone and buprenorphine recipients will be examined in a systematic way. It will allow us to compare the mortality of subjects receiving methadone and buprenorphine treatments and look at changes in mortality rates and causes of death over time. This will be an important policy resource.Read moreRead less
Life Expectancy among Disease-Diagnosed. This project aims to improve methodological tools for calculating life expectancy for populations with mental or physical disorders in Australia as well as to determine gains and losses in terms of excess mortality. To achieve this goal innovative measures, which solve methodological previous shortcoming regarding different age at diagnosis will be applied. The expected outcomes of the project include precise figures of excess mortality related to mental ....Life Expectancy among Disease-Diagnosed. This project aims to improve methodological tools for calculating life expectancy for populations with mental or physical disorders in Australia as well as to determine gains and losses in terms of excess mortality. To achieve this goal innovative measures, which solve methodological previous shortcoming regarding different age at diagnosis will be applied. The expected outcomes of the project include precise figures of excess mortality related to mental and physical disorders. Significant benefits for future public policy-making will be gained by analysing excess mortality among individuals diagnosed mental or physical disorders, and cross-country comparisons using national linkage data. Read moreRead less
Osteoporotic Fracture-Mortality Association And The Effect Of Anti-osteoporosis Treatment: A Multinational Study
Funder
National Health and Medical Research Council
Funding Amount
$84,800.00
Summary
Osteoporosis burden is due primarily to osteoporotic fractures resulting in economic and public health burden, increased disability, further fracture risk and more importantly early death. However, it remains under-treated although treatment reduces the number of fractures and may reduce early death. This study aims to understand which types of fractures result in early death and for which age groups and whether osteoporosis treatment does or does not reduce early death.
Deaths In Young People Involved In The Youth Justice System: Towards Evidence-based Prevention
Funder
National Health and Medical Research Council
Funding Amount
$620,705.00
Summary
Young offenders have complex health needs and are at dramatically increased risk of preventable death due to drug overdose, suicide and injury. In order to inform effective prevention, a more detailed understanding of mortality in these young people is required. This project will examine all deaths in young offenders in Queensland from 1993 to 2015, identify targets for prevention, and recommend policy reforms and interventions that are supported by evidence and are culturally appropriate.
Pathways To Avoidable And Unexplained Deaths In The Early Lifecourse
Funder
National Health and Medical Research Council
Funding Amount
$1,108,086.00
Summary
There continues to be unacceptable numbers of avoidable deaths in early life in Australia, particularity among disadvantaged groups. This project will use novel, large-scale population data to identify and quantify the impact of risks to early life mortality and preventable pathways. This new knowledge will inform new strategies to prevent stillbirth and child deaths for the benefit of Aboriginal and Torres Strait Islander and other populations.
Preventing Mortality In Adults After Release From Prison: Advancing Global Knowledge Through An International, Individual Participant Data Meta-analysis
Funder
National Health and Medical Research Council
Funding Amount
$613,687.00
Summary
Ex-prisoners are at increased risk of death, but not enough is known about the incidence, timing, causes, context or risk factors for preventable death in this population. In this project we have compiled 18 cohorts of ex-prisoners (total number=1,159,290) and will analyse the data to determine exactly which ex-prisoners are at the greatest risk from what, and when. This new knowledge will inform policy changes to reduce the unnecessary loss of life in this vulnerable population.