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 starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, healt ....The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, health baby, death, baby with a birth defect, termination, miscarriage etc), as well as factors such as maternal age, in relation to the risks in subsequent pregnancies. The expected outcomes and significance of the study are: * new evidence about factors causing adverse outcomes of pregnancy; * better information on the risk of recuurence of common birth defects; * more precise information on risks of adverse pregnancy outcomes for users and planners of maternity services.Read moreRead less
LONG TERM FUNCTIONAL ABILITY AND COSTS OF STROKE SUBTYPES.
Funder
National Health and Medical Research Council
Funding Amount
$270,604.00
Summary
Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on o ....Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on outcome beyond 1 year. It is thought that at 5 years after stroke about 55% of patients will die, and a further 10% will have another nonfatal stroke. Stroke is estimated to cost the community in excess of $1 billion a year. Little is known about the long-term costs of stroke to survivors and their relatives. These costs are likely to be substantial, and are likely to include costs related to hospitalisations, outpatient visits, general practitioner visits, medications, aids and community services. It is also likely that substantial informal care is provided by relatives and friends (e.g. assistance with shopping and personal care). The aim of this study is to assess the long-term outcome of patients with stroke. These will include measures of survival, stroke recurrence, and ability to perform usual daily activities. In addition, we aim to determine the long-term use of health care and community resources and the costs incurred by patients, their carers, and the community. Information on survival patterns, stroke recurrence and disability will provide information of great value for health service planning. Such information will also be useful to patients, their families, and medical staff who treat these patients. Information on the costs of stroke will provide the only information about the patterns of long-term health care and community resource use among stroke patients in Australia. This information will be useful for health service planning.Read moreRead less
Australian Vietnam Veterans Health Study: Cohort Wave 2
Funder
National Health and Medical Research Council
Funding Amount
$575,250.00
Summary
Military records show that Australia has committed troops to war since the time of the Boer War, continuing commitments through World Wars I and II, the Korean War, the Malaya Emergency, the Vietnam Conflict, the Gulf War, and numerous peacekeeping operations across the world, yet there has never been an epidemiological cohort study that tracked the path of their health and their lives after their return. This study will provide an approximate 10-year followup of an established cohort of Austral ....Military records show that Australia has committed troops to war since the time of the Boer War, continuing commitments through World Wars I and II, the Korean War, the Malaya Emergency, the Vietnam Conflict, the Gulf War, and numerous peacekeeping operations across the world, yet there has never been an epidemiological cohort study that tracked the path of their health and their lives after their return. This study will provide an approximate 10-year followup of an established cohort of Australian Vietnam veterans, which was the first such study ever conducted of returned Australian servicemen. It will test diagnostic stability and chart the trajectory of health and welfare over time in the men and relate this to possible causal determinants including military service, combat deployment and trauma exposure, post traumatic stress disorder and alcohol disorders. It will also allow us to examine the role of their previous health state, determined 10 years ago, in relation to their current health state. Data and methodology from the Australian Bureau of Statistics national surveys on physical and mental health will be incorporated so that comparisons can be made with Australian population data for the study group. Significantly, wave 1 preceded automatic compensation for veterans for cancer and PTSD; provoked the DVA's national survey that led to a $32M government program response; fed into the DVA mental health policy; fed into the Army selection guidelines for overseas service via the Psychology Corps; fed into DVA policy re Vietnam Veterans Counselling Service. Wave 2 will continue this informative process as the cohort ages. This study will provide a firmer basis for treatment of war veterans and others whose lives are visited by trauma, physical ill-health, alcohol disorders, or mental health problems in adulthood.Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less