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Childhood Cognitive Antecedents Of Adult Psychopathology: Follow-up Of The Port Pirie Lead Cohort Into Adulthood
Funder
National Health and Medical Research Council
Funding Amount
$587,263.00
Summary
The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead ....The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead to the development of that disorder. Early identification of disorder can significantly reduce public health cost and reduce the burden on the community by enabling individuals to get help before their symptoms become too severe and unmanageable. Few long-term studies have investigated the combined role of pre-natal, developmental, parental characteristics, biological and childhood cognitive risk factors in the development of adult psychiatric dysfunction. Even fewer studies have examinined this interrelationship in a group of individuals who have been exposed to an environmental toxin such as lead. This study will follow-up 723 adults from the lead smelting city of Port Pirie who were originally recruited between 1979 and 1982. All adults were exposed to lead to some degree in childhood and have been followed over various time points over the course their lives. This project will be conducted 27 years since they were first involved, and will hence be one of the longest studies to be conducted in this field. The extensive information already collected on this group of individuals will enable us to create a very comprehensive picture of risk and protective factors for various types of adult disorder.Read moreRead less
Biomechanical And Physiological Responses Of Children And Young Adults To Different Computer Workstations
Funder
National Health and Medical Research Council
Funding Amount
$207,352.00
Summary
Computer use is increasing with 95% of Australian primary school children now using computers. Two out of three children and three out of four adult workers report pain associated with computer use. This has lead to concerns that increased computer use may be responsible for an increase in musculoskeletal disorders in young people. Little is known about the physical consequences of children's use of computers. The information we have on adult use is now out of date because of changes to computer ....Computer use is increasing with 95% of Australian primary school children now using computers. Two out of three children and three out of four adult workers report pain associated with computer use. This has lead to concerns that increased computer use may be responsible for an increase in musculoskeletal disorders in young people. Little is known about the physical consequences of children's use of computers. The information we have on adult use is now out of date because of changes to computer technology and how computers are used. It is therefore not possible to provide evidence-based recommendations for safe use of computers by young people. Critical gaps in our knowledge include the appropriate desk design and computer display position. The proposed studies will use recent advances in biomechanical and physiological measurement and modelling of musculoskeletal stress to evaluate a range of desk designs and computer display positions for young adults, preadolescentchilden and early school age children. The outcomes will include the first detailed description of the physical stresses of computer use by children and preliminary guidelines for workstation design.Read moreRead less
Intergenerational Transmission Of Health Inequalities: Effects Of Work Conditions On Parent Resources And Child Health
Funder
National Health and Medical Research Council
Funding Amount
$482,385.00
Summary
The connection between socioeconomic inequalities and health is well documented in nations such as Australia. Research also shows that health inequalities persist from generation to generation. This project extends understanding of health inequalities by investigating whether work conditions contribute to health transmission from parents to children. Work conditions vary by class and occupation and have changed markedly over the last decade. They exert a direct effect on parents' health, and inf ....The connection between socioeconomic inequalities and health is well documented in nations such as Australia. Research also shows that health inequalities persist from generation to generation. This project extends understanding of health inequalities by investigating whether work conditions contribute to health transmission from parents to children. Work conditions vary by class and occupation and have changed markedly over the last decade. They exert a direct effect on parents' health, and influence resources like income, time, energy and attention that parents can invest in their children, thereby influencing children's health and well-being. In this study, we expand models of parent work and child health to include 1) working conditions (rather than employment versus unemployment); 2) collection of data on father's as well as mother's employment; and 3) investigation of the link between working conditions and parental resources as a route by which health inequalities can be transmitted across generations. Findings will contribute to the basis for interventions to improve children's health and development.Read moreRead less
FETAL ORIGIN OF ADULT DISEASE? A POPULATION-BASED STUDY OF THE OFFSPRING OF WOMEN WITH SEVERE MENTAL DISORDERS
Funder
National Health and Medical Research Council
Funding Amount
$442,875.00
Summary
Fetal origin of adult disease is a currently influential paradigm in epidemiological research into common diseases (ischaemic heart disease, hypertension, diabetes) and behaviour problems (suicide, criminal offending). It postulates an early pathophysiological programming of outcomes that become manifest in adult life. In the proposed research we aim to examine key aspects of this model by conducting a population-based study on the developmental outcomes, antecedent and concomitant risk factors, ....Fetal origin of adult disease is a currently influential paradigm in epidemiological research into common diseases (ischaemic heart disease, hypertension, diabetes) and behaviour problems (suicide, criminal offending). It postulates an early pathophysiological programming of outcomes that become manifest in adult life. In the proposed research we aim to examine key aspects of this model by conducting a population-based study on the developmental outcomes, antecedent and concomitant risk factors, and a spectrum of neuropsychiatric morbidity in all children (N-5150) born in Western Australia in 1980-2001 to women diagnosed with schizophrenia, bipolar affective disorder or unipolar depression, as compared to children (N-504,553) born to women without a diagnosed psychiatric illness. The study will be based on record linkage, utilising the unique resource of multiple, comprehensive population databases in Western Australia. Specifically, this research will identify the range of developmental outcomes and morbidity in four consecutive birth cohorts (1980-84; 1985-89; 1990-94; and 1995-2001) of children at high genetic and environmental risk and examine their relationship to specific risk factors, including familial genetic load, obstetric complications, severity of maternal illness, and psychosocial adversity. The study will be the first of its kind and its findings will inform aetiological research into the major mental disorders, as well as clinical and public health practice. It will provide novel data on fundamental issues, such as the interaction between genetic risk and environmental factors in the causation of schizophrenia, as well as on the extent to which the risk of developing severe mental illness is immutably embedded in its fetal origin, or is modifiable by subsequent mitigating factors and appropriate intervention.Read moreRead less
Statistical Methods For Handling Missing Data In Longitudinal Studies
Funder
National Health and Medical Research Council
Funding Amount
$198,000.00
Summary
Modern epidemiological research has a strong focus on studying the causes and consequences of major health outcomes over the life span. Studies are increasingly conducted on large cohorts of individuals over long periods of time, extending from before birth through to the later years of life. An example of this type of study is the Victorian Adolescent Health Cohort Study, which began in 1992 with participants aged 15 and is now seeking funding for a 9th wave of data collection in 2005. A major ....Modern epidemiological research has a strong focus on studying the causes and consequences of major health outcomes over the life span. Studies are increasingly conducted on large cohorts of individuals over long periods of time, extending from before birth through to the later years of life. An example of this type of study is the Victorian Adolescent Health Cohort Study, which began in 1992 with participants aged 15 and is now seeking funding for a 9th wave of data collection in 2005. A major challenge that arises in analysing data from studies of this kind is the difficulty created by the occurrence of missing data. In longitudinal studies with multiple measurement occasions, participants rarely complete all waves of data collection, and even when present an individual may not provide data on all study variables. Common practice in analysing such data is to omit individuals entirely if they have a missing value on any of the variables required for the analysis in question. This approach can lead to major biases in conclusions, by excluding individuals in whom patterns of association may be quite different than among those retained, and at best leads to loss of reliability in findings due to the reduction in numbers available for analysis. Recent statistical research has led to a range of new techniques for better handling of missing data in such studies, including the method of multiple imputation (MI), under which multiple copies of the dataset are created with imputed values filled in for the missing values. This approach has enormous potential for helping to produce better answers from large longitudinal studies but a number of issues require research to ensure that the method is made available to researchers in a convenient form and, most importantly, used in a way that leads to sound conclusions. This project will address many of these issues, leading to enhanced capacity to extract valuable information from large epidemiological studies.Read moreRead less
Children Of Parents With Mental Illness: A Population-based Study
Funder
National Health and Medical Research Council
Funding Amount
$774,715.00
Summary
Schizophrenia, bipolar disorder and major depression account for about 16% of the global burden of disease, according to estimates by the World Health Organization and the World Bank. These disorders tend to run a chronic or recurrent course, with devastating impact on sufferers and their families. We know today that part of their causes are genetic and may be transmitted to the next generation. However, another part of the causation is likely to be environmental, involving maternal pregnancy co ....Schizophrenia, bipolar disorder and major depression account for about 16% of the global burden of disease, according to estimates by the World Health Organization and the World Bank. These disorders tend to run a chronic or recurrent course, with devastating impact on sufferers and their families. We know today that part of their causes are genetic and may be transmitted to the next generation. However, another part of the causation is likely to be environmental, involving maternal pregnancy complications, as well as psychosocial adversity and stressful events impacting children who happen to carry a genetic susceptibility to such disorders. To disentangle and understand better such effects, our research is focusing on families where genetic risk to the offspring is present, due to a mother suffering from one of these disorders. By linking data available on population databases in WA, we aim to follow up the childhood development and young adult health outcomes of all children born to women with schizophrenia, bipolar disorder or depression. Few studies of this kind have been done worldwide, and we expect that the WA study will answer many unresolved questions, leading to preventative and treatment interventions that would reduce adverse outcomes and improve the quality of life of families at risk.Read moreRead less
Parenting Style As A Mediator Of Psychosocial Risk Factors And Childhood Externalizing Behaviour Problems
Funder
National Health and Medical Research Council
Funding Amount
$113,160.00
Summary
It is imperative that effective interventions be developed and evaluated for children with externalising disorders (e.g. oppositional disorder, attention deficit order and conduct disorder). The prevalence of these problems in the community is high, the prognosis of children is poor, and externalising problems are passed on across successive generations in the same family. Childhood externalising problems are also one of the most costly behavioural disorders for society. Many studies have examin ....It is imperative that effective interventions be developed and evaluated for children with externalising disorders (e.g. oppositional disorder, attention deficit order and conduct disorder). The prevalence of these problems in the community is high, the prognosis of children is poor, and externalising problems are passed on across successive generations in the same family. Childhood externalising problems are also one of the most costly behavioural disorders for society. Many studies have examined the nature and course of externalising problems in older children and adolescents. However, little attention has been paid to the early onset of externalising disorders amongst preschool and early school-age children. Whilst the relationships between family risk factors (e.g. marital discord and maternal depression), parental management styles and children's behaviour problems are widely recognised, the exact nature and direction of these relationships remains largely unknown. This proposal will provide new information about the mechanism through which family risk factors such as marital discord or parental distress influence the onset and persistence of externalising problems in young children, via their effects on parents' behaviour management techniques. This information can then be used to instruct early intervention efforts for parents and families of children at risk of developing externalising behaviour problems.Read moreRead less
Trajectories Between Childhood Internalising Behaviour Problems And Adolescent Depressive Symptoms
Funder
National Health and Medical Research Council
Funding Amount
$55,000.00
Summary
Depressive symptoms are known to escalate sharply through the adolescent years. Adolescents who experience an episode of depression are very likely to experience further mental illness as adults. Efforts to prevent depressive illness may be advanced by research delineating the factors and processes implicated in the early emergence of depressive symptoms. To advance such an understanding this project will analyse data collected, in part, through NHMRC support to Australian Temperament Project (A ....Depressive symptoms are known to escalate sharply through the adolescent years. Adolescents who experience an episode of depression are very likely to experience further mental illness as adults. Efforts to prevent depressive illness may be advanced by research delineating the factors and processes implicated in the early emergence of depressive symptoms. To advance such an understanding this project will analyse data collected, in part, through NHMRC support to Australian Temperament Project (ATP) researchers. The ATP data will be used to examine factors associated with the development and progression of depressive symptoms from childhood to adolescence. The ATP data set includes detailed longitudinal data collected from multiple sources (parents, teachers and youth) concerning child and adolescent temperament, behavioural problems, mother-child relations, health, depressive symptoms, school achievement, school adjustment, social skills, peer relationships, parenting practices, stressful life events, and sociodemographic factors. Of an original sample of 2443 enrolled in the cohort in 1983 (aged 4-8 months) a subsample of 1,350 adolescents should complete the data collection due in 2000 (age 17-18). Through the analysis of ATP data proposed in this application, models will be developed to explain the risk and resiliency processes in childhood and early adolescence influencing the development and course of adolescent depression, for different subgroups of adolescents. To achieve this objective, analyses will: 1. identify groups who have differing trajectories from childhood internalising behaviour problems to adolescent depressive symptoms; 2. compare groups to identify factors that contribute to the progression from internalising behaviour problems to depressive symptoms, while also identifying factors which appear to impede such progression and; 3. compare groups to identify factors associated with transient versus persistent depressive symptoms in adolescence.Read moreRead less
Randomised Controlled Trial Of A Brief GP Intervention To Reduce Overweight In Victorian Primary School Children
Funder
National Health and Medical Research Council
Funding Amount
$662,600.00
Summary
Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Childr ....Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Children and Adolescents for simple, well-designed intervention studies which can be translated into usual clinical practice. Effective and coordinated universal prevention, secondary prevention and management services will all be needed to reduce the problem, and a great deal of research is needed in all of these. This proposal addresses the most neglected area of research - secondary prevention in the primary care sector. Through our previous research, we have already showed that this approach is feasible and acceptable to families and GPs. Our multidisciplinary research team is well-established, and we are not aware of any other research team in Australia that has the capacity and expertise to conduct this research at this point in time. In this randomised controlled trial, we expect a halving in the rate of gain in BMI over 6 and 12 months. This would equate to the average participant achieving a BMI of 25 (verging on overweight) rather than 30 (obese) by adulthood. If effective, we expect the following outcomes: 1) The adoption and maintenance of healthy lifestyle behaviours in that segment of the population which has most to gain over a lifetime - overweight and obese children 2) Documentation that general practitioners can make a significant contribution to combating the childhood obesity epidemic 3) A replicable, feasible, cost-effective primary care approach to childhood overweight-obesity tailored to the Australian health care system.Read moreRead less