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
Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to n ....Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to need readmission to hospital in the first year after birth. Surviving infants are more likely to have major impairments, minor impairments, and school difficulties than infants born at term. There is a substantial impact on families, health services and society of very preterm birth.There has been no reduction in the proportion of births which are preterm, or very preterm in the last 20 years, though advances in treatment and care have markedly improved the survival of preterm and very preterm infants. This study will investigate the role of previous pregnancies which did not result in births (miscarriages and terminations), together with other procedures such as D and C (dilatation and curettage), in subsequent preterm birth. As these previous pregnancy losses are all fairly common experiences any associated risk is important and this particular factor has not been studied in this way before. There is preliminary evidence that they may be associated with preterm birth and the study will be able to measure the associations while taking into account all the other known risk factors. Other possible risk factors such as experiencing violence in pregnancy or social factors acting at a neighbourhood level will also be included. If it is found that previous pregnancy losses are independently associated with preterm birth it will be possible to develop and test preventive strategies.Read moreRead less
Psychosocial Disability And Return To Work In Younger Stroke Survivors
Funder
National Health and Medical Research Council
Funding Amount
$511,216.00
Summary
Each year about 12,000 Australians of working age survive a stroke. These younger survivors have responsibility for generating an income or providing care for families and state that their main objective is to return to work for financial reasons and to help rebuild confidence and independence. This observational 3 year study will determine thefactors are associated with returning to work, improving the wellbeing of thousands of stroke survivors and their families using multivariate regression.
Inter-relationships Between Life-stage Transitions, Depression And Cardio-metabolic Health In Young Adults
Funder
National Health and Medical Research Council
Funding Amount
$360,325.00
Summary
This study will investigate how social transitions and depression in young Australian adults affect the development of obesity and the adoption or persistence of behaviours that are associated with the risk of heart disease and diabetes. These behaviours include smoking, poor diet, physical inactivity and alcohol consumption. A better understanding of how psychosocial factors influence risk factors for heart disease and diabetes is needed to improve prevention strategies.
Reducing Maternal Depression Two Years After Birth: Follow-up Of A Cohort Within A Community Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$359,920.00
Summary
Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Suppo ....Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Support for Mothers). PRISM involves eight areas participating in a range of primary care and community based strategies designed to mobilise appropriate community support for mothers and children with a view to reducing maternal depression and improving maternal physical health and recovery after birth. The other eight areas are participating as comparison communities. Evaluation in PRISM is assessing major health outcomes for mothers and wider community benefits (flow-on effects) of the intervention program. Process and impact evaluation has also been undertaken to document and assess the different program elements and enhance the reproducibility of the program if successful. All women giving birth in the 16 areas are currently being surveyed six months after birth (from August 2000-February 2002). Within PRISM it is now proposed to follow-up women again two years after birth, to assess the impact of the intervention program on: *recovery from depression among the group of mothers in both intervention and comparison areas who were depressed six months after birth; and *the overall prevalence of depression and physical ill-health in all mothers. This follow-up study has the capacity to provide infromation on the poorly documented natural history of maternal depression from birth through the next two years in a large sample, including both urban and rural residents.Read moreRead less
Psychosocial Disorders Of Youth: A Population-based Prospective Study Into Young Adulthood
Funder
National Health and Medical Research Council
Funding Amount
$450,939.00
Summary
Much earlier work in adults has pointed to the teens as a common point at which many of the important causes of chronic disease and disability in adults begin. These include problems such as tobacco use, depression and anxiety disorders, obesity, alcohol abuse and illicit drug use. However, only a prospective study is able to clarify to what extent common health risk behaviours of teenagers pose a threat to later health and well-being and what characteristics indicate those most likely to go on ....Much earlier work in adults has pointed to the teens as a common point at which many of the important causes of chronic disease and disability in adults begin. These include problems such as tobacco use, depression and anxiety disorders, obesity, alcohol abuse and illicit drug use. However, only a prospective study is able to clarify to what extent common health risk behaviours of teenagers pose a threat to later health and well-being and what characteristics indicate those most likely to go on to problems such as nicotine dependence, recurrent depression and illicit drug abuse. The proposal deals with the follow-up ten years on of a representative sample of 2000 Victorian teenagers. Seven earlier waves of data collections have ascertained levels and risk factors for common behavioural and mental health problems in the teens and early twenties. These problems included depression and anxiety, smoking, heavy alcohol consumption, illicit drug use, deliberate self-harm, obesity, eating disorder, sexually risky behaviour, intravenous drug use, antisocial behaviours and accidental injury. This follow-up of participants at the age of 24 to 25 years will ascertain persisting rates of these problems including levels of substance dependence and mental disorder. Social outcomes such as educational achievement, employment, relationships, parenthood and friendships will be ascertained. In addition mouth washes will be used to collect DNA to allow investigation of genes that may make a contribution to more severe mental disorder and substance dependency. This study will give a clear picture of the outcome and consquences of common adolescent health problems. It will also clarify further psychosocial factors that contribute to their onset or outcome. Together with an analysis of candidate genes the study should make a great contribution to the information necessary for planning effective preventive intervention.Read moreRead less
A Prospective Study Of Health, Social And Forensic Outcomes In Young Offenders.
Funder
National Health and Medical Research Council
Funding Amount
$189,000.00
Summary
In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences ....In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences, the most serious end of the offending spectrum. Furthermore, overseas studies are of limited usefulness in the Australian context, as it is difficult to apply observations from communities where the social, ethnic and crime profile may be markedly dissimilar. We propose to interview 450 young people immediately after they obtain their first sentence, usually a community-based order. The problems we will ask about include depression and anxiety, heavy alcohol consumption, heavy use of cannabis and other illegal drugs, deliberate self harm, sexual risk taking behaviour and offending behaviour. We will also ask about the social circumstances, friends and family structure and support. We will then repeat this interview six months later. In addition, we will monitor the participants' compliance with their order, treatment programs they may be on and re-offending until the end of data collection. The study will give us the basis to examine continuity and inter-relationship between problems such as depression and substance abuse, social factors and continued offending. Further, the study will establish a framework to follow-up these young offenders in the medium and long-term. The development of this sound and thorough research program will provide a rational basis for the planning of preventative interventions, aimed at improving the health and welfare and at reducing recidivism in this marginalised and often disadvantaged group of young people.Read moreRead less