Developmental Changes In Cerebral Oxygenation After Term And Preterm Birth
Funder
National Health and Medical Research Council
Funding Amount
$445,306.00
Summary
Approximately 10% of all births are preterm and the numbers of infants surviving are increasing. We have previously found that infants born preterm have lower blood pressure over the first 6 months after term equivalent age than infants born at term. We will use new technology to examine how preterm birth affects brain oxygenation and how this is altered with gestational age, sleep states and sleeping position, to provide insights into their increased risk for SIDS.
Teeth And Faces Of Australian Twins: A Longitudinal Study
Funder
National Health and Medical Research Council
Funding Amount
$647,226.00
Summary
We are seeking support from the NHMRC to complete a longitudinal study of 250 pairs of twins, both identical and non-identical, whom we have examined at around 4-6 years of age when all the baby teeth were present in the mouth, then again at around 8-10 years of age when both primary and permanent teeth were present. We now plan to examine these twins again at around the age of 11-13 years when all the permanent teeth, except the wisdom teeth, are normally present. Records to be obtained from th ....We are seeking support from the NHMRC to complete a longitudinal study of 250 pairs of twins, both identical and non-identical, whom we have examined at around 4-6 years of age when all the baby teeth were present in the mouth, then again at around 8-10 years of age when both primary and permanent teeth were present. We now plan to examine these twins again at around the age of 11-13 years when all the permanent teeth, except the wisdom teeth, are normally present. Records to be obtained from the twins over the next three years will include dental examinations, dental impressions from which casts can be made, shed primary teeth, and intra- and extra-oral photographs. We will apply modern methods of genetic analysis to determine the importance of genetic and environmental influences on observed variation in several dental and facial features. We will also study the fascinating phenomenon of mirror imaging in twins, where one twin mirrors the other for one or more features. Longitudinal studies of twins, in which a large sample of children is studied over several years, provide a powerful means of determining how genes influence growth and development. As far as we are aware, ours is the only large-scale longitudinal study of dental and facial growth in twins being undertaken in the world at present. Once we have collected all the data and carried out analyses, we will gain a much better understanding of the factors that can influence development of the teeth and face, and be in a much better position to be able to predict those children who are most likely to develop malocclusions in later life.Read moreRead less
Parent Education For The Treatment Of Severe Behaviour Problems In Children With Developmental Disabilities
Funder
National Health and Medical Research Council
Funding Amount
$116,220.00
Summary
Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the ef ....Approximately 40% of children with developmental disabilities have severe behaviour problems (e.g., aggression, self-injury, property destruction, and extreme tantrums) (Einfeld and Tonge, 1996). The care of a child with such problems represents a significant burden to parents and society. One of the most promising treatments is functional communication training (FCT), which aims to reduce problem behaviours by improving the child's communication skills. Numerous studies have demonstrated the effectiveness of FCT (Mirenda, 1997). Wacker et al. (1998) have shown that parents can be taught to use FCT, but these parents received individual consultations, which would seem to limit its practicality. Preliminary results from our current APEX grant suggest that parents can learn to implement this treatment in a group format, which is more practical from a public health perspective. However, it is currently unknown if group training is as effective as individual consultation. In the present application, we aim to compare these two ways of teaching parents how to use FCT. From a total sample of 36, the parents of 18 children will be randomly assigned to the group training format and 18 to the individual format. All parents will receive 12 hours of training on how to use FCT, either as part of a group of 3 families (mothers and-or fathers) in the clinic or on a one-to-one basis in the family home. Pre, post, and follow-up measures of problem behaviours will be used to address the research question: Is group training as effective as individual consultation? If so, we would have demonstrated a more practical way of teaching parents how to implement this evidence-based treatment for child behaviour problems.Read moreRead less
A significant proportion of mothers give birth assisted by forceps or vacuum extraction (Ventouse) when problems occur during labour. A number of problems such as incontinence, haemorrhoids, persistent perineal pain, incontinence and sexual problems seem to be commoner after birth in mothers who have had an operative vaginal birth. It has been suggested that to avoid these problems more women should have an elective caesarean without going through labour at all. Although caesarean births would p ....A significant proportion of mothers give birth assisted by forceps or vacuum extraction (Ventouse) when problems occur during labour. A number of problems such as incontinence, haemorrhoids, persistent perineal pain, incontinence and sexual problems seem to be commoner after birth in mothers who have had an operative vaginal birth. It has been suggested that to avoid these problems more women should have an elective caesarean without going through labour at all. Although caesarean births would probably avoid the problems listed above caesarean births are not necessarily better for women's health in all ways - and they are much more costly. This study will follow-up 990 women who had an operative birth (vaginal or caesarean) in 1996-8, 'debriefing' after birth and assessment of health status and health problems 6 months after birth. It will assess their subsequent recovery and fertility, review the events of pregnancy, labour and birth in their medical records to identify factors associated with incontinence, perineal pain, haemorrhoids and sexual problems, and review the outcome of any pregnancies since the original study. The study will provide: * better long term information about health problems, recovery, and fertility after caesarean birth and after operative vaginal birth; * stronger evidence on factors during labour associated with incontinence and related problems; * documentation of the reasons why women with incontinence and related problems rarely seek help or treatment from GPs or specialists; * evidence of any long-term effects of 'debriefing' after birth.Read moreRead less
After Hours Medical Care And Personal Safety Needs Of Urban General Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$73,250.00
Summary
Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and ma ....Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and may inevitably have detrimental effects on health care services. Studies in the UK indicate that violence against general practitioners is increasing, violence against GPs in rural areas of Australia is also increasing but there have been no comparable studies carried out in our major cities. This research aims to ask general practitioners working in a range of different urban areas around NSW to describe their experiences of dealing with violent and aggressive patients. The study will be the first of its kind in Australia to provide an important insight into the level of violent and aggressive behaviour GPs are subjected to in city areas. One of the key areas of concern that has been reported in medical journals and the general press has been an increase in attacks on GPs making house-calls, this project will therefore be particularly focussed on GPs who provide after hours care. This study is important so in order to find out exactly what the incidence of violence against our urban general practitioners is, what type of violence is actually occurring, where it is occurring, who the perpetrators are, and also what the longer term psychological effects of abuse against general practitioners may be. The findings from this study will be used by the Commonwealth Government and Health Departments to plan better ways of providing after hours medical care. The findings may also be used to educate GPs and medical students about safety in the workplace.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