Investigating The Association Between Incarceration While Pregnant And Maternal And Infant Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$307,500.00
Summary
The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. Th ....The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. There has been no Australian research into the effect incarceration has upon pregnant women or their babies. Some believe that women who are incarcerated during their pregnancy may have better outcomes as they are outside their normal milieu with restricted access to alcohol and illicit drugs and separated from abusive partners. Others argue that the stress of incarceration and separation from family and friends could result in poorer pregnancy outcomes. This study will investigate whether being imprisoned while pregnant results in better or worse pregnancy and birth outcomes for Australian women and their babies.Read moreRead less
Explaining The Dark Matter Of Genome-wide Association Studies For Complex Disease
Funder
National Health and Medical Research Council
Funding Amount
$453,098.00
Summary
Common diseases, such as psychiatric disorders and cardiovascular disease, are caused by the interplay of genetic and envirionmental factors. In the last 4 years, very large studies have been conducted to associate genetic factors with risk of disease, but these studies have not accounted for known familial risk. We aim to use data on very distant relatives to explain why. Understanding the genetic basis of common disease is crucial to guide future experiments and for developing new treatments.
Validating And Optimising The Analysis Of Magnetic Resonance Physiology Data
Funder
National Health and Medical Research Council
Funding Amount
$91,725.00
Summary
Combined electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) is used to detect the anatomical areas in the brain that show electrical activity. Several centres worldwide use this technique to localise the seizure focus in patients with epilepsy. However, there is a lack of validation of the currently applied techniques. Current analysis methods have been developed and validated for other fMRI paradigms, such as motor tasks. It is not known whether the same principles ar ....Combined electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) is used to detect the anatomical areas in the brain that show electrical activity. Several centres worldwide use this technique to localise the seizure focus in patients with epilepsy. However, there is a lack of validation of the currently applied techniques. Current analysis methods have been developed and validated for other fMRI paradigms, such as motor tasks. It is not known whether the same principles are applicable and optimal for fMRI-EEG data. The proposed project aims at validating and optimising the analysis strategies for fMRI-EEG data.Read moreRead less
Regionalised Maternity Care - Is There Room For Improvement?
Funder
National Health and Medical Research Council
Funding Amount
$467,752.00
Summary
A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the ....A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the pool of women with existing medical conditions and risk factors for adverse pregnancy outcomes. There is an urgent need to identify risk-appropriate levels of maternity care based on women's antenatal conditions and risk factors that can be identified early or during pregnancy. The project will use existing population health data sets to determine to what extent regionalised maternity care is delivering women and their babies in risk-appropriate settings or whether there is room for improvement through increased transfer of at-risk pregnancies to higher levels of care. Variations in outcomes for mothers and babies may be due to factors that occur before or during pregnancy, or may be due to differences in the level of maternity care provided. We need to take account of maternal factors to fairly assess the role of the level of maternity care. To do this our project will develop and utilise innovative statistical techniques to look at the risk factors associated with poor outcomes (severe illness or death) for mothers and their babies. We will then be able to 'predict' outcomes and see if differences between levels of maternity care are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of maternity services. Results could be applied to direct health services policy and organisational changes to improve maternity care and optimise pregnancy outcomes for a healthy start to life.Read moreRead less
Using Mathematical Models To Assess The Impact Of Interventions To Reduce Sexually Transmitted Infections In Australia
Funder
National Health and Medical Research Council
Funding Amount
$562,276.00
Summary
Sexually transmitted infections (STIs) are an increasing public health problem in Australia. Australia's recent National Transmissible Infections Strategy identified chlamydia control, STI prevention in gay men and STIs in Aboriginal and Torres Strait Islander communities as priority areas. We propose to develop mathematical models of STI transmission and use these to help understand and identify the most cost-effective interventions to reduce the impact of STIs on Australian populations.
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
INVESTIGATING MORTALITY AMONG EX-PRISONERS IN QUEENSLAND: A DATA LINKAGE STUDY
Funder
National Health and Medical Research Council
Funding Amount
$716,801.00
Summary
NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project rema ....NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project remain largely unchanged. Studies in Australia and elsewhere have identified a heightened risk of death among ex-prisoners, with drug overdose, suicide and 'accidents' three major causes. Many deaths occur soon after release. Although the high incidence of 'overdose' among ex-prisoners is often attributed to reduced tolerance,most fatal drug overdoses are due to the combined effects of multiple drugs. A detailed understanding of deaths among ex-prisoners is a prerequisite for evidence-based preventive strategies. The proposed study will: (a) Link the identities of prisoners released from custody in QLD between 1994 and 2006, with the National Death Index (NDI). The linked database will permit exploration of the incidence, timing, causes and risk factors for death among ex-prisoners. (b) Compare correctional records of deceased ex-prisoners and a random sample of ex-prisoners known to be alive, focussing on suspected risk factors including criminal history, behaviour in custody, health status, psychosocial adjustment, socio-economic status, and history and treatment for drug use. This will allow more detailed analysis of risk factors for death post-release. (c) Conduct in-depth analysis of causes of death among ex-prisoners, using the National Coroners Information System (NCIS). Information regarding cause and context of death will be coded by a research assistant and analysed to identify group differences (e.g., between ATSI and non-ATSI ex-prisoners).Read moreRead less
Blue Mountains Cohort Study: Long-term (15-year) Incidence Of Eye Disease, Hearing Loss And Other Public Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$837,919.00
Summary
The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors pred ....The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors predict the risk or age at onset of eye disease or hearing loss. We will assess impacts of vision and hearing loss on independence, falls, quality of life and development of memory loss and depression. This information will help to develop services, and to plan interventions to prevent and treat these conditions. Because of the exponential age-related increase in frequency of these diseases, this long follow-up will provide more disease events, and a longer interval to assess impacts from the exposures we measured when we started the BMES in 2002. It will enable us to estimate the strength of risk factors for eye disease and hearing loss with greater precision, essential to understand their evolution. Surviving participants from the original BMES will be invited to attend follow-up exams at our Katoomba clinic, or to attend mobile- nursing home exams. We will conduct similar exams to those previously to detect new or worsened eye disease or hearing loss. In 2002-4, we saw 82% of the population of 2 Blue Mountains postcodes aged 50 or older. At the 5- and 10-year exams we saw 75% of people still living. We expect the same proportion to participate this time. The BMES is one of Australia's main cohort studies with over 200 publications. It has yielded key findings on the frequency and causes of the major diseases threatening vision and hearing. Longer follow-up will greatly increase our power to detect predictors of these key age-dependent conditions.Read moreRead less