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
The Role Of Past Sun Exposure, Infection History And Other Exogenous Factors In Multiple Sclerosis
Funder
National Health and Medical Research Council
Funding Amount
$92,011.00
Summary
Multiple Sclerosis (MS) is a chronic autoimmune inflammatory disease of the brain and spinal cord that leads to various degrees of disability. The causes of MS are not yet known, and there is presently no cure. However, there is strong evidence that both an inherited susceptibility and environmental factors are important. This environmental case control study will be conducted in Tasmania and will run concurrent to a genetic project on MS which allows assessment of gene-environment interactions. ....Multiple Sclerosis (MS) is a chronic autoimmune inflammatory disease of the brain and spinal cord that leads to various degrees of disability. The causes of MS are not yet known, and there is presently no cure. However, there is strong evidence that both an inherited susceptibility and environmental factors are important. This environmental case control study will be conducted in Tasmania and will run concurrent to a genetic project on MS which allows assessment of gene-environment interactions. It focuses on infections, timing of childhood infections and long term sun exposure. It has been suggested that MS may be due to an immune disturbance following viral infection and that the timing of childhood infections may be initially important. Also, in Australia, there is a sevenfold increase in MS prevalence as one moves from Queensland to Tasmania. This latitudinal gradient might be due to ultra violet radiation, through an influence on immune function. Beside those main focuses, the study will include other environmental factors like chemicals, diet and vaccinations. Hopefully this project will contribute to a better understanding of the causes of MS, which are relevant for preventative strategies and devising optimal treatment.Read moreRead less
Evaluation And Planning Of Coronary Revascularization Services.
Funder
National Health and Medical Research Council
Funding Amount
$591,527.00
Summary
This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary opera ....This project concerns operations to unblock or bypass the coronary arteries that supply the muscle of the heart. The project has two parts. One is concerned with checking that changes in medical and surgical treatment of coronary artery disease have been followed by improvements in survival of affected patients. The second will use data on changes in the Australian population, changes in the frequency of heart disease and changes in treatments for heart disease to predict how many coronary operations will be needed in Australia over the next decade. This is a vital step in planning hospital services for patients with coronary disease.Read moreRead less
Methods For Evaluating The Therapeutic Impact Of Diagnostic Tests - Development Of Guidelines
Funder
National Health and Medical Research Council
Funding Amount
$132,325.00
Summary
New diagnostic tests are frequently adopted in clinical practice without any evidence that they improve patient outcomes. This project will produce the first guidelines about the role and optimal design of studies assessing the impact of a new test on therapeutic decisions for conclusions about its clinical value. This work will inform researchers and clinicians to improve evidence-based diagnostic practice and promote the more efficient use of limited health care resources.
Melanoma Diagnosis, And The Effect Of Screening On Depth Of Invasion Of Melanoma.
Funder
National Health and Medical Research Council
Funding Amount
$399,961.00
Summary
AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma ....AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma. Melanoma diagnosed and treated when very thin has an excellent long-term outcome, whereas the outcome for deeply invasive melanoma is much less favourable. Improvements to diagnosis are currently our best hope of reducing deaths and serious distress from this disease. This will be the largest study in the world of the process of diagnosis of melanoma: information on how melanoma presents, and the time between presentation and diagnosis will be compared between thin and deeply invasive melanoma. Results may indicate areas for improvement in education or health services. The use of screening, either by individuals themselves or by health professionals, has the potential to achieve early diagnosis. However, there is currently no good information on whether screening is actually effective. This study will assess the impact of self-screening and doctor screening on the depth of invasion of melanoma at presentation, and ultimately on the likelihood of dying from melanoma. The study will also assess the potential impact of screening on the over-diagnosis of lesions which while labeled as melanoma, may in fact be biologically non-progressive. This is an important issue of current concern internationally. This study will be one of only two studies in the world currently addressing this issue. This project is directly relevant to the early detection and optimum management of the most common invasive cancer in Queensland, and will have relevance internationally.Read moreRead less
Using Broadcast Media And Internet To Increase Public Understanding And Participation In Randomized Controlled Trials
Funder
National Health and Medical Research Council
Funding Amount
$88,442.00
Summary
Around the world consumers use the media and search the internet for information regarding health and medical care. This research program aims to evaluate the validity and applicability of internet based randomized controlled trials compared to traditional methods of conducting randomized trials. The results will help determine the future direction of internet based trials, and will enhance public awareness of methods to assess the effectiveness of health care interventions.
Improving Research Evidence Quality Using Individual Patient Data, Prospective Meta-analysis And Trial Registration
Funder
National Health and Medical Research Council
Funding Amount
$387,489.00
Summary
The quality of evidence we use to make health care decisions can be improved if we use systematic reviews that are planned ahead, that use raw data from each participant and include all the trials that have looked at the clinical problem. This research program will utilise these three ways of obtaining better quality data and will thus make research results more reliable. In particular, we will use these techniques to address health problems in mothers and babies.
Identification Of Risk Factors Associated With Exposure To Australian Bat Lyssavirus
Funder
National Health and Medical Research Council
Funding Amount
$230,344.00
Summary
Australia is one of the few countries in the world known to be free of rabies. A dramatic impact on this status occurred in 1996. A flying fox in northern NSW was found to be infected with a rabies-like virus. Within 16 weeks of this discovery the first human case occurred. A further human case has now been reported. The newly discovered virus, named Australian bat lyssavirus (ABL) was found to be closely related to, but distinguishable from, rabies virus. Rabies virus is responsible for thousan ....Australia is one of the few countries in the world known to be free of rabies. A dramatic impact on this status occurred in 1996. A flying fox in northern NSW was found to be infected with a rabies-like virus. Within 16 weeks of this discovery the first human case occurred. A further human case has now been reported. The newly discovered virus, named Australian bat lyssavirus (ABL) was found to be closely related to, but distinguishable from, rabies virus. Rabies virus is responsible for thousands of human infections each year, mainly in Asia and South Asia where it is endemic in urban dogs. In contrast, other rabies-like viruses have caused only a handful of human infections. Although the number of human cases of ABL is likely to remain low, each of the two known cases has aroused a great deal of public anxiety. The natural hosts appear to be various species of bats which collectively have a distribution along the entire northern and eastern coastlines. The number of potential exposures is therefore quite large and state health departments are devoting considerable resources to dealing with public concerns. This project will establish clearly defined risk factors for exposure to ABL and will allow health authorities to better manage expensive and limited vaccine and therapy resources.Read moreRead less