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Cognitive Impairments And Post Traumatic Stress Symptoms In Children With Traumatic Brain Injury: A Longitudinal Study
Funder
National Health and Medical Research Council
Funding Amount
$482,250.00
Summary
Traumatic brain injury in children is common with more than 2000 new cases a year in Queensland and Victoria alone. Many children who experience a brain injury go on to have long-term difficulties such as significant educational and social problems. Post-traumatic stress occurs in children following traumatic physical injury. However it is not clear to what extent this is so for children who have received a traumatic brain injury. Furthermore, when there is a traumatic brain injury and traumatic ....Traumatic brain injury in children is common with more than 2000 new cases a year in Queensland and Victoria alone. Many children who experience a brain injury go on to have long-term difficulties such as significant educational and social problems. Post-traumatic stress occurs in children following traumatic physical injury. However it is not clear to what extent this is so for children who have received a traumatic brain injury. Furthermore, when there is a traumatic brain injury and traumatic stress, it is not clear how these interact, how they influence long-term outcomes, and what factors such as pre-injury functioning and family support and distress mediate outcomes. These issues are very important since effective rehabilitation of children following traumatic brain injury is essential to maximise long-term functioning and minimise disability. To be effective, rehabilitation must be guided by the knowledge about key factors that determine the recovery process. This study aims to provide answers to these questions by following two cohorts of children (aged 6-14) over 18 months after receiving a traumatic brain injury. In total 240 children will be recruited from Brisbane and Melbourne hospitals. They will be assessed at three, six, twelve and eighteen months post-injury using measures of cognitive, psychological and social functioning. Information on parent distress and behaviours will also be obtained. The information obtained will provide the basis for the development of a specific rehabilitation strategy for children with traumatic brain injury, including information on strategies to help prevent any confounding impact of post-traumatic stress on recovery.Read moreRead less
E-Cadherin Endocytosis In Morphogenesis: Recycling And Growth Factor Induced Uptake.
Funder
National Health and Medical Research Council
Funding Amount
$498,088.00
Summary
E-cadherin is a cell-cell adhesion protein expressed in all epithelia with essential roles in establishing cell polarity and in tissue patterning during development. In the adult, E-cadherin functions to maintain epithelial integrity. E-cadherin is also a vital tumour suppressor, protecting cells against metastatic transformation. Our earlier studies showed that E-cadherin is constantly moved, or trafficked, to and from the surface of epithelial cells. The endocytosis or internalisation of cell ....E-cadherin is a cell-cell adhesion protein expressed in all epithelia with essential roles in establishing cell polarity and in tissue patterning during development. In the adult, E-cadherin functions to maintain epithelial integrity. E-cadherin is also a vital tumour suppressor, protecting cells against metastatic transformation. Our earlier studies showed that E-cadherin is constantly moved, or trafficked, to and from the surface of epithelial cells. The endocytosis or internalisation of cell surface E-cadherin serves to regulate its role in adhesion. More recently, we and others have shown that E-cadherin is endocytosed in response to growth factors, in conjunction with the activated growth factor receptors themselves. E-cadherin can influence the trafficking and signaling of these receptor tyrosine kinases. This joint endocytosis is an elegant mechanism for the simultaneous downregulation of cell adhesion and activation of signaling for cell growth and motility. The growth and differentiation of epithelial cells during tissue patterning or morphogenesis relies critically on these endocytic pathways. Our research is aimed at defining the endosomes and cellular machinery involved in E-cadherin-receptor endocytosis, moreover we will pursue initial findings suggesting that there are different pathways and fates for E-cadherin endocytosed at the behest of different growth factors. We will study endocytosis during the processes of epithelial cyst formation and tubulation of cysts as an in vitro model for mammalian morphogenesis. These studies will provide important and novel information for understanding the roles of E-cadherin in adhesion and in growth factor signaling during epithelial morphogenesis. Ultimately these findings will be of relevance to epithelial development and the prevention of cancer.Read moreRead less
Which Mental Activities And When For Dementia Prevention? The Four Nations Longitudinal Collaboration
Funder
National Health and Medical Research Council
Funding Amount
$183,218.00
Summary
We will examine the link between lifetime participation in complex mental activities and long term dementia risk in a level of detail not previously possible. Four major studies of brain health from around the world will join forces for the first time to determine which mental activities are most closely linked to protection from dementia, and when during the lifespan these are most important. Mental activity will be assessed using our recently published Lifetime of Experiences Questionnaire.
Dynamic Postural Stability And Falls Prediction In Older People During Walking In Real-world Environments.
Funder
National Health and Medical Research Council
Funding Amount
$680,793.00
Summary
The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body i ....The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body is static rather than in motion. Given that up to 70% of falls occur during walking and performing transfers, there is a clear need to develop tests of falls risk prediction that incorporate indices of postural stability measured during more dynamic activities. Test development needs to be underpinned by clear evidence of how age-related sensory and motor deficits affect postural stability during walking. The studies outlined in this application will develop and utilise new accelerometer-based technologies to determine the fundamental mechanisms underlying balance control during walking in older people. Specifically, this project will aim to develop a clear understanding of how changes in factors as vision, neuromuscular function (strength, stiffness) and proprioception contribute to the overall decline in stability and balance during walking in older people. Combined with physiological assessment measures developed by the research team, the research will allow the development of a more definitive predictive test of stability and falls risk. This test will be able to be used by health professionals for assessment of older people to determine the most effective therapeutic and-or exercise interventions to target those individuals at risk. This technology will also be adaptable to a biofeedback device to allow individuals to monitor their own stability.Read moreRead less
A Multi-setting Intervention To Reduce Sedentary Behaviour, Promote Physical Activity And Improve Childrens Health
Funder
National Health and Medical Research Council
Funding Amount
$860,343.00
Summary
Sedentary behaviours and physical inactivity play a major role in the rising prevalence of obesity among children in Australia. This intervention study will take place in the school and family settings which play a critical role in shaping children's health behaviours. The objective is to determine whether a 2-year behavioural intervention reduces sedentary behaviour and promotes physical activity and results in improved health among 8-9 year old children.
An Implementation Trial Of A Telephone-based Care Management Program For Patients Following Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$641,656.00
Summary
We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such progra ....We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such programs due to transport and many other barriers. So, there is an urgent need to identify new, effective, and affordable ways of delivering cardiac rehabilitation programs to people after a heart attack. The proposed telephone-delivered program will be particularly appropriate for disadvantaged people, such as those living in rural and remote areas as well as Indigenous Australians, who do not currently have access to hospital-based cardiac rehabilitation programs. People who have had a heart attack will be recruited from three of Brisbane's largest public teaching hospitals, and will then be randomly assigned to the telephone-delivered cardiac rehabilitation program (Care Management Intervention group) or to a control or Usual Care group. The Care Management Intervention group will receive regular telephone calls from a highly qualified 'Care Manager' based at the renowned National Heart Foundation of Australia telephone support service, 'Heartline'. The Care Manager will help people to manage their heart condition and prevent the reoccurrence of further heart problems. People will also be encouraged to make necessary lifestyle and behavioural changes with the assistance of the Care Manager and some Heart Foundation educational and interactive resources to record their progress. We expect that the program or Care Management Intervention group will have better health outcomes than the control or Usual Care group at 6 and 12 months follow up.Read moreRead less
Implementation And Evaluation Of A Diabetes Intervention Program In Indigenous Australian Communities.
Funder
National Health and Medical Research Council
Funding Amount
$173,625.00
Summary
Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle ....Approximately 700,000 Australians have type 2 diabetes (also termed maturity-onset diabetes or non-insulin dependent diabetes), which is a condition associated with reduced lifespan, eye disease, heart disease, renal disease, stroke, and foot complications leading to amputation. Indigenous Australians are at particularly high risk, with over 30% of adults affected by this condition in a number of communities, associated with significant morbidity and mortality. Early diagnosis, healthy lifestyle modification and tight control of the blood sugar levels, blood pressure and cholesterol are the keys to preventing the complications of diabetes. Self-management is central to success, and education, support and encouragement play an important role. This research project incorporates an education program that has been developed in partnership with the indigenous health team at Cherbourg. Particular strengths include the emphasis on family involvement and community support. The central role of the indigenous health team will ensure continuity of benefit to the community. If proven to be effective, the program could be used as a model for interventions in other community settings to reduce the burden from type 2 diabetes in the indigenous Australian population.Read moreRead less
Predictors And Correlates Of Health-related Quality Of Life And Morbidity In Overweight/obese Adolescents: Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$512,525.00
Summary
There is now no doubting the size and long-term risks to health of the childhood obesity epidemic. However, very little research has examined at population level its immediate consequences for mental health and physical functioning, what pathways confer risk and protection for these consequences, and their likely healthcare consequences. This study will utilise an existing cohort of approximately 1500 Victorian adolescents followed since childhood to examine neglected aspects of the genesis and ....There is now no doubting the size and long-term risks to health of the childhood obesity epidemic. However, very little research has examined at population level its immediate consequences for mental health and physical functioning, what pathways confer risk and protection for these consequences, and their likely healthcare consequences. This study will utilise an existing cohort of approximately 1500 Victorian adolescents followed since childhood to examine neglected aspects of the genesis and impacts of overweight and obesity. The Health of Young Victorians Study was originally assembled in 1997 when the children were in Grades Prep-3. In addition to information on putative risk and protective factors for overweight-obesity and direct measures of height and weight, it is unique in having collected data on health-related quality of life (HRQoL) since children were first recruited during the early primary school years. Eight years after the first wave, the children will be adolescents in Grades 8-11. This third wave will retain a focus on HRQoL. Innovations include study of potential emotional, behavioural and physical consequences of childhood obesity that may in turn affect the natural history of obesity. This large, population-based longitudinal study will redress neglected aspects of child and adolescent overweight-obesity specifically identified in 2003 by the NH and MRC. As well as establishing whether a range of common problems are related to overweight-obesity, it will be able to shed light on mechanisms of adverse outcomes associated with adolescent overweight-obesity, and study protective factors predicting remitting overweight from childhood to adolescence that may inform preventive activities. The study will make an international contribution to knowledge about pathways, prevalence and preventive opportunities for child and adolescent overweight-obesity.Read moreRead less
Role Of IGF Binding Protein-3 (IGFBP-3) And IGFBP-5 As Modulators Of Nuclear Hormone Signalling
Funder
National Health and Medical Research Council
Funding Amount
$465,750.00
Summary
The insulin-like growth factors are small proteins involved in the growth of most tissues. Their actions are regulated by binding to larger proteins (known as IGFBPs) in the bloodstream and outside the cell. However, some IGFBPs are also found inside cells, where they seem to carry out other functions. We believe that two of these binding proteins, IGFBP-3 and IGFBP-5, change the way cells respond to vitamin A and vitamin D. These two vitamins are important in cell growth and in the way certain ....The insulin-like growth factors are small proteins involved in the growth of most tissues. Their actions are regulated by binding to larger proteins (known as IGFBPs) in the bloodstream and outside the cell. However, some IGFBPs are also found inside cells, where they seem to carry out other functions. We believe that two of these binding proteins, IGFBP-3 and IGFBP-5, change the way cells respond to vitamin A and vitamin D. These two vitamins are important in cell growth and in the way certain cells perform specialised functions. In test-tube experiments, IGFBP-3 and IGFBP-5 interact directly with the receptors that regulate the effects of these hormones. If the same thing happens inside the cell, IGFBP-3 and IGFBP-5 could change the way these receptors respond to signals from outside the cell. We will investigate what effect these IGFBPs have in living cells and in whole animals and how this may relate to human disease. If we are able to understand how IGFBP-3 and IGFBP-5 affect the way cells respond to vitamin A and D, then we may be able to develop new ways to treat certain human diseases.Read moreRead less