Economic Evaluation Of Interventions To Reduce The Burden Of Harm From Alcohol Misuse In Indigenous Australians
Funder
National Health and Medical Research Council
Funding Amount
$609,571.00
Summary
Indigenous people live considerably less than non-Indigenous Australians. Governments spend millions each year trying to close this health gap but there is little evidence to demonstrate that this money is being spent appropriately. This project aims to evaluate the return on investment on funds spent on addressing the harm caused by alcohol misuse in Indigenous Australians. These results will strengthen the evidence-base required to develop appropriate Indigenous health policy in Australia.
Stress During Pregnancy And The Developmental Origins Of Renal Disease In Aboriginal Australians
Funder
National Health and Medical Research Council
Funding Amount
$866,044.00
Summary
There is an epidemic of renal failure in Aboriginal people who also have high rates of premature birth of small babies. This project aims to understand the causes of kidney failure in Aboriginal people through testing if stress during pregnancy leads to the birth of preterm, small babies with small poorly formed kidneys that lead to kidney failure in later life. The effect of stressors impacting on pregnant women including infections, exposure to smoking and social stressors will be examined.
Trichomonas Vaginalis: Prevalence In An Urban Indigenous Population And Validation Of New Assays
Funder
National Health and Medical Research Council
Funding Amount
$88,880.00
Summary
The infection called trichomonas is the commonest sexually transmitted infection (STI) world-wide. It is caused by a parasite and is particularly common amongst disadvantaged, poor communities. It is important to diagnose and treat (readily available treatments exist) this infection because it is linked with early birth in pregnant women and increases the spread of HIV-AIDS virus. The diagnosis has not changed for decades until recently, when a new more sensitive test became available.Wehave ada ....The infection called trichomonas is the commonest sexually transmitted infection (STI) world-wide. It is caused by a parasite and is particularly common amongst disadvantaged, poor communities. It is important to diagnose and treat (readily available treatments exist) this infection because it is linked with early birth in pregnant women and increases the spread of HIV-AIDS virus. The diagnosis has not changed for decades until recently, when a new more sensitive test became available.Wehave adapted it to work on self-collected specimens such as in-out tampons or urines. Proof that this new diagnostic tool is better, is needed in Australia in high-risk groups such as Aboriginal and Torres Strait Islander communities where other STIs have already been shown to be at high rates. How this parasite causes disease in humans is poorly studied. We plan to test this new diagnostic method and compare it to traditional tests in a high-risk population and to ultimately study how the parasite causes disease.Read moreRead less
Health Outcomes Of Older Indigenous Australians- A 5 Year Follow Up Study Of A Population At Risk
Funder
National Health and Medical Research Council
Funding Amount
$833,759.00
Summary
The health of Indigenous people is poor and a number of risk factors contribute to lower life expectancy and the development of 'aged care syndromes' such as falls, incontinence, and dementia at a younger age. The research team has described high levels of dementia in a population survey completed in 2005 on 363 older people from the Kimberley. This population will be re-surveyed to document ageing syndromes and determine factors that may improve health for this population at risk
Assessing Cardiovascular Disease (CVD) Risk In Aboriginal People
Funder
National Health and Medical Research Council
Funding Amount
$73,550.00
Summary
Aboriginal Australians have higher death rates from cardiovascular disease (CVD) than other Australians, with rates in young and middle aged people increased 15-fold or more. A multi-factor approach, which considers all the risk factors, is the best strategy to identify and reduce CVD risk. The first step for selection of risk-reduction therapy in an individual is to assess his-her risk status and the benefit of intervention. Several risk assessment tools, incorporating traditional risk factors, ....Aboriginal Australians have higher death rates from cardiovascular disease (CVD) than other Australians, with rates in young and middle aged people increased 15-fold or more. A multi-factor approach, which considers all the risk factors, is the best strategy to identify and reduce CVD risk. The first step for selection of risk-reduction therapy in an individual is to assess his-her risk status and the benefit of intervention. Several risk assessment tools, incorporating traditional risk factors, have been developed from Western populations. They would be most appropriately applied to individuals who resemble the study sample; their validity in Aboriginal Australians has not been evaluated and no risk prediction formulae have been developed specifically for Aboriginal people. Recent reports suggest that a variety of other non-traditional risk factors also influence CVD risk, including markers of central fat deposition, inflammation, nutrition, alcohol use and early growth. Given the disadvantaged circumstances of many Aboriginal people, it is likely that some of the factors are influencing their CVD risk. The applicants have collected baseline risk factor data on volunteers in one Aboriginal community and followed their course, including CVD deaths and CVD hospitalisations, for more than a decade. From this baseline information, which goes beyond traditional risk markers, and from additional measures like birthweight, and markers of inflammation and nutrition assayed in retrieved serum, we will develop a variety of models for predicting a CVD risk in this group. We will also lay plans to evaluate these tools in other Aboriginal groups. A better understanding of the causes of CVD in this population is important to influence public health policy for CVD prevention. The models will be helpful health education tools at the community level and will allow therapeutic or lifestyle intervention in individuals to be targeted at their individual risk profile.Read moreRead less
A New Model For The Pathogenesis Of Rheumatic Fever: Superantigen Priming Of The Immune Response To Group A Streptococci
Funder
National Health and Medical Research Council
Funding Amount
$248,820.00
Summary
Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, c ....Acute rheumatic fever (ARF) is now rare in developed countries. However, it remains a major problem in Aboriginal Australians in the NT where the rate of ARF is the highest in the world. This leads to high rates of rheumatic heart disease (up to 3% of individuals in some communities) and a premature mortality of over four times that for developing countries. Immunisation and improved living conditions offer a long-term solution but these remain a distant prospect. In the short and medium term, control of this ARF will partly depend on new and better treatment and prevention strategies. To achieve these goals a deeper understanding of the immune mechanisms underlying this disease is urgently needed. It is known that ARF is caused by an abnormal immune response following streptococcal infection. This leads to the production of cells called T cells that attack the body s own tissues rather than the bacteria itself. This autoimmune disease is responsible for the heart damage that underlies ARF. It is believed that this proces only occurs when susceptible individuals are infected with specific rheumatogenic strains of streptococci. However there are a number of deficiencies in this model and it is proposed that there is an additional factor responsible for the abnormal immune response in ARF. This project will explore the possibility that bacterial toxins called superantigens are the critical missing factor , by studying the immune response in ARF. Superantigens are produced by certain streptococci and staphylococci, and are potent in minute quantities causing widespread activation of the immune system. They have been found to play an important role in a number of autoimmune diseases and the type of immune response found in ARF fits well with that expected if superantigens were involved. If superantigens play an important role in causing the abnormal immune response in ARF then a number of new avenues would open for the treatment and prevention of this disease.Read moreRead less
Assessing The Health Needs Of Older Indigenous Australians Living In The Kimberley
Funder
National Health and Medical Research Council
Funding Amount
$242,000.00
Summary
This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expend ....This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expenditure; yet, little is known about the extent of these problems amongst Indigenous Australians. This study builds on a successful project conducted in the Kimberley in 2003 that was designed with the aim of developing and validating a screening instrument for the assessment of dementia amongst Indigenous people. The present project proposes to expand the scope of our previous work to include the assessment of other common conditions associated with older age, such as depression, incontinence and falls and determine use of health services and potential impediments to their access.Read moreRead less
The Feasibility And Effectiveness Of A Family-based Intervention For Indigenous Australians With Alcohol Dependence.
Funder
National Health and Medical Research Council
Funding Amount
$218,291.00
Summary
This study aims to determine the feasibility of implementing a family-based intervention in an Indigenous community-controlled health service in rural NSW and it's level of acceptability to Indigenous patients. The expected main benefits of implementing the family-based intervention are increases in the percentage of Indigenous individuals with alcohol dependence entering and engaging in evidence-based treatment.