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
Culturally Appropriate Diabetes Care In Mainstream General Practice For Urban Aboriginal And Torres Strait Islander People
Funder
National Health and Medical Research Council
Funding Amount
$381,291.00
Summary
Main study objectives are to determine the enablers and barriers for urban Indigenous people to access mainstream primary care services, in particular diabetes chronic care services. This knowledge of critical access and acceptability factors will guide the development of a culturally approirate diabetes care intervention for Indigenous patients. This adpated intervention, to be delivered in mainstream general practices, will be pilot-tested for cultural appropriateness in Indigenous patients.
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
Extending The Australian Arm Of The International Tobacco Control Policy Evaluation Study
Funder
National Health and Medical Research Council
Funding Amount
$881,295.00
Summary
This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These i ....This project is to provide for the Australian arm of a large multi-national study to determine how tobacco control policies work. It is being conducted in the context of the implementation in 2005 of the World Health Organisation's Framework Convention on Tobacco Control, to which Australia is a party. We will provide new knowledge on the impacts of specific policies which are being implemented in Australia, as well as ones that occur in other countries that are part of the larger study. These include the adoption of graphic health warnings on tobacco packaging, removal of misleading constituents levels information from packs, bans of misleading descriptors such as Light and Mild, and implementation of smoke-free bars. In addition it will advance our understanding of how policy effects persist over time, their equity, and the means by which they contribute to increased cessation and reduced relapse. We do this by following smokers every year in each of the countries and asking them about their thinking and actions with regard to smoking, as well as about their awareness of the policies. By comparing the responses of smokers exposed to policies with those from other countries that are not exposed, we can work out the contribution of the policies to changes in smoking. Understanding policy effects on smokers and smoking cessation will lead to improved policies in Australia and the likelihood of improved dissemination of policies that work here to other countries. Similarly policies found to work in other countries, can be best adapted to Australia if we understand how they work. Taken in total, it should advance our efforts to reduce the burden of smoking-related harm both in Australia and the rest of the world.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