Design And Analysis Of Interrupted Time Series Studies In Health Care Research: Resolution Of Methodological Issues
Funder
National Health and Medical Research Council
Funding Amount
$307,125.00
Summary
An interrupted time series (ITS) study involves a population observed on multiple occasions before and after the implementation of an intervention program. However, methods for statistical analysis and designing such studies have not been well developed and many statistical analyses of such studies are flawed. This proposal will investigate appropriate methods for design and analysis, and develop guidelines and software for its implementation by health researchers.
The Development, Assessment And Treatment Of Early Indicators Of Psychopathy In Children
Funder
National Health and Medical Research Council
Funding Amount
$271,130.00
Summary
2.7 Significance - Lay description Conduct problems and antisocial behaviour cost Australian society millions of dollars every year directly through the mental health and criminal justice systems, indirectly through their association with substance abuse and other mental health problems, and associated disruptions to health, relationships, and personal and occupational functioning. Remediation is not effective once a chronic pattern has been established. Recently, research has shown that early s ....2.7 Significance - Lay description Conduct problems and antisocial behaviour cost Australian society millions of dollars every year directly through the mental health and criminal justice systems, indirectly through their association with substance abuse and other mental health problems, and associated disruptions to health, relationships, and personal and occupational functioning. Remediation is not effective once a chronic pattern has been established. Recently, research has shown that early signs of psychopathy in children predict chronic antisocial behaviour and lack of responsiveness to traditional treatments. The current research uses a combination of experimental, longitudinal, and treatment outcome studies to examine: the effectiveness with which early signs of a callous-unemotional temperamental style, hypothesised to be an early indicator of psychopathy, can be measured in children, causal factors and correlates of callous-unemotional traits, whether such traits pose a risk for chronic antisocial behaviour, the effects of callous-unemotional traits on responsiveness to traditional family-school based treatments, and the effectiveness of an innovative method for treating it in the early years. The project leads directly to a range of clinical assessment and treatment strategies for children at risk for chronic antisocial behaviour. The project has the potential to substantially improve the effectiveness of current treatment approaches to conduct problems in children that focus on family and school management.Read moreRead less
A Multisite Randomised Controlled Trial Of The Adolescent Cannabis Check-up
Funder
National Health and Medical Research Council
Funding Amount
$211,250.00
Summary
Recent Australian surveys cannabis use is more common than tobacco use among 14-19 year old (24.6% vs. 20.2%). More than 200,000 14-19 year olds have used cannabis in the last month and 7.1% report daily use. The population prevalence of cannabis dependence increases throughout adolescence, with a rate of 30% among those who use cannabis more than five times per year. Although experimentation is a normal part of adolescent development, regular cannabis use by young people exposes them to the neg ....Recent Australian surveys cannabis use is more common than tobacco use among 14-19 year old (24.6% vs. 20.2%). More than 200,000 14-19 year olds have used cannabis in the last month and 7.1% report daily use. The population prevalence of cannabis dependence increases throughout adolescence, with a rate of 30% among those who use cannabis more than five times per year. Although experimentation is a normal part of adolescent development, regular cannabis use by young people exposes them to the negative effects of cannabis at a time of rapid development and transitions in life roles. There have been no studies reported of interventions suitable for adolescents with cannabis problems who are not seeking treatment but are causing great concern for their families, schools and communities. The Adolescent Cannabis Check-up (ACCU) fills this serious gap by providing adolescents with an opportunity to objectively assess their cannabis use and develop strategies for change in a non-judgemental environment. The ACCU is a 2 session intervention: assessment and a follow-up session of personalised feed-back and brief skills-based therapy. Recruitment may be either direct or via a concerned family member. This novel approach provides parents with telephone coaching, and supporting booklets, on techniques to encourage their young person to participate. A feasibility study of 80 families has found more than 50% were able to do so. That study of 55 adolescents found a significant reduction in levels of cannabis use and an abstinence rate of 24.2% 3 months following participation in the ACCU. This project wll involve a multi-site RCT to compare the impact of the ACCU with a delayed treatment control group, on levels of cannabis use, dependence, and cannabis-related problems. This project would fill a gap in treatment service models and involve families in an initiative to assist young people to develop motivation and skills to abstain from problematic cannabis use.Read moreRead less
Maximising The Effectiveness Of Interactive Automated Programs For Smoking Cessation
Funder
National Health and Medical Research Council
Funding Amount
$922,582.00
Summary
This project is to design, implement and trial automated programs to help smokers quit. It makes use of the powers of modern computing and telecommunications. It uses information the person provides to personally tailor advice and assistance to smokers as they progress from beginning to think about quitting through to being a stable, happy non-smoker. In particular, we are interested in the relative value of detailed advice as compared with the capacity of modern messaging technology (SMS, voice ....This project is to design, implement and trial automated programs to help smokers quit. It makes use of the powers of modern computing and telecommunications. It uses information the person provides to personally tailor advice and assistance to smokers as they progress from beginning to think about quitting through to being a stable, happy non-smoker. In particular, we are interested in the relative value of detailed advice as compared with the capacity of modern messaging technology (SMS, voice, images) to provide a set of prompts and reminders that help smokers manage a quit attempt and help prevent them relapsing back to smoking. Once we have developed the interventions, we will subject them to a rigorous scientific trial to see how effective they are and also how cost-effective they prove. Our hope is that these programs will provide a cheap, accessible and effective way of helping smokers to quit and thus help reduce the huge toll of smoking-related disease.Read moreRead less
The Receptor-associated Protein (RAP) As A Molecular Chaperone For The Amyloid Protein (Abeta) Of Alzheimers Disease
Funder
National Health and Medical Research Council
Funding Amount
$402,403.00
Summary
Our research will examine the role of a protein known as the receptor-associated protein (RAP) in Alzheimer's disease. We will determine whether the protein contributes to the progression of Alzheimer's disease and we will examine the possiblity that that RAP may be used as a drug to treat the disease. The project could potentially have direct benefit for patients by leading to an effective treatment for dementia associated with Alzheimer's disease.
Alcohol Control, Consumption And Consequences: Time Series Analyses Of The Australian Experience
Funder
National Health and Medical Research Council
Funding Amount
$308,631.00
Summary
The study will be the first in Australia to systematically examine the relationships between population level alcohol consumption and mortality from specific causes such as liver disease, injuries and heart disease, with significant implications for epidemiology and health policy. The study will also undertake rigorous evaluations of the impact of historic changes to alcohol policies, which will provide evidence which can be used to guide future alcohol policy.
Buckle Up Safely: Pre-school Based Interventions For Appropriate Use Of Child Restraints.
Funder
National Health and Medical Research Council
Funding Amount
$731,552.00
Summary
Despite overwhelming evidence that child restraints dramatically reduce the risk of death and injury there are currently a large number of children globally who either do not use appropriate child restraints, or misuse them, contributing to the overwhelming burden of road traffic injury in children. This project, using rigorous methodology, will assess the efficacy of feasible, evidence based interventions aimed at increased use of appropriate restraints, and decreasing misuse.
Economic Evaluation Of PRISM: A Community Based Intervention Trial
Funder
National Health and Medical Research Council
Funding Amount
$512,845.00
Summary
This project evaluates the costs and outcomes of PRISM (Program of Resources, Information and Support to Mothers). PRISM is a community based intervention designed to promote the physical and mental health of mothers. This research project seeks to evaluate the costs and outcomes of the PRISM intervention in order to help inform judgements about its value. PRISM is being introduced in 8 local communities in Victoria with a further 8 communities acting as comparators. The full costs of the interv ....This project evaluates the costs and outcomes of PRISM (Program of Resources, Information and Support to Mothers). PRISM is a community based intervention designed to promote the physical and mental health of mothers. This research project seeks to evaluate the costs and outcomes of the PRISM intervention in order to help inform judgements about its value. PRISM is being introduced in 8 local communities in Victoria with a further 8 communities acting as comparators. The full costs of the intervention will be measured as will the impact the intervention has on the physical and mental health of mothers. Estimates of the intervention's economic benefits, that is the value that community members attach to the intervention's main outcomes will also be ascertained. In this way it is possible to judge whether or not the benefits of PRISM are worth its costs. Advanced statistical techniques will be used to ascertain the extent to which improved health outcomes in mothers are determined by individual, organisational or community-level factors.Read moreRead less
After Hours Medical Care And Personal Safety Needs Of Urban General Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$73,250.00
Summary
Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and ma ....Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and may inevitably have detrimental effects on health care services. Studies in the UK indicate that violence against general practitioners is increasing, violence against GPs in rural areas of Australia is also increasing but there have been no comparable studies carried out in our major cities. This research aims to ask general practitioners working in a range of different urban areas around NSW to describe their experiences of dealing with violent and aggressive patients. The study will be the first of its kind in Australia to provide an important insight into the level of violent and aggressive behaviour GPs are subjected to in city areas. One of the key areas of concern that has been reported in medical journals and the general press has been an increase in attacks on GPs making house-calls, this project will therefore be particularly focussed on GPs who provide after hours care. This study is important so in order to find out exactly what the incidence of violence against our urban general practitioners is, what type of violence is actually occurring, where it is occurring, who the perpetrators are, and also what the longer term psychological effects of abuse against general practitioners may be. The findings from this study will be used by the Commonwealth Government and Health Departments to plan better ways of providing after hours medical care. The findings may also be used to educate GPs and medical students about safety in the workplace.Read moreRead less
Regional Immunosuppression For Corneal Transplantation
Funder
National Health and Medical Research Council
Funding Amount
$268,264.00
Summary
Blindness exerts major physical, emotional and economic constraints and hardship upon the sufferer. Corneal transplantation is a well-accepted surgical treatment for visual impairment caused by opacification of the cornea, the transparent window at the front of the eye. Corneas for transplantation are retrieved from people who have recently died, after permission has been sought from the donor's family. Unfortunately, a significant proportion of corneal transplants fail because they are recogniz ....Blindness exerts major physical, emotional and economic constraints and hardship upon the sufferer. Corneal transplantation is a well-accepted surgical treatment for visual impairment caused by opacification of the cornea, the transparent window at the front of the eye. Corneas for transplantation are retrieved from people who have recently died, after permission has been sought from the donor's family. Unfortunately, a significant proportion of corneal transplants fail because they are recognized as foreign, and undergo rejection by the recipient. Once a corneal graft has failed, it is no longer transparent to light. A number of novel interventions are being developed to reduce the incidence of corneal graft rejection, but at present it is uncertain exactly how these should be delivered to the patient. The research described in this application is designed to discover how therapeutic agents and interventions can best be targeted, to prevent corneal graft rejection. Overcoming an unwanted immune response would improve the outcome of corneal transplantation by as much as thirty percent.Read moreRead less