Predicting The Risk Of Invasive Candidiasis In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,258,287.00
Summary
Invasive fungal infections (such as bloodstream infections) are a serious and increasing problem for critically ill patients managed in the Intensive Care Unit. Outcomes can be improved by giving early treatment only to those at highest risk of fungal infection. Our aim is to easily identify those at high-risk. Patients treated in seven major ICUs will be observed and a simple and accurate method of scoring their illness characteristics and amount-types of fungi present will be developed.
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.
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
Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone dens ....Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.Read moreRead less
Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to n ....Preterm birth, a birth before the 37th week of pregnancy occurs for fewer than 8% of mothers but is associated with two-thirds of all fetal deaths and deaths of liveborn infants in the first month after birth. In the late 1990s those deaths are concentrated among very preterm births i.e. births before the 32nd week of pregnancy. Infants born very preterm are very likely to need neonatal intensive care, quite likely to have had major respiratory, infectious or other problems after birth, and to need readmission to hospital in the first year after birth. Surviving infants are more likely to have major impairments, minor impairments, and school difficulties than infants born at term. There is a substantial impact on families, health services and society of very preterm birth.There has been no reduction in the proportion of births which are preterm, or very preterm in the last 20 years, though advances in treatment and care have markedly improved the survival of preterm and very preterm infants. This study will investigate the role of previous pregnancies which did not result in births (miscarriages and terminations), together with other procedures such as D and C (dilatation and curettage), in subsequent preterm birth. As these previous pregnancy losses are all fairly common experiences any associated risk is important and this particular factor has not been studied in this way before. There is preliminary evidence that they may be associated with preterm birth and the study will be able to measure the associations while taking into account all the other known risk factors. Other possible risk factors such as experiencing violence in pregnancy or social factors acting at a neighbourhood level will also be included. If it is found that previous pregnancy losses are independently associated with preterm birth it will be possible to develop and test preventive strategies.Read moreRead less