Retinal Vascular Signs As Risk Markers For Incident Stroke Or Cerebrovascular Death: A Population-based Assessment
Funder
National Health and Medical Research Council
Funding Amount
$410,199.00
Summary
Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of ....Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of retinal photographs taken on people who attended the Eye Study during 1992-4 and 5-year follow-up exams during 1997-9. We will grade these photographs manually (using a stereo-viewer), and with computer assistance to measure changes in the diameter of small arteries in the retina and other signs. By closely matching our grading technique to that used in a large American Study, we hope to develop reliable grading for these signs and will be able to compare our findings internationally. Our aim is to assess the frequency of abnormal retinal vessel changes in people of different age groups as well as the development and progression of these signs over time. Their relationship to well known vascular risk factors like smoking, blood pressure, obesity, diabetes and cholesterol will also be investigated. We hope to be able to discriminate those changes associated with an increased stroke risk from those due to normal ageing. We expect that the increased stroke risk associated with abnormal retinal vessel changes may be greater than shown in our early data. If confirmed, then these findings may provide a more sensitive and objective measure of stroke risk than relying on traditional risk factors, which are difficult to quantify and change with time. We may be able to develop simple rules so that doctors using an ophthalmoscope or examining a retinal photograph could identify high risk patients. These people could benefit from interventions to reduce their risk.Read moreRead less
Risk Factors For Serious Farm-work Related Injury Among Adult Males
Funder
National Health and Medical Research Council
Funding Amount
$665,930.00
Summary
This study addresses occupational injury among male adult farm workers. The health and safety performance of agricultural industries is among the worst in Australia. A recently published study of work-related fatalities from 1989 to 1992 found that rural industries ranked third, with a fatality rate 3-4 times that for all industries. The rural industries accounted for 80 deaths annually. Best estimates place the cost of farm injury between $0.5 and $1.29 billion per year. This study is designed ....This study addresses occupational injury among male adult farm workers. The health and safety performance of agricultural industries is among the worst in Australia. A recently published study of work-related fatalities from 1989 to 1992 found that rural industries ranked third, with a fatality rate 3-4 times that for all industries. The rural industries accounted for 80 deaths annually. Best estimates place the cost of farm injury between $0.5 and $1.29 billion per year. This study is designed to contribute to farm injury prevention by: (1) identifying factors associated with a higher risk of serious injury among adult farm workers and (2) determining the proportions of the farm workforce who are exposed to various injury risks. The study will recruit 300 seriously injured or killed farm workers from regional Victoria and collect information about themselves, their working life and the property on which they work. This information will be compared with 600 randomly selected farm workers who are not seriously injured to determine which personal, work and environmental factors place farm workers at higher risk of injury. The study will lead to the development of new or more refined prevention strategies and programs. A study of this kind has not been conducted before in Australia and would contribute to a continuing scientific basis for selection of interventions for farm injury and targeting of prevention programs, at a time of increasing momentum in agricultural health and safety.Read moreRead less
Incidence And Outcome Of Stroke In Rural South Australia
Funder
National Health and Medical Research Council
Funding Amount
$735,541.00
Summary
We propose to undertake a population-based study of the incidence, management and outcome of stroke (survival, disability, recurrent stroke) in geographically defined segments of rural South Australia and compare these with equivalent data, collected during the same period in a defined sector of metropolitan Adelaide. It is hard to over-state the value of this information for planning health services of many kinds for the next decade.
This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
The Real And Changing Atherothrombotic Disease Burden And Secondary Prevention
Funder
National Health and Medical Research Council
Funding Amount
$507,387.00
Summary
Absolute numbers of Australians with diseased narrowed blood vessels in the heart, brain or leg are increasing, dominating health priorities and expenditure. By linking Department of Health datasets, without identifying individual's, trends in hospital admissions, prescription of chronic protective medications and the cost consequences to the health system among and across conditions will be determined. The findings will provide quality measures of hospital care and inform quality improvement