Psychosocial Disability And Return To Work In Younger Stroke Survivors
Funder
National Health and Medical Research Council
Funding Amount
$511,216.00
Summary
Each year about 12,000 Australians of working age survive a stroke. These younger survivors have responsibility for generating an income or providing care for families and state that their main objective is to return to work for financial reasons and to help rebuild confidence and independence. This observational 3 year study will determine thefactors are associated with returning to work, improving the wellbeing of thousands of stroke survivors and their families using multivariate regression.
Developing An Australian Valuation For The EQ-5D-5L Quality Of Life Instrument
Funder
National Health and Medical Research Council
Funding Amount
$348,357.00
Summary
In the assessment of gains resulting from a health technology, it is standard to consider both mortality and quality of life effects. This project explores how Australians value different components of quality of life. To do this, we are running an online survey called a discrete choice experiment, and analysing the data using a range of cutting-edge econometric techniques. This will allow policy-makers to better reflect people's preferences when making decisions about new technologies.
THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
An Australasian, Multi-centre, Randomized, Double-blind, Placebo-controlled Trial Of The Efficacy Of Fluoxetine In Improving Functional Recovery After Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$2,306,367.00
Summary
Stroke is one of the top three causes of disability. Treatments that improve recovery after stroke are lacking. We reviewed the world literature and found a number of very small studies which, together, suggest that the antidepressant drug, fluoxetine, may improve the recovery in stroke patients. AFFINITY is a large trial in 1600 Australians and New Zealanders with stroke which aims to find out whether taking fluoxetine for 6 months after a stroke improves recovery compared to a placebo.
An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
Estimating The Burden Of Group A Streptococcal Diseases In Victoria
Funder
National Health and Medical Research Council
Funding Amount
$386,760.00
Summary
Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal pop ....Despite the considerable advances in the diagnosis and treatment of group A streptococcal (GAS) diseases made during the last century, the impressive spectrum of infections caused by this organism continues to have a significant impact in developed countries. This spectrum includes diseases that are mild but common (e.g. sore throat, skin sores), rare but very severe (e.g. bloodstream infections, flesh-eating bacteria) and those that are more common in developing countries and the Aboriginal population (e.g. rheumatic fever, kidney disease). Streptococcal sore throat remains one of the most common childhood infections, and severe group A streptococcal diseases are thought to be increasing in incidence in Australia. Yet, there are no accurate data on the incidence and costs of these or other GAS diseases in non-Aboriginal Australians, or in most other populations around the world. It is becoming more urgent to collect this data as numerous vaccine candidates are entering human trials, new approaches to the treatment of sore throat are emerging, and new strategies to treat and control the spread of severe disease are being developed. We propose a comprehensive strategy to measure the incidence, prevalence and costs of each group of GAS diseases. We will follow a group of families for 12 months to detect cases of GAS sore throat and skin sores and measure the impact on the family. We will survey children in schools to estimate the prevalence of skin sores. We will check hospital records to calculate the number of cases of rheumatic fever and kidney disease. And we will maintain surveillance for severe diseases by checking hospital and laboratory records. We will also check to see if family members of people with severe disease have the GAS bacterium in their throats. We will then compile these data into a comprehensive estimate of the burden of disease in Victoria, and estimate the cost-effectiveness of different treatment and prevention strategies.Read moreRead less
Advanced Heart Failure Management With Ventricular Assist Therapy – Evaluating Australian Costs Of Care And Effectiveness From Implant To Transplant Or End Of Life
Funder
National Health and Medical Research Council
Funding Amount
$45,668.00
Summary
Ventricular Assist Devices (VADs) are implantable heart pumps that are increasingly being used to slow down the progression of end stage heart failure. This project assesses the costs and effectiveness of VAD therapy and advanced heart failure medical management in an Australian health care setting. The aim is to provide Australian clinicians and health decision makers access to current and relevant, clinical, cost and effectiveness data for advanced heart failure and VAD therapy.
REACH: Researching Effective Approaches To Cleaning In Hospitals
Funder
National Health and Medical Research Council
Funding Amount
$657,862.00
Summary
Healthcare associated infections are a major challenge for hospitals. Infections can spread via the patient environment, because colonized patients and staff can contaminate surfaces and equipment with micro-organisms. Cleaning is a vital component of patient care, but is a complex process with little real evidence to inform practice. This project will take a targeted approach to improving hospital cleaning to reduce infection rates; and examine the cost-effectiveness of this approach.
Evaluation Of A Financial Incentive To Improve The Use Of Preventive Medicines By People With Asthma
Funder
National Health and Medical Research Council
Funding Amount
$137,860.00
Summary
Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement ....Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement the incentive.Read moreRead less
Economic Evaluation Of Alternative Pneumococcal Vaccination Strategies
Funder
National Health and Medical Research Council
Funding Amount
$242,894.00
Summary
Pneumococcal vaccination is a readily available preventive strategy that can offer substantial protection to the elderly but it is important that we carefully evaluate the different potential strategies to ensure the most (cost-) effective approach to prevention is identified. This grant will explore alternative strategies to control pneumococcal-related disease in elderly Australians using the available vaccines.