Neurocognitive And Social Changes Associated With Unleaded Petrol Sniffing And Abstinence From Further Sniffing
Funder
National Health and Medical Research Council
Funding Amount
$639,570.00
Summary
Currently, there is a poor understanding about the nature and permanence of brain damage associated with sniffing petrol. Previously, we used culturally-appropriate assessments of brain function to test Aboriginal petrol sniffers from remote communities in northern Australia. This showed that recreational petrol sniffers who remained living in their communities showed some degree of brain dysfunction that affected their ability to concentrate, remember things, learn, control their emotions and c ....Currently, there is a poor understanding about the nature and permanence of brain damage associated with sniffing petrol. Previously, we used culturally-appropriate assessments of brain function to test Aboriginal petrol sniffers from remote communities in northern Australia. This showed that recreational petrol sniffers who remained living in their communities showed some degree of brain dysfunction that affected their ability to concentrate, remember things, learn, control their emotions and control their behaviour. Petrol sniffing was then completely stopped in these communities. Two years later, among people who had shown brain dysfunction from sniffing petrol, our assessments showed some recovery of some of the brain damage caused by sniffing petrol. Initially, the current study aims to determine the longer-term outcomes for abstinent petrol sniffers by returning to these communities and assessing social and brain function outcomes in the original study participants, now over 10 years since they stopped sniffing petrol. The second part of the study will focus on the specific effects on the brain, behaviour and social function of sniffing unleaded petrol in comparison to leaded petrol, alcohol, other inhalants and polydrug use. It will also further investigate the time course of recovery of brain function and social outcomes in the immediate period following abstinence from petrol sniffing. This will involve recruiting petrol sniffers who move to outstation communities to stop sniffing, and have them perform brain function tests several times over the months or years that they spend recovering. These findings will enable the development of appropriate programs to minimise the harm from petrol sniffing. It will also establish an assessment protocol for the classification of petrol related brain damage that can be used by health professionals such as Aboriginal health workers, nurses and doctors.Read moreRead less
Psychological Morbidity, Unmet Needs And Patterns Of Care In Culturally And Linguistically Diverse Cancer Patients In Au
Funder
National Health and Medical Research Council
Funding Amount
$413,405.00
Summary
Australia has one of the most culturally diverse populations in the world. There is evidence that cancer patients from culturally and linguistically diverse (CALD) groups have poorer outcomes. People from CALD backgrounds may experience difficulties within the Australian health system for a variety of reasons, including langauge barriers, a lack of knowledge of the healthcare system, differing beliefs and attitudes abouit illness and treatment, religious and spiritual differences, communication ....Australia has one of the most culturally diverse populations in the world. There is evidence that cancer patients from culturally and linguistically diverse (CALD) groups have poorer outcomes. People from CALD backgrounds may experience difficulties within the Australian health system for a variety of reasons, including langauge barriers, a lack of knowledge of the healthcare system, differing beliefs and attitudes abouit illness and treatment, religious and spiritual differences, communication difficulties and social suffering. There is good evidence that English speaking cancer patients suffer high levels of anxiety and depression, and that their needs are not currently adequately met by the current system. Previous research in psycho-oncology has on the whole excluded patients from non-English speaking backgrounds due to a lack of resources and expertise to ensure scientific validity of results. This study aims to discover the prevalence of anxiety, depression, unmet needs and access to care in 1st generation Chinese, Arabic and Greek speaking cancer patients. This study will inform the development of appropriate interventions to reduce the burden of a cancer diagnosis on these groups.Read moreRead less
Randomised Trial Of A GP-initiated Tobacco Control Intervention With Arabic-speaking Smokers
Funder
National Health and Medical Research Council
Funding Amount
$232,000.00
Summary
Previous estimates of smoking rates among Arabic-speakers men and women range from 43% to 55%. No intervention has been designed specifically to target smoking in this community. Barriers to smoking cessation among Arabic-speakers are poorly understood. GPs find it difficult to counsel smokers about their smoking. Even when they do, they are as likely to use ineffective strategies. An alternative approach is referral of smokers by GPs to a smoking cessation skilled in evidence-based behavioural ....Previous estimates of smoking rates among Arabic-speakers men and women range from 43% to 55%. No intervention has been designed specifically to target smoking in this community. Barriers to smoking cessation among Arabic-speakers are poorly understood. GPs find it difficult to counsel smokers about their smoking. Even when they do, they are as likely to use ineffective strategies. An alternative approach is referral of smokers by GPs to a smoking cessation skilled in evidence-based behavioural strategies to facilitate abstinence. Therefore, we propose to conduct a randomised controlled trial to assess the effectiveness of referral of smokers attending general practices who offer consultation in Arabic to an Arabic-speaking counsellor for intensive support to improve quit rates at six and twelve months. We also will assess the acceptability of the intervention to smokers and GPs. Participating Arabic-speaking GPs in SWS will refer to the study about 1050 Arabic men and women aged between 18 and 65 years who self-report being current smokers. Participants will receive either intensive smoking cessation intervention or usual care provided by their GPs and self-help written information. The Intensive intervention will involve usual care by GPs and intensive smoking cessation counselling program that will involve series of scheduled telephone calls from an Arabic-speaking counsellor trained in smoking cessation counselling; printed self-help material in Arabic script and also will be offered a home visit and face-to-face counselling session. Results from this randomised trial will add to the scarce literature about smoking cessation among ethnic CALD minorities in Australia and overseas. If proven to be effective, a new choice will have been emerged to achieve optimal tobacco control in ethnic minorities in general practice. Divisions could consider employing bilingual counsellors as a resource for all GPs in their region.Read moreRead less
Goodness-of-fit Testing Of Log-link Models For Categorical Outcome Data
Funder
National Health and Medical Research Council
Funding Amount
$260,863.00
Summary
Information about the health consequences of exposure to causal factors is obtained from mathematical models of observed data. Incorrect inferences are possible if the model does not adequately represent the data. Relative risk models are recommended for observations over time on a cohort of subjects, but it is not known how best to assess the adequacy of such models. This project will assess the performance of summary measures of goodness-of-fit when applied to relative risk models.
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.
Social Aspects And Cultural Meanings Of Gynaecological Cancer Diagnosis, Treatment And Adjustment Of Victorian Women
Funder
National Health and Medical Research Council
Funding Amount
$158,500.00
Summary
Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social fact ....Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social factors that may influence their treatment decisions and care. The study will be conducted in metropolitan and rural Victoria. Women from a variety of ethnic, language and social backgrounds, who have been diagnosed with gynaecological cancer in the preceding three years, will be interviewed to gain insight into their understandings and experiences of the processes of disease, diagnosis and treatment procedures, the implications of for daily life, and the relationship of these events to their perceptions of their bodies, gender and sexuality. We will also interview oncologists and cancer support group facilitators, and participate in cancer support groups, to examine the role of such groups and to explore the experiences of health professionals providing care to women with these cancers. Research findings will be used to develop health educational information about gynaecological cancers, and to provide information to hospitals and clinicians to improve quality of clinical care and social support.Read moreRead less
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.
Exploring The Contributions Of Individual-, Area- And Service- Level Factors To Indigenous Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$486,919.00
Summary
We will use linked hospital and death data, and multilevel models, to estimate the contributions of individual-, area- and service-level factors to inequalities in the outcomes of hospital care between Indigenous and non-Indigenous people. Factors investigated will include socioeconomic status, remoteness, access to primary care services, and hospital characteristics. Conditions explored will include heart disease, stroke, diabetes, chronic obstructive pulmonary disease and asthma.
Is Infection An Acute Trigger For Preeclampsia? A Case-crossover Study.
Funder
National Health and Medical Research Council
Funding Amount
$207,761.00
Summary
Preeclampsia is a multisystem hypertensive disease affecting up to 10% of pregnancies. It puts both mother and baby at increased risk of major illness and death. The cause is unknown but inflammation appears to play a key role. We will use an innovative design to determine whether recent maternal infection triggers the onset of preeclampsia. If preeclampsia is associated with infection, preventative strategies can be developed.