Adult Consequences Of Childhood Exposure To Psychological Trauma
Funder
National Health and Medical Research Council
Funding Amount
$292,530.00
Summary
The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. ....The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. This study will follow a group of 808 primary school children who were exposed to the 1983 Ash Wednesday bushfires in SOuth Australia. They were involved in a study which examined them two months, eight months and twenty six months after the disaster. This rich descriptive set of information about these children and their families forms an objective data base against which their adult recall of the experience can be judged. The symptoms of these children were also documented at the time as was their disaster exposure. The impact of this one event, in the context of the other developmental influences will be examined as determinants of their adjustment in adult life. Finally, there has been an increasing interest in the way that previous traumatic exposure influences the nature of the hormonal response to stress. Using a test of functioning of the cortisol system, the stress response of this population will be compared with a control population who were also studied at the time of the original disaster.Read moreRead less
The outcomes to be assessed are recurrent ischaemic stroke, intracranial haemorrhage, myocardial infarction, parenchymal embolism and vascular death. Should these outcomes be significantly reduced, the public health and economic issues which will be addressed in this study are considerable. Approximately 40,000 new and recurrent cases of stroke occur in Australia each year, and about 80% of these are ischaemic. There is an average prevalence of about 20% of large or complex aortic plaque among p ....The outcomes to be assessed are recurrent ischaemic stroke, intracranial haemorrhage, myocardial infarction, parenchymal embolism and vascular death. Should these outcomes be significantly reduced, the public health and economic issues which will be addressed in this study are considerable. Approximately 40,000 new and recurrent cases of stroke occur in Australia each year, and about 80% of these are ischaemic. There is an average prevalence of about 20% of large or complex aortic plaque among patients with ischaemic stroke. About the same proportion of cases of ischaemic stroke yearly are associated with the presence of complex aortic plaque alone, and as many again with simple plaque (40% in total). Using the NHMRC estimated cost of $40,000 per stroke (and assuming that recurrent stroke costs are similar to initial stroke costs) and the estimated recurrent stroke rates of 11.9-100 person-years for plaque > 4 mm, the national cost of recurrent ischaemic stroke attributable to complex aortic plaque alone is about $3 million in the first year. This estimate does not include patients with incident TIA and atherosclerotic plaque or the resources spent on evaluating recurrent stroke and TIA attributable to aortic plaque, the cost of lost wages, or the negative impact on the quality of life of the victims. The economic and public health burden to our society could be greatly reduced by successful efforts at secondary stroke prevention in individuals with aortic plaque and TIA or ischaemic stroke. If just 25% of recurrent ischaemic strokes associated with aortic arch debris could be prevented by treatment interventions, the annual savings to society for recurrent ischaemic stroke alone would be considerable.Read moreRead less
A Case Control Study Investigating Factors Contributing To The Risk Of Bleeding In Patients Receiving Warfarin Therapy
Funder
National Health and Medical Research Council
Funding Amount
$572,242.00
Summary
Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking dru ....Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking drugs that interact with warfarin, they may have problems with their liver or kidney which affects the body's ability to get rid of it, they may have suffered a fall, to name a few. Studies done overseas have suggested that people are more likely to have a bleed if they do not know how to properly manage their tablets, if they are depressed, if they have no helpers to support them or if their care is not well organised. In Australia, we do not know what impact the organisation of care has on whether a person's warfarin is well managed. We do not know the impact that depression has on their care, or whether people are more likely to have pooorly controlled warfarin if they have few community ties. These are importnat questions to answer, so that we can make significant inroads into preventing death and disability from warfarin.Read moreRead less
Scabies is a global disease and a major health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia prevalences of up to 50% in children have been described, despite the availability of effective chemotherapy. Scabies is caused by a tiny mite burrowing under the skin and symptoms include intensely itching lesions that can be very distressing, and often become secondarily infected with Group A Streptococcus. Th ....Scabies is a global disease and a major health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia prevalences of up to 50% in children have been described, despite the availability of effective chemotherapy. Scabies is caused by a tiny mite burrowing under the skin and symptoms include intensely itching lesions that can be very distressing, and often become secondarily infected with Group A Streptococcus. These skin sores can result in serious complications, including blood poisoning and kidney damage. Control of scabies is hindered by difficulties with diagnosis, the cost of treatment, evidence for emerging resistance, and lack of effective vaccines. The symptoms of scabies infestations can mimic many other skin diseases such as dermatitis, eczema, impetigo, and allergic reactions, and traditional tests to diagnose scabies are often less than 50% accurate. Control measures in endemic regions include community-based scabies intervention programs and although successful at reducing levels of scabies in the short term, have proved difficult to sustain due to low levels of scabies persisting within communities. Recent developments leading to expression and purification of scabies mite recombinant antigens have identified a number of molecules with diagnostic potential and this study aims to investigate the accuracy of these recombinant proteins to identify scabies specific antibodies in people with active scabies. An effective simple, cheap, rapid, sensitive and specific diagnostic test for scabies will aid in the early identification of disease and thus treatment. Furthermore it will enable the selective treatment of affected children and their families, reducing the requirement for mass treatment and associated costs, decrease the potential for escalating mite resistance, and provide another means of controlling scabies in highly affected areas.Read moreRead less
Hepatitis B Virus Immunity In Indigenous And At Risk Children Who Received Hepatitis B Vaccination In Infancy
Funder
National Health and Medical Research Council
Funding Amount
$213,762.00
Summary
Hepatitis B virus (HBV) is transmitted by blood exposure or sexual contact and infection can result in chronic liver disease and liver cancer. Since 2000 Hepatitis B virus immunisation has been recommended for all infants in Australia with the first dose given at birth. However, prior to routine universal immunisation, a selective immunisation strategy was used in Australia from 1986. This targeted infants considered at high risk of HBV infection because of high prevalence in their population of ....Hepatitis B virus (HBV) is transmitted by blood exposure or sexual contact and infection can result in chronic liver disease and liver cancer. Since 2000 Hepatitis B virus immunisation has been recommended for all infants in Australia with the first dose given at birth. However, prior to routine universal immunisation, a selective immunisation strategy was used in Australia from 1986. This targeted infants considered at high risk of HBV infection because of high prevalence in their population of origin, (including Aboriginal- Torres Strait Islanders) and infants whose mother was a HBV carrier. These children, among the first to be vaccinated, are now adolescents. There have been no long-term follow-up studies in Australia, and limited studies elsewhere, to assess the extent of breakthrough infection and persistence of immunity to Hepatitis B after vaccine at birth. As onset of sexual activity is associated with an increased exposure to hepatitis B infection, booster doses may be needed, especially in high-risk individuals. This study includes 2 high risk groups - young indigenous adults in the Northern Territory and young adults born to HBV carrier mothers in central Sydney. It will measure the number of children who have been infected with HBV or are chronic carriers, compared to pre immunisation data, and also the persisting level of immunity in children who were vaccinated against HBV as an infant. Children whose blood test indicates that they have low immunity will be given a booster dose of HBV vaccine and their immune response measured. A rise in hepatitis B antibody following booster vaccination indicates that you have immunological memory and is currently considered to show protection from natural hepatitis B infection. If clinically significant HBV infections are found to be rare and immunologic memory can be demonstrated, this would provide good evidence to support the argument that booster vaccine doses are not required in the Australian context.Read moreRead less
The Effectiveness Of An Indicated Prevention Program For Anxiety
Funder
National Health and Medical Research Council
Funding Amount
$867,982.00
Summary
Generalised anxiety disorder (GAD) is a common disorder. In this research project, we evaluate the effectiveness of a new automated Internet program which is designed to reduce the risk of GAD and to promote self help. If found to be effective, this website will provide assistance to those at risk living in rural and remote areas without access to other resources, and individuals who prefer to seek help anonymously.