Risk Factors For Upper Limb Fractures In Children Falling From Playground Equipment - A Case Control Study
Funder
National Health and Medical Research Council
Funding Amount
$355,770.00
Summary
Each year in Victoria, up to 5,000 children attend hospital emergency departments with injuries associated with playground equipment. Approximately 1,000 children are admitted to hospital, reflecting the severity of these injuries. The estimated total lifetime treatment costs of these injuries is in the vicinity of $7.9 million (1996-97). In over three quarters of these children, a fall from equipment resulted in injury. Arm fracture is the most frequent and most costly injury. This study aims t ....Each year in Victoria, up to 5,000 children attend hospital emergency departments with injuries associated with playground equipment. Approximately 1,000 children are admitted to hospital, reflecting the severity of these injuries. The estimated total lifetime treatment costs of these injuries is in the vicinity of $7.9 million (1996-97). In over three quarters of these children, a fall from equipment resulted in injury. Arm fracture is the most frequent and most costly injury. This study aims to determine the factors which influence the risk of arm fracture in the event of a fall from playground equipment. It will focus in particular, on the height of the equipment and the type of undersurfacing. The study will involve interviewing children who have fallen from playground equipment at school or at pre-school. The results of the study will be used to make recommendations on how to improve the safety of playgrounds.Read moreRead less
Changes In Motor Control And Kinaesthetic Sensations After Eccentric Exercise.
Funder
National Health and Medical Research Council
Funding Amount
$287,250.00
Summary
It is a well-known observation that after a period of intense exercise we are unsteady on our feet and are clumsy when attempting to make precision movements. Such impressions are particularly marked after eccentric exercise, during which the contracting muscles are forcibly lengthened. Activities such as walking downhill, skiing and horse riding involve eccentric exercise. The debilitating consequences of this kind of exercise are attributed, not just to the post-exercise effects of fatigue, bu ....It is a well-known observation that after a period of intense exercise we are unsteady on our feet and are clumsy when attempting to make precision movements. Such impressions are particularly marked after eccentric exercise, during which the contracting muscles are forcibly lengthened. Activities such as walking downhill, skiing and horse riding involve eccentric exercise. The debilitating consequences of this kind of exercise are attributed, not just to the post-exercise effects of fatigue, but to loss of muscle force from damage to fibres. Eccentric exercise also leads to longer term effects. The breakdown of the damaged tissue leads to sensations of stiffness and soreness the next day. This application proposes experiments aimed at studying a number of effects of eccentric exercise on motor control, and establishing the muscle, spinal and brain levels at which they occur. Three studies are planned. In the first, the question will be explored whether we are less able to use the motor areas of our brains to execute voluntary contractions after exercise. So fatigue is not just a matter of exhausted muscles but perhaps also exhausted brains. We will use brain and spinal cord stimulation to explore this point. Then we plan to listen to single motor units, the basic elements of muscle control, to try to understand the mechanism by which the brain minimises the debilitating effects of fatigue. Finally we want to examine subjects' ability to locate their limbs in space as a means of providing a basis for the clumsiness we experience after intense exercise. These are all important issues relevant to clinical medicine and rehabilitation as well as sports science and exercise.Read moreRead less
C-JUN TARGETING STRATEGIES AS NOVEL CARDIOPROTECTIVE AGENTS IN ISCHAEMIA-REPERFUSION INJURY
Funder
National Health and Medical Research Council
Funding Amount
$361,148.00
Summary
Acute myocardial infarction (AMI) and its sequelae are an increasing problem in terms of morbidity, mortality and healthcare costs in Australia and the industrialised world; in the USA this is estimated annually at 900,000 and 225,000 patients and US$60 billion, respectively. Current treatment for AMI includes mechanical (percutaneous coronary intervention) or thrombolytic therapy; however, these approaches are directed primarily at epicardial arteries rather than the myocardium and are, therefo ....Acute myocardial infarction (AMI) and its sequelae are an increasing problem in terms of morbidity, mortality and healthcare costs in Australia and the industrialised world; in the USA this is estimated annually at 900,000 and 225,000 patients and US$60 billion, respectively. Current treatment for AMI includes mechanical (percutaneous coronary intervention) or thrombolytic therapy; however, these approaches are directed primarily at epicardial arteries rather than the myocardium and are, therefore, suboptimal. Strategies aimed at directly protecting cardiomyocytes from ischaemia-reperfusion injury, reducing leukocyte recruitment and myocardial cell death, would complement current approaches restoring epicardial artery flow and are keenly sought. This project will demonstrate the capacity of two separate gene-silencing strategies (DNAzymes and siRNA to suppress the expression of the immediate-early gene, c-Jun in cardiomyocytes and reduce infarct size, left ventricular dysfunction, apoptosis, inflammation, production of reactive oxygen species, angiogenesis and fibrosis in the injured rat myocardium. It will also shed light on the molecular mechanisms underlying c-Jun-mediated myocardial inflammation. As such, these studies will provide important proof of principle evidence for these small molecule nucleic acid agents as potential therapeutic tools as cardioprotective agents in ischaemia-reperfusion injury.Read moreRead less
Sympathetic Control Of Cutaneous Blood Flow And Blood Pressure In Human Spinal Cord Injury
Funder
National Health and Medical Research Council
Funding Amount
$242,002.00
Summary
While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracol ....While spinal cord injury can cause devastating changes in the nervous system paralysis and loss of sensation relatively little is known about changes to the sympathetic nervous system. The sympathetic nervous system is intimately involved in the ongoing control of blood pressure, blood flow and temperature control. Loss of sympathetic control can occur following spinal cord injury. Interruption of descending pathways can result in partial or complete loss of sympathetic outflow from the thoracolumbar segments. Complete decentralization can result in autonomic dysreflexia (autonomic hyperreflexia), in which sensory stimuli originating below the lesion evoke a reflex increase in sympathetic drive to the blood vessels, causing them to constrict. Because of this, blood pressure may rise suddenly and remain at such high levels that stroke and (occassionally) cardiac arrest may occur. This phenomenon, autonomic dysreflexia, is considered a medical emergency. The typical subjective signs of autonomic dysreflexia include a throbbing headache, tingling in the head or nasal congestion; sweating and flushing above the lesion are clinical signs that prompt medical staff to measure blood pressure and to locate the source of sensory irritation (usually a distended bladder or impacted colon, sometimes a pressure sore or ingrown toenail). Commonly, however, subclinical episodes go undetected, and this phenomenon of silent dysreflexia is of increasing concern. This project will develop means of assessing the integrity and state of the sympathetic nervous system below a lesion in patients with spinal cord injury and characterize the firing properties of reflexly activated sympathetic neurones.Read moreRead less
A Randomised Controlled Falls Prevention Trial Of Long Distance Glasses In Elderly Multifocal Wearers
Funder
National Health and Medical Research Council
Funding Amount
$493,000.00
Summary
Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glass ....Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glasses are useful for reading and seeing at close range only and there is now evidence that the use of these glasses is associated with an increased risk of falls due to the blurring of vision when looking through the lower lenses at ground level obstacles. This is particularly relevant in unfamiliar outdoor situations. This study will determine whether providing plain distance glasses (with extensive counselling and recommendations for use in standing and walking activities) will prevent falls and their consequences over a one year period in older persons who wear bi-, tri- or multi-focal glasses. Pilot studies suggest that most elderly bi-, tri-, or multi-focal wearers at risk for falls are willing to purchase and use a second pair of glasses if the benefit of new plain distance glasses for their vision is demonstrated. We expect that the results of the study will be incorporated into all relevant areas of clinical practice and public health strategies.Read moreRead less
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.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
SES And Injury In Children: A Cohort Study To Identify And Measure The Effects Of Preventable Mediating Factors
Funder
National Health and Medical Research Council
Funding Amount
$360,505.00
Summary
While changing an individual or group SES is at best a long term and challenging social objective, proximal risk factors for injury can be more readily modified. Once the proximal risk factor differential across SES groups has been adequately delineated, then the possibility arises for targeted public health intervention to redress the SES differential in the incidence of injury. The sophistication of the proposed modeling will result in a good assessment of the best point to target.
The Neural Reaction To Injury: Clues To The Cause And Prevention Of Acquired Brain Damage And Alzheimer's Disease.
Funder
National Health and Medical Research Council
Funding Amount
$390,326.00
Summary
The cellular mechanism underlying neuronal degeneration following head trauma and Alzheimer?s disease is not known and represents the major impediment to developing therapeutic strategies to protect nerve cells. This grant application will utilise a variety of modern research methods to determine the key changes in the brain that are associated with the response of nerve cells to physical trauma. These include not only the structural alterations that immediately follow such injury, but the compl ....The cellular mechanism underlying neuronal degeneration following head trauma and Alzheimer?s disease is not known and represents the major impediment to developing therapeutic strategies to protect nerve cells. This grant application will utilise a variety of modern research methods to determine the key changes in the brain that are associated with the response of nerve cells to physical trauma. These include not only the structural alterations that immediately follow such injury, but the complex cellular and gene expression changes that determine the ultimate fate of the cell. Both acquired brain injury and degenerative conditions such as Alzheimer?s disease represent an enormous health, social and economic burden. Furthermore, with predictions that Alzheimer?s disease will increase by 3-4 times by the middle of the next century due to the Oaging? of the population, it is becoming even more crucial to establish effective therapeutic interventions. The animal models investigated in this project can be used to unravel the crucial neuronal alterations associated with head trauma and the early stages of Alzheimer?s disease and, more importantly, may be the key to discovering novel strategies to prevent neuronal degeneration in these conditions.Read moreRead less
Characterisation Of Substance P Antagonists As A Novel Therapeutic Intervention For Use In Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$241,650.00
Summary
Traumatic brain injury (TBI) is responsible for more deaths in Australians under 45 years of age than any other cause. The economic and social cost of head injury to the community is enormous with billions of dollars spent each year on the management and rehabilitation of trauma patients. Despite the enormity of this public health problem, no effective treatment currently exists. A number of studies have demonstrated that much of the morbidity following TBI is associated with the development of ....Traumatic brain injury (TBI) is responsible for more deaths in Australians under 45 years of age than any other cause. The economic and social cost of head injury to the community is enormous with billions of dollars spent each year on the management and rehabilitation of trauma patients. Despite the enormity of this public health problem, no effective treatment currently exists. A number of studies have demonstrated that much of the morbidity following TBI is associated with the development of a secondary injury process that occurs between hours to days after the insult. This delayed progression of injury suggests that appropriate pharmacologic intervention can prevent, or at least attenuate, this secondary injury process with a resultant improvement in outcome. Over the past 15 years, a number of groups, including ours, have been investigating the secondary mechanisms associated with the development of functional deficits after TBI. Our previous studies have demonstrated that decline in brain free magnesium is associated with functional deficits after experimental brain injury, and that magnesium administration after injury can improve outcome. Magnesium is now on clinical trial as a pharmacologic intervention. Recent studies have suggested that magnesium decline facilitates neurogenic inflammation, which has been associated with oedema formation, oxidative damage and cell death. Although a number of neuropeptides have been implicated in this process, it is thought that substance P release is closely associated with these pathophysiological processes. Therefore, inhibiting neuropeptide release, or inhibiting substance P binding, may offer a novel therapeutic approach for the attenuation of oedema and development of neurologic deficits after TBI. This proposal will use a combined biochemical, pharmacologic and behavioural approach to characterise the role of neuropeptides in brain trauma, and attempt to develop a novel therapy for use in clinical trauma.Read moreRead less