Mortality And Survival Among Clients Of The Aboriginal Medical Service At Redfern
Funder
National Health and Medical Research Council
Funding Amount
$483,290.00
Summary
The aims of the mortality study are to: (a) document current age-sex specific and cause-specific Indigenous mortality; (b) establish trends in age-sex specific and cause-specific Indigenous mortality over time; (c) compare age-sex-cause specific mortality in the AMS Redfern cohort with patterns documented in other Aboriginal populations, and in the general Australian population. The null hypotheses for general and cause-specific mortality (age-adjusted) are that: (a) there has been no decline in ....The aims of the mortality study are to: (a) document current age-sex specific and cause-specific Indigenous mortality; (b) establish trends in age-sex specific and cause-specific Indigenous mortality over time; (c) compare age-sex-cause specific mortality in the AMS Redfern cohort with patterns documented in other Aboriginal populations, and in the general Australian population. The null hypotheses for general and cause-specific mortality (age-adjusted) are that: (a) there has been no decline in mortality in Aboriginal people attending AMS Redfern over 30 years covering 1972-2001; (b) survival in the AMS cohort is similar to that recorded in Aboriginal people from NT and WA (mostly rural) for similar time periods; (c) comparisons of the AMS cohort mortality with overall NSW mortality are similar to previously published comparisons of NT-WA Aboriginal mortality compared to overall Australian mortality data. Major causes of mortality will centre on endocrine (mainly diabetes), cardio- and cerebro-vascular diseases, and on external causes, including suicide-violence and accidental death. The mortality study will be extended back to the inception of the AMS, and will rely on computerisation of name(s), sex, date of birth and date of first and last AMS attendance for the whole AMS patient data base, to provide information for matching of patient records with the National Death Index (for deaths from 1980) and for matching with the NSW mortality data for 1971-79 (as there is no nationwide mortality data available from a single source prior to 1980).Read moreRead less
Alcohol Control, Consumption And Consequences: Time Series Analyses Of The Australian Experience
Funder
National Health and Medical Research Council
Funding Amount
$308,631.00
Summary
The study will be the first in Australia to systematically examine the relationships between population level alcohol consumption and mortality from specific causes such as liver disease, injuries and heart disease, with significant implications for epidemiology and health policy. The study will also undertake rigorous evaluations of the impact of historic changes to alcohol policies, which will provide evidence which can be used to guide future alcohol policy.
Mortality In Young Offenders Who Have Had Custodial Sentences
Funder
National Health and Medical Research Council
Funding Amount
$60,448.00
Summary
The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been in ....The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been incarcerated. A group of young people who have received their first custodial sentences between 1988 and 1999 in Victoria will be identified, starting with 10 year olds in 1988. Their details will then be matched with data held by The National Death index, housed at the Australian Institute of Health and Welfare, and with the Victorian Coroner's data in order to identify deaths that have occurred, the cause of death and the circumstances of death. This will provide an index of the excess deaths experienced by this group of young offenders compared with Victorian population data for the same age group and gender. Further analysis will elucidate cause specific mortality, will enable the identification of subgroups at particular risk and the examination of trends over time. The study will provide a solid foundation for health priorities, the development of interventions and policy in relation to young offenders. It will provide a resource for Australasia and be of worldwide interest. Juvenile offenders are a well-defined group who has extended contact with support services. There is a unique opportunity for the delivery of interventions aimed at improving the welfare and adult outcomes of this enormously disadvantaged and marginalised section of our community. The Centre for Adolescent Health, as the auspicing body for the Adolescent Forensic Health Service is in an excellent position to respond to this challenge.Read moreRead less
Mortality, Morbidity And Income Inequality In Australia
Funder
National Health and Medical Research Council
Funding Amount
$232,175.00
Summary
Evidence has been accumulating for some time indicates that an individual's life expectancy is affected by their socioeconomic circumstances. In general, it appears that people with higher incomes tend to live longer. More recently, some evidence has suggested that life expectancy is affected not only by a person's income level but also by their relative position in the income distribution. Some studies have found that, when income is more unequally distributed, mortality rates tend to be higher ....Evidence has been accumulating for some time indicates that an individual's life expectancy is affected by their socioeconomic circumstances. In general, it appears that people with higher incomes tend to live longer. More recently, some evidence has suggested that life expectancy is affected not only by a person's income level but also by their relative position in the income distribution. Some studies have found that, when income is more unequally distributed, mortality rates tend to be higher and life expectancy lower. Several explanations for this association have been advanced. One is that the association is a statistical artifact. Another is social-psychological, arguing that a sense of relative deprivation and social exclusion increases susceptibility to a variety of conditions. A third explanation is couched in terms of social capital, a term that refers to various forms of participation in voluntary organisations which strengthen community life. A fourth argues that it is material deprivation that is the underlying cause - income inequality is found in communities characterised by lower levels of provision of social infrastructure such as schools, libraries, and health services. The main purpose of this research project is to investigate the association between morbidity, mortality, income, and income inequality in Australia. The project will attempt to find which of the several explanations just discussed are supported by Australian evidence. The results of the project will enhance our understanding of the relationship between socioeconomic status and health, and will have implications for the design of different policies aimed at ameliorating the effects of income inequality on health.Read moreRead less
A Trial Of Prehospital Rapid Sequence Intubation In Patients With Severe Head Injury
Funder
National Health and Medical Research Council
Funding Amount
$311,000.00
Summary
In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. F ....In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. Following severe head injury, it is common for patients to have decreased oxygen levels and this is associated with a significant increase in brain damage. To prevent or treat this, patients with severe head injury require endotracheal intubation (a tube is placed in the airway to provide oxygen to the patient) as soon as possible following injury. However, in most patients with severe head injury, endotracheal intubation requires the use of drugs to facilitate placement of the endotracheal tube. The usual technique involves the administration of both a sedative drug and an appropriate muscle-relaxant. This technique is known as rapid sequence intubation (RSI). However, it is unknown whether RSI should be undertaken by paramedics early after injury or be delayed until arrival at the hospital. Since better evidence of improved outcome is required to justify the possible risk and considerable expense of training ambulance paramedics in the skill of RSI, it is proposed that a randomized, controlled trial of RSI in adults with severe head injury be conducted. This trial will compare rapid sequence intubation with standard airway management (no intubation) by ambulance paramedics for major trauma patients with severe head injury. This study will assess differences in patient outcome at 6-months post injury. The study will involve head injury patients treated by paramedics in Victoria.Read moreRead less
Cause Of Death In Men With Prostate Cancer: A Population-wide Data Linkage Study
Funder
National Health and Medical Research Council
Funding Amount
$305,255.00
Summary
3,000 Australians die of prostate cancer annually yet 100,000 are living with the disease. This project will identify the causes of death in men with prostate cancer. It will examine whether testing for the disease lowers the risk of death, whether patients are at higher risk of suicide or heart disease and if type of treatment is related to long term risk of heart disease. The results will help men and their doctors make informed decisions about testing and treatment for prostate cancer.
Investigating Causes Of Stillbirths: A Prospective Cohort Study Examining Use And Effectiveness Of A Comprehensive Investigation Protocol
Funder
National Health and Medical Research Council
Funding Amount
$567,508.00
Summary
The effects of stillbirth on women and their families are often devastating and long term. Many stillbirths are not appropriately investigated, resulting in lack of accurate data on causes with one-third classified as unexplained. A major driver for suboptimal investigation is the lack of research to guide which tests should be done. This study aims to accurately identify causes of death in 984 comprehensively investigated stillbirths and determine which tests are needed, with consideration of c ....The effects of stillbirth on women and their families are often devastating and long term. Many stillbirths are not appropriately investigated, resulting in lack of accurate data on causes with one-third classified as unexplained. A major driver for suboptimal investigation is the lack of research to guide which tests should be done. This study aims to accurately identify causes of death in 984 comprehensively investigated stillbirths and determine which tests are needed, with consideration of costs and value.Read moreRead less
Identifying Determinants Of Both The Origins And The Progression Of The Depressive And Bipolar (mood) Disorders.
Funder
National Health and Medical Research Council
Funding Amount
$6,235,352.00
Summary
Currently, mood disorders are classified by severity, largely ignoring causes and leading to limited treatments. The Team will clarify how differing depressive and bipolar (mood) disorders are best modelled and pursue their differing causes, so assisting identification of specific treatments relating to their underlying causes. Our studies employ a range of sophisticated technologies, including molecular biology, brain imaging techniques, and mathematical modeling. The capacity of such research ....Currently, mood disorders are classified by severity, largely ignoring causes and leading to limited treatments. The Team will clarify how differing depressive and bipolar (mood) disorders are best modelled and pursue their differing causes, so assisting identification of specific treatments relating to their underlying causes. Our studies employ a range of sophisticated technologies, including molecular biology, brain imaging techniques, and mathematical modeling. The capacity of such research to advance the management of mood disorders address a pressing clinical need.Read moreRead less
Burden Of Disease&cost Effectiveness Of Intervention Options:informing Policy Choices & Health System Reform In Thailand
Funder
National Health and Medical Research Council
Funding Amount
$787,978.00
Summary
This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much d ....This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much disease and injury in Thailand is being caused by major risk factors, such as tobacco and unsafe sex. Using this information the team will evaluate the effectiveness of the major interventions to reduces diseases and injuries from risk factors that are affordable and applicable in the Thai context.Read moreRead less