This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart ....This study will follow up over 12,000 men aged 65-83 years who have previously completed a questionnaire about their medical, social, family and occupational history and lifestyle and have undergone a simple physical examination (height, weight, waist, girth at the hips and blood pressure). The first aim is to determine which of these factors predicts serious ill-health from heart disease, stroke and certain cancers in old age. In addition, we will test the hypothesis that risk factors for heart disease also predict the development of dementia because it seems that part of dementia in some patients is explained by their having suffered multiple small strokes. Finally, we will examine the relationship between development of dementia and previous major surgery as there is growing evidence that major surgical operations in older patients can be followed by confusion and impairment of thinking that may never recover fully. The overall aim is to discover preventable factors for several of the leading causes of ill-health in old age.Read moreRead less
Improving Research Evidence Quality Using Individual Patient Data, Prospective Meta-analysis And Trial Registration
Funder
National Health and Medical Research Council
Funding Amount
$387,489.00
Summary
The quality of evidence we use to make health care decisions can be improved if we use systematic reviews that are planned ahead, that use raw data from each participant and include all the trials that have looked at the clinical problem. This research program will utilise these three ways of obtaining better quality data and will thus make research results more reliable. In particular, we will use these techniques to address health problems in mothers and babies.
Why Do Some Breast Cancers Present At An Advanced Stage In Women In Australia?
Funder
National Health and Medical Research Council
Funding Amount
$682,950.00
Summary
Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening ....Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening program, BreastScreen Australia, began in 1991. We expect that screening, through early detection, would reduce the numbers of women who die of breast cancer. Death rates from breast cancer have been falling in Australia since 1994. Despite this program, however, rates of larger breast cancers, more likely to have spread beyond the breast, are not falling. In 1997-98, the woman or her doctor detected nearly half of all breast cancers diagnosed outside of screening by detecting a change in the breast. Given that screening can detect cancers when they are small and that women themselves are also able to detect symptoms that may be small breast cancers and seek medical advice, we must ask why so many cancers are not diagnosed and treated until they are 2cm or larger and threaten life. This project aims to examine reasons in three broad areas: the woman herself, the cancer, and the wider health system, including the medical practitioner to whom symptoms or signs are first presented. Our study aims to understand the factors that contribute the most to the occurrence of larger breast cancers so that public health campaigns can be designed to increase the numbers detected at an early stage.Read moreRead less
Australian Vietnam Veterans Health Study: Cohort Wave 2
Funder
National Health and Medical Research Council
Funding Amount
$575,250.00
Summary
Military records show that Australia has committed troops to war since the time of the Boer War, continuing commitments through World Wars I and II, the Korean War, the Malaya Emergency, the Vietnam Conflict, the Gulf War, and numerous peacekeeping operations across the world, yet there has never been an epidemiological cohort study that tracked the path of their health and their lives after their return. This study will provide an approximate 10-year followup of an established cohort of Austral ....Military records show that Australia has committed troops to war since the time of the Boer War, continuing commitments through World Wars I and II, the Korean War, the Malaya Emergency, the Vietnam Conflict, the Gulf War, and numerous peacekeeping operations across the world, yet there has never been an epidemiological cohort study that tracked the path of their health and their lives after their return. This study will provide an approximate 10-year followup of an established cohort of Australian Vietnam veterans, which was the first such study ever conducted of returned Australian servicemen. It will test diagnostic stability and chart the trajectory of health and welfare over time in the men and relate this to possible causal determinants including military service, combat deployment and trauma exposure, post traumatic stress disorder and alcohol disorders. It will also allow us to examine the role of their previous health state, determined 10 years ago, in relation to their current health state. Data and methodology from the Australian Bureau of Statistics national surveys on physical and mental health will be incorporated so that comparisons can be made with Australian population data for the study group. Significantly, wave 1 preceded automatic compensation for veterans for cancer and PTSD; provoked the DVA's national survey that led to a $32M government program response; fed into the DVA mental health policy; fed into the Army selection guidelines for overseas service via the Psychology Corps; fed into DVA policy re Vietnam Veterans Counselling Service. Wave 2 will continue this informative process as the cohort ages. This study will provide a firmer basis for treatment of war veterans and others whose lives are visited by trauma, physical ill-health, alcohol disorders, or mental health problems in adulthood.Read moreRead less
ENDOPHTHALMITIS IN WESTERN AUSTRALIA (1980-2002): INCIDENCE, MANAGEMENT AND EFFECTIVENESS OF CHEMOPROPHYLAXIS
Funder
National Health and Medical Research Council
Funding Amount
$348,942.00
Summary
Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to p ....Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to prevent the infection that have not, as yet, been demonstrated beneficial. Our study will use a multidisciplinary team consisting of consultant ophthalmologists, public health researchers, a biostatistician and health economist to assess the impact of endophthalmitis in WA from 1980-2002 (around 480 cases). The population-based WA Linked Database provides a unique opportunity to produce what will be the largest population study of endophthalmitis. Data from the study will provide important information to develop best-practice treatment guidelines to prevent endophthalmitis following cataract surgery. The significance of this study will be that accurate information on the clinical epidemiology and true cost of endophthalmitis will be obtained for WA. By studying the records of patients with endophthalmitis and comparing them with matched patients, who did not have post-operative endophthalmitis following cataract surgery, we will characterise the risks for this severe complication by identifying the underlying factors that are responsible for the infection. We will also better understand the effect of methods used to prevent the infection. The use of a whole population-based study to assess methods of endophthalmitis prevention has not been done before and will have a significant beneficial impact on health policy and best-practice, not only in Australia, but also internationally.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
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
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.