The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, healt ....The starting point for this project is the recent finding that women who experience miscarriages or terminations of pregnancy before theuir first birth have an increased risk of having a preterm (premature) infant. These findings have prompted a re-evaluation of the relationship between the number of pregnancies a women has had and the likely outcome in later pregnancies. It will take into account the stage at which prior pregnancies ended, what the outcomes of the pregnancies were (birth, health baby, death, baby with a birth defect, termination, miscarriage etc), as well as factors such as maternal age, in relation to the risks in subsequent pregnancies. The expected outcomes and significance of the study are: * new evidence about factors causing adverse outcomes of pregnancy; * better information on the risk of recuurence of common birth defects; * more precise information on risks of adverse pregnancy outcomes for users and planners of maternity services.Read moreRead less
Melanoma Diagnosis, And The Effect Of Screening On Depth Of Invasion Of Melanoma.
Funder
National Health and Medical Research Council
Funding Amount
$399,961.00
Summary
AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma ....AIMS This study will assess how melanoma is diagnosed in Queensland, and if improvements can be made. It will assess if skin screening gives earlier diagnosis of some melanomas, and also if it leads to the diagnosis of some thin melanomas which would not progress if left alone. SIGNIFICANCE Melanoma is the most common invasive cancer in Queensland, with some 1,963 people diagnosed annually with the disease. The outlook for these patients varies dramatically with the depth of invasion of melanoma. Melanoma diagnosed and treated when very thin has an excellent long-term outcome, whereas the outcome for deeply invasive melanoma is much less favourable. Improvements to diagnosis are currently our best hope of reducing deaths and serious distress from this disease. This will be the largest study in the world of the process of diagnosis of melanoma: information on how melanoma presents, and the time between presentation and diagnosis will be compared between thin and deeply invasive melanoma. Results may indicate areas for improvement in education or health services. The use of screening, either by individuals themselves or by health professionals, has the potential to achieve early diagnosis. However, there is currently no good information on whether screening is actually effective. This study will assess the impact of self-screening and doctor screening on the depth of invasion of melanoma at presentation, and ultimately on the likelihood of dying from melanoma. The study will also assess the potential impact of screening on the over-diagnosis of lesions which while labeled as melanoma, may in fact be biologically non-progressive. This is an important issue of current concern internationally. This study will be one of only two studies in the world currently addressing this issue. This project is directly relevant to the early detection and optimum management of the most common invasive cancer in Queensland, and will have relevance internationally.Read moreRead less
Reducing The Injury And Disease Burden Attributable To Alcohol: Methodological, Aetiological And Intervention Studies.
Funder
National Health and Medical Research Council
Funding Amount
$408,412.00
Summary
The research examines the influence of individual, social and environmental factors on drinking behaviour, and seeks to determine the effectiveness of strategies to prevent alcohol-related harm, with a particular focus on youth drinking. A series of studies is proposed, examining the validity of methods for measuring drinking behaviour; social and environmental factors, and interventions. The findings will have relevance to reducing the burden of alcohol-related injury and disease in Australia.
Assessing The Impact Of Climate Change On The Transmission Of Mosquito-borne Diseases In Australia
Funder
National Health and Medical Research Council
Funding Amount
$346,689.00
Summary
Global climate change has potentially serious effects on the transmission of mosquito-borne diseases (MBDs). Bayesian spatiotemporal models will be developed to explore the underlying mechanisms of the current distribution of MBDs and to forecast future changes in pattern of these diseases. The model will be useful in examining where and when MBDs are likely to occur and how the future MBDs control strategies and prevention efforts need to be applied and strengthened in Australia.
Epidemiology Of Middle-age BHR: A Prospective Study From Childhood To Middle Age
Funder
National Health and Medical Research Council
Funding Amount
$593,840.00
Summary
Increased airway reactivity (BHR) in middle-age increases the risk of chronic respiratory diseases (CRDs) in old age, which are recognised as a major public health problem. Knowledge on the causes of these conditions is currently limited. This project will improve our understanding of the childhood and adult causes of increased reactivity of the airways in middle-age. Such knowledge will help in identifying preventive strategies for middle age BHR and thereby CRDs in old age.
Perinatal Outcomes Following Treatment For Cervical Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$98,600.00
Summary
A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have ....A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have more children after treatment. There are unanswered questions about the extent to which any or all of these treatments might, by changes to the cervix, lead to preterm birth in any subsequent pregnancy. In the proposed study, records relating to women referred from 1982 to 2000 for assessment and possible treatment of cervical abnormalities at a major hospital will be linked to Victorian birth records from 1983 to 2001. This will allow a comparison of preterm birth in the group of women referred with cervical abnormalities, with preterm births in the Victorian population, and comparing women who do and don't have treatment, taking into account other important factors such as the mother's age, and her previous pregnancies. The information will be of value to women themselves, to gynaecologists and to screening services.Read moreRead less
Antiplatelets For Prevention Of Pre-eclampsia: An Individual Patient Data Review
Funder
National Health and Medical Research Council
Funding Amount
$274,000.00
Summary
High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric intervent ....High blood pressure is a common complication of pregnancy affecting ~20,000 Australian women each year. Although most women and their babies do well, pre-eclampsia, defined as high blood pressure together with protein in the urine is a more serious problem. Severe pre-eclampsia is associated with 10-15% of maternal deaths. Fetal and newborn baby deaths are also increased. Mother and baby morbidity is high principally due to the associated complications in pregnancy, increased obstetric interventions, fetal growth restriction and preterm birth. As yet we have no safe and effective way of preventing this life threatening condition. Aggregation of platelets (involved in blood clotting) is known to be part of the disease and could lead to the disturbances in the circulation of the mother and the placenta. Antiplatelet agents, low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. Some trials and a Cochrane systematic review of all trials (involving over 30,000 women) suggest that pre-eclampsia, preterm birth and perinatal death could be reduced. However, it is still not clear which women will benefit, when in pregnancy the treatment should start and what dose of aspirin is both effective and safe. This proposed individual patient data review in which data on all women who have been entered in trials is gathered from the original investigators, including missing information on potential harms. This proposal represents a good investment of resources to obtain the information needed by women and health professional to make decisions about the use of aspirin. International investigators from all the primary trials have already formed a collaboration to oversee the project: the Perinatal Antiplatelet Review of International Studies (PARIS) Collaboration Furthermore, working through an international collaboration will ensure the highest quality in data availability, as well endorsement and implementation of the results in practice.Read moreRead less
PneuMum: An RCT Of Maternal Pneumococcal Vaccination For Protection Of Indigenous Children From Ear Disease
Funder
National Health and Medical Research Council
Funding Amount
$591,291.00
Summary
Ear disease starts in the first few months of life for most Indigenous children. By school entry, 2 out of every 3 Indigenous children in the NT have hearing problems. This proposal is to renew funding of the PneuMum study, which aims to find out whether the protection that a mother gets when she receives a pneumococcal vaccine late in pregnancy or soon after delivery can help to protect her child from getting ear disease.
Comprehensive Assessment Of Genetic And Environmental Risk Factors For Melanoma: A Population-based Family Study
Funder
National Health and Medical Research Council
Funding Amount
$150,679.00
Summary
Excessive sunlight can cause melanoma, a serious type of skin cancer. However, there are other factors including a person's genetic make-up that are thought to put some people at higher risk. Many 'healthy' people have small changes in their genes that might make them more likely to develop melanoma. We need to know more about these genetic factors. Our study will investigate how particular small genetic changes influence a person's likelihood of developing melanoma.