Determinants Of The Oral Health Of Adults Entering The Third Decade Life-stage
Funder
National Health and Medical Research Council
Funding Amount
$201,500.00
Summary
There has been a strong investment in the oral health of Australian children and their oral health has greatly improved. However, there are a number of indications that not all the gains in child and adolescent oral health are not carried through to the next life stage, adulthood. Somewhere in the intervening years, much of the gains in oral health invested in children and adolescents are dissipated. Hence, the purpose of this proposed research is to document the nature, distribution and determi ....There has been a strong investment in the oral health of Australian children and their oral health has greatly improved. However, there are a number of indications that not all the gains in child and adolescent oral health are not carried through to the next life stage, adulthood. Somewhere in the intervening years, much of the gains in oral health invested in children and adolescents are dissipated. Hence, the purpose of this proposed research is to document the nature, distribution and determinants of oral health among South Australian 29 year olds so as to identify points of intervention to maintain Australian's improved oral health further into adulthood. The specific aims of the research are to document the oral health of a cohort of 29 year olds describe their dental life history and key proximate influences on their oral health identify significant determinants of their oral health to compare the cohort with a representative SA sample of the same age. This project will approach some 3,763 29 year old adults who participated in earlier research as 13 year olds in 1988-89. It will also compare these adults with a random sample of 557 further 29 year olds from the SA Electoral Roll. Participants will be interviewed and then dentally examined, providing a range of key outcome measures on oral health status and explanatory factors from when they were 13 years old, their dental history and circumstances as 29 year olds. The research project is expected to provide detailed documentation of the prevalence and severity of oral disease and its distribution in an adult cohort, and exploration of the dental life history and current determinants of the oral disease observed. It is anticipated that the strength of hypothesised relationships of determinants will have direct policy implications.Read moreRead less
Evaluating Perceptual Benefits Of Bilateral Cochlear Implants For Young Children And Infants
Funder
National Health and Medical Research Council
Funding Amount
$452,843.00
Summary
The cochlear implant (bionic ear) has revolutionised communication for children with profound hearing loss. Nevertheless, children with the standard single implant still face huge challenges in educational and social settings. Difficulties include understanding speech that is soft, or speech in noisy environments, such as the classroom. Also, with one implant, children cannot locate the source of sound, such as the speaker in a group conversation, team-mates during sport, or an oncoming car. Res ....The cochlear implant (bionic ear) has revolutionised communication for children with profound hearing loss. Nevertheless, children with the standard single implant still face huge challenges in educational and social settings. Difficulties include understanding speech that is soft, or speech in noisy environments, such as the classroom. Also, with one implant, children cannot locate the source of sound, such as the speaker in a group conversation, team-mates during sport, or an oncoming car. Research with other normal hearing and hearing impaired groups suggests that two (bilateral) implants may possibly improve performance in these conditions. Although hundreds of children worldwide have received bilateral implants, very limited evidence is available to indicate whether two implants are significantly better than one, especially for young children. The main aim of the research is to evaluate the improvement in listening performance when young children and infants use two implants as compared with one. An additional aim is to gain clinical knowledge of bilateral implant use in order to develop selection criteria and management protocols for young bilateral candidates in the future. Results of this research will determine if bilateral implants should become a standard option for young children at the RVEEH-University of Melbourne Implant Clinic. The results will be published and presented internationally to influence clinical practice worldwide. All children using a cochlear implant, or in need of one in the future, will benefit as the study outcomes will indicate the best choice of hearing devices for individual children, and help to determine best-practice management if bilateral implants become an option for all children.Read moreRead less
Certain Death In Uncertain Time: A Qualitative Study Of The Experience Of Advanced Ovarian Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$221,755.00
Summary
Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful termi ....Modern medicine aims to find effective treatments for life-threatening diseases. Cures are seldom found, however. More typically, rapidly fatal diseases gradually become less rapidly fatal. Consequently, there is a category of patients who are certain they will die from their disease or a related factor, but who are equally uncertain as to whether they have weeks or years left to live. It is difficult to discuss this predicament because we do not even have a name for it, let alone a useful terminology to describe it. The absence of discussion exacerbates patients' social isolation. Also, the quality of their remaining life, and the quality of the care they get, depends heavily on the quality of understanding and communication within the social systems that support them. A growing proportion of patients in developed countries fall into this category, including the 1200 Australian women who are diagnosed each year with advanced ovarian cancer. This study aims to increase our understanding of the experience of certain death in uncertain time by recruiting a group of 20 women with advanced ovarian cancer, and interviewing them every few months over three years. The study will explore all aspects of the experience of having advanced ovarian cancer, and generate a terminology for it - one that grows out of the women's own language. The study will inform the organisation and delivery of clinical care and services to women with ovarian cancer. It will also inform patient education programs, and help to tune medical education to the particular needs and perceptions of patients who are experiencing the certainty of death in uncertain time. Finally, the researchers will also explore the implications of the findings for medical ethics and health law, and for communication, information and decision-making in cancer medicine.Read moreRead less
Social Aspects And Cultural Meanings Of Gynaecological Cancer Diagnosis, Treatment And Adjustment Of Victorian Women
Funder
National Health and Medical Research Council
Funding Amount
$158,500.00
Summary
Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social fact ....Most research worldwide concerning gynaecological cancers has related to cervical cancer screening because of the effectiveness of Pap tests, while limited research has been conducted on social aspects of cancer. However, cancer of the uterus and ovary are among the top ten cancers in Australian women, and the diagnosis of a gynaecological cancer has a profound effect on women. This study is concerned with women's understandings of cancer disease, its treatment and outcomes, and with social factors that may influence their treatment decisions and care. The study will be conducted in metropolitan and rural Victoria. Women from a variety of ethnic, language and social backgrounds, who have been diagnosed with gynaecological cancer in the preceding three years, will be interviewed to gain insight into their understandings and experiences of the processes of disease, diagnosis and treatment procedures, the implications of for daily life, and the relationship of these events to their perceptions of their bodies, gender and sexuality. We will also interview oncologists and cancer support group facilitators, and participate in cancer support groups, to examine the role of such groups and to explore the experiences of health professionals providing care to women with these cancers. Research findings will be used to develop health educational information about gynaecological cancers, and to provide information to hospitals and clinicians to improve quality of clinical care and social support.Read moreRead less
Exploration Of Exposures Associated With Bedding That Are Risks For Childhood Allergy And Asthma Symptoms
Funder
National Health and Medical Research Council
Funding Amount
$263,500.00
Summary
Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. Howe ....Asthma prevalence in Australia has doubled in the last 20 years, with 1 in 4 children now affected. House dust mites are probably the single most important allergen associated with asthma. The prevalence of mite allergy is linked to exposure, and such allergy when combined with high exposure, is a potent risk factor for asthma exacerbations. The current international advice for managing mite-allergic asthma, strongly advocates the use of bedding encasings as the best way to reduce exposure. However, three recent major trials using encasings and a meta-analysis of earlier trials all fail to show a clinical benefit. One of the applicants (ET) recently showed, using expertise in measuring personal exposure, that these encasings, as used, fail to significantly reduce aeroallergen exposure. By contrast, 3 recent Australian studies, involving the applicants, AK, ALP and NG showed that feather bedding compared to synthetic bedding, was strongly protective for asthma - the opposite of public advice. The suggested mechanisms involve reduced exposure to mite allergens, or altered exposure to bacterial endotoxin, but persuasive experimental support is lacking. We also propose a novel hypothesis that feather exposure may induce allergic 'tolerance'. Currently there is a lack of certainty about valid approaches to prevent asthma, and the Global Initiative for Asthma has described the need to understand mechanisms and improve interventions as urgent. This project is an ideal opportunity to combine the expertise of the CIA (ET) in measuring airborne exposures (mite, endotoxin, proteins) with that of the others who have expertise in children's asthma, and who are already involved in two large clinical trails involving different bedding and allergen avoidance. Our measurements of these bedding exposures and their clinical outcomes will provide, for the first time, a quantitative basis to refine public health allergen-based interventions to prevent and manage asthma.Read moreRead less