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
A Study To Pilot A Clinical Trial To Test Dignity Psychotherapy For The Frail Aged
Funder
National Health and Medical Research Council
Funding Amount
$25,000.00
Summary
One of the greatest challenges today is to preserve the dignity of the frail elderly. Our study will test and perfect a strategy to trial a new approach for this population, Dignity Psychotherapy. The approach will document aspects of the senior's life that they regard as meaningful, want remembered, or of which they are proud. Among the terminally ill, the approach has had positive outcomes. Benefits for elders may include that the approach forms a foundation for holistic care.
ACTIVE Dialysis: A Clinical Trial Of IntensiVE Dialysis
Funder
National Health and Medical Research Council
Funding Amount
$1,310,836.00
Summary
People with kidney disease requiring dialysis have substantially reduced life expectancy, poorer health status and quality of life. Better treatments are therefore urgently required. ACTIVE Dialysis is a clinical trial that will assess whether increased duration of dialysis improves these critical outcomes. A formal cost-effectiveness analysis will be conducted from a health system perspective.
This Study aims to answer the question: When is the best time for adults with kidney disease to start dialysis? This question is currently a subject of intense international debate. It has been suggested that patients who commence dialysis relatively early, when they still have a high level of remaining kidney function, have fewer complications, maintain a better level of function in the community and are less likely to die as a result of their kidney disease. However, this has not been determin ....This Study aims to answer the question: When is the best time for adults with kidney disease to start dialysis? This question is currently a subject of intense international debate. It has been suggested that patients who commence dialysis relatively early, when they still have a high level of remaining kidney function, have fewer complications, maintain a better level of function in the community and are less likely to die as a result of their kidney disease. However, this has not been determined in a rigorous scientific manner. In fact starting dialysis earlier may expose the person to the risks associated with the use of dialysis and may also impact on their quality of life. Many international kidney societies have formulated guidelines recommending that dialysis should be commenced early - when the remaining kidney function drops to a level of approximately 10-15% of normal kidney function. Recent practice in Australia and New Zealand has been to commence dialysis when the remaining kidney function is between 6 and 9% of normal. Hence, the adoption of these guidelines recommending an earlier dialysis start time will have a significant impact on health costs; therefore a net benefit to the patient and the community, needs to be demonstrated. To answer this important question, we have designed and instituted a multi-center trial, that was commenced in 2000. The trial has been scientifically designed (randomised controlled trial) to compare the effect of early start dialysis (remaining kidney function between 10-14%) versus late start dialysis (remaining kidney function between 5-7%) on survival, disease and dialysis complications and subsequent hospitalization. To date 748 of the required 800 patients have been entered into the trial and will be followed for a minimum of 3 years. We are confident the results of this trial will impact at a local, national and international level, delineating best practice management of dialysis in people with kidney failure.Read moreRead less
To investigate alternative strategies to treat end stage renal disease we have transplanted embryonic kidneys into the wall of the abdominal cavity of adult hosts where they become vascularised and undergo continued but limited development. Strategies to enhance their growth-development and decrease immunogenicity-rejection will now be determined, and the origin of a 'ureter-like' tube of tissue that grows to connect the transplanted embryonic kidney with the recipient bladder investigated.
Systematic Expansion Of The Clinical Evidence Base In Opioid Prescribing For Refractory Dyspnoea At The End Of Life
Funder
National Health and Medical Research Council
Funding Amount
$414,535.00
Summary
Morphine can relieve breathlessness in the palliative setting. But many important questions remain. What is the best dose, should the dose change over time, do different medications provide the same relief, and how common is dyspnoea in the general population? This three part project will extend our knowledge to answer these questions. Population data will provide critical background to plan best care for future palliative patients distressed by breathlessness.
Ageing Well And Productively: Pathways To Healthy Workforce Participation And Caregiving.
Funder
National Health and Medical Research Council
Funding Amount
$143,660.00
Summary
Good health is vital to increase workforce participation,which enables us to pay for rising health care costs. This study will examine how socio-economic, behavioural, environmental and health-related factors impact on healthy workforce participation among older Australians. It will identify ways to prevent people having to retire early because of ill-health and will inform policy makers and health program developers about how best to maintain or increase a healthy workforce participation.
Foot Complications Associated With End-stage Renal Disease.
Funder
National Health and Medical Research Council
Funding Amount
$99,002.00
Summary
People with renal failure and diabetes have been found to be at a high risk for serious foot complications including; foot ulceration and amputation. Currently, there is limited research regarding the risk of developing these foot complications in people with renal failure, without the influence of diabetes. Therefore, this study aims to evaluate whether people with renal failure, without diabetes, are at risk for developing foot complications.
ARDAC (Antecedents Of Renal Disease In Aboriginal Children) Follow-up Study
Funder
National Health and Medical Research Council
Funding Amount
$298,268.00
Summary
Indigenous people world-wide have higher rates of kidney failure than non-Indigenous people. Aboriginal Australians have the highest rates of kidney failure in the world, especially in those living in remote areas. The reasons for this are complex, and include well-known environmental risk factors that contribute to many diseases in Aboriginal people - socio-economic disadvantage, higher rates of infection, smoking, alcohol abuse and poor nutrition. There are also biological risk factors more sp ....Indigenous people world-wide have higher rates of kidney failure than non-Indigenous people. Aboriginal Australians have the highest rates of kidney failure in the world, especially in those living in remote areas. The reasons for this are complex, and include well-known environmental risk factors that contribute to many diseases in Aboriginal people - socio-economic disadvantage, higher rates of infection, smoking, alcohol abuse and poor nutrition. There are also biological risk factors more specific to kidney disease such as low birth weight babies, reduced kidney volume, female sex, family history of kidney disease, genetic influences, over and under-nutrition and high blood pressure. Many of these risks may take effect in childhood, resulting in silent kidney damage that may become chronic in adulthood when diabetes and other influences take effect. In order to clarify the degree of risk early influences have on Aboriginal kidney disease before adult confounders complicate the picture, a unique study of early signs of kidney disease in outwardly healthy Aboriginal children was planned. These school children come from different locations across NSW, and have a non-Aboriginal comparator group. The first primary aims are complete: To determine: 1. Rates of blood and protein in the urine, and high blood pressure in Aboriginal as compared to non-Aboriginal children. These are the early markers, or antecedents of kidney disease; 2. If these antecedents differ over urban, coastal, rural and remote regions, and socio-economic areas; 3. Any association between antecedents and other risk factors such as age, gender, birth weight and growth; Secondary aims are currently underway: To determine: 1. The natural history of these antecedents of kidney disease by following these children for a further 4 years; 2. Which risk factors are more likely in children with persisting antecedents -ie the children more likely to develop serious kidney disease.Read moreRead less