Curtin University

Working together to understand the factors which could be used to predict outcome following TBI, researchers examined factors related to social support, health, clinical care, biological markers, acute interventions, and longer-term outcomes. A team of Australia's leading health researchers has developed a new 'dictionary' to better predict outcomes for people who have experienced a moderate-severe traumatic brain injury (TBI). The Australian Traumatic Brain Injury Initiative (AUS-TBI) is a consortium of academics, researchers and healthcare professionals from institutions across the country. Working together to understand the factors which could be used to predict outcome following TBI in a study supported by the Australian Medical Research Future Fund Mission for TBI, the team examined factors related to social support, health, clinical care, biological markers, acute interventions, and longer-term outcomes. Published across eight articles in a special edition of the Journal of Neurotrauma, this work culminated in a Single Data Dictionary: a master list of information that if collected would give the best chance at understanding how a person will recover from their brain injury. Consortium lead and Curtin University Deputy Vice-Chancellor, Research Professor Melinda Fitzgerald said predicting each individual's outcome following a TBI was critical -- but also very difficult. "The rate and degree of recovery after moderate-severe TBI varies greatly, due in part to the complex and diverse nature of these injuries," Professor Fitzgerald said. "Despite decades of empirical research, prediction of outcomes after TBI for individual patients remains imprecise: we have only partial understanding of what it is about the person, their injury, their environment, or their care that moderates and/or determines the multiple outcomes that contribute to their quality of life. "At present, there is no indicator or group of indicators that can sufficiently predict treatment outcome or responsiveness to allow for personalised acute care and rehabilitation for patients with TBI." To create the Single Data Dictionary, the AUS-TBI team examined thousands of published research articles reporting factors which may impact a person's recovery, such as their medical history, social contexts, biological markers, level of personal support, effectiveness of treatment and more. The team also consulted extensively with people who have lived experience of TBIs, including an Aboriginal and Torres Strait Islander Advisory Group, to develop the Single Data Dictionary of predictive markers alongside guidelines on how to collect them in a coordinated, culturally sensitive national approach. Co-author Dr Sarah Hellewell, from Curtin's Faculty of Health Sciences, Curtin Health Innovation Research Institute and the Perron Institute, said providing personalised care to ensure the best outcomes for patients was critical, as TBIs are often catastrophic and have lifelong impact on patients, their families, workplaces, the criminal justice system and society as a whole. "Severe TBI has a mortality rate of 30-40 per cent, less than 50 per cent of patients achieve long-term independence and new injuries add $2 billion in lifetime direct costs to the Australian healthcare system each year," Dr Hellewell said. "Between 2006 and 2015, there was no change in survival or functional outcomes following TBI, proving the need for better, targeted management strategies to reduce mortality and improve quality of life for these individuals and reduce negative impacts on families and society." Organisations also involved in the consortium include the Perron Institute, Telethon Kids Institute, Monash University, Griffith University, Deakin University, University of Sydney, University of Queensland, University of Adelaide, University of Melbourne, University of Newcastle, Synapse, Hunter Medical Research Institute, John Hunter Hospital, Brightwater Care Group, The Children's Hospital at Westmead and Epworth HealthCare.

Researchers analyzed 52 studies involving more than 4 million pregnancies across 22 countries to investigate the health impacts of miscarriage, abortion and recurrent pregnancy loss (more than two miscarriages in succession) on subsequent pregnancies. The study found different health risks for each group. New Curtin University research has revealed a link between miscarriage and the increased risk of developing complications of gestational diabetes and high blood pressure-related disorders in later pregnancies. Researchers from the Curtin School of Population Health analysed 52 studies involving more than 4 million pregnancies across 22 countries to investigate the health impacts of miscarriage, abortion and recurrent pregnancy loss (more than two miscarriages in succession) on subsequent pregnancies. The study found different health risks for each group. People who had experienced a miscarriage were 44 per cent more likely to develop gestational diabetes during later pregnancies but only 6 per cent more likely to develop high blood pressure in subsequent pregnancies. Conversely, people who had experienced recurrent pregnancy loss showed no increased risk of gestational diabetes but were 37 per cent more likely to develop pre-eclampsia, a potentially dangerous complication characterised by high blood pressure, in later pregnancies. There was no evidence linking abortion to diabetic or hypertensive related issues, either during or outside of pregnancy. Lead study author Dr Jennifer Dunne said establishing the links between pregnancy loss, diabetes and high blood pressure could have a far reaching impact. "Miscarriages occur in 15-25 per cent of all pregnancies -- which is around 23 million per year, globally," Dr Dunne said. "Gestational diabetes and high blood pressure disorders in pregnancy can cause a variety of significant health problems; understanding the relationship between pregnancy loss and later pregnancy complications could reveal new ways to mitigate risks or possibly prevent these conditions from progressing. "Further research into the biological links between pregnancy loss and later health issues might reveal new targets for developing treatments." Dr Dunne said the study added to what was already known about pregnancy complications and health later in life, even beyond pregnancy. "Knowing miscarriage can lead to these pregnancy complications later on is important, as these conditions during pregnancy have previously been linked to a higher risk of people developing heart disease later in life," Dr Dunne said. "By shedding light on the long-term health effects of miscarriages and repeated pregnancy losses, this study paves the way for improved healthcare strategies, research, and support for those affected -- hopefully enhancing the outcomes for parents and babies in future pregnancies."

New research has shown the warming climate will turn Australia's soil into a net emitter of carbon dioxide (CO2), unless action is taken. Soil helps to keep the planet cool by absorbing carbon, however as the climate gets warmer its ability to retain carbon decreases -- and in some instances can start to release some carbon back into the air. A global research team has predicted the changes in the amount of carbon in Australia's soil between now and the year 2100. New Curtin University research has shown the warming climate will turn Australia's soil into a net emitter of carbon dioxide (CO2), unless action is taken. Soil helps to keep the planet cool by absorbing carbon, however as the climate gets warmer its ability to retain carbon decreases -- and in some instances can start to release some carbon back into the air. A global research team -- led by Professor Raphael Viscarra Rossel from Curtin's School of Molecular and Life Sciences -- predicted the changes in the amount of carbon in Australia's soil between now and the year 2100. To do so, the team ran simulations using three different paths for society: an eco-focused 'sustainable' scenario, a 'middle-of-the-road' scenario and another which predicted a continued reliance on 'fossil-fuelled development'. It found Australian soil will be a net emitter and could account for 8.3 per cent of Australia's total current emissions under the 'sustainable' scenario and more than 14 per cent by 2045 under the 'middle-of-the-road' and 'fossil-fuelled' scenarios. By 2100, soil emissions under both scenarios are predicted to account for an even higher proportion of total emissions, but the predictions are more uncertain. While some areas with arable farmland could continue to store carbon, the study found it would not be enough to offset the amounts of carbon lost from the soil in areas which are more sensitive to warmer weather, such as coastal regions and Australia's vast rangelands. Australian soil holds an estimated 28 gigatons of carbon, 70 per cent of which is stored in these rangelands. "Unless farming methods are further improved so farmland soils can continue to store carbon, any gains and benefit will likely decrease by 2045 and worsen in time, if the Earth continues to warm at its current rate," Professor Viscarra Rossel said. "This means Australia's soil could release even more carbon into the air instead of storing it, which will in turn make climate change worse. "If emissions continue at the current rate, the Earth's temperature is expected to reach 2 degrees above pre-industrial temperatures sometime this century, which is predicted to have dire consequences and potentially catastrophic impacts for the planet." Professor Viscarra Rossel said more sustainable pathways and improved management and conservation of soils were essential for Australia to meet its emissions reduction goals. "Ensuring Australia's rangeland soils can maintain their carbon stocks is imperative: capturing and storing additional carbon will require interdisciplinary science, innovation, cultural awareness and effective policies" Professor Viscarra Rossel said. "It will be challenging, given the rangelands' drier and more variable climate, its relatively sparse vegetation and other factors such as bushfires -- however, only a slight change over such large areas will make a positive difference. "Innovative grazing management, cultural burning and regenerating biodiverse, endemic native plant communities, for example, could see rangelands soils absorb and store more water and carbon, reduce erosion and lead to more stable ecosystems -- and ultimately, fewer emissions."