The Effect Of Exogenous Hormones, Smoking And HPV On The Incidence Of Screen Detected Pre-invasive Cervical Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$1,201,168.00
Summary
Cervical cancer is one of the leading causes of cancer death in women internationally. About 15,000 women are detected in NSW annually as having pre-invasive cervical cancer (cervical intraepithelial neoplasia (CIN) grade I, II or III). Infection with certain high risk human papillomaviruses is known to be necessary for the development of cervical cancer. In addition, recent long term exposure to smoking and to hormonal contraception are two new factors considered as independent risk factors for ....Cervical cancer is one of the leading causes of cancer death in women internationally. About 15,000 women are detected in NSW annually as having pre-invasive cervical cancer (cervical intraepithelial neoplasia (CIN) grade I, II or III). Infection with certain high risk human papillomaviruses is known to be necessary for the development of cervical cancer. In addition, recent long term exposure to smoking and to hormonal contraception are two new factors considered as independent risk factors for the disease. Hormone replacement therapy (HRT) preparations taken around the menopause are a similar composition to hormonal contraceptives, (oestrogen and progestogen), therefore women on HRT may also be at increased risk. No comprehensive study exists internationally to measure the relative importance of these exogenous hormones on the development of pre-invasive cervical cancer in a way that is of public health relevance (e.g. recent long-term use of oral contraceptives and time since stopped, and among smokers and non-smokers). No Australian data are available on the proportion of women who are current users of hormonal contraceptives or HRT. No local prevalence data on the major high risk HPV subtypes (e.g. 16, 18, 33, 45) are available for Australia to describe its distribution and to inform the cervical screening program and future vaccine initiatives. The NSW Pap Test Register holds the screening history of all women on the cervical screening program, hence this is an ideal source for recruiting a representative sample into a study. We wish to conduct a large study of ~2600 NSW women using the NSW Pap Test Register to measure the relative importance of hormones, smoking and HPV infection on the development of CIN II or III.Read moreRead less
Targeting early contact with the criminal justice system in young people. This project aims to identify who and why young people first come in contact with the criminal justice system and what determines the early course of contact. The project will focus on first police contact, as a victim, witness or offender, as a means of identifying young people at-risk of adverse life outcomes. It intends to build on the NSW Child Development Study, a large population-based intergenerational cohort, to de ....Targeting early contact with the criminal justice system in young people. This project aims to identify who and why young people first come in contact with the criminal justice system and what determines the early course of contact. The project will focus on first police contact, as a victim, witness or offender, as a means of identifying young people at-risk of adverse life outcomes. It intends to build on the NSW Child Development Study, a large population-based intergenerational cohort, to develop services and interventions aimed at preventing young people from becoming enmeshed in the criminal justice system.Read moreRead less
The Interaction Between Sexually Transmissible Infections And Human Immunodeficiency Virus Infection In Homosexual Men
Funder
National Health and Medical Research Council
Funding Amount
$635,931.00
Summary
This project examines the inter-relationship between HIV infection and sexually transmitted infections (STIs) in homosexual men. The overall goal of the projet is to inform the development of STI prevention and treatment strategies which may be important in reducing HIV incidence in this population. Homosexual men comprise over 80% of people diagnosed with HIV infecton in Australia, and in many developed nations are one of the largest groups affected by HIV. Rates of other STIs are also increase ....This project examines the inter-relationship between HIV infection and sexually transmitted infections (STIs) in homosexual men. The overall goal of the projet is to inform the development of STI prevention and treatment strategies which may be important in reducing HIV incidence in this population. Homosexual men comprise over 80% of people diagnosed with HIV infecton in Australia, and in many developed nations are one of the largest groups affected by HIV. Rates of other STIs are also increased in homosexual men. Currently, HIV rates are increasing in Australia and in many developed countries. We are in need of new and effective methods of HIV prevention. Data in heterosexuals suggest that where STIs are common, the early detection and treatment of these infections may help reduce HIV incidence. There are few data on this relationship in homosexual men. We propose to utilise an existing Sydney cohort of homosexual men to collect data on biologic tests for STIs, history of recent diagnosis of STIs, and symptoms, to allow a comprehensive description of the epidemiology of STIs and their overlap with HIV. The quality of data on the interaction between HIV and STIs in this cohort will be superior to any previously collected in homosexual men, as it will include data on self-reported doctor diagnosed illness, state of the art biologic testing, and symptom data, for the full spectrum of important STIs. The results of this study will be helpful in determining strategies for HIV and STI screening, education and control in the population which comprises the great majority of cases of HIV infection in Australia, and one of the largest risk groups for HIV infection in the developed world. Screening coupled with treatment of asymptomatic STIs may be an effective new approach to HIV prevention in this population.Read moreRead less
Prevention Of Multi-drug Resistant Tuberculosis In A High Prevalence Setting: ‘Connecting The DOTS’ In Vietnam
Funder
National Health and Medical Research Council
Funding Amount
$3,382,020.00
Summary
The close contacts of people with multi-drug resistant tuberculosis (MDR-TB) have a high risk of developing the disease. The V-QUIN MDR-TB Trial will evaluate the effectiveness of an oral antibiotic (levofloxacin) in preventing drug resistant TB among infected household contacts of TB patients. Household contacts from 10 Provinces in Vietnam will be randomly allocated to receive six-months of either levofloxacin or a placebo, and then followed for two years to see if they develop tuberculosis.
Reducing antibiotic usage in pig herds: controlling Lawsonia intracellularis by vaccination, housing and hygiene. Pigs are major consumers of antibiotics in Australia. Many of these antibiotics are fed to pigs to prevent proliferative enteritis (PE). There are increasing public concerns regarding the development and spread of antibiotic-resistant bacteria and the potential impact on human health. The adoption of an effective commercial vaccine to prevent PE will reduce the volume of antibiotics ....Reducing antibiotic usage in pig herds: controlling Lawsonia intracellularis by vaccination, housing and hygiene. Pigs are major consumers of antibiotics in Australia. Many of these antibiotics are fed to pigs to prevent proliferative enteritis (PE). There are increasing public concerns regarding the development and spread of antibiotic-resistant bacteria and the potential impact on human health. The adoption of an effective commercial vaccine to prevent PE will reduce the volume of antibiotics used in the pig industry and hence reduce the risk of antibiotic-resistant bacteria developing.Read moreRead less
HIV Treatment As Prevention: A Longitudinal Assessment Of Population Effectiveness
Funder
National Health and Medical Research Council
Funding Amount
$783,160.00
Summary
This project is a large-scale evaluation of an HIV strategy known as ‘treatment as prevention’ (TasP). Through routine and repeat HIV testing for gay men and early treatment initiation following diagnosis, TasP aims to reduce HIV community infection rates. Through the establishment of a large cohort of gay men in NSW and Victoria, this study will track HIV testing, treatment and management to assess the real-world efficacy of TasP for reducing HIV infections among this at-risk population.
Disparities In Care And Outcome For People With Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$74,047.00
Summary
This thesis will investigate disparities in lung cancer care and outcomes, provide an overview of lung cancer disparities in NSW and seek to identify and assess an intervention to reduce lung cancer disparities. This will involve a systematic review of cancer disparity measures, empirical research to investigate patterns and predictors of disparity. Mixed methods will be used to investigate observed disparities and identify interventions to improve cancer care and outcomes in vulnerable groups.
Temporal Trends In The Incidence, Site And Survival Of Metastatic Breast Cancer In Australia
Funder
National Health and Medical Research Council
Funding Amount
$190,494.00
Summary
There have been major advances in breast cancer treatment over the last decade. This project will use information collected from the NSW cancer registry and hospitals to report on changes in the type and risk of breast cancer spread and survival for women with a new diagnosis of breast cancer before and after new treatments introduced since 2005. This information is essential for doctors to provide women with up-to-date information; and for planning appropriate health services and research.
Optimising Care For Patients Diagnosed With Pancreatic Cancer: A Prospective Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$1,399,839.00
Summary
There is evidence from previous research in Queensland and NSW that elements of care provided to patients with pancreatic cancer are sub-optimal. We aim to improve compliance with evidence-based guidelines in Victoria and NSW by collecting high quality data, providing reports to hospitals benchmarking their performance against peers and working with health services to reduce variation. Making sure care known to improve practice is being delivered is as important as developing new targeted thera
Pathways, policies and prevention: better outcomes for western Australian children. This project will provide new knowledge to inform and enable future policy and prevention strategies for improving child health and wellbeing. The collaboration between researchers and policy makers across 11 government departments will deliver a new evidence base for understanding child, family and community level factors that increase or reduce vulnerability to poor outcomes through the utilisation of cross-sec ....Pathways, policies and prevention: better outcomes for western Australian children. This project will provide new knowledge to inform and enable future policy and prevention strategies for improving child health and wellbeing. The collaboration between researchers and policy makers across 11 government departments will deliver a new evidence base for understanding child, family and community level factors that increase or reduce vulnerability to poor outcomes through the utilisation of cross-sectoral population data. This collaboration will inform whole of government intervention and prevention strategies to improve outcomes, as well as evaluate and monitor existing initiatives. This project will provide a model for population-based research and policy development both nationally and internationally.Read moreRead less