Prognostic Factors Following A First Episode Of Central Nervous System Demyelination Suggestive Of Multiple Sclerosis.
Funder
National Health and Medical Research Council
Funding Amount
$719,475.00
Summary
Multiple sclerosis is the second most common cause of neurological morbidity in young Australians after trauma. Knowing who will progress to develop multiple sclerosis after a first attack and at what rate they will progress is an important question as it will allow us to target treatment to those at greatest risk and modify a person's lifestyle to reduce the risk of developing MS or slow their rate of progression.
Retinal Vascular Signs As Predictors Of Systemic Disease Outcomes: 10-year Evolution In A Population-based Cohort
Funder
National Health and Medical Research Council
Funding Amount
$389,575.00
Summary
Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important sys ....Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important systemic health outcomes in the population-based cohort of residents attending the Blue Mountains Eye Study (BMES. Two types of retinal signs will be evaluated: firstly, the presence of specific clinical signs, such as focal narrowing of small retinal vessels (arterioles), nicking of retinal veins as arterioles cross them or presence of retinopathy (haemorrhages and other signs) secondly, measures of generalized retinal vessel calibre (narrowing) using a computer-assisted method developed for the U.S. studies. We will also develop new grading methods for two other signs. Late and will compare computer-assisted grading from 35mm slides to automated grading of vessels using a scanning device (being developed) to screen the eyes of older persons. This project builds upon our current 3-year NHMRC grant (ID153948; 2001-2003) Retinal vascular signs as risk markers for incident stroke or cerebrovascular death: A population-based assessment . In the last 2 years, this has explored different aspects of measurement and grading of these signs, has documented their relation to blood pressure and has begun to assess whether these features predict vascular events and other systemic outcomes in older Australians. The new project will assess the evolution of retinal microvascular signs over a 10-year period, using data and retinal photographs from the 10-year examinations of the BMES cohort, currently being collected, in a further current NHMRC grant (ID211069; 2002-2004).Read moreRead less
A Long Term Follow-up Of The Offspring Cohort: A Controlled Study Of Those At Higher Risk Of Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$238,168.00
Summary
Osteoarthritis is the most common musculoskeletal disorder. Despite this, relatively little is known about how the disease develops. This study will use a powerful technique known as MRI scanning to determine the sequence of changes over 10 years in subjects at higher risk of osteoarthritis (based on their family history) but who do not yet have established disease on radiographs (even though many have symptoms).
Retinal Vascular Signs As Risk Markers For Incident Stroke Or Cerebrovascular Death: A Population-based Assessment
Funder
National Health and Medical Research Council
Funding Amount
$410,199.00
Summary
Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of ....Stroke remains a major cause of disability and death in Australia. Preliminary data from the Blue Mountains Eye Study suggest that blood vessel changes observed in the retina at the back of the eye may provide signs of an increased risk of stroke or death from stroke. Importantly, although stroke is strongly associated with elevated blood pressure, the risk associated with these blood vessel signs seems to be independent of blood pressure. The proposed study will conduct a detailed re-grading of retinal photographs taken on people who attended the Eye Study during 1992-4 and 5-year follow-up exams during 1997-9. We will grade these photographs manually (using a stereo-viewer), and with computer assistance to measure changes in the diameter of small arteries in the retina and other signs. By closely matching our grading technique to that used in a large American Study, we hope to develop reliable grading for these signs and will be able to compare our findings internationally. Our aim is to assess the frequency of abnormal retinal vessel changes in people of different age groups as well as the development and progression of these signs over time. Their relationship to well known vascular risk factors like smoking, blood pressure, obesity, diabetes and cholesterol will also be investigated. We hope to be able to discriminate those changes associated with an increased stroke risk from those due to normal ageing. We expect that the increased stroke risk associated with abnormal retinal vessel changes may be greater than shown in our early data. If confirmed, then these findings may provide a more sensitive and objective measure of stroke risk than relying on traditional risk factors, which are difficult to quantify and change with time. We may be able to develop simple rules so that doctors using an ophthalmoscope or examining a retinal photograph could identify high risk patients. These people could benefit from interventions to reduce their risk.Read moreRead less
The Relationship Between Airborne Particle Exposure, Incident Respiratory Symptoms And Decline In Lung Function
Funder
National Health and Medical Research Council
Funding Amount
$315,497.00
Summary
Air pollution has been consistently identified as the environmental health problem of greatest concern to the general public in Australia. Yet hard evidence of adverse health effects from air pollution in Australian cities and towns is limited to date. It has been estimated that high levels of particles in urban air could be responsible for as many as 2,400 deaths nationally, costing approximately $4,300 million each year. This study will follow two groups of young Melbourne adults recruited som ....Air pollution has been consistently identified as the environmental health problem of greatest concern to the general public in Australia. Yet hard evidence of adverse health effects from air pollution in Australian cities and towns is limited to date. It has been estimated that high levels of particles in urban air could be responsible for as many as 2,400 deaths nationally, costing approximately $4,300 million each year. This study will follow two groups of young Melbourne adults recruited some years ago for studies of respiratory health. They will be a sent a questionnaire by mail and invited back to our laboratory for breathing tests. We will obtain routinely collected air quality data and measure fine particles < 2.5 thousandths of a mm in outdoor air. A subgroup of 100 subjects will also participate in some measurements of indoor air pollution. The analysis will look for relationships between particles in the air, new symptoms and changes in lung function over time. Comparisons will also made with other centres doing a very similar study in Europe. Reviews commissioned by the National Environment Protection Council have highlighted the lack of Australian data to assist in setting standards for particulate air pollution. The proposed study would provide some of the necessary local data and assist in the development of new health based environmental protection measures for fine particles. Once these measures have been implemented, we would expect to see an improvement in the respiratory health of the Australian population.Read moreRead less
Metabolic Syndrome, Inflammation And Non-alcoholic Fatty Liver Disease In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$351,300.00
Summary
The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic synd ....The metabolic syndrome is a clustering of obesity, insulin resistance, high cholesterol and high blood pressure. It could affect up to 30% of the population and often leads to diabetes and heart disease. Fatty liver disease is a chronic liver condition that often has no symptoms but can lead to serious liver damage. It could affect up to 25% of the population and is common even in people who drink very little alcohol. The rising prevalence of obesity in Australia suggests that the metabolic syndrome and fatty liver disease may be on the increase and therefore so too could diabetes and heart disease which already consume significant health resources. Using the unique health data collection of the Busselton Health Study in Western Australia, this project will help to determine how common these conditions are in Australia and lead to a better understanding of the nature and causes of these conditions including the possible role of chronic inflammation. This important information will be used to provide opportunities for better risk assessment, disease prevention, and earlier intervention.Read moreRead less
Risk Factors For Molecular Sub-types Of Colorectal Cancer
Funder
National Health and Medical Research Council
Funding Amount
$439,194.00
Summary
Colorectal cancer is Australia's most common cancer. It actually has several subtypes that probably have different causes and which may respond differently to treatment . The aim of this study is to see whether risk factors for a newly identified form of colorectal cancer, called CIMP, differ from those for the more common form of colorectal cancer. Knowing this may help us understand better how the disease is caused and so design better ways to prevent it.
Practical Tools For Robust Analysis Of Large Epidemiological Studies With Incomplete Data
Funder
National Health and Medical Research Council
Funding Amount
$358,492.00
Summary
Studies of the causes and consequences of health outcomes follow large cohorts of individuals for long time periods. A major challenge in analysing data from these studies is that information is often incomplete. Participants rarely complete all waves of data collection, or provide all requested information. Statistical research has led to increased use of a statistical method (multiple imputation) that recovers information from incomplete cases. This project will develop and improve this method
Inter-relationships Between Life-stage Transitions, Depression And Cardio-metabolic Health In Young Adults
Funder
National Health and Medical Research Council
Funding Amount
$360,325.00
Summary
This study will investigate how social transitions and depression in young Australian adults affect the development of obesity and the adoption or persistence of behaviours that are associated with the risk of heart disease and diabetes. These behaviours include smoking, poor diet, physical inactivity and alcohol consumption. A better understanding of how psychosocial factors influence risk factors for heart disease and diabetes is needed to improve prevention strategies.