Blue Mountains Cohort Study: Long-term (15-year) Incidence Of Eye Disease, Hearing Loss And Other Public Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$837,919.00
Summary
The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors pred ....The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors predict the risk or age at onset of eye disease or hearing loss. We will assess impacts of vision and hearing loss on independence, falls, quality of life and development of memory loss and depression. This information will help to develop services, and to plan interventions to prevent and treat these conditions. Because of the exponential age-related increase in frequency of these diseases, this long follow-up will provide more disease events, and a longer interval to assess impacts from the exposures we measured when we started the BMES in 2002. It will enable us to estimate the strength of risk factors for eye disease and hearing loss with greater precision, essential to understand their evolution. Surviving participants from the original BMES will be invited to attend follow-up exams at our Katoomba clinic, or to attend mobile- nursing home exams. We will conduct similar exams to those previously to detect new or worsened eye disease or hearing loss. In 2002-4, we saw 82% of the population of 2 Blue Mountains postcodes aged 50 or older. At the 5- and 10-year exams we saw 75% of people still living. We expect the same proportion to participate this time. The BMES is one of Australia's main cohort studies with over 200 publications. It has yielded key findings on the frequency and causes of the major diseases threatening vision and hearing. Longer follow-up will greatly increase our power to detect predictors of these key age-dependent conditions.Read moreRead less
A Population-based Longitudinal Study Of Cancer Survivors' Psychosocial And Physical Well Being
Funder
National Health and Medical Research Council
Funding Amount
$454,600.00
Summary
Cancer control is a National Health Priority Area. About 345,000 new cases of cancer are diagnosed in Australia each year. It is the second highest cause of death accounting for 27% of all deaths in Australia each year. Improvements in diagnosis and treatment have resulted in a growing number of people living with a history of cancer and for longer periods. Many cancer survivors report experiencing negative effects of cancer such as fatigue, anxiety, depression, and disrupted family and social r ....Cancer control is a National Health Priority Area. About 345,000 new cases of cancer are diagnosed in Australia each year. It is the second highest cause of death accounting for 27% of all deaths in Australia each year. Improvements in diagnosis and treatment have resulted in a growing number of people living with a history of cancer and for longer periods. Many cancer survivors report experiencing negative effects of cancer such as fatigue, anxiety, depression, and disrupted family and social relationships well after treatment has finished. Despite the large burden of this disease, little is known about the later effects that cancer and its treatment has on cancer survivors, their ongoing concerns, how the issues they face change over time and the type of support they need. This will be the first population-based longitudinal survey of the physical and psychosocial effects that cancer has on adult cancer survivors to be undertaken in Australia. It will follow cancer survivors for the first five years from diagnosis to provide data on important outcomes including anxiety, depression, quality of life and unmet needs. It will also provide the first population-based data on the predictors of these outcomes, including social support, coping style and patient demographic, treatment and disease characteristics. Given the large-scale cancer survivorship initiatives underway internationally, it is timely for high quality and comprehensive Australian data to be obtained. These data will provide new information on how the physical, social and emotional impact of cancer changes with time since diagnosis and a better understanding of the support desired by cancer survivors at various stages of recovery or disease progression. This information will help guide the development of policies and services that are tailored to the needs of Australian cancer survivors.Read moreRead less
Genetic and environmental causes of asthma are poorly understood. The WATCH for asthma project will study Western Australian (WA) families in which there was a twin or higher order multiple birth (twin families) in order to measure inherited and environmental contributions to the development of asthma. All WA twin families, whose infants were born during 1990 to 1995, will be invited to become part of an existing Healthway funded, population based registry of WA Twin Child Health (the WATCH stud ....Genetic and environmental causes of asthma are poorly understood. The WATCH for asthma project will study Western Australian (WA) families in which there was a twin or higher order multiple birth (twin families) in order to measure inherited and environmental contributions to the development of asthma. All WA twin families, whose infants were born during 1990 to 1995, will be invited to become part of an existing Healthway funded, population based registry of WA Twin Child Health (the WATCH study). The WATCH study has already invited 2,751 WA twin families to participate and is the only population based twin study in Australia. Funding of this study by NH and MRC will enable the extension of this unique registry to include more specific clinical information about those families in which one or more of the twins has asthma. In addition to questionnaire data, DNA and physiological information will be collected, including a potentially important new measure of airway inflammation, exhaled nitric oxide which has yet to be studied for familial aggregation. We will use the extended WATCH dataset to undertake a comprehensive investigation of the genetic epidemiology of childhood asthma. This work offers the potential to advance our current understanding of the causes of both childhood asthma and associated traits (e.g., 'twitchy' airways). By exploring the relationships between different components of asthma, we will generate information to assist us to design better epidemiological and genetic studies of asthma. At the time of recruitment, if consent is given, blood will also be taken for DNA extraction and frozen storage. This will generate a powerful data base that can later be used for to search at a molecular level for genes potentially important in causing childhood asthma. Finally, by extending the WATCH study database we will be enhancing a research resource that could potentially be used for future studies of common complex diseases other than asthma.Read moreRead less
Risk Indicators For Periodontal Disease In An Urban Aboriginal And Torres Strait Islander Population
Funder
National Health and Medical Research Council
Funding Amount
$339,191.00
Summary
There is some evidence that Aboriginal and Torres Strait Islander adults have more severe gum disease than non-Indigenous Australians. Gum diseases are important chronic diseases as they can cause tooth loss. They are also related to general health conditions such as diabetes and heart disease. The ability to resist infection may be important in why people get gum disease. This study seeks to discover the factors which damage and which improve gum health in Aboriginal people.
Thai Health-Risk Transition: A National Cohort Study - Phase II
Funder
National Health and Medical Research Council
Funding Amount
$1,662,829.00
Summary
We are conducting a pioneering collaborative longitudinal study of population health in Thailand, following over time more than 80,000 adults living throughout the country. We repeatedly measure a wide array of health risks and outcomes. We capture information on the health-risk transition underway in Thailand as the population experiences the new burden of disease associated with economic development and modernisation. We team up with policy makers for national responses to lower the burden.
A Multi-component Intervention For Smoking Cessation Among Australian Male Prison Inmates
Funder
National Health and Medical Research Council
Funding Amount
$551,500.00
Summary
The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Rese ....The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Research has shown that people with depression or anxiety problems are less likely to quit, and more likely to relapse, than smokers without these symptoms. For this reason there has been interest in incorporating antidepressant medications into quit strategies. As a group with a high prevalence of depression and anxiety, prisoners may benefit from an intervention strategy that includes an antidepressant medication. Prisoners are often poorly educated, on a low income or benefits, or from a lower socioeconomic or an indigenous background. Members of this disadvantaged group have been shown to be less likely to use preventive health services, such as smoking cessation programs. This research proposal represents the first large scale randomised controlled trial of a multi-component intervention for tobacco dependence amongst a prisoner population in the world. This project will compare the effectiveness of adding an antidepressant medication to counselling, nicotine replacement therapy, a coping with change package and referral to a Quitline. The proposed research follows a small pilot study of the feasibility of a similar intervention. It brings together the expertise of several people across Australia with experience in tobacco dependence and prison research. The results will inform future smoking interventions for prison inmates and offers a real opportunity to impact upon the health and well-being of some of the most marginalised groups in Australian society.Read moreRead less
Fitness Versus Fatness: Disentangling Their Effects On Disease Outcomes And Estimating The Population Burden Of Disease
Funder
National Health and Medical Research Council
Funding Amount
$188,537.00
Summary
Overweight and physical inactivity are two of the major risk factors for cardiovascular disease and diabetes. With increasing population levels of overweight, governments are increasingly advocating public health measures aimed at increasing physical activity levels or otherwise decreasing weight. There has been much research concerning which of these factors is the key prognostic factor for adverse health outcomes, but an ongoing lack of clarity of research findings has led to uncertainty as to ....Overweight and physical inactivity are two of the major risk factors for cardiovascular disease and diabetes. With increasing population levels of overweight, governments are increasingly advocating public health measures aimed at increasing physical activity levels or otherwise decreasing weight. There has been much research concerning which of these factors is the key prognostic factor for adverse health outcomes, but an ongoing lack of clarity of research findings has led to uncertainty as to the direction of recommendations for preventive health strategies and population lifestyle changes. In addition, the risks of overweight, in particular, have been accused of being exaggerated in both the scientific and lay literature. This is often due to the difficulty of dealing appropriately with time varying confounders which are also intermediate factors (such as hypertension). To date, no studies have performed careful longitudinal modelling of the joint effects of physical inactivity and overweight on cardiovascular events and diabetes while taking into account the effects of factors, such as hypertension or atherosclerosis, that influence both physical activity and overweight as well as disease, and simultaneously are consequences of these risk factors. Standard statistical methods are known to produce biased estimates in these situations but we will apply more recently developed statistical techniques to provide much improved estimation of these effects. After the statistical modelling stage, we will model the burden of diabetes, cardiovascular disease and mortality associated with given levels of overweight and physical inactivity. These will be combined with population levels of overweight and inactivity to identify the fraction of the current and future burden of disease attributable to these risk factors.Read moreRead less
EVALUATION OF THE EFFECTIVENESS OF EXPANDED NEWBORN SCREENING BY TANDEM MASS SPECTROMETRY
Funder
National Health and Medical Research Council
Funding Amount
$375,250.00
Summary
Newborn babies in Australia are routinely tested for certain treatable disorders. Testing began in the 1960's with systematic testing for phenylketonuria, a rare amino acid enzyme defect. It causes severe mental retardation which can only be prevented if treatment is begun in the first few weeks of life. By 1997, only three other disorders, congenital hypothyroidism, cystic fibrosis, and galactosaemia, had been added to the testing protocol as tests became available. Using the new technology of ....Newborn babies in Australia are routinely tested for certain treatable disorders. Testing began in the 1960's with systematic testing for phenylketonuria, a rare amino acid enzyme defect. It causes severe mental retardation which can only be prevented if treatment is begun in the first few weeks of life. By 1997, only three other disorders, congenital hypothyroidism, cystic fibrosis, and galactosaemia, had been added to the testing protocol as tests became available. Using the new technology of tandem mass spectrometry (MSMS) it is now possible to screen for up to 30 extremely rare, treatable metabolic disorders simultaneously and cheaply, but it is not clear how effective this is. A formal trial of MSMS screening, randomly assigning babies to be tested or not tested, does not seem feasible because of the rarity of the individual disorders (most with a birth prevalence much less than 1: 50,000). Huge numbers would be needed in the trial for statistical significance. We began MSMS screening in NSW April 1998 and in South Australia in February 1999. Victoria is proposing to start screening now, but there are as yet no plans for this screening in the other states. We would like to assess the effectiveness of MSMS newborn screening using the best possible evidence drawn from all data available in the whole of Australia. We plan to undertake an economic evaluation, comparing costs and benefits such as development, hospitalisations, medical complications and other outcome measures, in screened and unscreened babies and also assess harms from screening. Because only 6 specialised laboratories in Australia, in Brisbane (2), Sydney, Melbourne, Adelaide, and Perth can diagnose these disorders, we are confident that we know of all diagnosed cases of the disorders in question. We hope to be able to show whether or not there is a benefit to affected babies by implementing newborn screening tests for these rare diseases.Read moreRead less