Chronic Gastrointestinal Symptoms And Diabetes Mellitus: Risk Factors And Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$271,527.00
Summary
Why many people with diabetes mellitus are afflicted by gastrointestinal (GI) symptoms remains uncertain. Irreversible damage to the nerves controlling the gut (autonomic neuropathy) is often considered to be important. An alternative cause of increased GI symptomatology in diabetics is poor glucose control. Some studies have shown that acute shifts in glucose levels induce changes in the gut relevant to the onset of GI symptoms. For example, high glucose levels acutely cause slower stomach empt ....Why many people with diabetes mellitus are afflicted by gastrointestinal (GI) symptoms remains uncertain. Irreversible damage to the nerves controlling the gut (autonomic neuropathy) is often considered to be important. An alternative cause of increased GI symptomatology in diabetics is poor glucose control. Some studies have shown that acute shifts in glucose levels induce changes in the gut relevant to the onset of GI symptoms. For example, high glucose levels acutely cause slower stomach emptying times, leading to feelings of fullness. Though the effects of chronic glucose levels are yet to be properly explored, population data show that poor control in the long-term is related to an increase in symptoms. The aim of this prospective study is to determine the roles played by both autonomic neuropathy and glucose control in the development of GI symptoms among diabetics. All past research has been cross-sectional, and so cannot tell us if one or both of these factors cause GI problems in diabetes. For example, it is possible that autonomic neuropathy causes an increase in GI symptoms such as nausea and fullness, which in turn induces poor glucose control though lack of appetite or inadequate stomach emptying. Upon study inclusion, all study participants will undergo a series of autonomic tests. At 3 month intervals for a period of 30 months, they will be asked to complete a 2-week diary card detailing their GI symptoms and glucose readings, and also supply blood and urine samples for analysis twice each year. Two years from the study outset, participants will again complete the autonomic test series. Psychiatric co-morbidity will be investigated using the Composite Diagnostic Interview (CIDI-Auto) at the autonomic testing time points. The study will be undertaken at the Gastroenterology Research Unit at Nepean Hospital, in collaboration with the Royal Adelaide Hospital, centres with proven track records in diabetes investigation.Read moreRead less
Case-control Studies Of Completed And Attempted Suicide In Young People In NSW
Funder
National Health and Medical Research Council
Funding Amount
$819,000.00
Summary
Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental fact ....Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental factors for both completed suicides and suicide attempts in young people aged 18-34 years living in NSW. The study will be undertaken in Sydney, Newcastle and in identified rural areas. The study is embedded in existing treatment, counselling and support services and will aid their improvement and augmentation. Cases of suicide and attempted suicide will be compared with community controls, and also completed suicides with attempted suicides, to identify potentially modifiable risk factors associated with suicidal behaviour. This will provide more comprehensive information relating to how various risk factors interact and influence suicidal behaviour, including in rural areas with significant Aboriginal and Torres Strait Islander communities. Information from this study will improve prevention initiatives and assist with community strategic development and provide evidence to enhance current health service and coronial interventions.Read moreRead less
Explaining Social Inequality In Population Oral Health Using A Multilevel Approach
Funder
National Health and Medical Research Council
Funding Amount
$103,500.00
Summary
Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also assoc ....Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also associated with oral wellness. This work is new Australian research and is yet to be published. In an expansion of this project, we move from describing oral health inequalities and identifying their social determinants to provide a better understanding of pathways to population oral health. In doing so we shift the focus from the individual to the social context in which individuals live. We suggest that characteristics of social environments contribute independently to the variation in oral health outcomes accounted for by the characteristics of the residents themselves. In particular, we seek to demonstrate that social cohesion (the social integration, trust, and reciprocity within an area) influences conditions linked to oral health. Previous research has demonstrated variation in health according to area. Such studies are able to demonstrate a clustering of health, but are not able to distinguish whether observed social patterns in health reflect characteristics of residents or some feature of the area itself. Such conclusions require multilevel statistical models designed to separate individual effects from contextual effects while simultaneously examining interactions between both levels. Oral health is ideally suited as a proxy for general health because of the ubiquity of dental diseases, the broad utilisation of dental services within the population, and the shared risk factors between oral disease and a wide range chronic health conditions.Read moreRead less