We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other co ....We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other countries (in North and South America, Asia, and Europe). This study will provide the first nationally-representative information on the burden of chronic obstructive pulmonary disease (COPD) and the opportunities for health gain by improving the management of this illness. In Australia, COPD is a relatively silent and under-recognised disease but nevertheless is the third most important contributor to the burden of disease and the third leading cause of hospital admission as well as being the underlying cause of 4.2% of all deaths. The information we will collect is needed to form a basis for prevention and disease management interventions to reduce the burden of COPD, particularly among population sub-groups who are disproportionately affected, either due to greater exposure to risk factors (mainly tobacco smoking and occupation), greater susceptibility, under-recognition and under-diagnosis, or inadequate disease management. Importantly, the study will serve to raise awareness about the hazards of smoking for all Australians. By identifying target groups, prevalent exposures and management deficiencies, it will lead the way towards policy-relevant randomised controlled trials testing community-based interventions to prevent COPD and-or manage it more effectively. The information collected will help advance knowledge of the prevalence, burden and treatment of COPD that will be relevant to communities throughout the world.Read moreRead less
The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue ....The prevalence of asthma in Australia is amongst the highest in the world yet no trials of primary prevention have been conducted which address the most common known causative agent (housedust mite allergens) and the most common known protective factor (dietary omega-3 fatty acids). Until the effectiveness of interventions which address these factors is certain, the value of the wide array of advice given to asthmatics by various health institutions will not be known. We are applying to continue the Childhood Asthma Prevention Study (CAPS) which has been underway since mid-1997. CAPS is a randomised controlled trial in which 616 infants at high risk of developing asthma because of a family history have been enrolled. The interventions include allergen reduction and dietary supplementation with omega-3 fatty acids. The interventions are designed to have maximum effect but be simple to implement by parents. Several measures of compliance are being collected and regular contact is maintained though telephone calls and frequent home visits. Objective and subjective measurements of exposures, atopy, diet and asthmatic symptoms are being collected at 3 month intervals and at medical assessments when the children are 18 months, 3 and 5 years old. It is essential that we continue the study until all children are aged 5 and we will be able to test conclusively whether the interventions have had a positive effect. If so, CAPS will form the basis for a nationwide public health campaign which will have the potential to reduce the incidence of childhood asthma in Australia.Read moreRead less
Squamous Cell Carcinomas Of The Head And Neck: Exploring The Role Of Human Papillomavirus Infection
Funder
National Health and Medical Research Council
Funding Amount
$217,213.00
Summary
Human papillomavirus (HPV) is the major cause of cervical cancer and the cause of 5% of all human cancers. HPV has recently also been associated with oral cancer, especially in patients younger than 50 years of age. In this project we will investigate how common HPV infection is in oral cancers in Australia. In these patients we will also investigate mutations in genes that have been found to play a critical role to clear persistent HPV infections and how cells respond to HPV infection.
Depression Prevalence: Delineation Issues In 2007 National Mental Health & Wellbeing And 2008 South Australian Surveys
Funder
National Health and Medical Research Council
Funding Amount
$257,051.00
Summary
It is believed depression is increasing and Australia has many health interventions to help, but it is unknown if these are reducing depression prevalence. Two surveys have reported on depression in the past 10 years. One shows it is decreasing, the other it is increasing. This study will examine depression measurement in both surveys to find out why they disagree. The findings will have implications for future depression measurement and what health care interventions should be planned.
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
Outcome Of Childhood Asthma In Adult Life And The Interaction With COPD
Funder
National Health and Medical Research Council
Funding Amount
$503,549.00
Summary
The Melbourne Study of Childhood Asthma (MESCA) is the longest, most comprehensive follow-up study of childhood asthma. The members were recruited in 1964 at the age of 7 and they have been reviewed at ages 10, 14, 21, 28, 35 and 42 years of age with a retention rate of 87% of survivors at the most recent follow-up. To date, the MESCA study has provided comprehensive data on the outcome of childhood asthma through to their adult years and has been particularly influential in establishing approac ....The Melbourne Study of Childhood Asthma (MESCA) is the longest, most comprehensive follow-up study of childhood asthma. The members were recruited in 1964 at the age of 7 and they have been reviewed at ages 10, 14, 21, 28, 35 and 42 years of age with a retention rate of 87% of survivors at the most recent follow-up. To date, the MESCA study has provided comprehensive data on the outcome of childhood asthma through to their adult years and has been particularly influential in establishing approaches to treatment of paediatric asthma nationally and internationally. The results of the study have been published widely over the years and cited extensively. The members of this cohort turn 50 in 2007 and will be invited to participate in a further review to reassess their clinical outcome to examine the relationship between long standing asthma and the development of COPD. Those members of the cohort who have had asthma persisting through their adult years have a degree of fixed obstruction on their tests of lung function and are potentially at risk of developing COPD. Some are at increased risk as approximately 30% of the members are regular smokers. In this review, at age 59 years, there is an excellent opportunity to examine the interaction of asthma and COPD and to compare the inflammatory processes between those who have continuing asthma, those whose asthma has resolved and in each group examine the effect of smoking. We will also look at a numbers of genetic markers associated with COPD to identify those who are more susceptible to the development of COPD. A second area of interest is the components of the immune system that influence asthma.. In an earlier study we identified one component of the immune system, known as the T cell system, that had returned to normal in those whose asthma had resolved. In this review, we plan to examine the T cell system in detail to understand what mechanisms may be responsible for resolution of childhood asthma.Read moreRead less
The Effect Of Chronic Maternal Asthma And Acute Exacerbations On Placental Function And Fetal Development
Funder
National Health and Medical Research Council
Funding Amount
$224,623.00
Summary
Maternal asthma is the most common disease to complicate pregnancies in Australia. The data we have collected so far suggests that asthma represents a physiological maternal stress during pregnancy that influences placental function and fetal development. The purpose of this grant is to continue to determine what changes occur in the presence of maternal asthma that alter fetal growth. The findings of this work will be applicable to any psycho-social or physiological stressor during pregnancy.