Early Retinal Vessel Changes In Diabetes And The Metabolic Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$212,500.00
Summary
Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the re ....Diabetes mellitus affects a large proportion of adult Australians. Furthermore, many non-diabetic Australians are at high risk of developing diabetes (e.g., people with lesser glucose abnormalities, and those who are obese, have high blood pressure, or have high lipid levels). It has been suggested that diseases affecting small blood vessels (microvascular disease) in the body is closely related to the development of both diabetes and the pre-diabetes state. The current study will examine the relationship of microvascular disease in the retina (at the back of the eye) to diabetes, pre-diabetes status and diabetes complications. We will use a computer-imaging technique to measure the diameters of retinal blood vessel from digital photographs taken in 2,177 participants of the 1999-2000 Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, a community-based survey of people aged 25 years and older examining risk factors and complications of diabetes. In the proposed study, we aim to answer the following questions: 1) Are changes in the retinal blood vessel diameter (e.g., narrowed or dilated vessels) associated with diabetes and pre-diabetes? 2) Are these retinal vessel changes related to obesity, high blood pressure and high lipid levels? 3) Are retinal vessel changes related to diabetes complications, such as heart disease, kidney disease, nerve problems and foot ulcers? 4) Do retinal vessel diameter changes predict people who will subsequently develop diabetes, irrespective of their risk factor profile? Using this well-characterized population, and existing digital retinal photographs, the proposed study will offer a unique and cost-effective opportunity to address important gaps in our understanding of how diabetes and pre-diabetes develop, and whether they are related to microvascular diseases. This may ultimately lead to new treatment and preventive approaches targeted at the small blood vessels in the body.Read moreRead less
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
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
Preventive messages and guidelines to reduce sitting — especially prolonged periods of sitting — have emerged. However, what prolonged sitting should be replaced with, and the feasibility of making real world changes to this behaviour, is unknown. This program of research will provide high quality evidence on the benefits of reducing prolonged sitting time, and the effectiveness and acceptability of achieving sitting reductions in real-world contexts.
Harnessing The Power Of Elite Sport Sponsorship To Promote Healthy Eating By Young Adults
Funder
National Health and Medical Research Council
Funding Amount
$304,220.00
Summary
Concerns have been raised about the role of unhealthy food sponsorship of elite sport in promoting unhealthy diets to vast numbers of the public, including young adults who are avid spectators of sport. This innovative project consists of two studies which systematically investigate the utility of alternative, health-oriented sport sponsorship models and counter-advertising strategies in promoting healthier diets among young adults.
Quantifying The Effectiveness Of Pertussis Vaccine In Older Adults
Funder
National Health and Medical Research Council
Funding Amount
$448,703.00
Summary
Pertussis is the most poorly controlled vaccine preventable disease in Australia. Childhood pertussis is a well-known public health problem but adult pertussis is also common and has a significant burden on the health system, especially in adults over 65 years. Pertussis vaccines for adults are currently not funded by our national immunisation program. This project will provide vital data to inform whether pertussis vaccination is cost-effective in older Australian adults.
Early Life And Contemporary Influences On Body Composition, Mental Health, And Chronic Disease Risk Markers In The Aboriginal Birth Cohort
Funder
National Health and Medical Research Council
Funding Amount
$3,117,044.00
Summary
The Aboriginal Birth Cohort study has been following the health of Aboriginal babies in the Northern Territory for the last 30 years. The participants were healthy till adolescence, but overweight and risk factors of diseases such as diabetes, kidney and heart disease are emerging. This follow-up will show when and whether these risk factors develop into disease, which factors are protective and which identify early those most at risk of developing diseases that cause the gap in life expectancy.
Pharmaceutical Opioid Prescription For Chronic Pain In Australia: Trajectories Of Prescribing, Risk Of Adverse Events, And Predictors Of Harm
Funder
National Health and Medical Research Council
Funding Amount
$1,086,274.00
Summary
There is concern about rising levels of opioid analgesic prescribing in Australia. This study is important because it will provide evidence about long term outcomes for patients using opioid therapy for chronic non-malignant pain. It will examine prescribing patterns and link them to other health outcomes such as overdose. We will also study patients beginning opioid therapy for chronic pain and follow them up over 2 years to examine outcomes such as pain relief and medication side effects.
A Solution Based Approach Developing Child Health Research With A Focus On Preventive Interventions For Common Childhood
Funder
National Health and Medical Research Council
Funding Amount
$2,599,538.00
Summary
There is an increasing recognition that research into child health should focus not only on disease but also on common childhood disorders such as obesity, depression and poor literacy. In addition, such research should include solution-based activity. That is, child health research should have an active program of testing new interventions to prevent the onset of disorders, or to allow optimal early management. The Murdoch Childrens Research Institute, the largest Australian child health resear ....There is an increasing recognition that research into child health should focus not only on disease but also on common childhood disorders such as obesity, depression and poor literacy. In addition, such research should include solution-based activity. That is, child health research should have an active program of testing new interventions to prevent the onset of disorders, or to allow optimal early management. The Murdoch Childrens Research Institute, the largest Australian child health research institute, is in a very good position to develop Australia's capacity further with regard to a coordinated research program into preventative interventions in child health. This is because of: - the Institute's location at the Royal Children's Hospital, Melbourne, the largest paediatric health service provider in Australia - the many individual relevant research projects that are already occurring in MCRI - the strong existing teams of researchers with skills in many different fields of child health such as psychology, speech pathology, clinical-medical care, epidemiology and biostatistics, and laboratory science including genetics. This capacity building program will coordinate population health work to develop the knowledge and skills of eight population health researchers. This development will occur within the context of an internationally competitive research program with structured continuing education and training to promote public health leadership. The capacity building program will develop skills not only in study design, conduct and analysis, but also in collaboration and the translation of research findings into better health services, government policy and parental knowledge to prevent problems and improve the health and well being of children and their families. To care for children in the best way, parents, families, schools, health care providers, and government need the best evidence base possible on the prevention of common child disorders.Read moreRead less