The Future Of Tobacco Control: Exploring The Feasibility, Acceptability And Cost-effectiveness Of New Policy Directions
Funder
National Health and Medical Research Council
Funding Amount
$495,752.00
Summary
We will examine the practical feasibility, ethical and public acceptability, and likely cost effectiveness of a number of different ways of reducing tobacco smoking and the harm caused by smoking in Australia. These policy options will include: (1) more restrictive policies towards tobacco products (such as prohibiting tobacco smoking and creating a government monopoly on the manufacture and supply of tobacco); (2) encouraging smokers to switch from smoking cigarettes to less harmful ways of usi ....We will examine the practical feasibility, ethical and public acceptability, and likely cost effectiveness of a number of different ways of reducing tobacco smoking and the harm caused by smoking in Australia. These policy options will include: (1) more restrictive policies towards tobacco products (such as prohibiting tobacco smoking and creating a government monopoly on the manufacture and supply of tobacco); (2) encouraging smokers to switch from smoking cigarettes to less harmful ways of using nicotine, such as using nicotine patches or gum ; (3) using new biotechnologies to improve smokers chances of quitting (e.g. genetic screening of smokers to select the most effective way of helping them to stop smoking and vaccinating ex-smokers against the effects of nicotine); and (4) new biotechnologies that may prevent nonsmokers from beginning to smoke (e.g. vaccinating nonsmokers against the effects of nicotine) or reduce the chances of their developing tobacco-related diseases (e.g. screening the population for genes that predict an increased susceptibility to nicotine dependence and tobacco-related diseases). The project will provide important information that will assist government in formulating policies to reduce the rate of cigarette smoking in the Australian population below current levels.Read moreRead less
Methylation As A Risk And Prognostic Factor For Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$594,913.00
Summary
DNA methylation is a process playing critical roles throughout life by altering the expression of genes. This study aims to investigate the potential use of methylation as marker of risk and early diagnosis of breast cancer in women with no clinical evidence of disease and marker of prognosis and response to treatment in breast cancer cases.
A Randomised Trial Assessing A Shade Development Intervention In Secondary Schools For Adolescent Skin Cancer Prevention
Funder
National Health and Medical Research Council
Funding Amount
$709,615.00
Summary
Skin cancer is a significant burden to health costs, and morbidity and mortality in Australia. Reduction of exposure to ultraviolet radiation (UVR) in sunlight, particularly during childhood and adolescence is an important strategy for preventing skin cancer in later life. Adolescents have been particularly resistant to skin cancer prevention messages. Despite a high knowledge of skin cancer, the majority of Australian adolescents report a reliance on sunscreen, a resistance to hat wearing, and ....Skin cancer is a significant burden to health costs, and morbidity and mortality in Australia. Reduction of exposure to ultraviolet radiation (UVR) in sunlight, particularly during childhood and adolescence is an important strategy for preventing skin cancer in later life. Adolescents have been particularly resistant to skin cancer prevention messages. Despite a high knowledge of skin cancer, the majority of Australian adolescents report a reliance on sunscreen, a resistance to hat wearing, and commonly experience sunburn, an important indicator of increased risk of skin cancer. Psycho-social interventions have shown limited influence on adolescents' sun protective behaviours to date. The current research proposal explores an alternative approach to psycho-social interventions for adolescents. The study will assess the effect of increasing available shade at secondary schools. In a randomised control trial study design, the change in the number of students using certain outdoor areas at intervention schools will be observed 'before' and 'after' the installation of built shade sail structures. Our main hypothesis states that the number of students using these newly shaded areas in intervention schools will increase compared with use of equivalent unshaded areas in control schools. Shade development is increasingly becoming an issue for secondary schools and given both the high cost of providing shade structures and adolescents' resistance to other forms of sun protection it is important to establish that adolescents will use this form of sun protection. This study will determine whether adolescents actively avoid or seek shade and so provide evidence for informing decisions about further investment in shade provision in schools.Read moreRead less
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.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
A Randomised Controlled Falls Prevention Trial Of Long Distance Glasses In Elderly Multifocal Wearers
Funder
National Health and Medical Research Council
Funding Amount
$493,000.00
Summary
Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glass ....Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glasses are useful for reading and seeing at close range only and there is now evidence that the use of these glasses is associated with an increased risk of falls due to the blurring of vision when looking through the lower lenses at ground level obstacles. This is particularly relevant in unfamiliar outdoor situations. This study will determine whether providing plain distance glasses (with extensive counselling and recommendations for use in standing and walking activities) will prevent falls and their consequences over a one year period in older persons who wear bi-, tri- or multi-focal glasses. Pilot studies suggest that most elderly bi-, tri-, or multi-focal wearers at risk for falls are willing to purchase and use a second pair of glasses if the benefit of new plain distance glasses for their vision is demonstrated. We expect that the results of the study will be incorporated into all relevant areas of clinical practice and public health strategies.Read moreRead less
Modulation Of Virus-cellular Receptor Interactions In Picornaviral Pathogenesis
Funder
National Health and Medical Research Council
Funding Amount
$422,036.00
Summary
Gastrointestinal viral infections of humans result in a wide variety of illnesses ranging from the common cold to infantile paralysis and viral myocarditis. Despite the wide range of tissues and organs targeted by these viruses, the manner in which infection is initiated is remarkably similar. The primary step in infection is the binding of a virus to a specific protein on the cell surface, similar to the lock and key analogy. This project seeks to investigate the nature of interactions between ....Gastrointestinal viral infections of humans result in a wide variety of illnesses ranging from the common cold to infantile paralysis and viral myocarditis. Despite the wide range of tissues and organs targeted by these viruses, the manner in which infection is initiated is remarkably similar. The primary step in infection is the binding of a virus to a specific protein on the cell surface, similar to the lock and key analogy. This project seeks to investigate the nature of interactions between representative picornaviruses and their cellular attachment proteins with a view to designing rational anti-viral strategies to block virus cell attachment and cell entry. Using the data raised when investigating why some viruses only infect certain cells, we plan to target human tumors cells based on their susceptibilty to different viruses.Read moreRead less
Endometrial cancer (uterine or womb cancer) is the most common invasive gynaecological cancer in Australia. Each year more than 1400 women are affected by the condition, and death is common amongst a subset with more aggressive disease. We plan to conduct a national study of endometrial cancer to identify options for prevention of the disease. No previous studies have looked at risk factors for endometrial cancer in Australian women. In particular, we hope to identify modifiable risk factors for ....Endometrial cancer (uterine or womb cancer) is the most common invasive gynaecological cancer in Australia. Each year more than 1400 women are affected by the condition, and death is common amongst a subset with more aggressive disease. We plan to conduct a national study of endometrial cancer to identify options for prevention of the disease. No previous studies have looked at risk factors for endometrial cancer in Australian women. In particular, we hope to identify modifiable risk factors for endometrial cancer, and identify genes that make some women particularly susceptible to the disease. There are at least two main types of endometrial cancer and limited evidence suggests that they may have different causes. Few studies have examined the two different types separately, and there is virtually no information regarding risk factors for the more aggressive forms. In addition, little is known about genetic factors that predispose women to endometrial cancer. In the present study, we will investigate which genes cause endometrial cancer in women who have a strong family history of the disease. We will also identify genes that are related to endometrial cancer in women with no obvious family history of cancer, and investigate how these genes interact with environmental factors (such as hormone replacement therapy and obesity) to cause disease. National epidemiological studies of other cancers are currently being conducted by our research groups within QIMR. In the present proposal, we will use our experience to build on the infrastructure and procedures already in place to conduct a new study on endometrial cancer. As one of the largest population-based studies of endometrial cancer ever conducted, it will be able to answer many of the questions that are currently unresolved. Moreover, answers will be relevant to Australian women and clinicians as well as to inform prevention strategies.Read moreRead less
Understanding Fear Of Falling And Risk Taking In Older People
Funder
National Health and Medical Research Council
Funding Amount
$355,877.00
Summary
Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be b ....Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be bad, and have not attempted to assess whether this fear is rational or irrational in relation to actual balance abilities or physical functioning. In this study, we aim to find out which psychological, physical, health and lifestyle factors distinguish between older people with and without an irrational fear of falling based on their actual physical falling risk. We also wish to understand the role that fear of falling and other psychological factors (anxiety, depression and avoidance) play in causing older people to fall; and to measure how falls can lead to increased fear of falling, anxiety and depression and reduced physical functioning. The complex nature of psychological risk factors of falling and the limited background information on this subject, hampers its integration in falls prevention programs. Although there is growing awareness of this problem among health care providers, additional research is needed about why older people develop a fear of falling in order to fully understand fear of falling and to tailor specific intervention and prevention strategies.Read moreRead less