Five Year Outcomes Of Care For Prostate Cancer In New South Wales
Funder
National Health and Medical Research Council
Funding Amount
$388,773.00
Summary
Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Stud ....Prostate cancer is the most common cancer in Australian males after non-melanocytic skin cancer. Each year more than 10,000 men are diagnosed with prostate cancer, and over 2,500 die from it. While the issue of early detection of prostate cancer through the use of Prostate Specific Antigen test continues to raise debate, the longer term quality of life outcomes after treatment for this disease remain of great interest to patients, clinicians and health planners. The Prostate Cancer Outcomes Study is an already established research project that was established in 2000 with the aim of documenting the quality of life outcomes of 2000 men with prostate cancer to five years after diagnosis. The Department of Veterans Affairs funded the study between 2000 and 2005, to establish the cohort, collect patterns of care information from clinicians and quality of life information from participants to 3 years post diagnosis. We are now seeking funds to complete the quality of life follow up for each surviving participant at five years after diagnosis. We also will assess rate of recurrence of prostate cancer to five years and seek support to be able to undertake linkage with death certificate information to determine the vital status of each study subject and begin analysis of five-year survival rates. Five-year quality of life information will be the main endpoint for this part of the study. Initial analysis of the three-year data showed a continued improvement in outcomes related to urinary and sexual function. We wish to determine whether these improvements continue to five years and the extent of the difference, at that time, between men with prostate cancer and men without prostate cancer (controls), whom we are also studying. This information will be uniquely useful in helping men make decisions about treatment options when diagnosed with prostate cancer.Read moreRead less
Physiological Mechanisms Of Efficacy Of Cervical Flexor Muscle Retraining
Funder
National Health and Medical Research Council
Funding Amount
$264,750.00
Summary
Neck pain is a significant problem in society and its frequency is beginning to match the proportions of back pain, probably reflecting our increasingly sedentary lifestyles. Several problems have been identified in the muscle system in persons who suffer from neck pain. Therapeutic exercise has been found to have benefit in preventing and relieving pain and improving the neck function. Currently there are several, quite different methods of exercise and there is controversy regarding how therap ....Neck pain is a significant problem in society and its frequency is beginning to match the proportions of back pain, probably reflecting our increasingly sedentary lifestyles. Several problems have been identified in the muscle system in persons who suffer from neck pain. Therapeutic exercise has been found to have benefit in preventing and relieving pain and improving the neck function. Currently there are several, quite different methods of exercise and there is controversy regarding how therapeutic exercise works. It has been argued that parameters such as changes in muscle strength, endurance, joint position sense or muscle coordination may be responsible for the clinical efficacy. It is difficult to disentangle the effective component of exercise strategies and thus prescribe the most effective exercise strategies. This series of experiments will evaluate the physiological factors that change with a specific exercise intervention and to compare different exercise modalities in order to identify the most effective means to induce these changes. Cervical muscle training, using a proven exercise intervention strategy for chronic neck pain and headache, has been chosen as the model to investigate these questions. This exercise strategy has been chosen not only because it has been shown to be effective, but also because it does not conform to contemporary rationales for strength or endurance training. Thus while effective in relieving pain, it is unlikely to produce changes in these parameters. Thus other mechanisms are likely to be responsible for the clinical change. This research stands to make a significant contribution to exercise therapeutics by identifying the effective components of different exercise methods and investigating the pain relieving effects of the specific exercise. This knowledge will lead to the construction of a research based exercise program for neck pain patients, rather than have the current situation of often arbitrary choice of exercise.Read moreRead less
COX-2 Inhibitors And The Development Of Unstable Angina And Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$171,450.00
Summary
Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are ....Anti-inflammatory drugs (sometimes called NSAIDs) are widely used in the treatment of arthritis and also as general purpose pain killers. Up to 10 million prescriptions are written each year for these drugs in Australia. Some of the older versions of these drugs like ibuprofen (eg Brufen) and naproxen (trade name Naproxen) cause side effects which can be serious. Damage to the stomach is a particular problem and this can lead to serious bleeding or perforation of ulcers. Less well recognized are the adverse effects of these drugs on the heart and the kidneys. The older fashioned members of this class of drug are rapidly being replaced by newer agents known as COX-2 inhibitors. Popular examples in Australia are celecoxib (trade name Celebrex) and rofecoxib (trade name Vioxx). These drugs are heavily promoted as being safer than the older NSAIDs. In the case of the stomach, this claim seems to be correct. However, the effects of the new COX-2 inhibitors on the circulation have not been fully assessed. Recently, claims have been made that these drugs may increase the risk of heart attacks. If this were true, it would be an effect that was unique to COX-2 inhibitors as it has not been reported with the older NSAIDs. We plan to carry out a 3 year study in Newcastle hospitals in which we compare the use of COX-2 inhibitors in a group of patients admitted to hospital with a heart attack or unstable angina with that of a control group of patients who were admitted to hospital around the same time, but not for heart problems. We are interested in whether COX-2 inhibitors are associated with an increased risk of heart attacks and whether use of small doses of aspirin protects against this effect. Depending on the results we may be able to improve the safety of these drugs in patients at risk of heart attacks.Read moreRead less
MATERNAL UNDERNUTRITION, INFANT REFEEDING, ADIPOSITY AND DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$297,323.00
Summary
Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is ....Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is associated with an increase in abdominal fatness, out of proportion to the rest of the body's size and shape. The increase in diabetes in this group is most worrying and a major public health problem. It is not known whether the diabetes and abdominal fatness are caused by the refeeding programs or whether they are due to the fact that the body's metabolism was programmed during pregnancy. Perhaps the infants were malnourished whilst they were developing during pregnancy and metabolism was changed so they could store fat easily and not use glucose as readily in the rest of the body. This study is designed to show whether there are metabolic changes which predispose to diabetes and fatness present at birth in those who are malnourished or whether the refeeeding program designed to help them grow is the cause of these later problems.Read moreRead less
Genetic Variation And Host-parasite Interactions Of Sarcoptes Scabiei
Funder
National Health and Medical Research Council
Funding Amount
$294,536.00
Summary
Scabies is a disease of skin caused by the burrowing of the 'itch' mite Sarcoptes scabiei. Although up to 45 different host species can be infested by this mite, this organism is currently classified as a single species existing as multiple strains or varieties. Previous studies have failed to identify any structural differences between host-associated populations, suggesting a single gene pool. Our recent molecular study of scabies in people and dogs, from Aboriginal communities in the Northern ....Scabies is a disease of skin caused by the burrowing of the 'itch' mite Sarcoptes scabiei. Although up to 45 different host species can be infested by this mite, this organism is currently classified as a single species existing as multiple strains or varieties. Previous studies have failed to identify any structural differences between host-associated populations, suggesting a single gene pool. Our recent molecular study of scabies in people and dogs, from Aboriginal communities in the Northern Territory and the North and South Americas, using DNA fingerprinting techniques, suggested mites cluster by host species with no evidence of cross-transmission. However although this data seems to suggest that these sub-species deserve species status, another molecular study suggests Sarcoptes is a single species, presumably a result of interbreeding. Understanding interbreeding between populations is important in the control of the disease and in controlling resistance to acaricides. We wish to further characterise the genetic separation of different 'strains' or populations of mites by studying the evolutionary gene flow between host-associated populations. We will use a mitochondrial DNA marker that will clarify fine scale transmission processes and more clearly delineate the biological species status of S. scabiei. Recent in vitro data and clinical evidence in a patient with severe crusted scabies indicated resistance to ivermectin, the treatment of choice for these patients. We will investigate the role and genetic mechanisms of ivermectin resistance. This is important for future control programs, as acaricide resistance can spread rapidly in parasite populations.Read moreRead less