Risk And Prognostic Factors For Breast Cancer Of Different Immunohistochemical Subtypes
Funder
National Health and Medical Research Council
Funding Amount
$294,461.00
Summary
Breast cancer is a heterogeneous disease. Gene expression analysis has identified a number of subtypes that are different with respect to pathology, prognosis, and response to treatment. Building on an existing cohort study, we aim to identify risk and prognostic factors for molecular subtypes of breast cancer.
The Epidemiology Of Staphylococcus Aureus And Antibiotic Resistance In Community-acquired Infections
Funder
National Health and Medical Research Council
Funding Amount
$1,267,784.00
Summary
Staphylococcus aureus infections range from boils to life-threatening diseases and are increasingly resistant to antibiotics and difficult to treat. This study follows patients with community-acquired S. aureus infections, and close contacts, for 24 months to see if they carry S. aureus (nose swabs) or develop infection. Our data on risk factors for colonisation and infection will help doctors decide whether to trace and treat contacts of patients to protect households from further infection.
Follow Up Of The 1985 Australian Schools Health And Fitness Survey Cohort
Funder
National Health and Medical Research Council
Funding Amount
$2,309,456.00
Summary
This study provides a unique opportunity to follow up a cohort of children on which an extensive range of physical and lifestyle measures were made in 1985. This study has the capacity to find out whether childhood lifestyle and physical measures are related to the risk of heart disease, diabetes and other common health problems in adulthood.
Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone dens ....Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.Read moreRead less
Risk Factors For Chronic Respiratory Diseases In Middle Age: 36-year Follow-up Of The Tasmanian Asthma Study
Funder
National Health and Medical Research Council
Funding Amount
$358,750.00
Summary
This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1 ....This project will improve our understanding of the causes of chronic respiratory diseases (CRDs) in adults. CRDs are clearly a major public health problem, but there are no good data on the natural history and risk factors for these diseases. Regular follow-up through childhood to adulthood is the best method to examine these factors, but such data is lacking due to difficulties in conducting long-term studies. The Tasmanian Asthma Study (TAS), based on 8,585 Tasmanians (i.e. probands) born in 1961, is one of the worlds most important resources of such information. The probands, their parents (16,267) and siblings (21,044) were first investigated for respiratory problems in 1968. Subsequently, three follow-up surveys were carried out at ages 13 (1974), 20 (1981) and 31 (1992) on either the total or sub-samples of the probands. In 1992, the children and spouses of the probands were also surveyed. Information on all respiratory problems was collected in all the follow-ups, although the main focus of the TAS to date has been asthma. The probands are now reaching the age at which all CRD as a group are beginning to inflict an increasing disease burden, which will become greater in the next two decades. Hence, TAS now provides an ideal opportunity to examine the potential risk factors and natural history of and of CRDs using data collected to date and new data collected at age 43. Also, it will provide a platform for future studies to investigate the progression of CRDs in this cohort. Hence, we propose to carry out the 36 year follow-up of this cohort focusing on CRDs. This will provide important information for preventing chronic respiratory morbidity and disability in the future, which will be original and significant not only in Australia but also internationally.Read moreRead less
Comprehensive Assessment Of Genetic And Environmental Risk Factors For Melanoma: A Population-based Family Study
Funder
National Health and Medical Research Council
Funding Amount
$150,679.00
Summary
Excessive sunlight can cause melanoma, a serious type of skin cancer. However, there are other factors including a person's genetic make-up that are thought to put some people at higher risk. Many 'healthy' people have small changes in their genes that might make them more likely to develop melanoma. We need to know more about these genetic factors. Our study will investigate how particular small genetic changes influence a person's likelihood of developing melanoma.
Why Do Some Breast Cancers Present At An Advanced Stage In Women In Australia?
Funder
National Health and Medical Research Council
Funding Amount
$682,950.00
Summary
Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening ....Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening program, BreastScreen Australia, began in 1991. We expect that screening, through early detection, would reduce the numbers of women who die of breast cancer. Death rates from breast cancer have been falling in Australia since 1994. Despite this program, however, rates of larger breast cancers, more likely to have spread beyond the breast, are not falling. In 1997-98, the woman or her doctor detected nearly half of all breast cancers diagnosed outside of screening by detecting a change in the breast. Given that screening can detect cancers when they are small and that women themselves are also able to detect symptoms that may be small breast cancers and seek medical advice, we must ask why so many cancers are not diagnosed and treated until they are 2cm or larger and threaten life. This project aims to examine reasons in three broad areas: the woman herself, the cancer, and the wider health system, including the medical practitioner to whom symptoms or signs are first presented. Our study aims to understand the factors that contribute the most to the occurrence of larger breast cancers so that public health campaigns can be designed to increase the numbers detected at an early stage.Read moreRead less
One of the current challenges in public health is to translate the progress from the Human Genome Project into reduced morbidity and mortality from disease. Once genetic defects are characterised, knowledge about the variability in severity of disease in mutation carriers, is important from a public health perspective. Hereditary Haemochromatosis (HH) is a common genetic disorder of iron overload that results in a wide spectrum of disease, varying from non-specific symptoms to severe damage to l ....One of the current challenges in public health is to translate the progress from the Human Genome Project into reduced morbidity and mortality from disease. Once genetic defects are characterised, knowledge about the variability in severity of disease in mutation carriers, is important from a public health perspective. Hereditary Haemochromatosis (HH) is a common genetic disorder of iron overload that results in a wide spectrum of disease, varying from non-specific symptoms to severe damage to liver, heart, pancreas and joints from iron deposition. It is easily treatable by regular blood donation, and population-based screening for HH has therefore been advocated. In this study we aim to address gaps in the existing data on HH regarding dietary and lifestyle factors that contribute to the variable clinical picture of HH. The study will be based on the Melbourne Collaborative Cohort Study, a cohort of 31,500 men and women who have been followed for approximately 10 years. Information on dietary and lifestyle factors was collected at initial enrollment, along with a blood specimen. We will test all non-Southern European participants (31,176) for the common HH mutations in the HFE gene and then select a subgroup of 1150 people, including all people with the main genetic defect as well as a comparison group, for further clinical followup. Participants will have genetic counselling and informed consent will be obtained. Participants will complete a short questionnaire and give a blood sample for measurement of iron overload, liver function, and other relevant blood tests, then undergo a brief clinical examination. Results of all tests will be given at a followup visit by genetic counsellor or physician. This study will provide important data on natural history of HH risk factors that influence variability in clinical presentation and the association of HFE mutations with chronic diseases and all cause mortality.Read moreRead less
A Prospective Study Of Health, Social And Forensic Outcomes In Young Offenders.
Funder
National Health and Medical Research Council
Funding Amount
$189,000.00
Summary
In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences ....In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences, the most serious end of the offending spectrum. Furthermore, overseas studies are of limited usefulness in the Australian context, as it is difficult to apply observations from communities where the social, ethnic and crime profile may be markedly dissimilar. We propose to interview 450 young people immediately after they obtain their first sentence, usually a community-based order. The problems we will ask about include depression and anxiety, heavy alcohol consumption, heavy use of cannabis and other illegal drugs, deliberate self harm, sexual risk taking behaviour and offending behaviour. We will also ask about the social circumstances, friends and family structure and support. We will then repeat this interview six months later. In addition, we will monitor the participants' compliance with their order, treatment programs they may be on and re-offending until the end of data collection. The study will give us the basis to examine continuity and inter-relationship between problems such as depression and substance abuse, social factors and continued offending. Further, the study will establish a framework to follow-up these young offenders in the medium and long-term. The development of this sound and thorough research program will provide a rational basis for the planning of preventative interventions, aimed at improving the health and welfare and at reducing recidivism in this marginalised and often disadvantaged group of young people.Read moreRead less
It has been proposed that inflammation plays a major role in prostate cancer risk. We are well placed to test this hypothesis following up evidence from our MCCS and RFPCS studies of associations between inflammatory markers and prostate cancer risk. This proposed project may open for the first time opportunities for the prevention of prostate cancer.