What Do Australians Think About Privacy And Participation In Epidemiological Research?
Funder
National Health and Medical Research Council
Funding Amount
$443,015.00
Summary
There is very little research available, in Australia or internationally, about what the general public considers privacy to be; or how important privacy protection is in the context of high and low risk epidemiological studies. We also know little about what affects willingness to participate in epidemiological research. Our research will provide an evidence base, and develop resources for the legislature, the NHMRC, ethics committees and researchers.
Cannabis is the most widely used illicit drug in the world. Delta-9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, is known to be preferentially taken up into fat tissue where it can be stored for weeks, months and possibly years. Boy fat has the capacity to store large quantities of THC and the slow passive release of THC from fat cells into the blood accounts for why THC remains at detectable levels in the blood or urine for weeks after exposure to cannabis. Under n ....Cannabis is the most widely used illicit drug in the world. Delta-9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, is known to be preferentially taken up into fat tissue where it can be stored for weeks, months and possibly years. Boy fat has the capacity to store large quantities of THC and the slow passive release of THC from fat cells into the blood accounts for why THC remains at detectable levels in the blood or urine for weeks after exposure to cannabis. Under normal conditions the slow passive release of THC from fat cells has negligible effects on the user as the amounts involved are so small. However, we have recent preliminary evidence to show that conditions associated with increased fat metabolism (e.g. dieting, exercise or stress) cause a greatly enhanced release of THC from fat stores into the blood supply. Further, we have demonstrated that such levels attained promote significant behavioural and physiological changes The current proposal aims to further characterise this phenomenon. We aim to: (1) determine the length of time that THC can be stored in fat before being released into blood, (2) establish that the release of THC stored in fat tissue may be promoted by fat breakdown associated with food deprivation, stress or exercise, (3) characterise the physiological and behavioural effects of THC released from fat, (4) determine the mechanisms responsible for THC release from fat, and (5) determine if THC released from fat can cross from the bloodstream into saliva. This proposal has far reaching consequences for our understanding of the long-term effects on cannabis use on physical health and behaviour. Further, it may have major implications for the correct interpretation of analytical data from road-side saliva testing and forensic and criminal cases involving cannabis use.Read moreRead less
Difficult Decisions: A Critical Analysis Of Consent To High-risk Medical Procedures
Funder
National Health and Medical Research Council
Funding Amount
$320,918.00
Summary
Consent is the cornerstone of ethics as applied to healthcare and is central to the relationship between healthcare and the law. Whilst no-one would deny the importance of seeking consent to high-risk medical procedures, much depends on the practical manner in which this is done. By studying consent for high-risk procedures with the participation of patients and their health care providers, we will both test the limits of consent and find practical ways to address those limits. In doing so, the ....Consent is the cornerstone of ethics as applied to healthcare and is central to the relationship between healthcare and the law. Whilst no-one would deny the importance of seeking consent to high-risk medical procedures, much depends on the practical manner in which this is done. By studying consent for high-risk procedures with the participation of patients and their health care providers, we will both test the limits of consent and find practical ways to address those limits. In doing so, the project will re-cast consent processes in a way that better accommodates the contingencies of clinical practice in high-risk settings in which patient autonomy is often compromised. Because this reformulation of consent will be grounded in the realities of high-risk clinical practice, our findings will reflect the needs and values of relevant stakeholders (patient and health professionals) and more likely to make a significant contribution to patient care and health policy. This project also addresses what the High Court of Australia has acknowledged as widespread weaknesses in the common formulation of consent in medicine. Finally this project, which operates in an important area of overlap between the law and medicine, will show how these disciplines can work jointly to serve the interests of all Australians, and Australian society.Read moreRead less
The Role Of Learning In The Development, Maintenance, And Treatment Of Paediatric Obsessive-Compulsive Disorder
Funder
National Health and Medical Research Council
Funding Amount
$189,604.00
Summary
Obsessive-compulsive disorder (OCD) in children is a severely debilitating mental health problem affecting between 0.5 and 1% of the population at any point in time. Children with OCD frequently experience high functional impairment as a result of their symptoms, including deteriorating school performance and poor peer relationships. Family life is often disrupted, causing significant distress and hardship to parents and siblings. However, little research attention has been paid to how families ....Obsessive-compulsive disorder (OCD) in children is a severely debilitating mental health problem affecting between 0.5 and 1% of the population at any point in time. Children with OCD frequently experience high functional impairment as a result of their symptoms, including deteriorating school performance and poor peer relationships. Family life is often disrupted, causing significant distress and hardship to parents and siblings. However, little research attention has been paid to how families affect and are affected by this disabling condition. This research examines the role of learning in the development, maintenance and treatment of OCD. Specifically, the study aims to: 1. explore the way in which children with OCD process threatening information 2. investigate the influence of parents on children's processing of OCD-relevant information 3. develop and implement the world's first randomised control trial of cognitive-behavioural plus parent training (CBT + PT) for childhood OCD 4. evaluate parent-assisted treatment in comparison to a standard cognitive-behavioural treatment (CBT) and a placebo control 5. examine the long-term maintenance of each type of treatment The outcomes of this project will be: 1. an improved understanding of OCD in children, and their families 2. an increased knowledge of the relationship between parenting processes and OCD symptomatology 3. the development and dissemination of an evidence-based treatment for childhood OCDRead moreRead less
Ethical And Legal Issues Surrounding The Decision-making Process For Donating And Banking Umbilical Cord Blood
Funder
National Health and Medical Research Council
Funding Amount
$417,550.00
Summary
Altruistic donation of umbilical cord blood (UCB) is essential to provide a source of stem cells to treat various cancers and blood-immune disorders. However, parents can instead, bank UCB for personal use. This project will determine if parents are aware and understand differences between UCB donation and banking, as well as analysing the legal issues surrounding both processes. We aim to make recommendations to improve the decision-making process with the hope of increasing UCB donation rates.
Autism and its milder forms affect approximately 6 per 1,000 children. The biological basis of the disorder is unknown, so considerable research is being invested in identifying cognitive processes that are atypical in children with autism because this may help identify key areas of the brain affected by the disorder. This research has established that children with autism often outperform their typically developing peers on tasks that require detailed analysis of visual information. In contrast ....Autism and its milder forms affect approximately 6 per 1,000 children. The biological basis of the disorder is unknown, so considerable research is being invested in identifying cognitive processes that are atypical in children with autism because this may help identify key areas of the brain affected by the disorder. This research has established that children with autism often outperform their typically developing peers on tasks that require detailed analysis of visual information. In contrast, visual tasks that require integrating information often reveal impaired performance in children with autism. Human vision is achieved through two pathways in the brain - a dorsal pathway most responsive to changing (e.g. moving or flickering) stimuli and a ventral pathway most responsive to enduring stimulus features (e.g. colour, pattern). Increasingly complex visual processing is achieved at higher levels in each pathway through integrating information from lower levels. One objective of our work is to identify which levels of processing in each of the dorsal and ventral pathways show atypical functioning (either enhanced or impaired) in autism. We will do this using tasks designed to establish thresholds for different perceptual judgements, such as identifying patterns in a field of dots. Children with autism will be compared to typically developing children and also to children with Specific Language Impairment (SLI). This will enable us to establish whether the same profile of strengths and weaknesses in perception and cognition are observed in autism and SLI, or whether they can be distinguished on this basis. The significance of the work is that it will advance considerably the understanding of atypical visual processing in autism and SLI. Also, by identifying perceptual and cognitive differences in children with autism, we may be able to develop tests to identify infants affected by the disorder and commence remediation at an early age.Read moreRead less
Deconstructing DTCA: Towards A Differentiated Policy Response To Direct-to-Consumer Advertising In Australia.
Funder
National Health and Medical Research Council
Funding Amount
$190,760.00
Summary
Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culmina ....Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culminate in a national workshop which will develop a differentiated set of recommendations for responding to different types and modes of DTCA. This is likely to lead to better health policy and to resources that may assist consumers and health professionals deal with DTCA.Read moreRead less
Overall Australia provides an ideal environment for research into the public health effects of prostitution laws. The eight states and territories effectively provide eight 'natural experiments' in legal responses to prostitution - ranging from prohibition through almost complete decriminalisation, with varying degrees of regulation and control in between these extremes. This project will examine how different legal and police responses to prostitution may affect the health of sex workers. These ....Overall Australia provides an ideal environment for research into the public health effects of prostitution laws. The eight states and territories effectively provide eight 'natural experiments' in legal responses to prostitution - ranging from prohibition through almost complete decriminalisation, with varying degrees of regulation and control in between these extremes. This project will examine how different legal and police responses to prostitution may affect the health of sex workers. These variable legal contexts guarantee international interest in this research. in addition this research team has extensive experience - dating back up to 20 years - in successfully researching even the most marginalised elements of the sex industry in Australia. By the conclusion of the project we will have assessed sex worker access to health promotion programs, including health services, in three states. We will be able to provide authorities with insights into the effects of prostitution laws and the enforcement of those laws on the health and welfare of sex workers. This finding will inform future interventions with sex industries in Australia and globally.Read moreRead less
Competence To Give Informed Consent For Research Participation In Schizophrenia And Related Psychoses.
Funder
National Health and Medical Research Council
Funding Amount
$300,000.00
Summary
There is current controversy surrounding the ethics of allowing people with mental illness to participate in research. By trying to safe guard what is considered a vulnerable group, we may also be denying these people their rights to make decisions for themselves. The potential benefits of clinical research in an area where treatments are often ineffective and cause serious side effects may also be denied to these people. This study aims to measure the capacities of patients with psychoses to gi ....There is current controversy surrounding the ethics of allowing people with mental illness to participate in research. By trying to safe guard what is considered a vulnerable group, we may also be denying these people their rights to make decisions for themselves. The potential benefits of clinical research in an area where treatments are often ineffective and cause serious side effects may also be denied to these people. This study aims to measure the capacities of patients with psychoses to give informed consent to participate in clinical research. The uniqueness of this project is that subjects will be rated as either competent or incompetent according to legal definitions applicable in Australia by utilising predetermined thresholds. We will also determine whether performance of patients in tests of competence can be improved through an established educational program. Additionally we plan to re-evaluate patients after a period of 6 months in order to test the reliability of competence performance.Read moreRead less