Improving Understanding Of Psychostimulant-related Harms In Australia: An Integrated Ethno-epidemiological Approach
Funder
National Health and Medical Research Council
Funding Amount
$612,430.00
Summary
National drug surveys and surveillance systems have detected sharp increases in the use of 'psychostimulant' drugs such as the amphetamines, ecstasy and cocaine. The level of harms associated with excessive use of these drugs, such as mental health problems and drug dependence, has also increased, as has the use of these drugs via injection. These increases in the prevalence of use and related harms have also been detected internationally. Previous research on psychostimulant drugs, in Australia ....National drug surveys and surveillance systems have detected sharp increases in the use of 'psychostimulant' drugs such as the amphetamines, ecstasy and cocaine. The level of harms associated with excessive use of these drugs, such as mental health problems and drug dependence, has also increased, as has the use of these drugs via injection. These increases in the prevalence of use and related harms have also been detected internationally. Previous research on psychostimulant drugs, in Australia and overseas, has suggested that using these drugs in particular ways might be associated with a greater chance of contracting HIV and other blood-borne viruses such as hepatitis C (eg through sharing needles and syringes or other equipment associated with injecting drugs); sexually transmitted infections and other sexual health problems (eg through engaging in unsafe sex); and of being involved in violent incidents. Despite this previous research, however, little is known about the specific social and cultural contexts associated with psychostimulant-related harms, and this has stymied the development of appropriate responses to prevent such harms occurring. This research project will provide a greater understanding of the individual, social and cultural factors associated with pychostimulant-related harm through an innovative combination and integration of anthropological and epidemiological research methods known as 'ethno-epidemiology'. In order to access a range of psychostimulant-using contexts, research will focus on three sites: street-based drug users in Sydney, club drug users in Melbourne, and home-based recreational drug users in Perth. These groups have been chosen because they have high prevalences of psychostimulant use. The research project will provide important data that will inform future interventions, improve multidisciplinary models for drug research, and build Australia's capacity to conduct cutting-edge public health research.Read moreRead less
Understanding The Barriers To Improved Access, Engagement And Retention Of Methamphetamine Users In Health Services
Funder
National Health and Medical Research Council
Funding Amount
$788,291.00
Summary
Drug surveys show widespread use of methamphetamine. Its regular use, particularly via injection, is associated with a range of serious harms, including drug dependence, psychosis, viral infection and violence. In order to improve access, engagement and retention of methamphetamine injectors in drug treatment and other health services, and thereby reduce these harms, further research is urgently needed to better understand their healthcare needs and the existing barriers to service utilisation.
Predicting The Individual Risk Of Prostate Cancer In Australian Men
Funder
National Health and Medical Research Council
Funding Amount
$348,656.00
Summary
Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently a ....Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently available for prostate cancer. We will apply standard statistical methods to existing data from the Australian Risk Factors for Prostate Cancer study and from the Australian Institute of Health and Welfare to develop a prostate cancer risk prediction model. We will test how factor like age, detailed family history, diet, baldness status and possibly previous PSA tests and prostate biopsies predict the risk. After developing the model, we will test the accuracy of the predictions in three ways. First, using existing data from the Australian Prostate Cancer Family Study, we will see whether the number of cases in a group of men is close to the number predicted by the model (calibration). Second, to test whether the model discriminate well men who develop prostate cancer from those who do not, we will collect family trees in a sample from the Melbourne Collaborative Cohort Study. We will use these data also to estimate the optimal cut point: men above this level of risk will be considered at high risk. Third, we will apply the model to existing data from the Dutch Prostate Cancer Family Study (DPCFS) to test whether the optimal cut point identify high-risk men and to validate the model in a non-Australian population. Finally, we will prepare a computer package that health professionals will use as decision-making tool in different scenarios including individual cancer risk assessment, design of prevention trials and targeting prevention programs to high-risk men.Read moreRead less
Automated Mammographic Measures That Predict Breast Cancer Risk
Funder
National Health and Medical Research Council
Funding Amount
$406,260.00
Summary
Mammographic density (MD) is one of the strongest predictors of breast cancer risk but its impractical measurement prevents its use in a clinical setting. An automated measure of MD would allow screening programs to identify and target women at higher risk of breast cancer which could lead to earlier diagnoses and better breast cancer outcomes. We aim to develop an automated measurement, maximized by its ability to predict breast cancer risk, and applicable to both film and digital mammograms.
Estimation Of Transient Increases In Bleeding Risk Associated With Physical Activity In Children With Haemophilia
Funder
National Health and Medical Research Council
Funding Amount
$102,143.00
Summary
Haemophilia A and B are genetic conditions which affect 1 in 7,000 males in Australia. These disorders cause frequent bleeding due to problems with the clotting factor in blood. Over the past decade there has been a move to administer clotting factor to children with haemophilia in order to prevent bleeds and the consequent damage to joints that occurs when bleeds occur in a joint. Participation in vigorous physical activity and sport is thought to increase the risk of bleeding. Because of this, ....Haemophilia A and B are genetic conditions which affect 1 in 7,000 males in Australia. These disorders cause frequent bleeding due to problems with the clotting factor in blood. Over the past decade there has been a move to administer clotting factor to children with haemophilia in order to prevent bleeds and the consequent damage to joints that occurs when bleeds occur in a joint. Participation in vigorous physical activity and sport is thought to increase the risk of bleeding. Because of this, children are often given clotting factor prior to playing sport. However clotting factor is extremely expensive. For example, a boy wanting to play tennis three times a week would require three injections of cIotting factor per week at a cost of approximately $250,000 a year. To date there is no good evidence about which physical activities are likely to increase the risk of bleeding. If this information was available clinicians would be able to optimise timing of administration of clotting factor so that it is administered prior to activities associated with high risk of bleeds. Another reason to quantify risk of bleeds associated with activity is to inform decisions about participation in physical activity. Every boy with haemophilia wants to know if he can play sport or ride a skateboard or jump on a trampoline. Informed decisions about participation require accurate estimates of risk. This study will use an innovative design to provide, for the first time, accurate estimates of the risk of bleeding associated with physical activity. This information will form the basis for clinical practice guidelines regarding participation in physical activity.Read moreRead less
High blood pressure affects 1 in 5 Australian adults and is a leading cause of mortality and morbidity from heart attack and stroke. The condition tends to run in families and genetic predisposition, in the face of environmental factors, leads to the elevation in blood pressure. My Lab has demonstrated the capacity of a cohort of affected hypertensive sibships we have collected to find loci for essential hypertension at a level that has achieved genome-wide statistical significance and has been ....High blood pressure affects 1 in 5 Australian adults and is a leading cause of mortality and morbidity from heart attack and stroke. The condition tends to run in families and genetic predisposition, in the face of environmental factors, leads to the elevation in blood pressure. My Lab has demonstrated the capacity of a cohort of affected hypertensive sibships we have collected to find loci for essential hypertension at a level that has achieved genome-wide statistical significance and has been published in a leading molecular genetics journal. Moreover, this previous work, which included fine-mapping after finding a suggestive locus following a scan of chromosome 1, not only demonstrated significant linkage, but also went on to compare gene markers between a different cohort of (unrelated) hypertensive subjects with 2 affected parents (and early-onset, moderate to severe hypertension) and control normotensive matched subjects with unaffected parents, to identify a likely candidate gene. This same approach will be used to complete the rest of the genome. The discovery of all of the genes for essential hypertension will be an important prelude to: (1) developing new, more effective treatments, since the gene products responsible will be able to be targetted by novel therapeutics, (2) genotyping individuals early in life in order to advise them what their risk is, and thus allow couselling about lifestyle modification, (3) more logically apply existing treatment strategies according to the volume-neural-vasoconstrctor component of the contribution to high blood pressure.Read moreRead less
Australian Stroke Genetics Collaborative - Genome-wide Association Study In Ischaemic Stroke
Funder
National Health and Medical Research Council
Funding Amount
$1,141,037.00
Summary
The majority of stroke is caused by atherothrombosis, the formation of blood clots in brain blood vessels. Numerous genes are linked to atherothrombosis, but many studies examined genetic influences in isolation from environmental risk factors. We will examine the relevance of genetic variations linked to atherothrombosis, in the context of environmental risk factors. By determining the contribution of genetic and environmental factors in stroke, we will develop a stroke risk assessment tool.
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.