The Osteoporosis fractures risk assessment study is the longest running study of osteoporosis in men and women internationally. Having engaged this large community for decades to follow the relationships between diet, activity, health, osteoporosis and fractures, the MBF Foundation has funded an extension of the study that will develop a model to assess the risk of individuals for osteoporosis and associated fractures and adverse health outcomes and determine which prevention options can be offered most cost-effectively across which population groups.

So far, researchers at the Garvan Institute have shown the major impact of these fractures on premature mortality, increasing the risk after all types of fragility fractures by 2 - 3-fold compared to other men and women of the same age. However a wide range of prevention strategies exist, some more expensive than others and some more effective for different sorts of people. This project aims to establish a model where an individual’s various risk factors can be entered and from this determine the best, cost-effective treatment and management.

www.garvan.org.au/research/research-groups/dubbo-epidemiology-study.html

A clustered randomised controlled trial will be conducted across Australia to evaluate an innovative intervention, the Stop-Stroke. Stop-Stroke is designed to optimise the evidence-based management of atrial fibrillation (an abnormal heart rhythm) in general practice which can otherwise result in strokes. Research has shown that not all doctors prescribe optimal treatment for their at-risk patients. The researchers aim to show that patients with atrial fibrillation in the care of GPs allocated to use Stop-Stroke will be more likely be prescribed 'appropriate' antithrombotic treatment.

Greater use and compliance with the taking of anticoagulants can reduce the risk of death and disabling stroke and reduces the cost of health care. Peak national and international medical authorities have urgently recommended the increased uptake of appropriate anticoagulation treatment for managing patients with atrial fibrillation. Rigorous evaluations of strategies designed to promote the uptake of antithrombotic treatment are needed to assess gaps between evidence-based knowledge and clinical practice to reduce the risk of death associated with atrial fibrillation; reduce the risk of fatal and disabling stroke in people affected by atrial fibrillation and reduce the burden and cost to the community associated with stroke caused by atrial fibrillation.

This is a longitudinal study of 1600 Victorian women newly diagnosed with invasive breast cancer. These women are, over at least 5 years, giving us an insight into their lives following treatment by providing information through annual questionnaires to follow the physical, psychological and socio-economic consequences of breast cancer, looking at the broader outcomes of treatment beyond simply surviving.

Women were recruited both directly from the community and through the Victorian Cancer Registry in their first year after diagnosis. Findings will provide a basis for the development of targeted management strategies to address issues affecting women with breast cancer and guiding further specific research where issues of significant need or poorer than expected outcomes can be identified. Other issues that may not otherwise have been considered significant may also be brought out.

This is the first Australian study to evaluate the broader health and social outcomes as well as the needs of women after their breast cancer has been diagnosed and treated. It may seem that gaining an understanding of these issues is routine but this is the only large study ever conducted in Australia and one of only a few in the reported literature worldwide that tracks women in this way from early diagnosis through subsequent years.

http://womenshealth.med.monash.edu.au/

The cost to the community of an ageing population combined with reduced post-retirement income and increasing pressure on the health system is enormous. Consequently, approaches are needed to effectively, safely and affordably improve the quality of life of older people so they can continue to work, remain independent and live an enjoyable life for as long as possible.

As men age their quality of life is often reduced because of musculoskeletal, metabolic and mental deterioration. These aspects of ageing are also seen in androgen deficient younger men, who can be and have been safely and effectively treated with testosterone, one of the hormones found in all men, but more so in some than in others. This research will test the theory that testosterone replacement may improve some of the significant health aspects of male ageing.

Experts in maintaining quality of life into the later years, researchers at the WA Centre for Health and Ageing will investigate how lifestyle, medical and social components interact to increase longevity and aid ageing free of disability. The findings will have direct implications for health promotion and policy and will provide information about potentially modifiable risk factors associated with ageing. Using an existing group of older men from a study running since 1996, researchers will measure changes in lifestyle habits, medical events and quality of life during the past 10 years that may contribute to survival free of significant disability.

http://www.wacha.org.au

Using the Southern Hemisphere’s biggest cohort study, this program will bring together experts from some of the country’s foremost health and medical organisations to improve the allocation of scarce health funds and resources for Australia’s ageing population. The three-year Policy in Action Program will use data from the 45 and Up Study, which will follow 250,000 volunteers aged 45 and over, tracking their interactions with Medicare, the PBS, hospital system and other parts of the health system. The 45 and Up Study is managed by the Sax Institute in partnership with the NSW Cancer Council, the National Heart Foundation (NSW branch), NSW Health, beyondblue: the national depression initiative, and the NSW Department of Ageing Disability and Home Care. For more information on the 45 and Up Study, visit www.45andup.org.au.

To celebrate the history and contribution of the people that created MBF and the organisation’s commitment to health and healthcare research and innovation, the MBF Foundation established the MBF Founding Medical Members Grant that will be dedicated to one project annually. This grant recognises and honours past medical members over the course of MBF Australia Ltd’s 61 year history. This year the Centre for Eye Research Australia was awarded the grant for its innovative research into a new low risk means of screening for and diagnosing heart and blood vessel (cardiovascular) disease. This research has great potential to allow people to identify their risk earlier, without the risk associated with some of the current diagnostic tests, and so improve health outcomes for Australians at high risk of cardiovascular disease.

Scientists at the Centre for Eye Research Australia aim to develop computerised recognition of blood vessel disease for early detection and intervention for cardiovascular disease. This is based on their previous findings that the eye can provide a window to heart health. Changes to the retina are early markers of the disease, and this study plans to evaluate how well the use of a retinal imaging technique can identify high-risk but often symptom-free people at an early stage. Knowing that damage has already occurred will prompt the earlier introduction of preventative measures such as dietary changes, physical activity and cholesterol lowering drugs. Currently available diagnostic tools based on conventional risk factors lack precision and there are some limitations in their ability to adequately capture a substantial proportion of people at high risk of cardiovascular disease.

http://cera.unimelb.edu.au/

With healthcare costs continuing to rise year on year as a result of a combination of the ageing population, new drugs and improved medical technology, the Australian Centre for Health Research is focused on whether consumers are getting value for money. The Centre works to promote informed, intelligent discussion about issues affecting health services and delivery in Australia to achieve a more efficient, effective public and private health system. The Centre was established by a number of organisations representing a broad range of interests across the health industry with the aim of commissioning independent research and using the results to promote consultation, discussion and increased understanding.

www.achr.com.au/

Less than one in three cardiac patients complete rehabilitation even with strong evidence of the effectiveness of these programs to enhance capacity and quality of life after a cardiac event such as heart attack or heart surgery. Barriers to participation include distance from the locations the programs are held, lack of transportation and patient work or time conflicts. The rapid penetration of internet and broadband technology throughout Australia, including regional, rural and remote locations offers the promise for alternate or blended delivery of information in a manner that connects patients and healthcare professionals across distance and time.

The overall objective of the project is to develop and test an internet-based “outpatient” cardiac rehabilitation program. There will be a formal evaluation of effectiveness and useability of a tailored and interactive website that will aim to deliver electronically an “outpatient” cardiac rehabilitation using the Best Practice Guidelines established by Queensland Health. The program is especially relevant to Australians living in rural and remote settings but a randomised control trial of the developed resource may show its relevance to the large numbers of cardiac patients in metropolitan as well as rural settings who do not access cardiac rehabilitation programs.

Patients with chronic ischaemic heart disease have insufficient blood flow and oxygen to the heart because of blockages in the heart arteries and damaged heart muscle that pumps abnormally. Many such patients suffer ongoing angina (chest pain) and significant functional limitation despite being on optimal medications and in some cases after all mechanical options (such as heart bypass surgery) to improve blood supply to the heart have been exhausted.

Treatments aimed at improving the blood supply to the heart by forming new blood vessels as well as repairing damaged heart muscle have enormous therapeutic potential. Patients with coronary artery disease often have to face lifelong treatment with medications and/or multiple surgical procedures and if any of this can be avoided there will be clear advantages with respect to both the cost of health care and the quality of life of those affected.

G-CSF is a naturally occurring chemical found in the body. G-CSF stimulates the formation of new blood vessels (neovascularisation) directly but also increases the number of stem cells produced and released by the bone marrow into the bloodstream that themselves aid in the building of new blood vessels. It also has a direct protective effect on heart muscle cells. Small human trials have investigated the use of G-CSF in patients with chronic refractory angina including a phase I study completed at St Vincent’s Hospital and the Victor Chang Cardiac Research Institute in 2006 (the GAIN I study). This showed that G-CSF treatment was safe in this group of patients and suggested potential benefits including improvement in angina and exercise capacity. Based on the data from this and other studies demonstrating safety of G-CSF therapy, and suggesting efficacy, a larger phase II study will be initiated to further examine the effects of G-CSF with a view to developing a powerful treatment option for patients with debilitating chronic refractory angina.

www.victorchang.edu.au

The primary aim of this project is to increase the proportion of the population achieving a ‘Prudence score’ of 6 or more out of 10 by conducting a randomised trial of a simple, widely applicable intervention in general practice. A comparison will be made between promoting a 'prudent' lifestyle against a set of other health protecting behaviours to see the update of both.

Former smokers and miners dealing with the health damage from exposure to fine air particles are among Australians with chronic lung diseases who could benefit from this major study by the University of Queensland to identify the most effective way to manage their conditions. The study will be the first in the world to compare the effectiveness of a seven-week rehabilitation program to a self-management approach and regular GP visits for people with emphysema and chronic bronchitis. Emphysema and chronic bronchitis – lung conditions comprising the Chronic Obstructive Pulmonary Disease (COPD) category – affect 10% of Australians aged over 45 at an annual cost of $800 million, with low income earners heavily represented. Despite the ease of diagnosis with no sophisticated medical testing involved, many people unknowingly have the disease.

www.uq.edu.au/health//AboutMBF/TheMBFFoundation

A healthcare policy initiative which will elevate awareness of the prevalence and economic cost of persistent pain to the community and address this issue through the development of a National Pain Strategy. A key aspect will be a focus on strategies in acute pain management that aim to reduce the risk of progression from acute to persistent (chronic) pain.

http://www.painsummit.org.au

The problem of Postnatal Depression is increasingly well-recognised, and preventative interventions for Postnatal Depression have begun to target women during pregnancy. However, recent evidence suggests that depression actually begins in pregnancy for many women and Antenatal Depression should be a target for treatment as a clinical condition in its own right. Antenatal Depression is under-recognised and is in urgent need of an evidence-based treatment.

The proposed study aims to fill this gap by evaluating a program we have developed but not yet systematically evaluated as a treatment for Antenatal Depression.

In recent years there has been an increasing focus on developing and applying disease management principles and programs to minimise the impact of common chronic diseases. Cardiovascular disease continues to be Australia’s leading cause of impaired quality of life, costly morbid events and premature death.

The Young @ Heart Program will assess the impact of chronic disease management for heart disease for 1000 privately insured patients aged over 45. Patients will be randomised to gold standard usual care or a nurse-led multidisciplinary home based education, care coordination and health risk management program. The primary aim of this study is to determine if a nurse-led home intervention program for chronic heart disease patients can work within the private health care system to improve patients’ quality of life, prolong survival, reduce hospital readmission rates and reduce costs.

In an Australian first, the Baker IDI Heart and Diabetes Institute, UnitingCare Health and MBF are offering this program to privately insured patients who have been referred for their heart disease to two major cardiac centres in Brisbane, the Wesley Hospital and St Andrew’s War Memorial Hospital. The Foundation has funded an independent evaluation of the effect, efficacy and cost impact of the program in order to establish whether this sort of program can provide for a cost-effective strategy to minimize poor outcomes for heart patients.

Bipolar disorder is a complex mental illness that has a high personal and societal toll, with high rates of suicide and relapse, interpersonal problems and a substantial economic burden. Thus, recognition and treatment of bipolar disorders is paramount. In a 2006 study excess costs of bipolar disorders in Australia were put as high as approx $3.97– 4.95 billion (Fisher et al). The study recommended the need for further evaluation of the cost effectiveness of different treatments or an alternative means of reducing the burden borne by individuals, the health system and the general community.

One of the key problems with this condition is that those with it have significant difficulties complying with and maintaining their treatments and relapse is common. This study aims to reduce relapse and hence healthcare costs through the provision of training specific to this issue for clinical services in the private and public health sector and community clinics. This training focuses on addressing the needs of people with bipolar affective disorder and improving access to treatment for people with bipolar affective disorder in community treatment settings.

This study will follow women during the course of initial treatment for early-stage breast cancer to identify factors that influence recovery from treatment. Women commonly identify pain as having a major impact on quality of life, and so pain experiences prior and during treatment will be a major focus of the study. Women who participate in the study will complete questionnaires pre-surgery and at 1 and 4 months after surgery. In addition, they will undergo clinical assessment of shoulder function and lymphoedema, as well as participating in a brief telephone interview 1 week after surgery. Relevant data on treatment and analgesic use will be abstracted from medical records.

Women who report troublesome pain at 4 months after surgery will have the option of having a clinical pain assessment at the Pain Management Research Centre at Royal North Shore Hospital.

Open Forum is a new interactive discussion e-forum developed by Global Access Partners (GAP) that provides a platform for focused dialogue on social, political, economic, ecological and cultural issues and challenges. The Forum is registration-based and enables participants to make connections and ultimately contribute to policy development. Operating as a powerful web-based consultative mechanism, Open Forum facilitates access to key people in our community and concentrates on practical outcomes.

www.openforum.com.au

Although it is taken as a given that weight loss is good for your heart and general health, there is limited clinical data as to what improvements people can expect if they are motivated to lose weight. The hypothesis will be tested that weight loss induced by a very low calorie diet along with a modest increase in physical activity, in obese men with and without type 2 diabetes, will reverse obesity related abnormalities in cardiovascular and reproductive function.

Specifically the effects of diet-induced weight loss will be measured against cardiovascular risk factors such as high blood pressure, abnormal glucose tolerance (pre-diabetes and diabetes), high cholesterol and obstructive sleep apnoea. It will also look at how this relates to the extent of remaining vascular and cardiac function.

One common symptom of a systemic vascular problem is erectile dysfunction and this, along with sexual desire, androgen levels and lower urinary tract symptoms, will be measured. This has significance on its own, but also has the potential to have a huge impact on the motivation of patients to try and achieve better heart and vascular health.

With a dramatic increase in obesity among young people, there has also been a corresponding rise in the number of adolescents with pre-diabetes, with an expectation that diabetes would follow in subsequent years. This study aims to establish a management plan for teenagers at risk of type 2 diabetes, examining the role of protein consumption and exercise in improving insulin sensitivity. The program will provide data on the effectiveness of managing impaired glucose metabolism in adolescents and will contribute crucial information about the prevention of complications. Furthermore, developing an approach for a homogeneous group like adolescents has the potential to inform the way in which we tailor approaches for other groups of patients.

With the total number of knee replacement operations performed in Australia doubling over the past eight years and demand for surgery expected to continue to increase in the next decade, the significance of knee replacement surgery is sizable. The MARKER study will determine the benefits and cost-effectiveness of an alternative to protracted inpatient rehabilitation in hospital after knee replacement by evaluating a delayed class-based outpatient rehabilitation program for people who have undergone primary total knee replacement.

Currently many patients, particularly the more elderly, stay in hospital, often for weeks, on their doctor’s advice following surgery, and outpatient rehabilitation in Australia is mostly provided through a resource-intensive program that usually starts immediately after discharge from hospital. This however is a time when patients are still recovering from major orthopaedic surgery and are restricted in their ability to exercise at an intensity that might otherwise be considered sufficient to achieve real and meaningful physiological changes. Poor recovery from knee replacement surgery often results in ongoing pain and restricted movement and mobility, and lengthy hospitalisation has its own risks so reducing either or both of these problems has the potential to substantially improve health in the community.

Physical activity and good nutrition give children the best start to life and reduce their risk of developing a chronic disease in adulthood. Now in its 12th year, the Sanitarium Weet-Bix Kids TRY-athlon inspires Australian children to join a program that teaches them to enjoy activity and feel a sense of accomplishment upon completing an event. In 2007, the International Triathlon Union acknowledged the Kids TRY-athlon as the largest childrens event of its kind in the world. The national series encourages children to dream, train, try and become a champion in an event where sporting abilities are not a barrier to entry.

The event is open to children aged 7 - 15 and involves a swim, cycle and run with variation in distances for junior and senior competitors. There are no times recorded or places given – everyone is rewarded equally and made to feel like a true Aussie champion.

http://www.weetbix.com.au/tryathlon/

Researchers at St Vincent’s aim to provide strategies for the treatment of obesity and type 2 diabetes by investigating their association with high calorie intake. Mounting evidence connects metabolic disorders with overeating and the study hopes to gain an understanding of the processes that link food consumption with insulin resistance, the precursor to diabetes.

Three annual triathlons held across Tasmania for 7-15 year old boys and girls.

The MBF Foundation Tasmanian Kidfit Triathlons through LifeBeInIt are held in three locations: Ulverstone, Georgetown and Hobart. Participation numbers have increased year to year and each of the three events generate significant local media coverage, promoting the benefits if physical activity for children.