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Department of Medicine – Alfred Hospital

How reliable is the food frequency questionnaire in older adults?

Supervisor: Dr. Rosalie Woods Ph: 9903 0952
Email: rosalie.woods@med.monash.edu.au
Location: Clinical Epidemiology Unit, Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital

PROJECT SYNOPSIS:

A study is already in progress to determine the prevalence of chronic obstructive pulmonary disease (COPD) and to ascertain whether diet is a risk factor for COPD in older adults. Approximately 1000 adults will be visiting our laboratory for this study. As part of the study, subjects complete a self-administered food frequency questionnaire (FFQ). This questionnaire was originally developed by the Anti-Cancer Council of Victoria. The aim of this project would be to get a sub-sample of subjects to complete the FFQ a second time to ensure that the FFQ is a reliable dietary assessment tool .

This project will involve:

randomly selecting the subjects who are to complete the FFQ a second time,
organising the mail-out of the FFQ's with an approriate explanatory letter,
ensuring the timely return of the completed FFQ's
arranging for the FFQ’s to be optically scanned by the Anti-Cancer Council of Victoria
developing a database of the results from each subjects initial and repeated FFQ
statistical analysis the results in terms of test-retest reliability
This project is suitable for someone who has the following:
interest in conducting human research
excellent communication skills (verbal & written), particularly with members of the public
good database design and analytical skills

How well does assessed fat intake correlate with blood fatty acid levels?

PROJECT SYNOPSIS:

The data collection for a study looking at the prevalence and risk factors (including diet) for asthma in young adults has already been completed. Over 1000 randomly selected subjects participated in this study. As part of the study, subjects completed a self-administered food frequency questionnaire (FFQ) and also had venous blood taken to ascertain their plasma fatty acid levels. The FFQ was originally developed by the Anti-Cancer Council of Victoria. The aim of this project is to assess how well dietary fat intake, as measured by an FFQ, correlates with plasma fatty acid levels.

This project will involve:

developing a database of the results from the FFQ and the plasma fatty acid levels
statistical analysis
initial draft of manuscript
This project is suitable for someone who has the following:
good database design and management skills
excellent analytical skills
above average writing skills

Assessing Cost Effectiveness (ACE) – Heart Disease

Supervisor: Dr Theo Vos (Ph. 9637 4236)
Email: theo.vos@dhs.vic.gov
Location: Epidemiological Modelling Unit, Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital and Assessing Cost Effectiveness (ACE) – Mental Health Public Health Division, Department Human Services – Victoria, Spencer St, Melbourne, 3001

PROJECT SYNOPSIS:

Cardiovascular diseases are the largest cause of disease burden in Australia and are responsible for a large portion of healthcare expenditure. Mental disorders also rank high in terms of burden of disease, and this burden is projected to increase substantially in the coming years. With rising pressure on healthcare budgets in Australia and around the world, policy makers increasingly need to justify decisions on healthcare spending.

The Assessing Cost Effectiveness (ACE) – Heart Disease and Mental Health projects aim to analyse the costs and impact of existing and potential new interventions in the area of coronary heart disease (CHD) and mental disorders respectively. These projects will provide governments and health service providers in Australia with evidenced based information on the relative cost-effectiveness of the major preventive, curative and rehabilitative interventions for these areas. The Honours student(s) will work as part of a team of researchers and will be responsible for analysing at least one of the selected interventions in either Mental Health or Heart Disease.

This project will involve:

Selecting an intervention, eg promoting increased physical activity in the community,
Literature review for measures of effectiveness/efficacy for the intervention
Analysis of current practices, ie what is currently being done in terms resource utilisation for the selected intervention
Determination of costs of the intervention and cost savings due to prevention of disease
Modelling cost effectiveness using decision analysis software
Performing Monte-carlo simulation to assess the effects of uncertainty
Writing a report or research paper to disseminate findings to health policy makers and the research community

This project is suitable for someone who has:

An interest in health policy and/or health economics
Strong computing skills
Strong statistical and data analysis skills
Good writing skills

Epidemiology of major trauma using the Victorian State Trauma Registry (VSTR)

Supervisor: Karen Smith (Ph: 9903 0951)
Email: karen.smith@med.monash.edu.au
Location: Trauma Epidemiology Unit, Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital

PROJECT SYNOPSIS:

Based on recommendations from the Ministerial Taskforce on Trauma and Emergency Services a new system of trauma care is currently being implemented in Victoria. In order to ascertain the effectiveness of this system and to provide ongoing monitoring of major trauma patients, a Statewide Trauma Registry has been established. This registry, the Victorian State Trauma Registry (VSTR), is coordinated by the Victorian State Trauma Outcome Registry and Monitoring group (VSTORM) which is comprised of experts in trauma care and trauma epidemiology. The registry is chaired by Professor John McNeil and is based at the Department of Epidemiology and Preventive Medicine, Monash University.

The ongoing monitoring of the statewide system for trauma management is designed to reduce preventable death and permanent disability resulting from major trauma, and return injured patients to an optimal state of functioning. The VSTR will be used to monitor the effectiveness of the Victorian Trauma System. A project is available to an honours student to use the registry to look at the epidemiology of major trauma in Victoria.

Identification of factors effecting progression of knee osteoarthritis as measured by a novel magnetic resonance imaging based technique

Supervisor: Flavia Cicuttini and Anita Wluka (Ph: 9903 0553)
Email: flavia.cicuttini@med.monash.edu.au
Location: Diagnostics Unit, Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital

PROJECT SYNOPSIS:

Osteoarthritis (OA) is the single biggest cause of disability in Western society. Despite this, relatively little is known about the factors that effect disease progression. This will be the first extended follow up study of cartilage volume in people with early OA. This study will build on our existing work where we have developed a cohort study of adults with early knee OA. These people were initially recruited in 1997/8. An extensive data base of potential risk factors for OA has been collected and both X-rays of the knee and MRI have been performed at baseline and 2 years. Extending the follow up from 2 to 5 years will allow not only more precise estimation of rates of cartilage loss and assessment of risk factors, but also enable assessment of the assumption of linearity of cartilage volume loss. It will also be possible to partition the observed variability in rates of loss into true between-subject variability and within subject residual variability. This partitioning will provide valuable information for the design of future studies in OA, similar to the establishment of statistical design principles for patterns of loss in bone mineral density.

This project will involve:

Literature review of the issues surrounding radiographic progression of OA
Recruiting subjects
Learning to assess knee joint space radiographically
Learning to measure knee cartilage using magnetic resonance imaging
Assembling the data
Analysis of the data
Writing and submitting a publication
This project is suitable for someone who has the following:
interest in conducting human research
excellent communication skills (verbal & written), particularly with members of the public
keen to develop good research design and analytical skills

Comparison of X-rays and MRI in measuring progression of knee osteoarthritis

PROJECT SYNOPSIS:

Osteoarthritis (OA) is a common cause of disability in people aged over 65 years. Development of treatments for OA is limited by the lack of a non-invasive method that is reproducible and accurate and can be used to measure progression of disease. Change in width of medial tibiofemoral joint space has been recommended as the primary measure of biological effect in OA by expert consensus. However precise measurement of this variable is dependent on standardized radiographic techniques and could be biased when the presence of pain impairs the ability of participants to position the knee.

The relevance of radiographic joint space as a single measure of biological severity in knee OA has been raised. The use of this measure has resulted from the idea of OA as a disorder joint cartilage loss and the belief that joint cartilage thickness correlates with the width of radiographic joint space. However, a recent magnetic resonance imaging study has highlighted the pan-articular nature of knee OA and has shown that mild to moderate joint space loss reflects meniscal extrusion rather than joint cartilage erosion. There has been increasing interest in the use of magnetic resonance imaging (MRI) in the measurement of knee cartilage volume as a possible outcome measure in arthritis. A potential advantage of MRI cartilage volume over plain knee radiographs is that since the whole 3 dimentional structure is measured rather than a single dimentional structure. Thus, there is the potential of reducing the problem of reselecting identical section locations in follow-up examinations or small positional changes from one examination to the next due to change in symptoms. We plan to compare changes in knee cartilage volume as measured by MRI and joint space narrowing in a cohort of 106 subjects with symptomatic knee OA followed over 4 years.

This project will involve:

Literature review of the issues surrounding measurement of disease progression in osteoarthritis
Recruiting subjects
Learning to assess knee joint space radiographically
Learning to measure knee cartilage using magnetic resonance imaging
Assembling the data
Analysis of the data
Writing and submitting a publication
This project is suitable for someone who has the following:
interest in conducting human research, especially in the area of medical diagnostics
excellent communication skills (verbal & written), particularly with members of the public
keen to develop good research design and analytical skills

The relationships between knee cartilage loss, knee joint proprioception and oestrogen replacement therapy (ORT) in postmenopausal women

PROJECT SYNOPSIS:

There is no treatment available that effects progression of osteoarthritis (OA). Joint position sense is reduced in people with OA. Of potential great clinical importance is the prospect that the deterioration in knee joint position sense may contribute to more rapid progression of OA. This has important implication for the care of patients with OA. To date, although management strategies are available, they have not been used in people with knee OA. If a decline in knee joint position sense predisposes to the development of knee OA, there may be a role for preventive therapies that enhance knee joint position sense and neuromuscular joint protection. Furthermore, oestrogen replacement therapy has already been shown to be important in reducing the risk of fractures in women. It has been suggested that the effect of hormone replacement therapy on fractures may be more than just due to the effect on bone loss but that it may be due to other neurological benefits. We are currently investigating the effect of oestrogen on knee cartilage in healthy women. In this study we propose broadening the scope of the study to examine the effect of oestrogen replacement therapy on knee joint position sense and gait in healthy women and then to determine whether this is associated with loss of knee cartilage volume.

This study will test the following hypotheses:

That women on oestrogen replacement therapy will have significantly better knee position sense than post-menopausal women not on ORT.
That women with better static and dynamic knee joint joint position sense will have a reduced rate of loss of knee cartilage

This project will involve:

Literature review of the issues surrounding oestrogen replacement therapy, joint proprioception of development of osteoarthritis
Recruiting subjects
Assembling the data
Analysis of the data
Writing and submitting a publication
This project is suitable for someone who has the following:
interest in conducting human research
excellent communication skills (verbal & written), particularly with members of the public
keen to develop good research design and analytical skills

The effect of physical activity on knee cartilage in normal men and women

PROJECT SYNOPSIS:

In evaluating the benefit of recreational physical activity as a major public health initiative to reduce cardiovascular disease and osteoporosis, the risks need to also be determined. There is much controversy as to whether physical activity will damage joints or whether it will improve amount of knee cartilage and thus reduce the risk of developing knee osteoarthritis. In this study we will examine the effect of physical activity of the amount of knee joint cartilage in healthy men and women. This will have important implications for public health recommendations regarding exercise.

This project will involve:

Literature review of the issues surrounding the optimum way to assess physical activity
Collecting measures of physical activity from subjects participating in other studies who have already had their knee joints assessed
Assembling the data
Analysis of the data
Writing and submitting a publication
This project is suitable for someone who has the following:
interest in conducting human research
excellent communication skills (verbal & written), particularly with members of the public
keen to develop good research design and analytical skills

Diagnosis and natural history of occult scaphoid fracture

Supervisor: Flavia Cicuttini and Louise Prentice (Ph: 9903 0553)
Email: flavia.cicuttini@med.monash.edu.au
Location: Diagnostics Unit, Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital

PROJECT SYNOPSIS:

Fracture of the scaphoid bone is the most common fracture of the carpal bones (wrist region). It accounts for about 50-80% of carpal injuries and predominantly occurs in young, healthy individuals. Up to 25% of these fractures are not visible on the initial radiographs.

Given the diagnostic difficulty associated with scaphoid fractures, even experienced observers often incorrectly diagnose scaphoid fractures. It has been shown that only 15-20% of the patients treated initially for occult scaphoid fracture actually had a scaphoid fracture. In 50-75%, the definite diagnosis was a simple wrist sprain. Since it is well recognised that if scaphoid fractures are not immobilised, there is a high tendency of delayed union up to, and with eventually, non-unions with resultant long-term disability, the current management recommendations are cast immobilisation, even if a fracture cannot be confirmed on the original radiographs. The duration of immobilisation and repeat radiographs is 10-14 days. Consequently, about 50% of patients with suspected scaphoid fracture are having wrist immobilisation for wrist sprains, where this is not indicated.

In this study we will compare nuclear medicine and magnetic resonance imaging in the diagnosis of occult scaphoid fractures and determine the natural history of this condition.

This project will involve:

Literature review of the issues surrounding diagnosis and outcome in occult scaphoid fracture
Collecting measures of physical activity from subjects participating in other studies who have already had their knee joints assessed
Assembling the data
Analysis of the data
Writing and submitting a publication
This project is suitable for someone who has the following:
interest in conducting human research
excellent communication skills (verbal & written), particularly with members of the public
keen to develop good research design and analytical skills

Medication Error Prevention

Supervisor: David Kong (Ph: 9903 9000)
Email: david.kong@vfp.monash.edu.au
Location: Victorian College of Pharmacy Medicine, Monash University, 381 Royal Parade, Parkville 3052

PROJECT SYNOPSIS: To be confirmed

Foetal metabolism and placenta transfer of anti-retroviral agents

Supervisor: David Kong (Ph: 9903 9000)
Email: david.kong@vfp.monash.edu.au
Location: Victorian College of Pharmacy Medicine, Monash University,
381 Royal Parade, Parkville 3052

PROJECT SYNOPSIS: To be confirmed

Synthesis of either carbohydrate-based bio-active probes or potential potassium channel antagonists

Supervisor: David Kong (Ph: 9903 9000_
Email: david.kong@vfp.monash.edu.au
Location: Victorian College of Pharmacy Medicine, Monash University,
381 Royal Parade, Parkville 3052

PROJECT SYNOPSIS: To be confirmed