Foundation initiatives

Chronic pain is a problem that is not always well managed, leading to unnecessary suffering. This project will develop an online educational program for primary health care professionals to improve pain management. The program will be accredited by the RACGP, which will make it attractive to doctors, particularly to rural and regional professionals who have difficulty accessing quality education.

It will focus on the need for a holistic approach to pain management and the importance of early treatment of pain to prevent it becoming a chronic problem. Once developed for health professionals, this program will be adapted to become an educational tool for patients too.

The TEXT ME study will target people who are at high risk of developing cardiovascular disease. Participants will receive semi-personalised messages via their mobile phone about living a healthy lifestyle with advice, motivation and support to quit smoking (if relevant) and engage in healthy diets and exercise.

The study will evaluate the feasibility, acceptability and effect of these messages on cardiovascular (CV) risk factors. With the rising ownership of mobile phones both in Australia and globally, this intervention has the potential to be a cheap, safe and simple way to reduce the risk of cardiovascular disease in millions of people.

Bringing dental care to some of the most remote communities in Australia has significant consequences not only for people’s teeth but also for their overall health. This program will begin in South Australia giving many people their first opportunity to see a dentist.

With the support of the Foundation, RFDS dental students will fly out regularly to provide oral health checkups and treatment to communities that have otherwise been underserved. As well as benefiting people in remote areas this will also contribute to a high quality medical education for Australia’s dentists in training, and is one of the first programs of its kind in Australia.

One of the greatest challenges to the health and wellbeing of Australians is the dramatic increase in obesity among young people, which has brought a corresponding rise in the number of adolescents with pre-diabetes, a condition that significantly increases the risk of developing diabetes.

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. This also has the potential to inform the way in which we tailor approaches for other groups of patients.

The problem of post-natal depression is increasingly well-recognised, and preventative interventions for PND have begun to target women during pregnancy. However, recent evidence suggests that depression actually begins in pregnancy for many women and ante-natal depression should be a target for treatment as a clinical condition in its own right. Ante-natal 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.

The Foundation supports three annual triathlons held across Tasmania for 7-15 year old boys and girls. The Kidfit Triathlons through LifeBeInIt are held in three locations: Ulverstone, Georgetown and Hobart. Participation numbers have increased every year and are real community success stories, helping to promote increased activity and healthy lifestyles among Australia’s young people.

Physical activity and good nutrition give children the best start to life and reduce their risk of developing a chronic disease in adulthood. Having existed for over a decade, 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.

Targeting children's lifestyle behaviours when they are at an impressionable age is a key to encouraging a lifetime of healthy habits. Channel Nine's Melissa Doyle and former Ironman Champion Guy Leech launched a Bupa Health Foundation funded children's exhibit at Sydney's popular Powerhouse Museum. The Magic Garden: Bupa Health Foundation Healthy Kids Unit taught children aged 2 - 8 about healthy food choices and physical activity through interactive play units in a bright imaginative environment.

The purpose-built unit is in a self-contained play space that is enormously entertaining for them while giving positive messages about activity and food. Children learn the difference between fresh, whole foods and artificial, highly processed foods while parents can watch a short film on nutrition and their important role in encouraging activity. The Foundation engaged nutritionist, Susie Burrell, to create a healthy lunchbox for children in the museum's café.

With funding from the Bupa Health Foundation, QAST conducted a comprehensive survey in Queensland to better understand the needs of tuckshops in providing healthy menu options at schools. The results showed that recent initiatives have almost eliminated high energy, nutrient poor foods, such as soft drinks and confectionery, from tuckshop menus. However, the survey showed that food and drinks that are high in energy, saturated fat or salt with little or no fibre (or 'fast foods') remain popular on tuckshop menus.

The survey showed that non-state schools often have menus with a higher percentage of these items. It was found that schools generally believe their menus to be healthier than they are. The Foundation hopes to educate schools while increasing the availability and consumption of safe, healthy and affordable food that will develop better dietary habits, contribute less to childhood obesity and deliver a healthier community.

One-day workshops with continuing professional development points from the appropriate associations were provided on a regular basis around Australia to GPs and practice nurses. Workshops were in 4 topic areas:

• introduction to lifestyle medicine
• lifestyle medicine and mood states
• understanding addictions and behaviour for lifestyle medicine
• environmental aspects of lifestyle medicine.

Workshops were jointly sponsored with Pfizer pharmaceuticals and are provided at no charge for practising clinicians or those in training.

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 was 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, would reverse obesity related abnormalities in cardiovascular and reproductive function.

Specifically the effects of diet-induced weight loss was measured against cardiovascular risk factors such as high blood pressure, abnormal glucose tolerance (pre-diabetes and diabetes), high cholesterol and obstructive sleep apnoea. It also looked 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, was measured. This was significant on its own, but also showed potential to have a huge impact on the motivation of patients to try and achieve better heart and vascular health.

Bipolar disorder is a complex mental illness that has a personal and social toll, with high rates of suicide and relapse, interpersonal problems and a substantial economic burden. One of the key problems with this condition is that those with it have significant difficulties complying with and maintaining their treatments and relapse.

This study aimed 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. The training addressed the needs of people with bipolar affective disorder while improving access to treatment for people with bipolar affective disorder in community treatment settings.

The primary aim of this project was 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 was made between promoting a 'prudent' lifestyle against a set of other health protecting behaviours to see the improvement of both.

Skin cancer affects 60% of Australians. Daily sunscreen use can reduce skin cancer incidence, but compliance is surprisingly poor. Nicotinamide (vitamin B3) protects against many of sunlight’s damaging effects and reduces the risk of patches of pre-malignant keratoses.

In this project, patients will receive either Nicotinamide or placebo tablets for 16 months in a double blind randomised trial. The results will then be compared to evaluate the impact of Nicotinamide on skin cancer.

Nicotinamide is safe, widely available and presents an exciting opportunity for cost-effective skin cancer prevention.

Chronic disease is one of the biggest challenges facing health services. This program will evaluate an approach to patient self-management of their illness based on telephone health coaching from nurses and other professionals.

Managing a chronic condition more effectively can lead to considerable gains for the patient and health system by helping to avoid emergency hospital admissions that are both undesirable for the patient and expensive to maintain. This study compares different groups of patients, some of whom will be offered telephone health coaching through Bupa Health Dialog to evaluate and establish its impact on managing chronic diseases.

Depression is common in people with diabetes mellitus. Although the links are not well understood, it is clear that poor mental health has a significant impact on people’s ability to manage their illness. For example, depression can present a major barrier to effective and sustainable behavioural change in diabetes patients with obesity.

Treatment approaches in this context tend to make the mistake of separating the physical illness and the patient's emotional reaction to it. This initiative aims to adopt a ‘whole-person model’ in developing and evaluating an integrated ‘chronic disease self-management’ education program for people with type 2 diabetes, obesity and depression.

The program, constructed around a patient manual, will provide key information about disease management and skills training designed to facilitate self management. Patients are encouraged to consider how their body, thoughts, feelings, and their health behaviours are all connected.

Researchers engaged in the Strong Study have previously shown that strength training is effective for improving health and wellbeing in adults with type 2 diabetes, at least in the short term. However, sticking to an exercise program can be difficult and effective strategies for promoting adherence and maintenance are lacking.

This new initiative has been designed to investigate the effectiveness of incorporating tailored adherence and maintenance strategies into the existing Baker-IDI –developed ‘Lift for Life’ specialised strength- training program.

The Stong Study aims to put people with or at risk of type 2 diabetes through a six-month community-based strength program, with or without behavioural intervention. A two-year assessment of maintenance will follow to compare long term adherence to the program.

Having already established a large cohort of participants (the largest of its kind in the world), the study will provide valuable evidence to improve primary and secondary prevention strategies among older adults in this patient group.

Cardiovascular disease continues to be Australia's leading cause of impaired quality of life, costly morbid events and premature death. 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 such as CV disease.

The Young @ Heart Program assesses the impact of chronic disease management for heart disease for 1000 privately insured patients aged over 45. Patients are randomly allocated either to gold standard usual care or to a nurse-led multidisciplinary home based education, care coordination and health risk management program.

This study will determine whether 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.

The Centre for Eye Research Australia was awarded a partnership for its innovative research into a new low risk means of screening and diagnosing heart and blood vessel (cardiovascular) disease. This gives people the potential to identify risks earlier and carries fewer downsides associated with current diagnostic tests, thus improving 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 based on their previous findings that the eye can provide a window to heart health. 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, leading to early introduction of preventative measures such as dietary changes, physical activity and cholesterol lowering drugs.

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 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.

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. Former smokers and miners dealing with health damage from exposure to fine air particles are among Australians with chronic lung diseases whom the University of Queensland aims to benefit with this major study which identifies the most effective way to manage their conditions.

The study was 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 these illnesses.

Despite strong evidence of the effectiveness of rehabilitation programs after a heart attack or heart surgery, less than one in three cardiac patients take part in such programs due to barriers like distance from the locations the programs are held at, lack of transportation and time conflicts.

The rapid penetration of internet and broadband technology throughout Australia offers a new approach to connecting patients and health professionals. 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 aims to deliver an "outpatient" cardiac rehabilitation using the Best Practice Guidelines established by Queensland Health, electronically.

The program is designed to connect Australians living in rural and remote settings. However a randomised control trial of the website may also be useful for cardiac patients in metropolitan settings who do not access rehabilitation programs.

Researchers at St Vincent's aimed 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 hoped to gain an understanding of the processes that link food consumption with insulin resistance, the precursor to diabetes.

This study followed 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 were a major focus of the study.

Those participating in the study completed questionnaires pre-surgery and at 1 and 4 months after surgery. They also underwent clinical assessments 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 was also abstracted from medical records.

Those women who reported troublesome pain at 4 months after surgery were given the option of having a clinical pain assessment at the Pain Management Research Centre at Royal North Shore Hospital.

An often neglected aspect of treating people with dementia is making plans for the end of life. This project empowers people with dementia, their families and carers to make informed end-of-life decisions through a better understanding of their legal rights and care options, including palliative care.

This will be achieved through:

• market research to determine public attitudes and knowledge gaps
• consumer guides that synthesise the latest research, policy and regulation, and outline the range of options available
• public seminars throughout Australia
• media campaigns supporting the publications and seminars to raise awareness and generate public debate.

The majority of older people with dementia are admitted to hospital for reasons other than their dementia. This means that their treatment can be complicated, and result in adverse events like falls and medication errors. Care costs can be increased because of the need for specialist treatment, and families can suffer from anxiety about their loved one.

This project tests the ability of the Dementia Care in Hospital Program to improve outcomes for people with dementia when they are treated in hospital. This has potential to influence how people are treated in the public and private sectors both at home and abroad.

Everyone knows that an unhealthy lifestyle can contribute to health problems later in life. Poor diet and lifestyle choices can lead to Oxidative Stress – which adversely affects cells in the body that are associated with ageing and degenerative diseases.

Evidence shows that Oxidative Stress is a major underlying factor in brain cell degeneration, and this study investigates the primary causes of Oxidative Stress in the brain, and its impact on the vital systems that keep us healthy.

It also seeks to identify factors that may be helpful in treating and preventing diseases like Alzheimer’s and Parkinson’s, as well as developing strategies to help maintain brain cell function into old age.

Every year over one million people over the age of 65 are given anaesthesia during a health procedure. While there is laboratory evidence showing that anaesthesia promotes the risk of Alzheimer’s Disease, the extent of any relationship between the two is currently unknown.

This project compares the incidence of Alzheimer’s in elderly patients who have previously received anaesthesia with those who have not been anaesthetised. It is aimed at helping researchers understand whether there is an association of anaesthesia with Alzheimer’s Disease, which, potentially, has far reaching consequences for medical practice across the world.

As men age their quality of life is often reduced due to 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.

From a public health perspective, efforts to prevent depression are crucial if we are to reduce costs and improve health in the whole community. However few trials have tested interventions aimed at reducing symptoms and preventing depression.

Following studies which show that fish oils may prevent depression and suggestions that they are an acceptable remedy to older adults, this initiative is the first to investigate whether omega-3 fatty acid (fish oil) supplements are effective in reducing rates of depressive symptoms, reducing incidence of new cases of major depressive disorder and reducing cognitive decline associated with ageing.

The study also looks at whether brain changes in those risk factors for vascular disease are reduced by administering fish oil.

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 Bupa Health Foundation has funded an extension of the study to develop a model to assess the risk of individuals for osteoporosis, associated fractures and adverse health outcomes, and determine which prevention options can be offered most cost-effectively across each population group.

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 –two to threefold compared to other men and women of the same age.

However a wide range of prevention strategies exist, some more expensive and effective than others, for different sorts of people. This project aims to establish a model where an individual's various risk factors can be entered to determine the best, cost-effective treatment and management.

Experts in maintaining quality of life into the later years, researchers at the WA Centre for Health and Ageing, (WACHA) investigated how lifestyle, medical and social components interact to increase longevity and aid ageing free of disability.

The findings have direct implications for health promotion and policy and provide information about potentially modifiable risk factors associated with ageing. Using an existing group of older men from a study running since 1996, researchers measured changes in lifestyle habits, medical events and quality of life during the past 10 years that may contribute to being free of significant disability.

Using the Southern Hemisphere's biggest cohort study, this program brought 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 used data from the 45 and Up Study, which followed 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 was 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.

The Department of Medicine at the University of Sydney trialled a study for an internet based cholesterol assessment. 990 participants were recruited to the trial throughout Australia from all age groups.

The purpose of the trial was to determine if a special website might help people discover and manage their cholesterol levels more appropriately. High cholesterol (the amount of fat in the blood) can cause serious health problems like heart attack and stroke. This is a major problem in Australia and a significant issue for the private health sector, and, if discovered early, could be reduced by using simple steps, such as diet or medication.

This study aimed to solve the medical riddle of why older people's burns take longer to heal but with less severe scarring than experienced by the young, and use these findings to help reduce disfigurement from serious burns and wounds. This study furthers our understanding of scar-less healing and the development of treatments tailored to individual patient needs. Led by 2005 Australian of the Year, Professor Fiona Wood, the McComb Foundation aimed to identify how genetic expression in the skin changes with ageing and how it can affect the comparative healing and scarring rates of older and younger people.

Post Natal Depression (PND) is common, but is rarely dealt with until after it has become a problem, with negative consequences for mothers, babies and other family members. PND is strongly linked to sleep difficulties for mother and child.

In this project, expectant mothers are randomly allocated to normal prenatal classes, or classes that offer additional education and support for sleep. Other pregnant women are given information about sleep through their local pharmacy. These groups will be compared to see which approach is more effective in improving sleep after a baby is born, to reduce the risk of PND.

The aim of the project is to increase awareness and help parents seek help for sleep problems

Adolescents can be offered a vaccination against a virus called HPV that is linked to some forms of cancer. HPV can be passed on through sexual activity, leading to sensitivity among parents and teenagers about whether to take up the vaccination.

This project aims to understand parental perceptions of barriers to vaccinating their adolescents against HPV and develop a method of facilitating informed choices. This ‘decision aid’ will then be pilot tested and evaluated to understand the impact on shared decision-making and vaccination uptake.

In Australia, children and parents are constantly exposed to food industry marketing and promotions that encourage them to buy and consume unhealthy foods that are aimed at children. Despite strong community support for tighter restrictions on food advertising to children, little has been done to change the way these foods are promoted.

This project tests the responses of parents and children to a counter-advertising intervention designed to debunk misleading food promotions and empower consumers to evaluate advertised foods more critically and accurately.

In Australia, more people over the age of 80 years are having cardiac surgery, with elderly patients often agreeing to surgery through a belief that it will restore them to full health. But because these patients are older, recover less quickly and often have other ongoing health conditions, their quality of life after the operation may not be the same as before.

However, research is yet to confirm this. Given the cost and risks associated with these procedures, research is urgently needed to assess whether patients enjoy an improved quality of life two years after cardiac surgery.

This study assesses 120 cardiac surgery patients, both clinically and via questionnaire, at three, six, 12 and 24 months following surgery, to find out about their quality of life and how well they function in day-to-day life.

The outcomes of this study will help patients decide between cardiac surgery and alternative options to manage their condition. It will also help hospitals understand the cost-effectiveness of these procedures.

This initiative aims to develop resources for an online interactive oral health intervention program. Material will be specifically designed with and for the use of older people, rather than helping them to use programs designed for younger generations.

It aims to improve knowledge, and attitudes, and encouraging people to do the things that help guarantee good oral health, with resources based on well established material for older adults (Oral Health Information Seminars/Sheets, or ORHIS).

Resources will be developed to support five ORHIS information sheets, employing digital storytelling techniques, quizzes, question-and –answer facilities, and pathways to access further information and services. The program will be run by a trained peer-educator, and piloted in social clubs and community centres. It has the potential to provide a stronger base for future community-based oral health promotion activities for older Australians.

This is a longitudinal study of 1600 women in Victoria newly diagnosed with invasive breast cancer. During a period of at least five years, these women give 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.

The women were recruited both directly from the community and through the Victorian Cancer Registry in their first year after diagnosis. The findings will provide a basis for the development of targeted management strategies to address issues affecting women with breast cancer. It will also guide 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 discovered.

This is the first Australian study to evaluate the broader health and social outcomes as well women’s needs after their breast cancer has been diagnosed and treated. It is also one of only a few studies worldwide that tracks women in this way from early diagnosis through subsequent years.

Mental health issues disproportionately affect younger people, with up to one in four suffering a mental health problem in any given year. Treatment options are not always accessible or appropriate for young people. Exacerbating the situation is the stigma and silence that still relates to mental health issues. Many young people do not want to ask for help and, if they do look for support, don’t find it.

This partnership contributes to better mental health services for young people by engaging the community in improving care. This has included the first International Youth Mental Health Conference as well as community forums exploring different aspects of mental health from suicide to body image.

Radiation proctitis is a debilitating condition causing rectal bleeding, faecal urgency and pain. It occurs in 5 – 15% of all patients who have had pelvic radiotherapy for treatment of cancers.

There is some anecdotal evidence that suggests oral vitamin A supplements assist in improving the symptoms for radiation proctitis. This study examines the evidence in a simple trial that could provide a solution to the problem that is significant for a minority of cancer patients.

In Australia, over 90,000 admissions to hospital each year are considered potentially preventable, costing the healthcare system an estimated $330 million annually. Using administrative health databases, it is now possible to identify and routinely monitor those hospitalisations that are preventable. Although clinical indicators of medication-related hospitalisations have been developed internationally, none have been developed specifically for the Australian setting.

This study aims to develop and validate Australian clinical indicators of potentially preventable medication-related and primary care-related hospitalisations.

This study assesses the impact of routine mental health and psychosocial risk assessment of pregnant women and new mothers. Its objective is to refer women identified ‘at risk’ for additional support and treatment.

Despite increasing investment dedicated to perinatal (just before birth) mental health in Australia, information is still lacking about how many women participate in psychosocial assessments and its impact on their health.

The total number of knee replacement operations performed in Australia has doubled over the past eight years, and demand is expected to increase in the years ahead. The MARKER study will determine the benefits and cost-effectiveness of an alternative to protracted inpatient rehabilitation in hospital after knee replacement.

Currently many patients, particularly the more elderly, stay in hospital for weeks following surgery. Outpatient rehabilitation in Australia is mostly provided through a costly 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.

Using data from the Australian Longitudinal Study of Women’s Health, this study endeavours to fill that gap. It also examines other factors that underpin the health of mothers, including social inclusion factors such as the employment patterns of women having children, social support, and where people live.

Weakening and expansion of the main abdominal artery (abdominal aortic aneurysm, AAA) is a common problem in older Australians. This project is designed to evaluate the efficacy of telmisartan, a promising new medical treatment for AAA, in a carefully designed randomised pilot study.

Surgery is currently the only treatment available for AAA. It is expensive and associated with significant complications, and has also failed to benefit patients with early stage or small AAA. Only five, small, randomised controlled trials examining the role of medications for small AAA have been published worldwide, and all have failed to identify an effective treatment that has translated into clinical practice.

Preliminary data suggests that candesartan could reduce the growth rate of small AAA by 50%. Such a treatment could reduce the number of patients requiring costly surgery; reduce the number of surgery-related deaths and complications; and provide a therapy more suited to the rapidly expanding elderly age group that typically develops AAA

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. In some cases problems persist 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. 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 help to build new blood vessels. It also has a direct protective effect on heart muscle cells.

Small scale human trials have investigated the use of G-CSF in patients with chronic refractory angina and suggested potential benefits including improvement in angina and exercise capacity. Based on studies demonstrating the safety and efficacy of G-CSF therapy, 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.

In light of an ageing population, this study was aimed at getting a better understanding of the health funding gap between perceived future healthcare costs and projected funding levels. A model was developed by considering the demand for health related services for different life stages of the population, the expenditure on health care related services, the likely sources of funding between the government and individuals, and the gap between the demand and cost to the individual of health care related services and the available sources of funding.

Persistent pain costs Australia $34.3 billion annually, nearly $11,000 for each of the approximately 3.2 million people grappling with pain. In collaboration with Access Economics and the University of Sydney Pain Management Research Institute, the Bupa Health Foundation study also found that people with pain bear more than half the total cost burden.

This is the first ever study to put a dollar value on persistent (or chronic) pain in Australia and the data will be used to guide policy and decision makers and identify priority actions to ease suffering, save healthcare dollars and help patients get on with productive lives.

A healthcare policy initiative to 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 aims to reduce the risk of progression from acute to persistent (chronic) pain.

Melbourne mental health researchers have succeeded in halving the number of hospitalisations of people with bipolar disorder. This was achieved through a structured group program to help people with bipolar disorder better manage their condition and improve compliance with treatment.

The 12-session program, led by trained mental health clinicians, enabled people with the disorder to effectively monitor their mood, assess personal triggers and early warning signs of oncoming illness and take the necessary steps to stay well.

In a controlled randomised study of 84 people diagnosed with bipolar disorder, those on the special intervention program had half the number of relapses after 12 months as the control group that continued with normal treatment.