Department of Public Health and Primary Care

Research Assistant/Research Associate Statistician

Andy — Tue, 08 May 2012 09:33:57 +0000

Salary: £23,661-£26,629 or £27,428 – £35,788

Unit: Department of Public Health and Primary Care

*Limited Funding

The Primary Care Unit is seeking to appoint an ambitious and highly able statistician to support programmes of internationally competitive health services research on patient experience and cancer diagnosis and treatment.

The post holder will work closely with investigators at the Cambridge Centre for Health Services Research (led by Professor Martin Roland, Professor of health services research). The ideal candidate will have a broad, solid and practical knowledge of statistical analysis methods. The post is offered at either pre- or post-doctoral level.

Whilst aiming to fill this post immediately, we would happily defer the start date until September 2012 to recruit a talented individual who is currently completing Masters or PhD studies. We expect and encourage initiative, ambition, and a self-critical outlook on quality assurance and improvement of the methods and relevance of our work, and we reciprocate by offering mentoring and coaching and ample opportunities for professional development and growth. A recent previous pre-doctoral post-holder of a fixed-term post of similar nature was supported in achieving 14 peer reviewed publications, including 4 publications in journals with an impact factor > 10, and 3 publications as a first author.

Depending on demonstrated excellence in performance after appointment, and the motivation and stage of the career of a successful candidate, we will support them to compete for pre-doctoral or post-doctoral research fellowships at the end of the tenure of the present post.

The University has a responsibility to ensure that all employees are eligible to live and work in the UK.

Further particulars can be found here

Applications should comprise of a) a full CV, b) Parts 1 and 3 of Form CHRIS/6 – downloadable here and c) the names and contact details of three referees; at least of whom must be an academic referee whom we may approach before interview.

Applications should be sent, preferably by email to Lynette Watson: ku.ca.mac.cphpnull@nimda or by post to Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN

To enquire about the nature of the post please contact Dr Georgios Lyratzopoulos on ku.ca.mac.lhcsdemnull@092lg

Location: Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR

ALL APLLICATIONS MUST BE RECEIVED BY 5PM ON THE CLOSING DATE

*Limit of tenure: The appointment will initially be for 3 years, in the first instance.

Closing Date: June 10

Short-listed candidates will be called for interview on 25 June 2012.

Quote reference: RH00242

Professor Carol Brayne Guest Edits Research Horizons

Andy — Wed, 02 May 2012 06:55:59 +0000

This month, the University of Cambridge is profiling research that addresses public health. To begin, Professor Carol Brayne, Director of the Cambridge Institute of Public Health explains how the goals of a new University Strategic Network, PublicHealth@Cambridge, will generate fresh insight into the health and well-being of populations.

Senior Project Manager for International Studies: Senior Research Associate/Research Associate

Andy — Mon, 30 Apr 2012 09:19:27 +0000

Salary: £27,578-£46,846

Unit: Department of Public Health and Primary Care (DPHPC)

*Limited Funding

DPHPC, one of Europe’s leading academic departments of population health sciences, wishes to appoint an experienced Project Manager to oversee a portfolio of major international biomedical projects.

The post-holder will have a demonstrated track record of managing multiple, complex projects, ideally large-scale biomedical studies. The post-holder will be responsible for the operational management of a range of collaborative projects, (particularly EU-funded), ensuring that key milestones, financial and administrative commitments are met, and that scientific plans are successfully implemented.

The post will be based in the Cardiovascular Epidemiology Unit, a dynamic, interdisciplinary group at the forefront of research into the genetic, biochemical and lifestyle causes of cardiovascular disease.

The post-holder will have: (1) relevant qualifications (eg, a PhD in a scientific field), (2) experience in project management, including financial management (3) excellent organisational and communication skills (4) knowledge of EU funding and reporting mechanisms would be desirable. The post-holder should also be able to work independently, accurately judge priorities, and work to tight deadlines.

Further Particulars are available here

Details of how to apply are available at http://www.phpc.cam.ac.uk/ceu/vacancies/

Informal enquiries can be made to Dr Adam Butterworth by email (ku.ca.mac.lhcsdemnull@83bsa) or telephone + 44 (0) 1223 741302.

Location of post: Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, CB1 8RN

ALL APPLICATIONS MUST BE RECEIVED BY 5PM ON THE CLOSING DATE

*The funds for this post are available until 31 December 2015 in the first instance.

Closing Date: 01 June 2012

Interview Date: TBC

Quote reference: RH00225

Research Associate/Social Scientist (part-time)

Andy — Thu, 26 Apr 2012 10:49:16 +0000

Salary: £27-578 – £35,938 pro-rata

Unit: Institute of Public Health

*Limited Funding

Applications are invited for a part-time Research Associate/Social Scientist to work on the Get Moving Project, as part of a team of researchers promoting fitness and decreasing the risk of ill health.

Working closely with medical anthropologist Simon Cohn, the successful applicant will conduct interviews with participants to explore their experiences - in particular, the extent to which interventions may have made increases in physical activity routine and habitual. Applicants should be able to apply a theoretical social science perspective to their work, boast methodological expertise, and be comfortable analysing and progressing data from research into published work within strict timeframes.

You will be flexible and well organised, with strong and effective research skills, capable of using your own initiative and have the ability to build and maintain excellent working relationships.

Further particulars can be found here

The University has a responsibility to ensure that all employees are eligible to live and work in the UK.

To apply please send a covering letter explaining your reasons for applying and your suitability for the post, a copy of your current CV, plus completed parts 1 and 3 only of form CHRIS/6 – downloadable here - including the names and contact details of three referees. Applications should be emailed to Mrs Helen Ludford ku.ca.mac.lhcsdemnull@43lmh: or posted to her at the Institute of Public Health, Forvie Site, Robinson Way, Cambridge CB2 0SR

For an informal discussion about the post, please contact Dr Simon Cohn: ku.ca.mac.lhcsdemnull@nhoC.nomiS

ALL APPLICATIONS MUST BE RECEIVED BY 12 NOON ON THE CLOSING DATE

*Fixed-term: The funds for this post are available for 12 months from the date of appointment.

Closing Date: 31 May 2012

Interview Date: 08 June 2012

Quote reference: RH00221

Depression linked to longer hospital stays for illness

Andy — Wed, 25 Apr 2012 10:41:11 +0000

Health problems may linger longer if they’re coupled with mental health problems. A new study finds that depression is a risk factor for more time spent at the hospital.

Researchers suggest that treating depressive symptoms in patients with physical illnesses could result in shorter stints in the hospital and overall less cost in health care.

Matthew Prina, Doctoral candidate at the University of Cambridge, and lead author of this study, conducted in the Department of Public Health & Primary Care at the University of Cambridge Institute of Public Health. Prina directed a team of researchers to look at hospitalization rates for elderly patients with and without depression.

Elderly patients with depression, that are being admitted into hospitals for non-mental health reasons, are sticking around hospitals for longer periods of time than patients without depression.

Prina’s study aims to find any links that exist between depressive symptoms in elderly patients and hospitalizations for non-mental health reasons.

The data for the study was retrieved from the 1995-2006 archives of the Longitudinal Aging Study Amsterdam (LASA). According to the study, researchers were able to see: “Hospital outcomes including admission, length of stay, readmission and death while in hospital were recorded at 6, 12 and 24 months intervals after each LASA interview.”

The point was to find out if the patients were getting what they needed in terms of care. If depression is a risk factor that may contribute negatively to a physical illness, does the depression need to be treated as well for optimal recovery?

After one year the LASA group reported 14 percent of patients with depressive symptoms compared to only 10 percent of patients without depressive symptoms were hospitalized. The death rate for people during a hospitalization was twice as high for depressed patients, .8 percent vs. .4 percent, for non-depressed patients.

The length of time patients stayed in the hospital was also nearly double, 2.6 days vs. 1.4 days: patients with depressive symptoms vs. those without.

Armed with this knowledge, Prina and his team hope that medical professionals can treat patients that present with depression as an independent risk factor to their physical illness more effectively.

Awareness of depressive symptoms could influence treatment plans, speed up physical recovery and improve health. Overall the result could be better care for the patient, reduction in treatment costs and shorter sick time for the patient.

This study was published in the online journal PLoS ONE, April 2012. The study was funded by the Ministry of Health, Welfare and Sports to The Longitudinal Aging Study Amsterdam (LASA), no conflicts of interest were found.

Taller women at greater risk of ovarian cancer

Andy — Tue, 10 Apr 2012 07:29:24 +0000

Tall women are more likely to develop ovarian cancer than their shorter friends, research suggests.

Oxford University scientists reviewed 47 studies involving more than 100,000 women – many of them with ovarian cancer – and found a link with height.

They also found the disease is more common in overweight women.

Dr Paul Pharoah, a Cambridge University cancer expert, said while the analysis was valid, the impact on individual women would be small.

Researchers say that with women in the Western world gradually getting taller as well as fatter, it is important to make the link.

But others urged tall women not to worry, saying their overall odds of developing the disease are still small.

Ovarian cancer is the fifth most common cancer in women, with more 6,500 cases diagnosed each year in the UK.

Two-thirds of these die from the disease, because it is often symptomless in its early stages and not spotted until it has started its poisonous spread around the body.

Tall order: Crunching together the results of almost 50 individual studies of the disease revealed that it is also more prevalent among women who are overweight

Age and not having had any children are known to increase the odds of the disease, while the contraceptive pill helps protect against its development.

But previous attempts to look at the role of height and weight have provided inconsistent results, so researchers decided to put together as much information as they could on the topic to come up with an answer.

Every extra two inches in height raised the odds of the disease by 7 per cent.

The finding held true even when other factors such as age and use of the pill were taken into account, the journal PLoS Medicine (MUST CREDIT) reports.

The researchers aren’t sure what’s behind the link but say it may simply be that tall women have more cells that can become cancerous.

Growth hormones may also be important.

The study also found that the heavier and more obese a woman was, the greater her risk of ovarian cancer, but only if she had never been on HRT.

Dr Paul Pharoah, a University of Cambridge cancer expert, said that while the analysis was done well, the impact on individual women will be little.

To illustrate his point, he compared a woman who is 5ft tall with one who is 5ft 6in in height.

The shorter woman will have a 1.6 per cent chance of developing ovarian cancer in her lifetime, the figure for the taller woman will be 2 per cent.

He added that there are many other good reasons for a woman to maintain a healthy weight.

Researcher Professor Valerie Beral described the link with height as ‘curious’.

She said that with extra inches also raising the odds of other cancers, including breast cancer, it is important to pin down what is at the root of the link.

Arthritis drugs to treat heart disease

Andy — Wed, 14 Mar 2012 13:57:11 +0000

Arthritis drugs could provide a new approach to treating heart disease by targeting inflammation, research suggests.

Two new genetic studies have found a clear causal link between a specific inflammation signalling pathway and the development of coronary heart disease.

The evidence indicates that heart disease can be tackled using certain anti-inflammatory drugs. One such drug, tocilizumab, is already commonly used to treat rheumatoid arthritis, an auto-immune disease.

Inflammation is a basic immune response to infection or injury which can become too strong and end up damaging body tissue. Experts have long suspected that it plays a role in heart disease by contributing to artherosclerosis, the build-up of hard deposits on artery walls, but until now no causal link involving a specific inflammatory pathway has been found.

The new research, published online in The Lancet medical journal, focused on an inflammatory signalling protein called interleukin-6 receptor (IL6R).

Combined data from more than 2,000 people taking part in 82 studies found that one variant of the IL6R gene protected against heart disease. The mutation dampened the effects of inflammation, and each of two copies of the gene inherited reduced the risk of heart disease by 3.4%.

A separate “meta-analysis” pooling the results of 40 studies involving 133,449 participants showed that the IL6R variant and tocilizumab had similar effects.

Dr Adam Butterworth, from Cambridge University, who co-led the first study, said: “Typically, it can take many years to make safe and effective drugs to target new disease pathways. However, in this case, drugs have been previously developed due to this pathway’s involvement in auto-immune disease. In fact, one such drug, tocilizumab, is already used for treating arthritis, and might therefore be a viable drug for preventing heart disease.”

Heart disease claims 200,000 lives each year in the UK, accounting for one in three deaths.

Professor Jeremy Pearson, associate medical director at the British Heart Foundation (BHF), which co-funded the research, said: “These two powerful complementary studies provide very strong evidence that new medicines, which reduce inflammation by blocking the IL-6 receptor, could be a powerful tool in helping to combat heart disease.”

Study examines number of GP visits before cancer patients are referred to specialists

Andy — Fri, 02 Mar 2012 13:11:18 +0000

Patient information reveals women, young people, ethnic minorities and people with less common cancers have the highest number of pre-referral consultations.

More than three quarters (77%) of cancer patients who first present to their family doctors (GPs) with suspicious symptoms are referred to hospital after only one or two consultations, a new study has found. However, the new research also shows a wide variation in the number of times a cancer patient sees their general practitioner before they are referred to a specialist, with the most pre-referral consultations occurring when the cancer was one of the less common types, or when the patient was either female, young, or an older person from an ethnic minority. The research was published today, 24 February, in the journal The Lancet Oncology.

The study, led by researchers at the University of Cambridge, found that patients with breast, melanoma, testicular and endometrial cancers are more likely to be referred to a specialist after just one or two consultations. However, patients with some less common cancers such as multiple myeloma, pancreatic, stomach and ovarian cancer, as well as patients with lung and colon cancers and lymphomas are more likely to require three or more visits to their family doctor before they are referred to a hospital specialist. Patients with multiple myeloma, a blood cancer that is notoriously difficult to diagnose since it mimics many other conditions, are 18 times more likely to require three or more pre-referral consultations compared with patients with breast cancer.

“These findings highlight limitations in current scientific knowledge about these cancers,” said lead investigator Dr Georgios Lyratzopoulos, Clinical Senior Research Associate at the University of Cambridge. “Medical research in recent decades has prioritised improving cancer treatments, but knowledge about the ‘symptom signature’ of common cancers and practical solutions on how best to diagnose them is still emerging. Hopefully, our study will stimulate investment into research, focusing on patients with cancers and characteristics where the potential to improve the experience of diagnosis of cancer is greatest.”

The researchers have also found that the diagnosis of cancer is more challenging among young patients, women, and older ethnic minority patients – all of these three groups are known to have a lower risk of developing cancer compared with older, male and white patients in the United Kingdom.

These findings amplify similar patterns first reported by co-author Dr Richard Neal, Senior Lecturer in General Practice at Bangor University, among cancer patients who took part in a similar survey that was carried out in 2000. Dr Neal said: “The fact that the diagnosis of cancer may be more challenging in some patient groups and for some cancers can help us to tailor diagnostic efforts. The findings will also inform the forthcoming update of the NICE Guidelines for Referral of Suspected Cancer, which will have an important impact on policy and practice.”

The researchers proposed some explanations as to why some of the patient groups were less likely to receive a prompt referral:

As differences in ethnic minorities were only apparent for older patients, they indicate that communication difficulties may be responsible.
For bladder cancer, women were more than twice as likely as men to have required three or more consultations with their doctor before a decision to refer to hospital was made. In women, there may be difficulties in discriminating symptoms and signs of bladder cancer from those of benign gynaecological conditions or bladder infection.
As young people have a lower rate of cancer, the researchers believe GPs are less likely to consider cancer as a possibility.

The research used data from more than 41,000 patients with 24 different cancers who took part in the English National Cancer Patient Experience Survey 2010. (The UK government has indicated that patient experience is a critical aspect of measuring care quality.) The researchers examined variation in the number of general practitioner consultations with cancer symptoms before hospital referral to diagnose cancer.

“Whilst doctors may have concerns about the accuracy of patient-reported data, we have good reasons to believe the validity of our findings”, said co-author Greg Rubin, Professor of General Practice and Primary Care at Durham University. “This is because they correlate well with data collected by general practitioners who took part in the independent National Audit of Diagnosis of Cancer in Primary Care. We hope further strides towards diagnosing cancer earlier will be made through the use of both patient experience and clinical audit data.”

In order to improve the promptness of referrals, the study makes recommendations for both clinicians and policy makers. For clinicians, they highlight the need to be more aware of some of the patient groups and cancers which tended to be diagnosed less promptly and the need to participate in data collection to benchmark their practice. They also suggest that policy makers ‘should explore and evaluate physician-level educational interventions, further development of point-of-care decisions aids, risk calculators and diagnostic tests, and system re-design to enable greater appropriate and timely use of specialist diagnostic tests (such as imaging or endoscopy)’.

Although the researchers are based in the UK, they believe their findings have implications for other countries as well, as they reflect the difficulties of diagnosis cancers with non-specific symptoms and signs more generally. Most patients subsequently diagnosed with cancer first see a doctor in the community regardless of where they live.

New genetic clues to breast cancer?

Kimberley — Tue, 24 Jan 2012 10:25:04 +0000

Researchers have identified three new genomic regions they believe are linked with breast cancer that may help explain why some women develop the disease.

All three newly identified areas “contain interesting genes that open up new avenues for biological and clinical research,” said researcher Douglas Easton, a professor of genetic epidemiology at the University of Cambridge in England.

NEW GENES IDENTIFIED FOR CORONARY ARTERY DISEASE AND HEART ATTACKS

Kimberley — Fri, 28 Oct 2011 10:27:50 +0000

Findings could help in developing new treatments and improve prediction of coronary heart disease

In a study to be published in the open-access journal PLoS Genetics on September 22^nd, an international consortium of scientists report the discovery of five new genes that affect risk of developing coronary artery disease (CAD) and heart attacks.

Coronary artery disease is the commonest cause of premature death and disability in the world. The findings could, in the future, help in developing new treatments and improve prediction of CAD.

The Consortium examined 49,094 genetic variants in ~ 2100 genes of cardiovascular relevance, in 15,596 CAD cases and 34,992 controls (11,202 cases and 30,733 controls of European descent / 4,394 cases and 4,259 controls of South Asian origin) and replicated their principal findings in an additional 17,121 CAD cases and 40,473 controls. The study was funded by the British Heart Foundation and the National Institute for Health Research in the UK with additional funding from the NIH in the USA and from other funding sources in Europe.

Co-principal investigator Professor Nilesh Samani, (British Heart Foundation Professor of Cardiology University of Leicester, UK) said: “The findings add to the growing list of genes, now over 30 that affect risk of CAD and heart attacks. The findings provide new insights into and understanding of the causal biological pathways that cause heart disease, and particularly highlight the role of lipids and inflammation”

Professor Hugh Watkins (co-principal investigator, British Heart Foundation Professor of Cardiovascular Medicine, University of Oxford) said: “Although the effects of the new genetic variants that we have identified are individually small, in the order of 5-10% per copy, new treatments that are developed on the basis of the findings could have a much broader effect, as we have learnt, for example with statins”.

Professor John Danesh (co-principal investigator, University of Cambridge) said: “This is one of the first genetic studies of CAD to include a significant proportion of subjects of South Asian origin. This ethnic group has a higher risk of CAD. Our study shows that many of the genes that affect risk of CAD do so similarly in European Caucasians as in South Asians.”

Dr Adam Butterworth (University of Cambridge) who co-ordinated the analysis said: “One of the other strengths of our study is that in the literature there were a lot of genes which had been suggested to be associated with CAD based on small studies. Our very large study has allowed us to clarify this literature, and show that most of these reported associations are spurious.”

http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1002260

A window on suffering: using qualitative research to study practices surrounding palliative sedation for refractory symptoms

Kimberley — Thu, 22 Sep 2011 11:46:02 +0000

Professor Jane Seymour

Sue Ryder Care Professor of Palliative and End of Life Studies, University of Nottingham.

Tuesday 1 November 2011, 12.30pm – 2pm

Qualitative Research Forum Open Meeting

Large Seminar Room, IPH

Forvie Site

A significant minority of dying people experience refractory symptoms or extreme distress unresponsive to conventional therapies: sedation may be used to decrease or remove consciousness until death occurs. Surveys (relying on recall and response to fixed categories) show large unexplained variation in incidence of sedation at the end of life across countries/care settings and there are ethical concerns about the use, intentions, risks and significance in palliative care. The UNBIASED study (UK Netherlands Belgium International Sedation Study) aims to explore decision-making surrounding continuous sedation until death in contemporary clinical practice, and understand the experiences of clinical staff and decedents’ informal care-givers and their perceptions of its contribution to the dying process. To our knowledge this is one of the few studies which seek to take a qualitative perspective on clinical decision making surrounding the use of continuous sedation until death and the only one which includes the perspectives of nurses, physicians, as well as bereaved informal care-givers. Its potential strengths, weaknesses, opportunities and threats (associated with the study design, the sensitive nature of the topic and the different frameworks for ethical review in the participating countries) will be addressed, drawing particularly on experiences from theUKarm of the study, which is funded by the ESRC.

Population health – methods and challenges Conference

Kimberley — Wed, 07 Sep 2011 11:44:49 +0000

Call For Papers

ICC, Birmingham, 24th – 26th April 2012

Organised by the MRC Population Health Sciences Network and the UKCRC Centres of Excellence in Public Health. The focus of the meeting is on the big challenges facing translational research in population health, with topics including:

• Natural experiments and RCTs of complex population level interventions
• New approaches to evidence synthesis
• Making best use of routine data
• Improving causal inference from observational studies
• Measuring and understanding behaviour
• Evaluating mediators of change
• Applying methods from other disciplines, e.g. engineering, actuarial science
• Economic evaluation in public health
• Knowledge translation/engaging policy makers
• Population screening programmes
• Reacting to health scares

For further information, including on-line registration and abstract submissions, please visit www.populationhealthchallenges.com

The deadline for abstract submissions is Friday 14^th October

Population Health- Methods and Challenges

A limited number of bursaries are now also available, comprising a cheque to be presented at the conference of £100.00, plus waived registration fees. These bursaries are open to students and early career researchers (those who completed their PhD or other terminal degree no later than 1st September 2007) and also to delegates from low income countries.

Chocolate linked to Heart Health

Kimberley — Tue, 30 Aug 2011 10:47:59 +0000

Research: Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis

High levels of chocolate consumption might be associated with a one third reduction in the risk of developing heart disease, finds a study published on bmj.com today.

The findings confirm results of existing studies that generally agree on a potential beneficial link between chocolate consumption and heart health. However, the authors stress that further studies are now needed to test whether chocolate actually causes this reduction or if it can be explained by some other unmeasured (confounding) factor.

The findings will be presented at the European Society of Cardiology Congress in Paris at 10:10 hrs (Paris time) / 09:10 hrs (UK time) Monday 29 August 2011.

The World Health Organisation predicts that by 2030, nearly 23.6 million people will die from heart disease. However, lifestyle and diet are key factors in preventing heart disease, says the paper.

A number of recent studies have shown that eating chocolate has a positive influence on human health due to its antioxidant and anti-inflammatory properties. This includes reducing blood pressure and improving insulin sensitivity (a stage in the development of diabetes).

However, the evidence about how eating chocolate affects your heart still remains unclear. So, Dr Oscar Franco and colleagues from the University of Cambridge carried out a large scale review of the existing evidence to evaluate the effects of eating chocolate on cardiovascular events like heart attack and stroke.

They analysed the results of seven studies, involving over 100,000 participants with and without existing heart disease. For each study, they compared the group with the highest chocolate consumption against the group with the lowest consumption. Differences in study design and quality were also taken into account to minimise bias.

Five studies reported a beneficial link between higher levels of chocolate consumption and the risk of cardiovascular events and they found that the “highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease and a 29% reduction in stroke compared with lowest levels.” No significant reduction was found in relation to heart failure.

The studies did not differentiate between dark or milk chocolate and included consumption of chocolate bars, drinks, biscuits and desserts.

The authors say the findings need to be interpreted with caution, in particular because commercially available chocolate is very calorific (around 500 calories for every 100 grams) and eating too much of it could in itself lead to weight gain, risk of diabetes and heart disease.

However, they conclude that, given the health benefits of eating chocolate, initiatives to reduce the current fat and sugar content in most chocolate products should be explored.

Full study details available on the BMJ website http://www.bmj.com/content/343/bmj.d4488

http://www.guardian.co.uk/lifeandstyle/2011/aug/29/chocolate-is-good-for-you-study

http://healthland.time.com/2011/08/29/enjoy-chocolate-is-good-for-your-heart/?iid=pf-main-mostpop2

http://yourlife.usatoday.com/health/healthcare/studies/story/2011-08-29/Chocolate-lowers-heart-stroke-risk/50174422/1

Inherited genetic variation linked to aggressive prostate cancers

Kimberley — Tue, 23 Aug 2011 10:54:44 +0000

Researchers have discovered five inherited genetic differences that can increase the risk of men developing an aggressive form of prostate cancer.

The researchers hope that their findings could eventually pave the way for a simple blood test to identify patients who need aggressive treatment and those who would benefit from a more conservative monitoring before treatment approach.

The international research team, led by Dr Janet L Stanford from the Hutchinson Center’s Prostate Cancer Research Programme, looked at DNA samples from more than 1,300 prostate cancer patients in Seattle.

They examined single-nucleotide polymorphisms (SNPs) – variations in just one ‘letter’ of a person’s DNA sequence that are often linked to inherited characteristics – including a raised or lowered risk of cancer.

Finding that 22 of the SNPs were more common among study participants who had more aggressive forms of prostate cancer, the group checked their results against data from 2,875 prostate cancer patients in Sweden.

The team found that five of the original 22 SNPs were more likely to be present in men who had died of prostate cancer (and hence were likely to have had aggressive disease). They were found near or in five genes that may affect prostate cancer progression: LEPR, RNASEL, IL4, CRY1 and ARVCF.

Patients with four or all five of these genetic markers had a 50 per cent higher risk of dying from their prostate cancer than those with two or fewer.

The results show that the more of the SNPs a man inherited, the greater his risk of dying from prostate cancer.

The findings were published in the Cancer Epidemiology, Biomarkers and Prevention journal.

Dr Laura McCallum, Cancer Research UK science information officer, said: “These results need to be confirmed in different populations of men, but if successful could help identify men with more aggressive forms of prostate cancer. If doctors can tell how a cancer will respond to treatment from the outset, they can make the best possible decisions about the care of each man with the disease.”

“These findings also offer new insights into the genetic causes of prostate cancer – the more we learn about how the disease develops, the greater chance we have of identifying people at risk and finding new treatments.”

Professor Doug Easton, director of Cancer Research UK’s Genetic Epidemiology Unit at the University of Cambridge, said: “Work by Cancer Research UK and others has uncovered over 30 SNPs that are associated with prostate cancer risk. This new study is particularly interesting because it links other DNA changes with prostate cancer aggressiveness or survival. Before any test based on these results is developed though, we need to see if these early results are confirmed in larger studies.

“A challenge with all such studies is to translate potential associations into tests that are clinically useful. My own group is working on a very large study of over 40,000 patients to uncover links that can one day be exploited in the clinic.”

Reference: Lin, D. W. et al. Genetic Variants in the LEPR, CRY1, RNASEL, IL4, and ARVCF Genes Are Prognostic Markers of Prostate Cancer-Specific Mortality. Cancer Epidemiology, Biomarkers and Prevention. DOI: 10.1158/1055-9965.EPI-11-0236

Source: http://info.cancerresearchuk.org/news/archive/cancernews/2011-08-18-Inherited-genetic-variation-linked-to-aggressive-prostate-cancers

Dance Dance Party Party: the night out clubbing that’s good for you

Kimberley — Tue, 23 Aug 2011 10:50:21 +0000

It may sound terrifying but a freestyle freakout with a room full of strangers is the perfect workout.

The Nutrition Games – The Forum, Norwich

Kimberley — Tue, 02 Aug 2011 13:57:14 +0000

EPIC-Norfolk,

Saturday, 20 August 2011
The Atrium 9am – 5pm

A study looking at the links between diet, lifestyle and health – the nutrition games. Come and meet the study team to play your nutritional cards right; balance the leaning tower of pizza; and enjoy a ‘trolley dash’ through the EPIC supermarket, all whilst learning about the vital role that specific vitamins and minerals play in our daily lives.

For more information: http://www.theforumnorwich.co.uk/events/view/epic-norfolk/20-08-2011

High-risk hearts: a South Asian epidemic

Kimberley — Tue, 02 Aug 2011 13:54:22 +0000

Cardiovascular disease (CVD) is the most common cause of death and disability worldwide. For South Asians, though, this global killer poses an even more sinister threat. Over the past three decades, the incidence of heart attacks and strokes among South Asians has risen steeply. Today, South Asians, even those living in other countries, are considerably more likely to die prematurely from the disease than any other group. Moreover, the increase appears to be unrelenting.

The identification of ‘classic’ risk factors such as blood fats, blood pressure, diabetes and smoking has contributed to a decline in CVD-related deaths in high-income countries. Although the same risk factors apply to South Asians, it seems likely that they may be affected by additional, as-yet-unrecognised, factors.

“The study of vascular disease among people living in South Asia has been comparatively neglected,” said Professor John Danesh, Head of the Department of Public Health and Primary Care. “South Asians number 1.5 billion people worldwide, yet until recently there have been few powerful studies tailored to evaluate the distinctive genetic, biochemical and lifestyle risk factors affecting this group.”

Now, two population studies jointly led by Professor Danesh and other researchers at the Department of Public Health and Primary Care hope to find some answers. With 35,000 participants, the Pakistan Risk of Myocardial Infarction Study (PROMIS) is the most powerful study so far to search for biological and other risk factors for CVD among Pakistanis. And, despite commencing only in January 2011, the Bangladesh Risk of Acute Vascular Events (BRAVE) study already exceeds any previous Bangladeshi study in scale.

PROMIS

“Pakistan is a country of 187 million people, yet fewer than 1,000 patients have been assessed in previous epidemiological studies of heart disease,” said Dr Danish Saleheen, who jointly leads PROMIS. “When I was a medical student in Pakistan, infrastructure was lacking to conduct large-scale genetic investigations in that region. Moreover, there were not any instruments or studies that could specifically investigate lifestyle and dietary exposures which are very specific to South Asia in relation to conditions like heart attacks and stroke.”

He began a project with colleagues in Pakistan to investigate what it might be about South Asians that makes them more vulnerable to the development of heart diseases. Were local dietary practices, such as the use of ghee as cooking fat, to blame? Or the many non-cigarette-based ways of consuming tobacco, including chewing, sniffing and ingesting? Or cultural habits such as marriage between first cousins? Or environmental influences such as contaminants in food and water?

After Dr Saleheen moved to Cambridge in 2006 as a Cambridge Commonwealth Trust scholar, the study design was optimised, long-term funding was secured, and full-scale recruitment commenced under the joint leadership of Professor Danesh. It now recruits patients with heart disease, stroke or diabetes at a rate of 10,000 per year from 13 institutes across Pakistan through the Centre for Non-Communicable Diseases in Karachi, whose current Director is Dr Saleheen.

The study is poised to yield a harvest of novel findings. For example, it has recently contributed to the discovery of nine genes for coronary artery disease and six separate genes for type 2 diabetes, with the findings published in Nature Genetics. Other detailed analyses are in progress with the support of more than £10 million in research funding from the US National Institutes of Health, Wellcome Trust and British Heart Foundation.

Perhaps where PROMIS will have its greatest potential impact will be the evaluation of local risk factors that can be modified. “We are beginning to identify distinctive factors which increase the risk of, or protect against, heart diseases,” said Dr Saleheen. “For instance, consumption of ghee and indigenous types of tobacco, including ‘naswar’, increases the risk of heart attack. Through PROMIS, we are now able to pinpoint the contribution of these factors in a more precise manner than ever before.”

BRAVE

Of all South Asian countries, Bangladesh probably has the highest rates of CVD and yet is the least studied. Dr Rajiv Chowdhury, who is himself from Bangladesh, explained the severity of the situation: “In the late 1990s it was estimated that there would be a 100% increase in CVD across South Asia by 2020. But, when you look at Bangladesh, there has already been a 3,500% increase. In the global combat against CVD, Bangladesh is a country ‘missing in action’.”

Gates Scholar Dr Chowdhury jointly leads the BRAVE study, which began seven months ago in pilot form in readiness for a subsequent large-scale study. Because of the astonishing rate at which patients are arriving at the National Institute of Cardiovascular Diseases in Dhaka, medical officers are recruiting three times as many patients as was anticipated, and the study will reach 1,000 by the end of this year.

“One important objective is to build an epidemiological resource – the first in Bangladesh – to be shared between the Bangladeshi and UK collaborators with equal intellectual partnership,” said Dr Chowdhury, who jointly leads the study with Dr Emanuele Di Angelantonio and Professor Danesh. “The biorepository will be used to test current and future hypotheses relating to potential risk factors to help shape local and global cardiopreventive policies.”

Dr Chowdhury is certain that, as in Pakistan, crucial risk factors will be discovered: “Bangladesh has the highest rate of urbanisation and population density in South Asia, and is facing the worst threats of climate change globally. Factors associated with such extraordinary circumstances may have influenced the population’s massive shift in epidemiology towards increased CVD. Equally, it could be linked to suboptimal nutrition, widespread environmental contaminants such as arsenic in ground water and plants, or specific vulnerabilities in the genetic or metabolic make-up that have yet to be discovered.”

For more information, please contact Professor John Danesh (ku.ca.mac.lhcsdemnull@824sh) at the Department of Public Health and Primary Care (www.phpc.cam.ac.uk/).

Source: http://www.cam.ac.uk/research/features/high-risk-hearts-a-south-asian-epidemic/

Andrew Lansley visits the BHRU

Kimberley — Tue, 28 Jun 2011 12:35:35 +0000

Andrew Lansley, Secretary of State for Health, paid a visit to the Behaviour and Health Research Unit (BHRU) on Friday 24th June to learn more about the work of the Unit.

Mr Lansley and the BHRU team enjoyed a stimulating and wide ranging interchange. Discussions focussed on the scientific basis for understanding everyday behaviour, using the presentation of food as an example of how people’s desire and consumption can be affected by their environments without them being aware of it. Also under discussion was the effect of changing environments to alter people’s behaviour: when to encourage people to change their behaviour through ‘nudging’ and when to regulate. Finally, a lively debate ensued about how judgments about evidence and its uncertainty influence public and policy-makers views on the acceptability of government intervention to change behaviour.

The meeting with Mr Lansley underscored the great potential of the Unit’s work to inform government policies aimed at improving population health and the importance of inputs from a wide range of disciplines including psychology, neuroscience, epidemiology and economics.

Leadership and Management for Doctors in Training

Kimberley — Thu, 16 Jun 2011 10:36:12 +0000

Professor Stephen Gilliam, GP in Luton and Director of Undergraduate Public Health Teaching for the University of Cambridge has recently published a guide to help undergraduate, junior doctors and more experienced practitioners become effective leaders and managers. The guide called Leadership and Management for Doctors in Training a practical guide was published by Radcliffe Publishing in April 2011.

The book is designed to help new doctors with relevant theory and practice via three primary guidelines:

You already have more leadership and management knowledge and experience than you realise
Management and Leadership are core medical skills
Management and Leadership skills development continues over a professional lifetime

Professor Sir Bruce Keogh states in the forward that Clinical leadership across the NHS may take many forms ranging from frontline leaders who provide excellent service through a spectrum of clinical innovators and academics, to those who provide leadership through their professional bodies or through managerial involvement at various levels in their employing institution.

This admirable book is aimed at young clinicians and invites them, through a series of vignettes and issues coupled with practical theory, to enter the world of management. I hope that everyone who reads this book will accept that invitation, because it is only through effective service design, management and change that we can practise medicine in the way and in the environment that is best for both patients and clinicians.

The book is available to order online at www.radcliffepublishing.com or via email at orders@radcliffepublishing .com.

ISBN: 978 184619 416 0

Paperback , 160pp

£24.99

Simon Thompson elected Fellow of the Academy of Medical Sciences

Kimberley — Mon, 23 May 2011 13:57:21 +0000

Professor Simon Thompson, Director of Research, Department of Public Health and Primary Care, was elected to the Academy Fellowship following the Council meeting in April 2011.

Forty distinguished medical researchers will be recognised for the contributions to medical science this year.

“Fellowship of the Academy is based on exceptional contributions to the medical sciences either in the form of original discovery or of sustained contributions to scholarship. Fellows are drawn from clinical academic medicine, veterinary science, dentistry, laboratory science, medical and nursing care and other professions allied to medical science.

The majority of candidates will be selected primarily for their outstanding contribution to the advancement of medical science, or for the application of existing scientific knowledge or understanding in an innovative way, so as to bring about advances in human health and welfare”.(Information taken from the Academy of Medical Sciences website)

The new Fellows will be formally admitted to the Academy at a ceremony on Wednesday 29 June 2011.

For further details click here.

For information about the Academy click here