The ADDITION paper “Screening for type 2 diabetes and population mortality over 10 years (ADDITION-Cambridge): a cluster-randomised controlled trial” was voted the BMJ Awards Research Paper of the Year. The paper was authored by Rebecca Simmons, Justin Echouffo-Tcheugui, Stephen Sharp, Lincoln Sargeant, Kate Williams,  Toby Prevost,  Ann Louise Kinmonth, Nicholas Wareham and Simon Griffin. 

Richard Lehman, from the University of Oxford who does the weekly blog in the BMJ summarising papers in the big five journals, was one of the judges. He said about the paper: ‘Here is one of the most important papers to have come out of UK general practice for some years. It reports a cluster randomised trial with 9.6 years of follow-up which shows that screening for diabetes in high risk individuals has no benefit. It used a validated risk score to identify 15,000 individuals at risk who were offered screening, with a control group of 4,137 who were not. Individuals identified with diabetes were then randomized to usual care or intensive multifactorial treatment. I know that at least one of the investigators was expecting the trial to demonstrate benefit, but there was simply no reduction in all-cause, cardiovascular, or diabetes-related mortality within 10 years. And this trial not only shows a lack of benefit from the early detection of diabetes, but also casts grave doubt on the doctrine of a “legacy effect” from early tight control, as claimed by the UKPDS investigators.’

For the full publication in the Lancet, click here

Simon Griffin and Rebecca Simmons picking up the award on behalf of the Addition team.

Unit: Institute of Public Health, CEDAR

*Limited Funding

We are looking for an enthusiastic and focused researcher to join the UKCRC Centre for Diet and Activity Research (CEDAR) and work on an innovative modelling project “Changing Commutes? Exploring the uptake of cycling to work through an agent-based model focusing on social interactions and social norms” bringing together social science, transport studies, public health, and mathematical modelling.

 The successful candidate will:

• Lead on the implementation of an agent based model as part of the ESRC funded study “Changing Commutes?”
• Contribute to the other work packages within the project “Changing Commutes?” and to the production of research reports, academic publications and oral presentations
• Work effectively with team members in an interdisciplinary group
• Communicate effectively with colleagues and collaborators and other stakeholders
• Contribute to developing research proposals and grant applications

Changing Commutes is funded by the ESRC Secondary Data Analysis Initiative. For further details on the project please go to http://changingcommutes.org/

The UKCRC Centre for Diet and Activity Research (CEDAR) is a collaboration between Medical Research Council (MRC) Units in Cambridge, the University of Cambridge, the University of East Anglia and non-academic partners including the Eastern Region Public Health Observatory (http://www.iph.cam.ac.uk/cedar/).  It is one of five Centres of Excellence in Public Health Research that are funded by the UK Clinical Research Collaboration

CEDAR is driven by the overall goal of developing effective public health interventions for changing population level diet and physical activity behaviours.  Projects span early work to develop an understanding of the determinants of these behaviours, through intervention development to the evaluation of effectiveness and estimation of the public health impacts of interventions.

Our research encompasses multiple disciplines, spanning diet and activity research, epidemiology, biostatistics, health economics, behavioural science, social science, health geography and intervention development and evaluation.  

Further particulars can be found here

Formal applications consisting of a covering letter, CV and a completed CHRIS 6 form, parts 1 and 3 only to be completed (available from http://www.admin.cam.ac.uk/offices/hr/forms/chris6/) should be sent, preferably by email to Lynette Watson: phpc.admin@medschl.cam.ac.ukor by post to Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN.

Within the cover letter, applicants are asked to provide a description of the expertise that they bring, how they meet the person specification for the role and an outline of their research interests.

Please quote reference number SY01230 on all correspondence

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

For an informal discussion about the post, please contact Dr James Woodcock (jw745@medschl.cam.ac.uk)

Please note that we will only contact short-listed applicants.

*One year fixed term position

Closing date: 17th June 2013

Interview date: 28th June 2013

Salary: £24,049-£47,314

Unit:  Department of Public Health and Primary Care 

*Limited Funding

PLEASE NOTE: previous candidates need not apply.

An exciting opportunity has arisen for an ambitious and talented statistician, with an interest in genetics, to join an interdisciplinary team working on large-scale genetic studies of cardiovascular disease at the Cardiovascular Epidemiology Unit at the University of Cambridge. The Cardiovascular Epidemiology Unit (CEU) conducts world-leading interdisciplinary research into the prediction and prevention of cardiovascular disease, with a portfolio of studies that comprises >2.5 million participants and is currently, expanding into genetics. Professor John Danesh is the Unit’s overall Director, Professor Simon Thompson is the Unit’s Director of Research in Biostatistics and Dr Jo Howson leads statistical genetics.

The post holder will be expected to design and implement analyses of genetic datasets from large consortia in relation to cardiovascular disease and its risk factors. Specific examples of these analyses include (but are not limited to):

- analyses of common, low-frequency and rare variants in population-based studies of discrete and quantitative traits;

- fine-mapping and multi-marker tests to locate causal variants;

- pathway analysis using rare and common variants;

- integration of genetic data with biochemical factors for the assessment of causality (“Mendelian Randomisation”);

The post holder will also be expected to advise on appropriate statistical practices, and test and develop the statistical methods necessary to evaluate hypotheses of interest, such as those listed above. The work of the post holder is expected to lead to high-impact publications.

The post-holder will have: (1) relevant qualifications e.g,, a postgraduate degree in statistics, biostatistics, genetic epidemiology or similar, (2) a sound understanding of statistical concepts, ideally in relation to chronic disease epidemiology (3) strong quantitative skills, including experience of using relevant statistical software (STATA, R), (4) high level report writing and presentational skills, (5) a working knowledge of genetics is desirable but not essential. The post-holder should also be able to work independently, accurately judge priorities, and have excellent organisational and communication skills.

This position can be filled by an appropriate candidate at Senior Research Associate, Research Associate or Research Assistant level, depending on relevant qualifications and experience. Senior Research Associate is awarded on the basis of individual merit and may be awarded to the successful candidate if approved by the Faculty Board of the Cambridge School of Clinical Medicine.

Further Particulars are available here

Formal applications consisting of a covering letter, CV and a completed CHRIS 6 form, parts 1 and 3 only to be completed (available from http://www.admin.cam.ac.uk/offices/hr/forms/chris6/) should be sent, preferably by email to Lynette Watson (phpc.admin@medschl.cam.ac.uk) or by post to Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN.

 Your cover letter should describe how you meet the person specification for the role. 

Informal enquiries can be made to Dr Jo Howson by email (jmmh2@medschl.cam.ac.uk) or telephone + 44 (0) 1223 740078.  

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 these posts are available until 31 December 2015 in the first instance. 

Please quote reference RH01195 on all correspondence about this post.

Closing date: Friday 7 June.

Interview Date(s): w/c 24 June 2013

Exciting new project based in one of Europe’s leading academic departments of population health sciences and one of the world’s leading pharmaceutical companies.

Applications are invited from UK/EU nationals* for a PhD studentship hosted at the new Pfizer-Cambridge University Translational Centre for Cardiovascular Research. This prestigious studentship, which is co-funded by the Medical Research Council and Pfizer, will commence in October 2013. The successful candidate will undertake a 3-year PhD research project, working closely with both University and Pfizer scientists. This programme offers a unique opportunity to relate the PhD research to drug development in a real world setting. It also allows the successful candidate to deepen their understanding of the many challenges involved in the development of a new medicine.

The project will advance understanding of the potential causal relevance of novel and emerging risk markers to cardiovascular and metabolic diseases  The student will have the opportunity to develop a range of skills, including statistical analysis of large-scale epidemiological datasets, genetic and biomarker epidemiology and integration of multidisciplinary datasets. Prospective applicants with strong quantitative skills are particularly encouraged.

Applicants will require a Masters degree in a related subject (eg, Epidemiology, Public Health, Human Genetics etc). Support includes a generous annual MRC/Pfizer stipend, fees at UK/EU student rate, research expenses and some travel costs.

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

*Before applying, please check your eligibility under MRC residency requirements: http://tinyurl.com/8bjyrm

Download an application form here.

To apply please send your CV, a cover letter and the above application form, preferably by email to Lynette Watson (phpc.admin@medschl.cam.ac.uk) or by post to Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN.

For further information contact Adam Butterworth at asb38@medschl.cam.ac.uk

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

Closing date: 31 May 2013

Please quote RH01192 on your application and all correspondence about this vacancy

Unit: Primary Care Unit

Funding:  Maternity cover: This post is fixed-term until 1 July 2014 or the return of the post holder, whichever is the earlier.

 An exciting opportunity and challenging opportunity has arisen for a Senior Secretary at the Primary Care Unit (PCU), part of the Department of Public Health and Primary Care and a member of the Institute of Public Health.

The successful candidate will provide support and assistance to the Director of the General Practice Education Group (GPEG), the Director of General Practice Studies and Assistant Directors of GP Studies. 

Responsibilities include monitoring and approving payments to GPs and practices for medical student teaching, providing administrative support for academic members of GPEG, supporting the delivery and quality assurance of medical student teaching delivered by GPEG. 

You will be well organised, committed, responsible, capable of using your initiative and able to meet deadlines. Experience of financial administration experience would be an advantage. Good IT and secretarial skills plus at least 2 years’ experience are imperative. 

Further Particulars can be found here.

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

Formal applications consisting of a covering letter, CV and a completed CHRIS 5 form, parts 1 and 3 only to be completed (available from http://www.admin.cam.ac.uk/offices/hr/forms/chris5/) should be sent, preferably by email, to Lynette Watson (admin@phpc.cam.ac.uk) or by post to Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN 

Your cover letter should describe how you meet the person specification for the role. 

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

For an informal discussion about the post, please contact Mr Keith Hoddy kh446@medschl.cam.ac.uk or 01223 748623

Closing date:  17 May 2013

Interview date:  30 May 2013

Start date:  1 July 2013

Please quote RH01153 on your application and in any correspondence about this vacancy.

Salary: £24,049 – £36,298

Unit:  Department of Public Health and Primary Care 

*Limited Funding

The Cardiovascular Epidemiology Unit (CEU) conducts world-leading interdisciplinary research into the prediction and prevention of cardiovascular disease, with a portfolio of studies that comprises >2.5 million participants.

Professor John Danesh is the Unit’s overall Director and Professor Simon Thompson is the Unit’s Director of Research in Biostatistics.

An exciting opportunity has arisen for a specialist data manager interested in developing expertise in the linkage and exploitation of electronic health records involving world-leading large-scale population health studies. This position can be filled at either Research Associate or Research Assistant level depending on relevant qualifications and experience.

The main responsibility of this role will be to maintain complex databases for epidemiological studies, in particular health records information. The post-holder will support Principal Investigators who are looking to develop methods for tracking the future health of study participants through health record linkage. For example, in the NHSBT Blood Donors Cohort comprising up to 50,000 English blood donors, we are seeking to establish electronic health record linkage to study the impact of blood donation on future health outcomes.

The post holder will be required to collate, clean, and harmonise data from various sources, perform some analyses for QC purposes, as well as to help identify scientific priorities and contribute to some applied analyses.

The post-holder will have: (1) relevant degree or post graduate qualification (preferably in mathematics, science or computing based disciplines), (2) experience of using statistical packages such as SAS, STATA or SPSS (or experience with other equivalent statistical software), (3) experience of programming, preferably in a structured programming language such as SAS or JAVA, (4) high level report writing and presentational skills. The post-holder should also be able to work independently, accurately judge priorities and have a systematic and rigorous approach to work with excellent organisational and communication skills.

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

Further Particulars area available here

Formal applications consisting of a covering letter, CV and a completed CHRIS 6 form, parts 1 and 3 only to be completed (available from http://www.admin.cam.ac.uk/offices/hr/forms/chris6/) should be sent, preferably by email to Lynette Watson (phpc.admin@medschl.cam.ac.uk) or by post to Department of Public Health and Primary Care, Strangeways Research Laboratory, Worts Causeway, Cambridge CB1 8RN.

Your cover letter should describe how you meet the person specification for the role. 

Informal enquiries can be made to Dr Emanuele Di Angelantonio by email (ed303@medschl.cam.ac.uk) or telephone + 44 (0) 1223 741302.  

ALL APPLICATIONS ARE DUE BY 5PM ON THE CLOSING DATE

*The funds for these posts are available for two years in the first instance.

Please quote reference RH01149 on all correspondence

Closing date:  22 May 2013

Interview Date(s): w/c 3 June 2013

Read more here

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.

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.

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.

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.

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.”

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.

To read more: http://www.tennessean.com/article/20120124/LIFE03/301240012/New-genetic-clues-breast-cancer-

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

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.

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.

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

To read more: http://www.guardian.co.uk/lifeandstyle/2011/aug/01/dance-dance-party-party

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

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 (hs428@medschl.cam.ac.uk) 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/