Medical Research: Bench to Bedside RMH Academic Centre Honours Program

Population Health

See full list of projects

Health and the housing interface; the health impacts of precarious housing amongst refugees in Melbourne
Supervisors:          Dr Kudzai Kanhutu, Professor Beverley Ann Biggs, Dr Joanne Gardiner,
Project Site:          Doherty Institute/Royal Melbourne Hospital International and Immigrant Health Group,     Cohealth community health service
Contact:                 Dr Kudzai Kanhutu  Email: kudzai.kanhutu@mh.org.au
Project description: Victoria currently receives one third of the national refugee intake. In addition
80% of immigrants come from low and middle income countries some of whom are from refugee-like backgrounds.

Refugees and asylum seekers encounter a number of barriers to accessing suitable housing.
Precarious housing can be defined across a number of dimensions.
Unaffordable housing;  high housing costs in proportion to income,
Unsuitable housing; overcrowded and/or poor dwelling condition and/or unsafe and/or poorly located.
Insecure housing; insecure tenure type and subject to forced moves.
The negative impact of precarious housing on mental and general health and is well documented in the literature.

Currently, little is known about the frequency of precarious housing in Australian hospital and primary care based patients and the co-occurrence of underlying medical comorbidities.

We intend to perform a prospective study of our outpatient and primary care clinics to establish baseline figures on the prevalence of precarious housing in our cohort of patients from refugee and asylum seeker backgrounds.  Survey questionnaires relating to refugee clients perceptions of the impact of housing on their health will provide much needed qualitative data. In addition, participants with a lived experience of precarious housing will also be interviewed regarding what supports could enable them to achieve greater housing security.
The combination of quantitative and qualitative data sets will help to pave the way to developing client focused housing policy and interventions for affected refugee clients.

Skills/techniques acquired:
Systematic review – literature search, data synthesis and report writing.
Qualitative research methodology – survey writing, data collection and data synthesis.
Journal writing for peer review publication.
Abstract writing and presentation techniques for conference settings.

Additional career benefits:
The successful applicant will have the opportunity to present their research findings to the Victorian Refugee Health Network, the Department of Health and Human Services as well as representatives from the Federal Government’s Department of Immigration and Border Protection.

 

Life-long Lifestyle Factors for Healthy Ageing - also offered as MBiomedSc
Supervisor:           A/Profesor Cassandra Szoeke
Project Site:         Healthy Ageing Program, Dept of Medicine, Centre for Medical Research, Royal Melbourne Hospital.
Contact:               A/Professor Cassandra Szoeke T: 61 3 8344 1835 E: cszoeke@unimelb.edu.au
Project description: Several studies have described the benefit of lifestyle change for healthy ageing and cognitive improvement. For example smoking, alcohol consumption and a lack of physical activity have been linked to an increased rate of cognitive impairment and cardiovascular diseases. Studies investigating lifestyle factors have been limited by cohort sampling bias, cross sectional designs, short follow‐ups and small sample sizes. Furthermore the frequency and intensity of lifestyle alteration is still not defined. In this project we examine a 20 year longitudinal dataset to determine the influence of lifestyle (i.e. alcohol consumption, smoking, diet and physical activity) on cognitive performance and health.

This project will involve direct hands-on participant evaluation. You will also have the opportunity to work with a rich database with lifestyle data that spans over 20 years. As well as an opportunity for publication.

 

Iron and Fatigue - also offered as MBiomedSc
Supervisors:          A/Professor Cassandra Szoeke
Project Site:         Healthy Ageing Program, Dept of Medicine, Centre for Medical Research, Royal Melbourne Hospital.
Contact:                A/Professor Cassandra Szoeke T:61 3 8344 1835  E: csoeke@unimelb.edu.au
Project description: Iron deficiency is prevalent in ageing women. Studies have shown that iron deficiency results in fatigue, reduced physical performance and impaired cognition. These symptoms are commonly reported in ageing populations. The Women’s Health Ageing Project is an epidemiological sampled longitudinal prospective study that contains 20 years’ worth of data on a number of measures including blood, cognition, diet and lifestyle, mood and wellbeing, hormones, illnesses, bone, and genes among others. This unique resource will therefore have the potential to identify new preventive health interventions and address issues relating to social determinants of health and health inequalities through social epidemiology across two decades. Over a hundred papers on this study have been published in peer reviewed journals. The results of this study have been internationally recognised and contributed significantly to the understanding of healthy ageing. The benefits of this project are:
Opportunity to publish
The study has data over 20 years already collected
Will suit a candidate with an interest in commercialisation

 

Vitamin D deficiency and balance - also offered as MBiomedSc
Supervisors:          A/Professor Cassandra Szoeke, Professor Meg Morris
Project Site:         Healthy Ageing Program, Dept of Medicine, Centre for Medical Research, Royal Melbourne Hospital.
Contact:               A/Professor Cassandra Szoeke T: 61 3 8344 1835  E: cszoeke@unimelb.edu.au
Project description: Vitamin D is made in the skin, a process that requires sun exposure, ingestion in the diet or being taken as a nutritional supplement. Adequate levels of vitamin D are essential for healthy bones and muscle function, and research has only recently started to associate low levels of vitamin D to depression and other mood related disorders. The effects of mild to moderate deficiency are less clear‐cut, but symptoms may include muscle pain, weak bones, low energy, fatigue, lowered immunity, and symptoms of depression; moods swings, and sleep irregularities. In Australia, mild to moderate vitamin D deficiency is relatively common in the adult population, but the health consequences of this deficiency in apparently healthy adults are poorly understood. It is also not clear below which level in the blood, vitamin D level mood disorders may arise. The purpose of this project is to investigate the consequences of mild to moderate vitamin D deficiency (blood already collected) on mood including depression, anxiety, and wellbeing (measures already collected) in healthy women from the internationally renowned Women’s Healthy Ageing Project (WHAP).

Opportunities:‐ You will have the opportunity to work with an internationally renowned cohort and research team each with international recognition.

The study has data over 20 years already collected. There is opportunity for publication. This project will suit a candidate with an interest in balance, sports physiology and physiotherapy. There will be interaction with industry partners.

 

Sexting, porn, and Tinder. An investigation of education and health promotion needs and evidence
Supervisors:          Dr Megan Lim
Project Site:         Burnet Institute
Contact:               E: lim@burnet.edu.au
Project description: Access to new technologies could present novel risks to young people’s sexual health. The emerging popularity of sexting, online pornography use, and dating apps has been linked in some studies to sexual risk behaviours (e.g. not using condoms). There is very little known about how to educate young people about these topics. Many previous programs have taken a fear-based approach which tends to exaggerate the risks of these behaviours and promote abstinence as the only option. This project will investigate previous campaigns, survey the opinions and needs of young people, schools, parents, and health promotion practitioners, and provide recommendations for future campaigns.
A mixed methods approach will involve content analysis and review of existing health promotion, online surveys, interviews, and focus group discussions.

 

Sex, drugs and rock n roll: young people and risk behaviours
Supervisors:          Dr Megan Lim
Project Site:         Burnet Institute
Contact:               E: lim@burnet.edu.au
Project description: Sexually transmitted infections (STI) are on the rise among young Victorians. Since 2005, we have surveyed over 9,000 people aged between 16 and 29 years of age at Melbourne’s Big Day Out about sexual risk behaviour and drug use. From 2015, we have moved the survey to an online form. Questions have covered participant’s sexual histories, condom use, knowledge and perceptions of STIs, and STI testing histories. We ask about alcohol and other drug use, and other risks and behaviours such as gambling, diet and exercise, contact with police, mental health, and smoking. There is also a series of questions concerning media use, e.g. pornography, sexting, social media and smartphones, online gambling. The student project could focus on one of these issues or a range of themes. These findings, in the context of current public health measures, will be used to advise on the design of future sexual health promotion campaigns.

In this project the student will use the data collected to investigate patterns of sexual risk behaviours, knowledge, and attitudes. This will involve quantitative analysis of the relationship between variables such as condom use, number of sexual partners, drug and alcohol use, and perceptions of risk. The project could also involve in-depth qualitative data collection via focus group discussions or interviews.

 

Taking a punt: Exploring gambling attitudes and behaviours among a sample of young Victorians
Supervisors:          Dr Rebecca Jenkinson and Dr Megan Lim
Project Site:         Burnet Institute
Contact:               E: rebeccaj@burnet.edu.au
Project description: The gambling environment in Australia has changed markedly over recent years and young people are a high-risk group for experiencing gambling-related harm. While estimates of gambling prevalence among young people vary considerably, there is consensus that gambling participation is increasing among young people and that youth problem gambling rates are around 2-3 times those of adults. With increasing exposure to gambling promotion and greater opportunities to gamble, the ‘normalisation’ of gambling among young people is likely to continue. In order to respond to increasing concern around these issues and inform future research and policy responses, this project will explore young people’s gambling behaviours and experience of negative consequences in more detail, especially with regard to participation in higher risk activities such as sports betting and pokies.

In this project the student could employ a mixed-methods approach to explore gambling attitudes, behaviours and experience of negative consequences among young people (aged 15-29 years) in Victoria. Quantitative data collected as part of the Burnet’s online survey of young people’s health behaviours could be utilised. In addition to gambling, this annual, cross-sectional survey explores young people’s alcohol and other drug use, sexual health and behaviour, experiences of mental health problems, and social media use. The student project could also involve in-depth qualitative data collection via focus group discussions or interviews.

 

Alcohol advertising on public transport: level of exposure among children and young people
Supervisors:          Dr Megan Lim and Dr Nick Scott
Project Site:         Burnet Institute
Contact:               E: megan.lim@burnet.edu.au
Project description: Alcohol advertising is associated with increased alcohol consumption, particularly among young people. Current regulations attempt to limit exposure of alcohol marketing to children, however, no restrictions are in place regarding advertising on public transport.

This project will include an audit of alcohol advertising on public transport. Basic modelling will be conducted using publically available public transport usage data. The project will result in a policy document advising on the potential level of exposure of children to these advertisements.

 

Trends in STI testing and positivity in priority populations in Australia
Supervisors:          Carol El Hayek
Project Site:         Burnet Institute
Contact:               E: carol.el-hayek@burnet.edu.au
Project description: In the last decade, communicable disease notification systems have seen a dramatic increase in the number of notifications for chlamydia and several other STIs. Higher prevalence is commonly seen in populations that have higher sexual risk practices (such as men who have sex with men, Aboriginal and Torres Strait Islander People, Sex Workers). It is important to monitor rates of STI testing and positivity in these priority populations, as well as the general population, in order to identify emerging patterns and trends in STI epidemiology.

The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmitted Infections and Blood Borne Viruses (ACCESS) project is a sentinel surveillance system that monitors STI testing and positivity in a range of priority populations. This project will use existing data collected in the ACCESS project to explore STI testing and positivity in priority population and identify factors which are associated with both testing and positivity.

This project will involve quantitative data analysis of data collected through the ACCESS project. Data analysis will involve analysis of data collected through either laboratories or general practices and family planning clinics, and supplemented with behavioural data collected in the Victorian Primary Care Network for Sentinel Surveillance of STIs. Data analysis will involve calculation of testing and positivity rates for a range of STIs and factors associated with these (such as age, gender and other relevant characteristics) in priority populations (including men who have sex with men, Aboriginal and Torres Strait Islander People, Sex Workers).

 

Understanding risky single occasion drinking and links to harms in a cohort of young Melburnians - also offered as MBiomedSc
Supervisor:           Paul Dietze, Michael Livingston, Sarah Callinan
Project Site:         Burnet Institute
Contact:               E:  paul.dietz@burnet.edu.au Telephone: 9282 2134
Project description:  Young Australians frequently engage in Risky single occasion drinking (RSOD). This drinking pattern is associated with a variety of harms including increased risk of accidents, exposure to violence and risky sex. Most research on RSOD has focused on normative drinking behaviours within the past year rather than on the specific circumstances of RSOD.The aim of this study is to examine specific occasions of RSOD by young people to understand the specifics of drinking contexts and links to harms.

The proposed study involves analysis of quantitative data collected through the Young Risky Drinkers (YRD) study. The YRD is a representative sample of 802 young high-risk drinkers recruited across metropolitan Melbourne using Computer Assisted Telephone Interviewing (CATI) during 2012. Specific questions were asked about their most recent episode of high risk drinking. The cohort is being followed up in 2013 with a similar questionnaire. Analysis will be undertaken to characterize risky drinking occasions and use findings from these analyses at baseline to examine whether these predict subsequent experiences of harm. Findings from the project will present a unique picture of RSOD.

 

Modeling the syphilis epidemic in Victoria - also offered as MBiomedSc
Supervisor:           Ms Carol El Hayek, Dr Nick Scott
Project Site:         Burnet Institute
Contact:               E: carol.el-hayek@burnet.edu.au Telephone: 8506 2303
Project description: In Victoria 80% of infectious syphilis cases are in men who have sex with men (MSM). Mathematical modeling of syphilis transmission in Australian MSM suggests an effective way to reduce syphilis is to increase the frequency of testing and treatment of MSM.

In recent years, we have seen a sustained increase in routine syphilis testing among MSM at high caseload clinics alongside a decline in infectious syphilis incidence.

How much testing needs to occur in Victoria’s MSM community to eradicate infectious syphilis? 
This project will involve the design of a syphilis transmission schema and model for mathematically predicting infection rates. Running the model will require defining input parameters which should be based on an extensive literature review.

 

Low income as a barrier to opioid substitution therapy - also offered as MBiomedSc
Supervisor:           Dr Peter Higgs, Co-Head, Alcohol & Other Drug Research, Centre for Population Health, Burnet Institute
Project site:         Burnet Institute, Email:   peterh@burnet.edu.au
Project description:  People who inject drugs (PWID) often report low levels of income, with many reporting weekly incomes of less than $250. PWID on opioid substation therapy (OST) commonly describe an adverse impact from pharmacy dispensing fees for accessing OST. These fees are typically around $5 per dose, or $35 per week – for many a significant proportion of weekly income, especially after necessary expenditures (rent, food, etc.) are deducted.

This project would involve analysis of data from the Suboxone (a national year-long examination of a particular OST formulation, with a number of cross-sectional arms investigating the health domains of PWID and practices of prescribing pharmacists) and MIX studies (a Melbourne-based prospective cohort study running since 2008 with over 700 PWID as participants), examining the dispensing practice/cost for differing pharmacies, and personal in-depth interviews with PWID to further illicit the impact of dispensing costs and the extent that low income is a barrier to substitution therapy

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