Research news in brief

Celebrating research that makes a real-world difference

Three Australian researchers whose work has had a significant impact on health care policy and delivery have been honoured in the Sax Institute’s 2018 Research Action Awards. The winners are:

• Associate Professor Anne Abbott, Monash University – stroke prevention in carotid stenosis. Up until very recently, people with advanced carotid stenosis (narrowing of the main arteries supplying blood to the brain) and without related stroke symptoms were routinely recommended procedural treatment. This typically includes either surgery designed to clear the blockage, or stenting, which involves inserting a metal or other device to prop open the artery and keep the blood circulating. However, like all invasive procedures, both these interventions come with a significant risk of harm. Associate Professor Abbott’s key discovery was that in patients with advanced carotid stenosis and without related stroke symptoms, medical intervention (appropriate medication and lifestyle changes) alone can reduce the risk of stroke in these people by at least 65%, compared with previous practice (surgical intervention).
• Professor Kate Curtis, University of Sydney – prevention and care of critical childhood injury. Professor Curtis heads up a major program of research that aims to fill the gaps in paediatric trauma knowledge and reduce the incidence and impact of childhood injury. Her research has for the first time described the incidence and causes of paediatric injury in Australia, using data from over half a million hospitalisation and mortality records. She and her team have also assessed processes of care and associated outcomes for 535 severely injured children in New South Wales, and conducted a 2-year study to determine which aspects of care patients feel could improve their experience and wellbeing. This research is already having a significant impact on national prevention policy.
• Associate Professor Lisa Wood, University of Western Australia – improving the health of homeless people. She leads a rapidly growing program of research and collaboration with homelessness organisations across WA and Victoria. Her team has developed the largest database of linked homelessness and health data in Australia. This innovative project has involved linking hospital records for 3400 homeless patients to other homeless, housing and police data to glean new insights into predictors of homelessness, the effectiveness of interventions and the barriers to delivering policies and services that work. One of the focuses of Associate Professor Wood’s research program has been the use of evidence to advocate for services.

Effective new target for mood-boosting brain stimulation found

US researchers have found an effective target in the brain for electrical stimulation to improve mood in people with depression. As reported in Current Biology, stimulation of the lateral orbitofrontal cortex (OFC) reliably produced acute improvement in mood in patients with depression at the start of the study. Those effects were not seen in patients without mood symptoms, suggesting that the brain stimulation works to normalise activity in mood-related neural circuitry, the researchers from the University of California, San Francisco, say. The researchers studied 25 patients with epilepsy who had electrodes placed in the brain for medical reasons to pinpoint the origin of their seizures. Many of those patients also had depression, which is often seen in people with epilepsy. With the patients’ consent, the researchers took advantage of those electrodes to deliver small electrical pulses to areas of the brain thought to be involved in regulating mood. They focused their attention and the electrical stimulation on the OFC. The researchers used the implanted electrodes to stimulate the OFC and other brain regions while collecting verbal mood reports and questionnaire scores. Those studies found that unilateral stimulation of the lateral OFC produced acute, dose-dependent mood-state improvement in subjects with moderate to severe baseline depression. The changes in brain activity the researchers observed after stimulation closely resembled those seen when people are in a good mood. The findings show that mood can be immediately improved by electrical stimulation of a relatively small area of brain, the researchers say. They also add to evidence that mood disorders are the result of dysfunction in brain circuits.

Knowing about dangers of inactivity might get you moving

Most people have a poor understanding of how much physical activity is good for you, and what health benefits such activity conveys. But the better your knowledge on these topics, the more physical activity you’re likely to get, according to a study published in PLoS One. A study from Central Queensland University surveyed 615 Australian adults about their physical activity as well as their level of knowledge about physical activity’s health benefits and the risks of inactivity. Based on their answers, each participant was assigned a ranking in four areas: knowing that physical activity is beneficial and inactivity is harmful, knowing that specific health conditions are related to inactivity, knowing how much physical activity is recommended, and applying this knowledge to one’s own risks. Participants were 24.4% male and 75.3% female, between 18 and 77 years old, with a median age of 43 years, and had a range of education levels and employment statuses relatively representative of the general Australian population. While 99.6% of participants strongly agreed that physical activity was good for health, most were not aware of all the diseases associated with inactivity. On average, participants correctly identified 13.8 out of 22 diseases associated with a lack of physical activity. Moreover, 55.6% incorrectly answered how much physical activity is needed for health, and 80% of people failed to identify the probabilities of developing diseases without physical activity. A significant association was found between these scores on knowledge of the probabilities of inactivity-related diseases and how active a person was. Future research is needed to determine whether the results hold true equally between men and women, and whether the survey-based data correctly gauge a person’s true levels of physical activity.

What’s new online at the MJA

29 November Perspective: The MJA–Lancet Countdown on health and climate change: Australian policy inaction threatens lives
Zhang et al; doi: 10.5694/mja18.00789
Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives … FREE ACCESS permanently

29 November Podcast: Associate Professor Paul Beggs, an environmental scientist in the Department of Environmental Sciences at Macquarie University … FREE ACCESS permanently

3 December Guideline summary: Methods of melanoma detection and of monitoring the skin for individuals at high risk of melanoma: new Australian clinical practice
Adler et al; doi: 10.5694/mja18.00234
Early detection of primary melanoma remains an effective strategy to reduce melanoma-related mortality … FREE ACCESS for one week

3 December Podcast: Dr Nikki Adler, Clinical Fellow at the Victorian Melanoma Service, The Alfred Hospital … FREE ACCESS permanently

3 December Medical history: Forty years of “Waltzing Matilda”: the history of the multichannel cochlear implant
Ho; doi: 10.5694/mja18.00365
The fascinating history of the multichannel cochlear implant and its inventor, Professor Graeme Clark