About IHRR Home Staff Contacts Our Purpose Media and Promotion Annual Reports Other Services How to Get Involved Research Projects Healthy Children and Youth Education and Training in Health Settings Diabetes and Obesity Healthy Ageing Rehabilitation Studies Indigenous Health Student Projects Looking for a research project? Some potential projects are outlined below: From the clinic to the community The effect of bone density in adolescents with low motor competence Toward a National Test of Physical Fitness in Australia Exploring Service-Learning in Catholic Secondary Schools Sexual risk behaviour in men attending a peer-based Investigating outcomes-based education in Western Australia Modeling and quantification of sports surfaces during dynamic human surface interactions Lower limb mechanics during landing on unknown surfaces Reaction times and rate of force development in dancers with and without benign hypermobility joint syndrome Variability and coordination in ballet dancers Collaborations Centre for Faith Ethics & Society Nulungu Centre for Indigeonous Research General Practice and Primary Health Care Research HBF Telethon - Raine Study Events Upcoming Events Research Seminars Past Events

Rehabilitation Studies

Exploring the experience of self-compassion in self and other relationships in women with breast cancer.

Breast cancer (BC) is a well-reported and researched public health issue and is currently the most prevalent form of cancer in Australian women, with the numbers of women diagnosed between 1982 and 2007 more than doubling.  As a result of diagnosis and treatment, women are exposed to a range of psychological and psychosocial stressors. This study focuses on what aspects of self-compassion may be relevant for women with BC.  The study investigates ways in which women in remission from diagnosis and treatment for BC develop and nurture self-compassionate relating with themself, their body, and with significant others. A purposive sample of ten to fifteen participants will be drawn from women aged between 24 and 55 years of age who have completed treatment for primary breast cancer and been disease free for at least twelve (12) months following diagnosis and treatment. Participants will be women who reside in the Perth metropolitan or rural areas of Western Australia.  Participants will be invited to take part in three focus groups, an in-depth semi-structured interview and a 12-hour (6-week) self-reflection program. Data will also be gathered, using one-on-one, semi-structured interviews, from three participants who each are a ‘significant other’ (spouse, partner, close family member) in the life of one of the women with BC. Three counsellors who work with women with BC will also be invited to take part in an individual semi-structured interview. Interpretive Phenomenological Analysis (IPA) will be used to analyse data from all interviews and focus groups. To better understand the psychological issues that positively or negatively affect their quality of life means an increased capacity to support and care for BC survivors. Exploration of interconnectedness between emotions and the body in the experience of BC can contribute to greater understanding of the social impact BC has on women’s lives. Primarily, this study aims to contribute to the body of existing research data that seeks to understand what women most need from health care systems, specifically counselling, psychological and emotional support programs.

Investigator: Ms H Wilson (UNDA)
Contact: Helenmargaret.wilson@nd.edu.au

A Group Exercise and Counselling Program to improve Quality of Life for Breast and Prostate Cancer Survivors . (Martin, Naumann, Philpott, Parker, Piggott, Hands, Bulsara M, Bulsara C, Arnold-reed, Brett, Woolfitt, 2011-2012)

The immediate and lasting symptoms observed in patients diagnosed with cancer have gained attention in the oncology arena, especially as survival rates have improved.  Unfortunately, survival is also often associated with compromised quality of life and lingering side effects that may persist for many years.  These side-effects include debilitative fatigue, sleeping problems, pain, loss of strength, increased subcutaneous fat and weight gain, lymphodema, disrupted sexual function, disturbances in body image and self-concept, anxiety, depression and the development of co-morbidities.  Treatment success may be improved if patients are able to develop physical and psychological strength to deal with its debilitating side effects.  Thus, it is crucial that an integrated approach towards managing the physiological and psychological needs of clients with cancer be developed, that involves strategies to reduce the symptoms and enhance recovery and quality of life.  This program aims to evaluate the effects of combining two powerful modalities, exercise and counselling, on the quality of life for breast and prostate cancer survivors.

We are currently recruiting men and women who have completed their treatments for prostate or breast cancer within the last 5 years to participate in this FREE research program.

For further information or to register your interest, contact Eric Martin at 9433 0906 or eric.martin@nd.edu.au

Cancer in the Adolescent and Young Adult Population: Incidence, Survival and Patterns of Care in Western Australia from 1981-2007.

In Australia, cancer is the most common cause of natural deaths among adolescents and young adults (AYAs) and is exceeded only by transport accidents and suicides. In 2008, nearly 106,544 new cases will be diagnosed and approximately 5,591 will be among AYAs aged 15-39 years and 491 are expected to die. This pattern of mortality and morbidity is also seen in other economically developed countries. Given the burden of illness and death represented by these statistics, it is somewhat surprising that relatively little is known about biologic, genetic, epidemiologic, therapeutic, psychosocial and economic factors that affect the incidence, disease outcome and quality of life in AYAs diagnosed with cancer.

Investigators: Dr Kristjana Einarsdottir (UWA), Ms Fatima Haggar (UWA); Assoc Prof David Preen (UWA); Prof D'Arcy Holman (UWA), Prof Max Bulsara (UNDA).
Contact: Max.Bulsara@nd.edu.au

Green Tea Polyphenols and cancer prevention: Use of Biomarkers and Population Controls to elicit causal pathways

This is a three parallel case-control studies of colorectal cancer, adult leukaemia and breast cancer with research objectives as follows:

1. Green tea and protection from cancer:  Estimation of the effects of green tea intake on the incidence rates of colorectal cancer, adult leukaemia and breast cancer, to be characterised in relation to duration, frequency and quantity of green tea and adjusted for confounding by hormone-related, sociodemographic and other behavioural factors.
2. Genetic biomarkers (concerning green tea polyphenols) and cancer:  Estimation of the effects of genetic polymorphisms, relevant to the biological mechanisms of green tea polyphenols, on the incidence rates of colorectal cancer, adult leukaemia and breast cancer.
3. Environment/behaviour-gene-gene interactions:  Assessment of the interactions between green tea intake and the genetic polymorphisms in objective (2) in order to elicit causal pathways and to characterise the genotypes of individuals most likely to benefit from consumption of green tea as a chemopreventive agent against cancer.

Investigators:  Prof C D J Holman (UWA), Dr M Zhang (UWA), Prof  X Xie (Zhejiang University), Prof Y Liu (Zhejiang University), Prof X Zhao (Zhejiang University), Prof M Bulsara (UNDA)
Contact: Max.Bulsara@nd.edu.au .

TARGIT: Targeted Intraoperative Radiotherapy for Early Breast Cancer.

A Phase III Randomised Controlled Multi-Centre Trial to compare targeted (‘INTRABEAM’) Intra-operative Radiotherapy (IORT) with conventional post-operative radiotherapy after conservative breast surgery for women with low risk of recurrence, early stage breast cancer.
Patients are randomised to one of two arms; the conventional radiotherapy (control) arm or the study arm (IORT approach). Post randomisation, patients in both arms undergo a wide local excision (WLE) of the primary tumour and axillary management. Post-operative detailed review of pathology occurs.
Patients in the study arm with suitable pathology (Tumour <20mm, Grade I or II, Unifocal, Ductal or Special type and Node negative) will receive IORT alone either during WLE or as a second procedure a short time later. If the pathology review identifies close (<1mm except deep or superficial) margins, re-excision (or mastectomy*) is performed. If IORT has been administered prior to re-excision, then it is up to the clinician as to what further management is offered. It may be considered feasible to re-treat with IORT, however conventional whole breast radiotherapy is the preferred approach.
If further pathology is unacceptable (Tumour > 20mm, Grade > II, EIC+, Multifocal, Lobular Type, Node Positive), the patient goes on to receive conventional whole breast radiation therapy without the boost (unless the patient has since undergone subsequent mastectomy*).
Post surgery, patients in the conventional radiotherapy arm will go on to receive the institution-specific standard conventional radiation therapy (with or without a boost), followed by suitable systemic treatment (according to institution-specific guidelines, usually Tamoxifen).

Investigators: Prof David Joseph (Sir Charles Gardner Hospital), Ms Tammy Corica (Sir Charles Gardner Hospital), Prof Christobel Saunders (UWA), Dr Boon Chua (University of Melbourne), Prof Max Bulsara (UNDA)
Contact: Max.Bulsara@nd.edu.au

Policy translation of an Australian evaluation of Computed Tomography (CT) Scanning

The ageing population, an increasing propensity to ‘medicalise’ disease and changing community expectations have all contributed to rising health care costs over the last decade  One of the most significant factors responsible for these phenomena are innovations in medical technology, including advances in diagnostic imaging.  Despite the benefits conferred by these innovations, there are growing concerns about the increasing economic costs and radiation burden imposed on the community by the unrestricted use of medical imaging.  While the newer technologies have enhanced the opportunity to diagnose conditions with potential for improved treatment, they have also considerably increased the diversity and volume of imaging procedures, including exposure of individuals to multiple scans.  Computed tomography (CT) scanning is arguably the most notable example of this due to enormous technical advances and growth in clinical applications since its discovery in 1972 by Hounsfield.
This study will use state-of-the-art methods from clinical epidemiology, health services research and radiation protection to evaluate the utilisation of CT scanning in the Australian health system context

Investigators: Assoc Prof Rachael Morrin (Curtin University), Prof D’Arcy C. Holman (UWA); Prof Max Bulsara (UNDA); Prof Richard Fox (UWA)
Contact: Max.Bulsara@nd.edu.au

Use of Endocrine Therapies for early Breast Cancer management: Utilisation and Health outcomes in Australian practice.

Breast cancer is one of the most common cancers and the leading cause of cancer-related mortality in Australian women. This project will utilise population-based data from the NSW 45 and Up Study linked to: i) Medicare claims, ii) Pharmaceutical Benefits Scheme (PBS) claims, iii) the NSW Admitted Patient Data Collection, iv) the NSW Cancer Registry, v) the NSW Mortality Registry, and the vi) Australian Bureau of Statistics. This resource, unique in Australia, will enable us to provide the first Australian evidence of how different endocrine therapies (ie, selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs)) are being used outside of trial conditions, in real-world clinical practice. Our study will also evaluate, for the first time, the effectiveness of the 2001 NHMRC guidelines for treatment of breast cancer with endocrine therapies in the early and longer-term.

Investigators: Assoc Prof D. Preen (UWA), Prof L. Roughead (University of Sydney), Prof C. Saunders (UWA), Dr A. Kemp (UWA), Prof Max Bulsara (UNDA), Prof D’Arcy C. Holman (UWA)
Contact: Max.Bulsara@nd.edu.au

A Partnership Intervention Trial to redress treatment delay and improve outcomes in Rural Cancer Patients.

This project will bring together partner organisations involved directly in cancer services
delivery/organisation/funding and an experienced, multidisciplinary research group
(collectively, the ‘project team’). The project team aims to redress the inequalities in cancer
treatment outcomes seen in Australian rural and remote populations, using non-metropolitan Western Australia (WA) as the setting for the development of a ‘best prospects’ package of community, provider and patient-based interventions and the subsequent evaluation of this package using a factorial, randomised controlled trial (RCT).
Thus the project will consist of two intimately-linked phases over a five-year term: a
development phase, which will identify health system, doctor and patient factors that affect
outcomes in rural patients with cancer of the prostate, breast, colorectum or lung and assess their potential to be modified by a complex intervention; and an implementation/evaluation phase, in which the ‘best prospects’ intervention will be rigorously evaluated by an experimental trial.

Investigators: Prof CDJ Holman (UWA), Prof JD Emery (UWA), Prof SM Saunders (UWA), Prof FM Walter (University of Cambridge), Assoc Prof RE Moorin (Curtin), Prof KA Auret (UWA), Assoc Prof DB Preen (UWA), Prof Max Bulsara (UNDA)
Contact: Max.Bulsara@nd.edu.au

The role of distorted body perception in chronic low back pain

Chronic low back pain is a widespread problem for which current treatment is only marginally helpful. In an attempt to better understand and treat people with CLBP, recent interest has focused on the role maladaptive changes in the functional organisation of the brain may play in the problem. Our research has been focused on investigating clinical correlates of cortical reorganisation in the CLBP population, particularly those related to alterations in body perception. We have begun development of a number of simple clinical tools to document alterations in body image as well as preliminary testing of treatment approaches which explicitly target cortical changes and disturbed body perception.

Investigators: A/Prof Ben Wand, Neil O’Connell (Centre for Research in Rehabilitation, Brunei University), Dr Lorimer Moseley (Oxford University), Pam George
Contact: ben.wand@nd.edu.au

Functional mobility and deconditioning after brain and spinal cord injury

Investigators: Prof Peter Hamer, Alison Kirkman
Contact: Alison.Kirkman@nd.edu.au

Motor recovery after stroke

Investigator: Alison Kirkman
Contact: Alison.Kirkman@nd.edu.au

Intensive care survivors: an evaluation of the capacity to ambulate at the time of discharge from acute care, and hospitalisations during the following 12 month period

This study represents the first step in an overall program of research involving a collaborative initiative between the Sir Charles Gairdner Hospital (SCGH) Physiotherapy Department, Curtin University of Technology and the University of Notre Dame Australia that aims to optimise functional outcomes of individuals following an intensive care unit (ICU) admission. Specifically, data collected during this study will assist in identifying the characteristics of those individuals who survive an ICU admission, but have difficulty walking at the time of discharge and have high healthcare needs after they leave SCGH. Together with other research currently being undertaken in the ICU at SCGH, the results of this study represents a baseline for future work that will assist in the development of future studies to investigate rehabilitation strategies, such as neuromuscular electrical stimulation, to optimise functional outcomes in this population.

Investigators:
A/Prof Shane Patman (UNDA) , Dr Kylie Hill (Curtin University), Diane Dennis (SCGH)
Contact: Shane.Patman@nd.edu.au