NHMRC draft information paper: evidence on the effectiveness of homeopathy for treating health conditions

This report summarises an assessment of homeopathy undertaken by the National Health and Medical Research Council, including an overview of published systematic reviews, evaluation of information provided by interest groups and the public, and consideration of clinical practice guidelines and government reports on homeopathy published in other countries. Introduction: Purpose: This information paper provides an overview of evidence from research on the effectiveness of homeopathy in treating health conditions in humans. It summarises the findings of an assessment of homeopathy undertaken by National Health and Medical Research Council (NHMRC), which included an overview of published systematic reviews, evaluation of information provided by homeopathy interest groups and the public, and consideration of clinical practice guidelines and government reports on homeopathy published in other countries. Scope: NHMRC assessed the evidence on homeopathy to answer this question: Is homeopathy an effective treatment for health conditions, compared with no homeopathy, or compared to other treatments? NHMRC did not consider evidence for whether or not homeopathy is effective for preventing health conditions (including evidence about homeopathic ‘vaccines’), or whether homeopathy is good for general health. NHMRC did not assess evidence on the safety of the ingredients of homeopathic medicines.   The NHMRC are asking for submissions by Monday the 26th of May 2014 (5:00 pm).  Click here to find out more about making a submission

A novel approach for prediction of vitamin D status using support vector regression

BACKGROUND Epidemiological evidence suggests that vitamin D deficiency is linked to various chronic diseases. However direct measurement of serum 25-hydroxyvitamin D (25(OH)D) concentration, the accepted biomarker of vitamin D status, may not be feasible in large epidemiological studies. An alternative approach is to estimate vitamin D status using a predictive model based on parameters derived from questionnaire data. In previous studies, models developed using Multiple Linear Regression (MLR) have explained a limited proportion of the variance and predicted values have correlated only modestly with measured values. Here, a new modelling approach, nonlinear radial basis function support vector regression (RBF SVR), was used in prediction of serum 25(OH)D concentration. Predicted scores were compared with those from a MLR model. METHODS Determinants of serum 25(OH)D in Caucasian adults (n = 494) that had been previously identified were modelled using MLR and RBF SVR to develop a 25(OH)D prediction score and then validated in an independent dataset. The correlation between actual and predicted serum 25(OH)D concentrations was analysed with a Pearson correlation coefficient. RESULTS Better correlation was observed between predicted scores and measured 25(OH)D concentrations using the RBF SVR model in comparison with MLR (Pearson correlation coefficient: 0.74 for RBF SVR; 0.51 for MLR). The RBF SVR model was more accurately able to identify individuals with lower 25(OH)D levels (<75 nmol/L). CONCLUSION Using identical determinants, the RBF SVR model provided improved prediction of serum 25(OH)D concentrations and vitamin D deficiency compared with a MLR model, in this dataset.Dr. Guo is funded by an Australian Postgraduate Award. Prof. Lucas is funded by a National Health and Medical Research (NHMRC) Career Development Fellowship and receives research funding from Cancer Australia, NHMRC, and MS Research Australia. Prof. Ponsonby is funded by a NHMRC Research Fellowship and receives research funding from NHMRC and MS Research Australia. The Ausimmune Study was funded by the US National Multiple Sclerosis Society, NHMRC, and MS Research Australia

Contrasting roles of condensin I and condensin II in mitotic chromosome formation

© 2012. Published by The Company of Biologists LtdIn vertebrates, two condensin complexes exist, condensin I and condensin II, which have differing but unresolved roles in organizing mitotic chromosomes. To dissect accurately the role of each complex in mitosis, we have made and studied the first vertebrate conditional knockouts of the genes encoding condensin I subunit CAP-H and condensin II subunit CAP-D3 in chicken DT40 cells. Live-cell imaging reveals highly distinct segregation defects. CAP-D3 (condensin II) knockout results in masses of chromatin-containing anaphase bridges. CAP-H (condensin I)-knockout anaphases have a more subtle defect, with chromatids showing fine chromatin fibres that are associated with failure of cytokinesis and cell death. Super-resolution microscopy reveals that condensin-I-depleted mitotic chromosomes are wider and shorter, with a diffuse chromosome scaffold, whereas condensin-II-depleted chromosomes retain a more defined scaffold, with chromosomes more stretched and seemingly lacking in axial rigidity. We conclude that condensin II is required primarily to provide rigidity by establishing an initial chromosome axis around which condensin I can arrange loops of chromatin.This work was supported by an Australian Research Council discovery project [grant number DP110100784 to D.F.H., K.H.A.C. and W.C.E.]; National Health and Medical Research Council (NHMRC) project grants [APP1030358 and 546454]; an NHMRC RD Wright Fellowship to P.K.; an NHMRC Senior Research Fellowship to C.B.W.; an NHMRC Senior Principal Research Fellowship to K.H.A.C.; and by the Victorian Government’s Operational Infrastructure Support Progra

Cognitive Deficits Are Associated with Frontal and Temporal Lobe White Matter Lesions in Middle-Aged Adults Living in the Community

BACKGROUND The association between brain white matter lesions and cognitive impairment in old age is well established. However, little is known about this association in midlife. As this information will inform policy for early preventative healthcare initiatives, we investigated non-periventricular frontal, temporal, parietal and occipital lobe white matter hyperintensities (WMH) in relation to cognitive function in 428 (232 women) community-dwelling adults aged 44 to 48 years. RESULTS Frontal white matter lesions were significantly associated with greater intraindividual RT variability in women, while temporal WMH were associated with face recognition deficits in men. Parietal and occipital lobe lesions were unrelated to cognitive performance. These findings did not differ when education and a range of health variables, including vascular risk factors, were taken into account. CONCLUSION Gender differences in WMH-cognition associations are discussed, and we conclude that small vessel disease is present in midlife and has functional consequences which are generally not recognized. Preventative strategies should, therefore, begin early in life.David Bunce's collaboration in this work was supported by the Leverhulme Trust and the British Academy. The study was funded by NHMRC of Australia Unit Grant No. 973302, Program Grant No. 179805, NHMRC project grant No. 157125, grants from the Australian Rotary Health Research Fund and the Australian Brewers Foundation. Nicolas Cherbuin is funded by NHMRC Research Fellowship No. 471501. Kaarin Anstey is funded by NHMRC Research Fellowship No. 366756. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

DRD4-exonIII-VNTR moderates the effect of childhood adversities on emotional resilience in young-adults

Most individuals successfully maintain psychological well-being even when exposed to trauma or adversity. Emotional resilience or the ability to thrive in the face of adversity is determined by complex interactions between genetic makeup, previous exposure to stress, personality, coping style, availability of social support, etc. Recent studies have demonstrated that childhood trauma diminishes resilience in adults and affects mental health. The Dopamine receptor D4 (DRD4) exon III variable number tandem repeat (VNTR) polymorphism was reported to moderate the impact of adverse childhood environment on behaviour, mood and other health-related outcomes. In this study we investigated whether DRD4-exIII-VNTR genotype moderates the effect of childhood adversities (CA) on resilience. In a representative population sample (n = 1148) aged 30-34 years, we observed an interactive effect of DRD4 genotype and CA (β = 0.132; p = 0.003) on resilience despite no main effect of the genotype when effects of age, gender and education were controlled for. The 7-repeat allele appears to protect against the adverse effect of CA since the decline in resilience associated with increased adversity was evident only in individuals without the 7-repeat allele. Resilience was also significantly associated with approach-/avoidance-related personality measures (behavioural inhibition/activation system; BIS/BAS) measures and an interactive effect of DRD4-exIII-VNTR genotype and CA on BAS was observed. Hence it is possible that approach-related personality traits could be mediating the effect of the DRD4 gene and childhood environment interaction on resilience such that when stressors are present, the 7-repeat allele influences the development of personality in a way that provides protection against adverse outcomes.The study was supported by NHMRC of Australia Unit Grant No. 973302. DD is funded by NHMRC Capacity Building Grant No. 418020 in Population Health Research. NC is funded by NHMRC Research Fellowship No. 471501. KA is funded by NHMRC Research Fellowship No. 366756

General Practitioners’ Experiences of, and Responses to, Uncertainty in Prostate Cancer Screening : Insights from a Qualitative Study

Acknowledgments We thank the General Practitioners for their participation in this research. The project was funded by NHMRC grant 1023197. Stacy Carter is supported by NHMRC Career Development Fellowship 1032963. Funding: The project was funded by a National Health and Medical Research Council grant 1023197 (https://www.nhmrc.gov.au/). SMC and LR obtained funding and are CIs on the NHMRC funded project grant. SMC is supported by NHMRC Career Development Fellowship 1032963. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Can patient-led surveillance detect subsequent new primary or recurrent melanomas and reduce the need for routinely scheduled follow-up? A protocol for the MEL-SELF randomised controlled trial

This research project is funded by a National Health and Medical Research Council (NHMRC) Project grant (#1163054). The funder had no role in the design of the study and will have no role in the collection, analysis, and interpretation of the data; the writing of the report; or the decision to submit the report for publication. Funding Information: AEC is funded by a Career Development Fellowship from the National Health and Medical Research Council (NHMRC; 1147843). JFT is a recipient of an NHMRC Program Grant (1093017). RPMS is supported by Melanoma Institute Australia. RAS is supported by a NHMRC Program Grant and Practitioner Fellowship. For RAS, support from the from colleagues at Melanoma Institute Australia, Royal Prince Alfred Hospital and NSW Health Pathology is also gratefully acknowledged. RLM is supported with an NHMRC Investigator grant (1194703) and a University of Sydney Robinson Fellowship. HPS holds an NHMRC MRFF Next Generation Clinical Researchers Program Practitioner Fellowship (APP1137127). JH is supported by an NHMRC Early Career Fellowship (1112509). KB is supported by an NHMRC Investigator Grant (1174523) and a University of Sydney Research Accelerator (SOAR) Prize.Peer reviewedPublisher PD

IVF versus IUI with ovarian stimulation for unexplained infertility : a collaborative individual participant data meta-analysis

Funding Information: WL is supported by a NHMRC Investigator grant (GNT2016729). RW is supported by an NHMRC Investigator grant (GNT20009767). BWM is supported by a NHMRC Investigator grant (GNT1176437) and he reports consultancy for ObsEva and Merck and travel support from Merck.Peer reviewe

What do women undergoing in vitro fertilization (IVF) understand about their chance of IVF success?

Funding No external funding was used for this study. S.L. is supported by a NHMRC Investigator Grant (APP1195189). R.W. is supported by a NHMRC Investigator Grant (GNT2009767). B.W.M. is supported by a NHMRC Investigator Grant (GNT1176437) and has received research funding and travel funding from MerckPeer reviewedPublisher PD

Revisiting Old Ground in Light of New Dilemmas: The Need for Queensland to Reconsider the Regulation of Assisted Reproductive Technologies

In recent years, there have been many advances in assisted reproductive technology, in terms of both technological advances and changes in social attitudes. The system of regulation in Queensland is in need of review since it was last considered nearly 25 years ago. The need for review is demonstrated by examining the regulation in Australia as a whole and the impact this has on regulation in Queensland. The paper considers two specific issues. The general access criteria are examined in order to determine who is able to gain access to treatment services, together with how this impacts on gaining access to, and the regulation of, in vitro fertilisation (IVF) and pre-implantation genetic diagnosis (PGD). These issues are discussed mainly in the context of creating tissue-matched children that could act as a cure for an existing ill sibling. The recent review of assisted reproductive technologies (ART) regulation conducted by the Victorian Law Reform Commission is also considered in context of how this may impact on the future regulation of other jurisdictions. The main focus however, is on future options available for Queensland should regulation be reviewed in the future