Celebrating 10 years of improving health & care outcomes2005-2015

Over the past 10 years the Bupa Health Foundation has grown to be one of the largest corporate foundations dedicated to health in Australia.

5 Foreword

6 Introduction

8 Cancer

12 Cardiovasculardisease

16 Diabetes

20 Dementia

24 Tacklinghealthchallenges

28 Emerginghealthresearcher

30 2015healthawards

Winner of Research Australia’s Leadership in Corporate Giving Award 2014.

32

5

0

10

15

20

25

2005

$ M

illio

ns

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Bupa Health Foundation $ Investment

We have invested close to $26 million in projects that aim to improve health outcomes for all Australians.

ForewordThis year we’re celebrating the 10th anniversary of the Bupa Health Foundation. The Foundation is one of Australia’s leading private charitable organisations dedicated to health and has played an important role in the last decade in shaping research outcomes to improve the health and wellbeing of Australians.

In10yearsAustraliahaswitnessedmajoreconomic,socialandculturalchangestimulatedbyenormousadvancesininformationtechnologyanddigitalapplications.

Healthresearchhasalsoseenmajoradvancesandbreakthroughs;genomics,stemcells,diagnosticsandtargetedcancerdrugstonameafew.Australiamademajorcontributionswiththedevelopmentofthecervicalcancervaccineandinpublicpolicychangestoreducesmokingrates.

Thelastdecadehasseentheemergenceofhealthchallengestoanextentthatcouldneverhavebeenimagined–theriseofobesityandlifestylediseases,diabetes,cardiovasculardisease,dementiaandcancer;theimpactoflongerlives-itisnolongerararitytoseepeoplelivingwellintotheir90sandreaching100.

Increasingly,theresearchcommunityisbeingaskedtoidentifythecomplexandinterrelatedfactorsinfluencingtheescalationofchronicdiseases,andtofindwaystoreducetheensuingburdenplacedonhealthservicesandhealthexpenditure.

WhilesupportinghighqualityhealthandmedicalresearchinAustraliaisanessentialdriverofinnovation,productivityandenhancedhealthservice

effectiveness,itismostimportantlyadriverofimprovedcommunitywellness.

OurhealthcareandresearchlandscapescontinuetochangeandtheBupaHealthFoundationlooksforwardtoworkingwithourpartnerstomeetthesechallenges.

IwouldliketoacknowledgeeveryonewhohascontributedtotheBupaHealthFoundationfromitscreation10yearsagotonow.IthinkespeciallyofthesupportoftheBupaGroupintheUK,theAustralianBoard,DeanHolden-ManagingDirectorofBupaAustraliaandNewZealand,ourSteeringCommitteeandthespecialpartthatProfessorChristineBennetthasplayed.Thankyouall.

Onour10thanniversary,wealsocelebrateandmarvelattheachievementsofourpartners.Welookforwardtostrengtheningourexistingpartnerrelationshipsandestablishingnewones,withourfundamentalobjectivebeingtohelpAustralianslivelonger,healthier,happierlives.

John Conde AO

Chairman,BupaHealthFoundation

4 5

FromitsearlybeginningstheFoundationworkedwithkeyindustrypartnerstoadvocateforcertainhealthissues.Theseincludedpain,youthmentalhealth,ahealthystarttolifeandobesity.TheFoundation’sHighCostofPainReportremainsseminalevidenceoftheeconomicandhumanburdenofpaininAustralia.TheNationalPainSummitconvenedbytheFoundationledtotheNationalPainActionPlan.TheFoundationalsochampionedtheneglectedissueofmentalhealthinyoungpeoplebypartneringwithProfessorsPatMcGorry,IanHickieandcolleagues,tosupporttheinauguralInternationalYouthMentalHealthConferencein2010aswellasanationalprogramofraisingpublicawarenessacrossAustraliafocusingonsuicideanddepression.Similarly,theworkwithAustralianResearchAllianceforChildrenandYouthtoholdanationalsummitonahealthystarttolifeledtoareportandactionplan.ObesityAustraliahasalsobeenakeypartneringeneratingdebateandactionontacklingtheinternationalhealthchallengeofincreasinglevelsofobesity.

Withover100activeandcompletedresearchprojectsandmorethan70partnersitishardtoselectthe“highlights”!AfewspecialmentionsincludetheBupaHealthFoundationWellbeingAfterBreastCancerStudypartnershipwithMonashUniversity;theRemoteDentalHealthServicespilotwiththeRoyalFlyingDoctors;“BeBrave”anonlinesupportaddressinganxietyandresilienceinchildren;theBrainyApp,forpreventionofheartandbrainhealthriskswithAlzheimer’sAustralia;exploringaskincancervaccinewithProfessorIanFrazer;andtheawardwinningwebsiteMyJointPainwithArthritisAustralia.ThisReporthighlightsmanymoreofthesuccessfulpartnershipsoftheFoundation.

OneofthemostimportantingredientstotheFoundation’ssuccesshasbeentheinvolvementoftheBupateaminofferingarangeofexpertiseandsupporttoactivelypartnerwithgroupsoninitiatives.ThankyoutomycolleaguesontheSteeringCommitteeandthosethroughoutBupafortheirinterestandcontribution.

IcongratulateBupaonitsvisionandcontributiontomakingadifferencetohealthandwellbeinginAustraliaandindeedaroundtheworldoverthelastdecade.IlookforwardtothenexteraoftheFoundationaswecontinuetopartnerwithhealthleaders,researchersandcommunitygroupstotacklenewandemerginghealthchallengeswithinnovationthattranslatesnewknowledgeintoaction.

Introduction

Alzheimer’s AustraliaArthritis Australia

AustinHealth-PIRI

ANZGOG

AIHI

ARACYBakerIDI

BMRI

CancerCouncil

Cancer Institute NSWCQU

CQU

CSIRO

CRUfAD

Deakin

Garvan Institute

Griffith

JCU

LungFoundation

Monash

NationalStrokeFoundation

Obesity Australia

PMRI

Royal Far WestSax InstituteSJGHC

SJGHC

St Vincent’s

The George Institute

RACGP

UNSW

UniversityofAdelaide

CERA

UniversityofNotreDame

DiamantinaInstitute

USA

University of Sydney

UTAS

UWA

VCCRI organisationswith77partnerships100Over

As we celebrate our 10th year of the Bupa Health Foundation it is appropriate to pause and reflect on the contributions and many achievements of the Foundation and our partners over the last decade. The role of the Foundation has evolved to become a recognised and highly-regarded investor in innovation, advocacy and research in ways that make a difference to the health and care of Australians.

Professor Christine Bennett AO

Chair,BupaHealthFoundationSteeringCommittee

RFDS

UQ

76

Vaccines against skin cancer

ProfessorIanFrazerdescribeshimselfascurious.Helikestopullthingsapartandseehowtheywork,acharacteristicwhichhashelpedhimbuildanimpressiveresearchcareer,includingthedevelopmentofthecervicalcancervaccine.

Now,theBupaHealthFoundationissupportingProfessorFrazerandhiscolleaguesfromtheUniversityofQueenslandDiamantinaInstituteinsomeexcitingresearchfornewtreatmentoptionsandpotentialvaccinesagainstsquamouscellcarcinoma(SCC),thesecondmostcommonformofskincancerinAustralia.

Squamousskincancerisanon-melanomaskincancer,andit’sthoughtaround500-600Australiansdieeachyearfromit.However,mostcanbesuccessfullytreated,thoughatahighcosttothehealthsystem.

ProfessorFrazerandhisteamareresearchingcost-effectiveoptionstohelppreventorreducetheriskofdevelopingSCC,whichcouldrepresentasignificantsavingacrossthehealthsystem.Theircuttingedge

workislookingtoseeifvirusescancauseskin

cancerstoformand,ifso,whethervaccinesorsimple

treatmentscanbedevelopedtohelpwithprevention.

ProfessorFrazersays“Itiswellknownthatdamage

fromUVlightisamajorfactorincausingsunspots

andotherskindamage.Butforsquamousskincancer

todevelop,sunlightisnottheonlyculprit.Sunlight

initiatesthedamagebutexposuretootherfactorsis

requiredforcancerdevelopment.”

“Theseotherfactorsmayincludethingsthatcan

affectthebody’simmunity,suchassomevirusesor

certainmedications”

ProfessorFrazersaystheoutcomeoftheirresearch

ispromising.“Basedonourfindingsitlookslike

wearejustifiedindoingaclinicaltrialofasimple

interventionforpeoplewithsunspots.”

Asuccessfultreatmentwillhopefullyhelpprevent

squamousskincancers,aswellasreducethepainand

discomfortofcurrenttreatmentssuchassurgery.

CancerNon-melanoma skin cancer is a major public health problem in Australia, involving significant health costs and disfigurement from the disease and its treatment.Cancer Council Australia

Two in three Australians will be diagnosed with skin cancer by the time they are 70.Cancer Council Australia

98

Health and wellbeing after breast cancer

ProfessorsSusanDavisandRobinBellandcolleagues

fromMonashUniversitylookedatthehealthand

wellbeingofmorethan1,600womendiagnosedwith

breastcancerover5years.Thisisanareaofgrowing

importanceassurvivalratesfrombreastcancer

improve.

ProfessorsDavissays,“Womenaresurvivingbreast

cancerbuttreatmentwillprofoundlyaffecttheirlives.

Soit’simportanttounderstandmoreaboutthese

impactsovertime.”

Theyfoundtreatmentcanhavelong-termphysical

effects.Forexample,manywomenhaveongoing

sexualproblemsandsymptomsofmenopausecan

besevereandlong-lasting.

“Thisisprobablyrelatedtotheprolongedand

profoundoestrogendeficiencyresultingfromtheir

cancertreatment,”theysay.

Women’slevelofknowledgeandunderstanding

ofbreastcanceralsoaffectedtheirwellbeing.They

foundthatwomenwhohadabetterunderstanding

oftheirconditionhadahigherchanceofbeingon

appropriatehormonetherapy.

Theyalsofoundwomenwerevulnerableto

misinformationafterbreastcancertreatment,and

manymade“unusualdecisions”abouttheirdietsand

lifestyle.Twooutofthreewomendiagnosedwith

breastcancerwhowerecigarettesmokerscontinued

tosmoke2yearslater.Veryfewwomenwhodrankat

moderate-to-heavylevelschangedhowmuchalcohol

theyconsumed,eventhoughitcouldincreasetherisk

oftheirbreastcancercomingback.

“Womenaresurvivinglongerafterbreastcancer,so

it’simportanttheylookafterthemselves.Manystill

needtoreducetheiralcoholintake,quitsmokingand

managetheirweight.”

Overhalfthewomenstudiedbelievedthatstresswas

thecauseoftheircancerandthereforecarriedalotof

selfblame.

“Thereisnoevidencethatstresscausesbreastcancer

andthereisnoneedtofeelguiltyaboutit,”theysay.

FindingsfromtheresearchsupportedbytheBupa

HealthFoundationhavebeenpublishedinmorethan

20peer-reviewedpublications.DavisandBellare

continuingtoresearchtheeffectsofbreastcancer

treatmentonotheraspectsofhealthandwellbeing.

Diana, a 67-year-old mother of two, was first diagnosed with breast cancer 20 years ago. She has been active in her care, seeking multiple opinions and researching options.

“AtfirstIgotascarethinking,‘I’mgoingtodie’.Intime,ImovedbeyondthatandfeltconfidentIwasgoingtolickthis.ButwiththesecondcancerIwasdevastated.WhenIfoundoutaboutBRCA1itsentmeintoatailspin.”

Eightyearsaftershehadapartialmastectomywiththeremovalof20lymphnodesandacourseofradiation,Dianawasgiventhebadnewsofasecondcancerinthesamebreast.Shethenhadafullmastectomyandbreastreconstruction.AndwiththeriskaBRCA1genemutationposed,shechosetohaveheruterusandovariesremovedaswelltohelppreventthecancerfromrecurring.

IthasbeenanemotionaljourneyforDianaandshe’sfacedmanychallenges,particularlyindealingwithchangestoherbody.“Thefullmastectomywasarealattackonmybody,likeanamputation.EverythingchangedinwhatIcouldwear.Ihatedlookingatmyselfinthemirror.”

Shehasalsoexperiencedfrustrationswithalackofunderstandinginthecommunity.Forexample,buyinglingeriecontinuestobehard.“Notmanyshopsarehelpfulifyouhavehadafullmastectomy.”

Therearealsolong-lastingphysicaleffects.“Mywritingwillneverbethesameandmyarmstillgoestosleeponme.”

However,Dianahaslearnttobemoreresilient,tryingnottodwellonthingsandnotlettingissuesbotherherasmuchanymore.Shealsomakessuretolookafterherself,byeatingwellandexercisingregularly.

Diana’s story.

1110

Eyes may be a window to chronic disease

ProfessorTienWong,fromtheCentreforEyeResearchAustralia(CERA),ispassionateaboutresearchthattransformsdiscoveriesintoclinicalcaretomakeadifferencetopeople’slives.

In2008ProfessorWongandcolleaguesreceivedaBupaHealthFoundationAwardtodevelopatechniqueofretinalscanning–lookingatchangesintheappearanceofbloodvesselsatthebackoftheeye–toaccuratelypredictaperson’sriskofheartattackorstroke.

Theyfoundtheirretinalscanningtechniquewasatleastasgoodas,ifnotbetterthan,existingtechniquesusedtopredictcardiovasculardiseaseusingbloodtests.

“Sincethenwehavenowdevelopedandrefinedtheretinalscanningsoftwaretoimprovetheabilitytopredictcardiovasculardisease,andareworkingwithvariousgroupstotestandimplementit,”saysProfessorWong.

“OngoingstudiesinAustraliaarealsohappeningwithdifferentpatientpopulationsforindicationsotherthancardiovasculardisease.Forexample,weare

workingwithneurologiststoseeifretinalscanning

willhelpdifferentiatethedifferenttypesofcognitive

impairment.”

Byusingdifferentimagingtechniquestomeasure

theretinalnervelayers,notjustthebloodvessels,

ProfessorWongandhiscolleaguesbelievethe

technologymayalsobehelpfulinpredicting

dementia.

“We’realsoworkingwithendocrinologiststoseeif

itwillhelppredicteyeandkidneycomplicationsin

youngpeoplewithtype1diabetes.”

Theresearchisalsobeingusedtoseewhether

theycanpredictifpregnantwomenwilldevelop

pre-eclampsia,themostcommonseriousmedical

complicationofpregnancyinAustralia.

Theresearchisalreadybeingrecognised

internationally.“Wehavemorethan20groupsaround

theworldinUS,UKandAsiawhoarekeentouse

theretinalscanningsoftwarefortheirpatients,”says

ProfessorWong.

“Theworkisexciting,butimplementationwilltaketime”.

Cardiovascular Disease

Empowering people for better stroke prevention

AssociateProfessorAnneAbbottfromMonashUniversityhaspatientoutcomeimprovementclearlyonheragenda.

LastyearshereceivedaBupaHealthFoundationHealthAwardforherresearchonoptimisingoutcomesinpatientswithcarotidarterialdisease.Shefoundthatinpeoplewithnarrowingofthecarotidarterybutnosymptoms,medicaltherapy–thatis,medicationandahealthylifestyle–canreduceriskofstrokebyatleast80%.

“Thereisnocurrentevidencethatsurgicalinterventionsareofbenefittothisgroupofpeople.Overwhelmingevidenceindicatestheyarenowmorelikelytobeharmedbysurgeryandnotbenefitiftheyarealreadygettingoptimalmedicaltherapy,”saysProfessorAbbott.

“Aswellasbeingwrongtocontinuetodoproceduresthatareshowntodomoreharmthangood,it’salsoeconomicallyunsustainable.”

Inthepastyear,ProfessorAbbotthasbeenworkingtirelesslytoimprovestandardsofstrokepreventionglobally.

Cardiovascular disease is Australia’s single biggest killer of men and women. Heart Foundation

Inadditiontopublishingpapersandgivinglecturesaroundtheworldbasedonherresearch,shehaslaunchedawebsitefactcats.orgwhichbringstogetherexpertisefrommorethan125peoplefromaroundtheworld.Theaimistoeducatethepublic,policymakersandhealthprofessionalsaboutbetterstrokeprevention.Theirfirststepisundertakingareviewofinternationalguidelinesinsixlanguages.

Shesaysit’simportanttomakepeopleawareofthecurrentevidenceandhowpracticeevolveswithevidence.

“Peoplecanbeempoweredtopreventtheirownstrokeandothercardiovasculardiseases.Havingahealthylifestylemeanspeoplefeelmuchbetterandaremoremotivated.Everyeffortmakesadifference.”

1312

Paul, a 73-year-old grandfather of 10, has good reason to look after his heart health.

“IhaveatrialfibrillationandmycardiologistsaysI’matthestagewhereifIgetsymptoms,medicationalonewon’tsolvetheproblem.SoIlookaftermyselftostaveoffsurgeryonmyheart.”

Tohelphimpreventcardiovascularproblemssuchasheartdiseaseandstroke,Paulhasbuiltmanystrategiesintohistolife.

“Ibelieveexerciseanddietarebothveryimportantforgoodhealth.

“IgoforashortwalkeverydayandIgoupanddownhillswhenIcan.IplaytennisregularlywithmyfriendsandIalsoliketoplaylawnbowls.”

AswellasvarioustypesofexercisePaulalsostaysgenerallyactive.Hestillworks3.5daysaweekasapharmacistandspendsmostofthattimeonhisfeet.

Paulalsomakessuretotakehisprescribedmedicationsforbloodpressureandcholesterolmanagementaswellasaspirin,whichhelpspreventclotting.Healsohasregularcheck-upswithhisGP.

“MostlyItrytokeepapositivethinkingapproach.Iwanttobeatmygrandkidsweddings…I’mdetermined.”

Paul’s story.

1514

Keeping obesity from becoming ‘the new normal’

Since2012,theBupaHealthFoundationhasworkedwithObesityAustraliatohelpstemthetideoftheextraordinaryincrease,overthelast40years,inthenumbersofpeoplewithobesity.Indoingso,theymayalsobehelpingtoreducetheriskandincidenceofdiabetes.

ProfessorJohnFunderAC,patronofObesityAustralia,says,“WhileObesityAustraliaisprimarilyinterestedinobesity,halfthepeoplewhobecomeobesealsobecomediabetic.”

AccordingtoProfessorFunder,27%ofAustralianadultsarenowconsideredobeseandanother40%areoverweight:“Overweighthasbecomethenew‘normal’.”

Peoplewithobesityarealsoatriskofserioushealthissuesincludinganincreaseinsomecancers,sleepdisturbancesandreproductivedifficulties.Butevensmallchangescanhelpimprovethehealthofthepopulation.

“Inpeoplewithdiabeteswhoarealsoobese,losing5-10%oftheirbodyweightmeanseventhoughtheymaystillbetechnicallyobese,theirdiabeteswillbecomefarlesssevereandmayevengoaway.Theirbloodpressurealsousuallygetsmuchbetter,”ProfessorFundersays.

ProfessorFunderacknowledgespeoplewithobesityoftenbattlestigmainthepubliceye.“Obesityisnotafailureofwillpowerandit’snotamoralfailing.It’snotamatterofjusteatinglessandexercisingmore.It’smorecomplicatedthanthat.”

Evenbeforeachildisborn,therearefactorsatplaythatcanleadtothembecomingobese,includingthemotherhavingdiabetesordevelopinggestationaldiabetes,havingaverylowcalorie/lowproteindiet,orbeingverystressed.Obesityinbothparentshasalsobeenlinkedtochildhoodobesity.

“Thedieiscastwithobesitybeforeachildcanreachthefridgedoor.The4yearsbeforethethirdbirthdayarecrucialtowhetherornotachildbecomesobese,”saysProfessorFunder.

“Thisisbecauseupto90%ofushavegenesprogrammedtostorefatforsurvival.Howweeatinourearlyyearsinfluenceswhetherthosegenesareturnedonoroff,andatwhatpointourbrainsrecognisewearefull.”

“Theimportantthingistotryandgetprospectiveparentstominimisethechancestheiroffspringwillbeobese.Evenbeforeconceptionparentscanmakeadifference.”

Diabetes

About 4% of Australians have diabetes. That’s almost 1 million people.Australian Institute of Health and Welfare

Over half of all Australian adults are overweight or obese, which puts them at greater risk for diabetes.Australian Institute of Health and Welfare

16 17

Michael’s story.

Identifying sleep apnoea in at-risk people

ProfessorPaulZimmetandcolleaguesfromtheBaker

IDIHeartandDiabetesInstitutearecontinuingtheir

researchtofindbetterwaystouncoverobstructive

sleepapnoea(OSA)intheAustraliancommunity,

particularlyinpeoplewithconditionslinkedtothe

problem,suchasdiabetes.

IdentifyingOSAisimportantbecauseitisacommon

disorder,withaconservativeestimateofalmost2

millionAustraliansaffected,butit’salsocommonly

undiagnosed.

“Sleepapnoeahasserioushealth,socialandeconomic

consequencesfortheAustraliancommunity,”says

ProfessorZimmet.

Roadaccidentsduetodriversfallingasleepatthe

wheelasaresultofundiagnosedsleepapnoeacontinue

tooccur.OSAisalsoproblematicinworkplacesandin

high-riskoccupationssuchasaviation.Thetotalannual

costassociatedwithsleepdisordersinAustraliawas

estimatedat$36.4billionin2010.

TheBupaHealthFoundationissupportingProfessor

Zimmetandhiscolleaguesintheirworkinindentifying

amoreaccessibleandlesscostlyscreeningpathway

foridentifyingOSAinhighriskindividualssuchas

thosewithtype2diabetes.

“Alinkbetweensleepapnoeaanddiabeteshasonly

recentlybecomeknown,”saysProfessorZimmet

“Ourresearchconfirmstheapparentindependent

linkbetweentype2diabetesandsleepapnoea.”

Hislatestresearchtrialled3questionnairesfor

screeningforOSAagainstahome-basedsleep

apnoea-testingdevice.

“Thecurrentquestionnairesaskaboutsymptomsof

snoring,beingoverweight,andbeingsleepyduring

theday.Butthesesymptomsarerelativelyvagueand

commoninotherconditions.Thenewquestionnaires

weregoodatidentifyingOSAinpeoplewithdiabetes,

buttheyalsopickeduppeoplewhodidnothaveOSA.”

ProfessorZimmetisplanningtocontinuehisresearch

todevelopareliablescreeningtoolforOSA.“This

willhelpmorepeoplebediagnosedandgettheright

treatment,”hesays.

Michael, a 56-year-old father and grandfather, was diagnosed with sleep apnoea about 10 years ago.

“IwouldsnoreloudlyandthemoreIslepttheworseIfelt,”saysMichael.

“I’dreadaboutsleepapnoeaandthoughtIcouldhaveit.Ihadasleeptestandtheyfoundmyoxygensaturationdroppedto89%andIhadepisodeswhereIstoppedbreathingfor60-90seconds.Thatwasscary.”

MichaelnowusesaCPAPmachineeverynighttohelpmanagehissleepapnoea.

“Ican’tsleepwithoutit–IeventakeitwithmewhenItravelforwork.I’vestoppedfallingasleepduringmeals,andI’vestoppedfallingasleepatthewheel.”

Hesaysit’sprettyquietanddefinitelybetterforhisfamilythanhissnoring!

Michaelwasalsodiagnosedwithdiabetes5yearsago.Hefoundtakingmedication,andlosingexcessweightusingdietandexercisehasreallyhelpedhishealth.

“Idroppedfrom107to96kg,whichhadadramaticeffectonmysugarlevelsandmybloodpressure.Walking,andreducingsugarinmydietmadeabigdifference–althoughIdocheatabitsometimes.”

“Our research confirms the independent link between diabetes and sleep apnoea.”

1918

Can brain food help prevent depression and dementia?

ProfessorIanHickieandcolleaguesfromtheBrain&MindResearchInstituteattheUniversityofSydneyareresearchingwaystopreventdepressionanddementiainolderpeopleaspartoftheBeyondAgeingproject.

“Weknowthatyoucanretainyourbrainfunctionquitelateintolife.Andthatage,perse,isnolongeranimpedimenttogoodcognitivefunction.”

ProfessorHickie’steamiscurrentlylookingatwhetheromega-3fattyacid(fishoil)supplementsandantidepressantscanhelpstoporslowdowncognitivedecline,depressionanddementiainolderpeople.

Hesays,“Wearenowmovingtotestinginmuchbiggerpopulationsofanumberofspecificinterventions–exercise,diet,vascularriskmodification–andlookingattheireffects.Notjustovershortperiods,butoverreallylongperiods

sothatweknowhowtostructureourlivesandstructureourhealthsothatwecanallagesuccessfully.”

Thisresearchisimportantgiventhelongliveswenowleadandfocusesonmaximisingyourchancesofhavingthebestbrainfunctionatanyage,ProfessorHickiesays.

“Intheverynearfuturewearegoingtohavemuchbetterinformationtoprovidetopeople,particularlyinmiddlelifeandastheyage,astowhattheycanspecificallydotoincreasetheirchancesthattheywillliveindependentlyandmaintaincognitivefunctionastheyage,”hesays.

“Wehavedevelopedconsiderableoptimismaboutwhatcanbedonetoimprovepeople’schancesofsuccessfulageing.”

Dementia

By 2030, the number of people with dementia is estimated to increase to 76 million worldwide.Alzheimer’s Disease International

“People who are living with dementia in their 70s and 80s would already have the pathology in their brains from their mid 40s. Adopting health and lifestyle advice at an early stage will be critical and should be a cornerstone of public policy.”Professor Graham Stokes, BupaGlobalDirectorofDementiaCare

2120

BrainyApp success

SuhaAli,theNationalDementiaRiskReductionManager,Alzheimer’sAustralia,saystheideaforBrainyAppgrewoutofthelackofknowledgeinthecommunityaboutbrainhealthandwaystopreventdementia.

“Mostpeopleareunawareofthelinkbetweenheartandbrainhealth,andthevascularriskfactorsfordevelopingdementia.”

Theapp,whichaimstohelpusersliveabrainhealthylifeandreducetheirriskofdementia,hascomealongwaysinceitsinitiallaunchinAustraliaandNewZealandin2011.Withinthefirst48hoursithadbeendownloaded50,000times.

AnAndroidversionandaSpanish-languageversionsoonfollowed,withasubsequentworldwidelaunchwithcloseto400,000downloadsglobally.ThegreatestresponsehasbeenintheUSandtheUK.

Tohelpreachandbenefitevenmorepeople,anupdatedandimprovedBrainyAppisdueforreleasethisyear.

“TheobjectivesforBrainyAppremaintohelpraiseawarenessoftheriskfactorsfordementia,andencouragechangesinbehaviour.”

Thenewversionwillhavemoreinteractivityandgoalsettingelements.Thisisdesignedtohelpmovepeoplefrompre-contemplationandcontemplationintotakingaction.

Alisaystheyarealsobuildingincommunitysharingfeaturesthatpeoplecanusetocompetewithfriendsandsharesuccess.

Adesktopversionisalsoplannedforthosepeoplewhodon’thaveasmartphoneortabletdevice.

Katrina is expecting her fifth child and even at only 39 years of age, preventing dementia is becoming increasingly important to her.

“Ihadgrandparentsonbothsidesofmyfamilywhowerediagnosedwithdementiaintheirlateryears,sothinkingaboutdementiahasbeenattheforefrontofmymindforsometime.

“Iwanttotakeanactiveroleinmykids’andgrandkids’lives.Idon’tjustwanttobethepersontheycometovisitwhoisconfusedanddoesn’trecognisetheirfamily.Youcanseetheirpainbehindtheconfusion.I’ddoanythingtopreventthat.”

Eventhoughtherearenoguarantees,Katrinaisdeterminedtodowhatshecan.“Iquitsmoking,andIpaymoreattentiontowhatIeatandwhatweeatasafamily.ExercisingisalsoimportantandItrytokeepmyselfmoving.”

“I’vealsobeenlookingatresearchthatshowsdoingthingslikebraintraininggamesandcrosswordscanhelppreventdementia.”Shetriestokeepherbrainactivewiththeseactivitieswhenshecanandhastriedapp-basedbraintraininggamesaswell.

“I’veonlyrecentlycomeacrossBrainyAppandthinkit’sagoodthing.Ilikeit.It’sholisticandIlikehowyoucantrackyourbrainandbodyhealthtogetherinoneplace.Itmakeslifeeasier.”

Katrina’s story.

2322

Almost 10,000 serious workplace injuries and more than 25,000 serious injuries from road crashes are caused by poor alertness each year.CRC for Alertness, Safety and Productivity.

Better sleep for better health at work

BupaHealthFoundationisparticipatingintheCooperativeResearchCentre(CRC)forAlertness,SafetyandProductivity.TheCRCwaslaunchedin2013,bringingtogetherindustry,governmentanduniversity-basedthoughtleaderstohelpreducetheburdenofimpairedalertnessonsafety,productivityandhealthinAustralia.

“Bettersleepandalertnessarecriticalforproductivityandsafety,”saysProfessorShanthaRajaratnamfromMonashUniversity,whoisleadingoneoftheresearchprogramsattheCRC.

“TheCRCisonthebeginningofajourney.Itaimstodesignaseriesofsolutionsforsleeplossandpoorsleepqualityinoccupationalandclinicalsettings.Wearealsodevelopingarangeoftoolsandsystemstobettermanageimpairedalertnessatwork.”

OneworkstreamoftheCRCinvolvesdesigningnewlightingsystemstohelppeopleadjusttheirbodyclocksandbetteradapttoworkscheduling.

“Weareworkingwitharchitectsandlightingdesignerstoimprovelightingstandardsatworktopromotegoodhealthandwellbeing,”ProfessorRajaratnamsays.

“Flickeringfluorescentsarenogood.It’simportanttogettherightsourceoflightoverheadasnoteverybodyhasaccesstoawindowduringtheworkday,andparticularlybecausethereisnosunlightatnight.”

Lightintensity,colourcompositionandtimingofexposureareallimportantfactorsinhowthebrainrespondstolight,hesays.

“Therightsourceoflightattherightintensityandtherighttimeisanon-pharmacologicalstimulant.It’sasgoodasacupofcoffee.”

OtherareasrelatedtosleepandproductivitytheCRCisinvestigatinginclude:

• biologically-informedsystemsforschedulingshiftwork

• newwaystomeasurealertnesstoassistinassessingfitnessfordutyormonitoringimpairedalertnessduringashift

• newwaystoscreenforsleepdisorderssuchassleepapnoea,insomnia,ordisorderedsleepduetoshiftwork.

Tackling health challenges

24 25

Getting to the bone of fracture prevention

ProfessorJackieCenterandcolleaguesfromtheGarvanInstituteofMedicalResearchhavebeenlookingathealthoutcomesofpeoplewhohavehadafractureduetoosteoporosis.

ByreviewingdatafromtheDubboOsteoporosisEpidemiologyStudy,theyfoundthattheriskofasecondfractureisincreasedinpeoplewhohavehadafracture.

ProfessorCentersays,“Inwomen,theriskofasecondfractureisuptodoubletheriskoftheirpeers.It’sevenworseformen.Theirriskofare-fractureis3-4timeshigherthantheirpeerswho’venothadafracture.”

Hipfracturessubstantiallyincreaseaperson’sriskofdyingcomparedtootherswho’venotexperiencedafracture.“Peoplewhohavehadevenalowtraumafracturehaveroughlydoubletheriskofdying.Theriskofdyingisprobablygreatestafterahipfracture,butisnearlyashighafteraspine,armorlegfracture.”

Theserisksofdyingremainraisedforabout5yearsafterthefracture.

“Wedonotknowtheexactcauseofthehighmortalitybuthavesometheories,”ProfessorCentersays.“Toxicsubstanceslikeleadarestoredinbone.Theboneturnoverthatoccursafterafracturemayreleasethesetoxicsubstancesintothebloodandcauseproblems,particularlyforolderpeople.Inthefuturewewanttoexamineleadlevelsinbloodafterafracturetotestthistheory.”

Toexploretheirfindingsfurther,ProfessorCenterandcolleagueshavesetupaninternationalcollaborationtolookatdatafromothercountriesincludingCanada,Norway,theNetherlands,theUK,DenmarkandItaly.

“Resultsfromthiscollaborationwillhelpusunderstandmoreabouttheoutcomesfromosteoporosisfractureandinformstrategiesforfractureprevention,”shesays.

“Medicationslikebisphosphonates,whichareusedtotreatosteoporosishavebeenshowntohelpwithsurvivalafterafracture.Howeverosteoporosisisstillpoorlytreated.Onlyathirdofwomengetappropriatetreatment,andevenfewermendo.”

Samantha’s story.Samantha is a 74-year-old grandmother who was first diagnosed with osteoporosis 20 years ago.

Despitehavingaverylowbonedensityshehasonlyeverhadasinglehairlinefractureinherlowerspine.“Idotripandfallduetobadeyesight,soI’mveryfortunateIhaven’thadanyotherfractures,”shesays.

Forseveralyearsshetriedseveraldifferentmedicationsandluckily,abisphosphonatehelpedslowthedeclineinherbonedensity.Shehadtostoptakingitforacoupleofyearsassheneededadentalimplant,andnowsheishavinginjectionsevery6months.

AswellastakingmedicationSamanthaexercisesanddoesweighttraining.“Istartedweighttraining10yearsagoatalocaluniversitywhowasrunningsessionsforseniors.Thishelpedimprovemybonedensityinadditiontowhatthemedicationwasdoingforme.”

“NowIhaveapersonaltrainerwhocomestomyhousetwiceaweek.Ialsogotoastrengthandbalanceclassonceaweek.IplantokeepupexerciseaslongasIcan.Itreallyimprovesmysenseofwellbeing.”

“People who have had even low trauma fracture have roughly double the risk of dying.”

26 27

Revolutionary treatmentsWinnerofthe2014BupaHealthFoundationEmergingHealthResearcherAward,DrGregEbertfromtheWalterandElizaHallInstituteofMedicalResearch,isinvestigatingarevolutionarynewwaytotreatchronichepatitisBinfection,avirusthataffectsover200,000Australians.

DrEbertsays,“WewereveryexcitedthattherewerealreadydrugsinclinicaltrialsforcancertherapythatcouldalsobeeffectiveintreatingHepatitisBinfection.Werealisedthatthewaythesedrugsworkisverysimilartomechanismsthatcanactuallyeradicatethevirus.ThesedrugshavethepotentialtokillhepatitisBvirusinfectedlivercells,andimportantlywillnotharmuninfectedcells.”

ThisnovelapproachoferadicatingthehepatitisBvirusthroughkillinginfectedcellsisatotalshiftfromthecurrenttreatmentapproach,whichusesantiviralmedicationtostopthevirusmultiplyingasmuchaspossibletoreducetheriskofprogressiveliverdisease.

Havingshowntheconceptworksinthelab,DrEbertisnowtestinghowwellthedrugworksinpatientsacrossAustralia.

TheresultsofthisresearchcanpotentiallybenefitmillionsofpeopleacrosstheworldwhohavechronichepatitisBinfection.Inthefuture,otherchronicconditionssuchastuberculosismayalsobeabletobetreatedwithasimilarapproach.

DrEbertsayshisresearchisrewarding,“WhatIenjoymostaboutmyworkistheexperienceofseeinganideaevolveintoaclinicalapplicationwhichhasthepotentialtohelpmanypeoplebecomehealthierandachieveabetterqualityoflife.”

From strength to strength DrPriyaSumithranfromtheUniversityofMelbournewasthewinneroftheinauguralEmergingHealthResearcherAwardandherresearchintoweightlosscontinuestogainattention.

ShewontheAwardin2012forherresearchwhichshedlightontherolethatcertainbiologicalfactorsplayinweightlossanditsmaintenance.

Itturnsoutputtingweightbackonafterweightlossisnotjustaboutfallingbackintooldhabitsofdietandexercise.DrSumithranexplains,“Whenweloseweight,changesoccurinourhormonesthataffecthowhungryweareandhowwestorefat.Thesechangespersistforoneyearaftertheinitialweightloss.Thismeanstheworkofweightlossisnotoverwhenyoustopdieting.It’shardertokeepweightoffthanmostpeopleexpectbecauseyouneedtokeepvigilantaboutdietandexerciseatatimewhenyouactuallyfeelhungrier.”

Thishasimportantimplicationsfortheplanningandimplementationofsuccessfullong-termweightlossstrategiesandprogramsinAustralia.

PriyahasbuiltonthesefindingsandlastyearreceivedaBupaHealthFoundationHealthAwardtosupportherongoingresearchintowhetherit’spossibletopredictthelikelihoodofsuccessofaweightlossprogram.

Shesays,“Alldietsworktosomeextentintheshorttomediumterm.However,thereisalargevariabilityinhowindividualsrespondtoeachapproach.

“Withverylowenergydiets(VLED)commonlyusedundermedicalsupervision,somepeoplehavesustainedsuccessinlosingweight,somehaveearlysuccessbutthenputweightbackon.Othersjuststruggletoloseweightatall.”

Herresearchislookingatanumberofdifferentbiological,socialandpsychologicalfactorstoseeiftheycanfindawaytopredicthoweachpersonwillrespondtoaVLEDdiet.

Oncethestudyiscompleteditmayhelppractitionersandweightlossclinicstotargetandtailorinterventionstopatientstohelpensurethebestchancesofsuccess.

Rising stars of health research

Curiosityandcreativityarejustsomeofthequalitiesthatmakeoutstandinghealthresearchers.

TheBupaHealthFoundationEmergingHealthResearcherAwardcelebratesthosetalentedresearcherswho,atanearlystageoftheirresearchcareer,demonstratethepotentialtomakepivotalcontributionstohealthandwellnessinAustraliaandpotentiallyacrosstheworld.

Theawardbeganin2012torecognisethevaluablecontributionemergingresearchersmaketohelpingpeopleleadhealthierlives.Theworkofthefinalistsforthe2014awardcoveredadiverserangeofimportantareasinhealththathavepotentiallysignificantbenefitsforthecommunity.

Emerging health researcher award

2928

This year’s successful research

proposals from the annual

competitive funding process

reflect the increasing need for

cost-effective and innovative ways

to improve health outcomes.

We are very excited about these

opportunities to make a difference

to the health and wellbeing of

Australians.

Telemedicine: harnessing technology to manage diabetic foot ulcers in rural AustraliaTranslational research on endocrinology and Diabetes, James Cook University Associate Professor Usman Malabu

Informationtechnology(‘telemedicine’)willbeusedtohelpnursesmanagefootulcersinpeoplewithdiabeteslivinginremoteareasofAustralia.Footulcersareaseriouscomplicationofdiabetes,andpeopleinremoteareashavelimitedaccesstowoundcarespecialists.Ifthismodelissuccessful,androlledouttoruralfacilities,itwillprovidegreateraccesstospecialistwoundcare,andreducehospitalisationsandamputationsinpeoplewithdiabetes.

Brain imaging techniques could help guide treatment in people with dementiaCSIRO – Digital Productivity FlagshipAssociate Professor Stephen Rose

Thisstudywillinvestigatewhethermeasuringbrainactivityinpeoplewithearlydementiacanpredicttheirresponsetocholinesteraseinhibitors,medicinesthatmayenhancecognitivefunctionandstabilisememory.Imagingtechniques(PETandMRI)willbeusedtomeasuretheactivityofspecific(cholinergic)nervesinthebrain,tohelpdoctorsdecidewhethertoprescribethecholinesteraseinhibitors.ThisindividualisedtreatmentcouldimproveoutcomesforpeoplewithAlzheimer’sdisease.

An automated web-based screening system for eye diseasesCentre for Eye Research Australia, University of Melbourne Professor Mingguang He

Eyediseasessuchasglaucoma,retinadamagecausedbydiabetes,andage-relatedmaculardegeneration,causemorethan50%ofblindnessinAustralia.Thisprojectwilldeliveratechnology-driven,user-friendlyscreeningsystemtoidentifypeoplewiththeseconditions.Thesystemcanbeusedatoptometryordiabetesclinics,improvingaccess,reducingwaitingtimesandpotentiallyreducingvisionloss.

Clinical decision-making in the appropriate use of angiograms University of Melbourne Associate Professor Vijaya Sundararajan

Anangiogramisacommonprocedurerecommendedfordiagnosingheartattacks.However,researchsuggeststhatangiogramsarenotroutinelyusedforthispurpose.Thisstudywillinvestigatehowangiogramscouldbeusedmoreappropriatelyusingspecificpatientinformation(includingage,gender,riskfactorsandmedicalhistory)toimproveclinicaldecision-makingandpatientcare.

STEP: St Vincent’s Early mobilisation Pathway for hip and knee joint replacement surgeryUniversity of Melbourne Dr Trisha Peel

Theseresearcherswillconductaclinicaltrialcomparingtwodifferentcareplansinpeoplewhohavehadhiporkneejointreplacementsurgery.ThestudywillcomparethelengthoftimepatientsstayinhospitalaftersurgerywithanEarlyMobilisationPlancomparedwithStandardCare.Theresultswillhelptoimprovehealthoutcomes,andthestandardandcost-effectivenessofcareforthesepatients.

Bupa Health Foundation leadership

2015healthawardrecipients

Foundation Board

MrAndrewPeeler

MrJohnCondeAO

MrDeanHolden

MrRichardHumphryAO

MrTrevorMatthews

MrBryanMogridgeONZM

DrLisaO’Brien

MsNicolaRoxon

MsNicolaWakefieldEvans

Acknowledgements

OverthelastdecademanypeoplehavecontributedtothesuccessoftheFoundation.TwopeopleinparticularmadeasignificantcontributiontothegrowthoftheFoundationanditsattainmentofcategoryoneresearchfunderstatus.DrStanGoldstein,formerHeadofClinicalLeadershipandAdvisoryatBupaandamemberoftheFoundationSteeringCommitteeandMsSoniaDixon,formerExecutiveOfficeroftheBupaHealthFoundation.

FormerFoundationSteeringCommitteemember,HishamEl-Ansary,completed5yearsofmembershipandwethankhimforhiswisecounsel.

Foundation Management

AnnetteSchmiede,ExecutiveLeader

AlanaFisher,OperationsManager

PatriciaOliveira,AdministrationAssistant

Foundation Steering Committee

ProfessorChristineBennettAO(IndependentChair)

DrPaulBates,ChiefMedicalOfficer,BupaANZ

DieterLehmann,Director,CorporateAffairs,BupaANZ

JohnMoore,MarketingDirector,BupaANZ

DrDanielValleGracia,MedicalServicesDirector,BupaCareServices

3130

bupa.com.au/foundation