Body Composition Changes In Cardiac Cachexia: Pathophysiology, Quantification And Approaches To Therapy
Funder
National Health and Medical Research Council
Funding Amount
$120,000.00
Summary
Cachexia is weight loss and weakness caused by disease, or as a side effect of illness. Congestive heart failure is a common cardiovascular condition that is accompanied by high mortality (up to 50% over 2 years) and considerable suffering. People with congestive heart failure often develop cachexia. This project will explore the mechanisms responsible for the development of cachexia using an animal model of cardiac cachexia that the researchers have developed. It will be complemented by an exam ....Cachexia is weight loss and weakness caused by disease, or as a side effect of illness. Congestive heart failure is a common cardiovascular condition that is accompanied by high mortality (up to 50% over 2 years) and considerable suffering. People with congestive heart failure often develop cachexia. This project will explore the mechanisms responsible for the development of cachexia using an animal model of cardiac cachexia that the researchers have developed. It will be complemented by an examination of the effects of exercise on measures of cachexia in patients with congestive heart failure. The researchers believe that this study will supply valuable new information about the development of cachexia and lead to new therapies for this syndrome.Read moreRead less
The Impact Of Hospital-based Aged Care And Dementia Services On Outcomes For People With Dementia Admitted To Hospital-a
Funder
National Health and Medical Research Council
Funding Amount
$1,308,580.00
Summary
This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence ....This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence that there are many hazards for people with dementia when they are hospitalized. The project will result in recommendations about the types of services and their features which produce better outcomes for people with dementia. Every stage of the research will be guided and informed by an Expert Panel comprising representatives of dementia service consumers, aged care providers, health service planning staff and key researchers. The Panel will provide contextual information about the service environment and how it affects people with dementia. Details of the patient's complete hospital stay can be investigated by linking existing administrative datasets. Data about hospital services will be gathered through a census of NSW hospitals, supplemented with in-depth interviews with key stakeholders and small group expert discussions with experts in each Area Health Service. The research team will also visit selected hospital sites. Multilevel modelling techniques will test for statistical associations between hospital based dementia services and care outcomes including admission rates to hospital, total length of hospital stay, mortality, admission rates to hospital, and the level of patient dependency on entry to residential aged care. The model will include the influence of regional variations in the provision of community aged care packages and residential aged care and the availability of informal care. The project will include a focus on the outcomes for people with co-morbidities and for people from different culturally and linguistically diverse backgrounds.Read moreRead less
Development Of National Protocols For The Detection Of Influenza A H5N1
Funder
National Health and Medical Research Council
Funding Amount
$248,229.00
Summary
This project will develop a best practice approach to the diagnosis of influenza A H5N1 (Bird Flu) in Australian public health laboratories. Tests such as reverse transcription polymerase chain reaction (RT-PCR) are in use globally for influenza A H5N1 detection. Some proprietary rapid influenza A tests also claim to detect influenza A H5N1. However there is little information on systematic evaluation of these, largely because there have been relatively few human influenza A H5N1 cases and patie ....This project will develop a best practice approach to the diagnosis of influenza A H5N1 (Bird Flu) in Australian public health laboratories. Tests such as reverse transcription polymerase chain reaction (RT-PCR) are in use globally for influenza A H5N1 detection. Some proprietary rapid influenza A tests also claim to detect influenza A H5N1. However there is little information on systematic evaluation of these, largely because there have been relatively few human influenza A H5N1 cases and patient specimens. Australian laboratories need authoritative guidelines as to optimal influenza tests, target genes and reagents. Development of a simple, potentially automated type specific test for influenza A H5N1 antibody such as enzyme immunoassay (EIA) is also desirable, as widely used tests cannot distinguish between infection with H5 or other influenza types. Reference methods such as haemagglutination inhibition (HAI) are cumbersome. In this project mock specimens for virus and antibody detection will be created using viral cell culture and infected chicken derived influenza A H5N1. This will be undertaken in physical containment level 4 (PC4) facilities in Australia's designated human and animal PC4 laboratories. This material will be used for (i) specimen panels to compare the performance of candidate laboratory tests (ii) positive control material in all tests undertaken and (iii) quality assurance exercises to ensure high standards of testing. Using these panels the group will assess influenza H5N1 RT-PCR, tests for detection of influenza proteins including immunofluorescence, and rapid point of care influenza A detection tests available in Australia. An EIA method currently used to detect influenza antibodies from different animal species will be refined to develop a simple test for type specific detection influenza A H5N1 antibodies, and subsequently evaluated using animal sera. A standard method for HAI reference serology for use in public health laboratories will also be recommended, and the best approaches to high throughput automated RT-PCR, and performing RT-PCR in the field on portable instrumentation will be explored. Recommendations for standard protocols for influenza A H5N1 will be developed and will submitted for review and endorsement by Commonwealth ministerial advisory committees.Read moreRead less
Research & Training To Reduce Morbidity & Mortality From Malaria In Papua ( Indonesia)& Papua New Guinea
Funder
National Health and Medical Research Council
Funding Amount
$1,649,828.00
Summary
Malaria kills many thousands of people each year in Indonesia and PNG. This project will look at better ways to treat and prevent malaria. The team will examine whether using new combinations of drugs in clinics can reduce the amount of severe malaria seen in Papua. The team will examine whether giving people with severe malaria arginine, a naturally occurring amino acid, can increase molecules that may protect against severe malaria. Finally it will examine how lung damage occurs in people with ....Malaria kills many thousands of people each year in Indonesia and PNG. This project will look at better ways to treat and prevent malaria. The team will examine whether using new combinations of drugs in clinics can reduce the amount of severe malaria seen in Papua. The team will examine whether giving people with severe malaria arginine, a naturally occurring amino acid, can increase molecules that may protect against severe malaria. Finally it will examine how lung damage occurs in people with severe malaria and whether this can be predicted.Read moreRead less
Palliative Care For Aboriginal And Torres Strait Islander People With End-stage Renal Disease: An Action Research Initiati
Funder
National Health and Medical Research Council
Funding Amount
$295,554.00
Summary
There are significant gaps in current knowledge for providing culturally appropriate and effective palliative care for Aboriginal and Torres Strait Islander people with kidney failure. This project will consider these issues in partnership with the Kowanyama Community and the associated key Aboriginal and Torres Strait Islander and other agencies. Echoing the recommendations by the �National Indigenous Palliative Care Needs Study� this study will address the absence of a culturally appropriate m ....There are significant gaps in current knowledge for providing culturally appropriate and effective palliative care for Aboriginal and Torres Strait Islander people with kidney failure. This project will consider these issues in partnership with the Kowanyama Community and the associated key Aboriginal and Torres Strait Islander and other agencies. Echoing the recommendations by the �National Indigenous Palliative Care Needs Study� this study will address the absence of a culturally appropriate model of care pathway for Aboriginal and Torres Strait Islander people with advanced kidney failure to make effective informed choices for palliative care. Through the use of action research methodology this study will engage with Aboriginal and Torres Strait Islander people to consider these issues, taking into consideration their cultural, spiritual and social needs, those of their family, carers, healthcare personnel and the wider community. Subject to discussions and input from the Aboriginal and Torres Strait Islander people and other key stakeholders it is anticipated that the key areas of interest will focus on spirituality, quality of life, role of the family, carer and community, understandings and experience of kidney failure, treatment options, patient advocacy systems, the need for relocation, and the potential role of advanced care planning. Intervention strategies will also be conducted and evaluated. Subject to discussions and input from the Aboriginal and Torres Strait Islander participants and other key stakeholders it is anticipated that these will focus on a community based education program, development of a culturally appropriate quality of life questionnaire, development and piloting of a culturally appropriate mechanism for people to consider advanced care planning and development and piloting of a patient advocacy process for those from remote areas visiting metropolitan renal - palliative care health services.Read moreRead less
Detection And Management Of Depression In General Practice Patients With Chronic Manifestations Of Ischaemic Heart Disea
Funder
National Health and Medical Research Council
Funding Amount
$499,797.00
Summary
This research will investigate the impact of ischemic heart disease on the prevalence and severity of patients with depression. This will be done via a 12 month general practice based program of 1) systematic screening for depression 2) informing general practitioners of best-practice guidelines for management of depression in these patients, and 3) providing the treating general practitioner with patient-specific, psychiatric advice.
Oxygen To Relieve Dyspnoea In Non-hypoxaemic Patients With End-stage Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$445,658.00
Summary
Chronic heart failure is a cause of suffering and a major cause of death in the Australian community. Patients who have chronic heart failure suffer from a range of symptoms that severely impacts every aspect of their life. One of the most common and distressing symptoms is breathlessness. As people with heart failure near death, their breathlessness may worsen not only in terms of its frequency, but also in its intensity. This worsening of symptoms is a source of great distress, both to patient ....Chronic heart failure is a cause of suffering and a major cause of death in the Australian community. Patients who have chronic heart failure suffer from a range of symptoms that severely impacts every aspect of their life. One of the most common and distressing symptoms is breathlessness. As people with heart failure near death, their breathlessness may worsen not only in terms of its frequency, but also in its intensity. This worsening of symptoms is a source of great distress, both to patients as well as their carers and family. Breathlessness is also the most common cause of admission to hospital for patients. A key strategy for managing this distressing symptom in the home is the supply of oxygen. However, due to a lack of scientific evidence for the benefit of home oxygen for people with heart failure, who do not necessarily have low levels of oxygen, it is very difficult for clinicians to access this therapy for their patients. This study seeks to assess if a specific breathlessness action plan alone or if the addition of either oxygen or air can relieve this distressing symptom. The scientific evaluation of these strategies will assist in improving the palliative care of people with chronic heart failure.Read moreRead less
Which Heart Failure Intervention Is Most Cost-effective And Consumer Friendly In Reducing Hospital Care: The Which
Funder
National Health and Medical Research Council
Funding Amount
$921,640.00
Summary
Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. ....Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. We confirmed the results of pioneering Australian research that CHF-MPs dramatically improve health outcomes in CHF. CHF-MPs now form part of the recommended gold-standard management of CHF. However, we also have evidence that only a small proportion of patients are exposed to a CHF-MP in Australia. Residual issues such as consumer preference and the cost of applying these programs are hindering their wide-spread application. The WHICH? Study addresses this _road block� to implementing a potentially valuable health care service by tackling a number of critical issues: which form of CHF-MP (home or specialist clinic-based follow-up), will produce the best health outcomes, save the most money and meet the needs of consumers at the same time? To answer this question, we will undertake a randomised, head-to-head study of a home versus clinic-based CHF-MP, in 1000 recently hospitalised CHF patients recruited from SA, VIC, NSW and QLD. Patterns and of health care and consumer preferences and quality of life will then be compared for these two different forms of CHF-MP from a combined health economic, health policy and consumer perspective to determine the best form of CHF-MP to be applied. A _consensus� vision for applying an Australia-wide service will then be developed. The potential impact of the results of the study will then be modelled on the status of Australian CHF-MPs in the year 2010 and a blue-print for action devised.Read moreRead less