Mechanisms Of Bone Formation At The Device/tissue Interface: Role Of Biomaterial Surface Chemistry Modification
Funder
National Health and Medical Research Council
Funding Amount
$489,375.00
Summary
In 1992 300,000 prosthetic devices, artificial hips and knees were implanted into patients in a global market worth $2.1 billion. Growth in this field of medicine has been exceptional with now more than 1 million implants carried out each year. In 1998-99, 38,512 artificial hips and knees were implanted in Australia alone, with approximately 10% of these replacing older, failed implants. Since joint replacements provide great benefits for the patient considerable health funding is required for j ....In 1992 300,000 prosthetic devices, artificial hips and knees were implanted into patients in a global market worth $2.1 billion. Growth in this field of medicine has been exceptional with now more than 1 million implants carried out each year. In 1998-99, 38,512 artificial hips and knees were implanted in Australia alone, with approximately 10% of these replacing older, failed implants. Since joint replacements provide great benefits for the patient considerable health funding is required for joint replacements. However, failure of the implants is a major concern to the patient and financially to our health system, especially with the ever increasing life expectancy of our population. The long-and short-term success of an implant depends on the healthy support of the surrounding bone. This study aims to find ways of improving the attachment of healthy bone to the implant by modifying the surface characteristics of the implant. We will modify the surface chemistry of biomaterials with divalent cations, such as magnesium, which is known to play a critical role in bone remodelling and skeletal development. Our goal is to improve the formation of healthy bone that will promote a rapid and permanent fixation of implant into skeletons. This study goes further to study the factors, inside the cell, on the cell surface and secreted by the cell, which promote this attachment. Once these factors are identified, it should be possible to alter implant surfaces in ways to improve stability. In this proposal we will use novel bioceramic coatings and ion beam technologies. This study will not only improve our understanding of the interactions of bone and implant but also identify ways of improving implants to benefit the patient's quality of life and reduce costs in this important heath areaRead moreRead less
At present the failure rate of joint replacement is unacceptably high and will continue to rise due to the ageing and active life styles of the baby-boomer generation, placing an increasing burden on the health budget. We have developed a new bioactive material with improved mechanical-biological properties for bone regeneration. We will modify the surface of the currently used orthopaedic implants with this bioactive material to promote permanent fixation of the prosthesis to the bone.
Assessing The Health Needs Of Older Indigenous Australians Living In The Kimberley
Funder
National Health and Medical Research Council
Funding Amount
$242,000.00
Summary
This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expend ....This study was designed to address the need for accurate assessment of the health care needs of older Indigenous people, particularly in remote regions of Australia. Indigenous people have higher rates of premature chronic medical illness, and there is substantial evidence that chronic functional disorders start at younger ages in this population. Common conditions of older age, such as dementia, falls and incontinence, are associated with substantial morbidity, disability and health care expenditure; yet, little is known about the extent of these problems amongst Indigenous Australians. This study builds on a successful project conducted in the Kimberley in 2003 that was designed with the aim of developing and validating a screening instrument for the assessment of dementia amongst Indigenous people. The present project proposes to expand the scope of our previous work to include the assessment of other common conditions associated with older age, such as depression, incontinence and falls and determine use of health services and potential impediments to their access.Read moreRead less
A Longitudinal Population Based Study Of Alzheimer's Disease: Prescription Drug Use And Survival
Funder
National Health and Medical Research Council
Funding Amount
$186,353.00
Summary
Population linked health data (2002-2009) will be used to study patterns of care and outcomes for people with Alzheimer's disease. Use of prescription drugs to treat Alzheimer's disease, the survival experience from time of first supply of Alzheimer medication and the identification of inequalities in accessing medications will be examined. The research will provide critical data for strategic sustainable healthcare planning and assist in the development of dementia-specific healthcare policies.
Health Outcomes Of Older Indigenous Australians- A 5 Year Follow Up Study Of A Population At Risk
Funder
National Health and Medical Research Council
Funding Amount
$833,759.00
Summary
The health of Indigenous people is poor and a number of risk factors contribute to lower life expectancy and the development of 'aged care syndromes' such as falls, incontinence, and dementia at a younger age. The research team has described high levels of dementia in a population survey completed in 2005 on 363 older people from the Kimberley. This population will be re-surveyed to document ageing syndromes and determine factors that may improve health for this population at risk
Peptides Bound To Commonly Used Orthopaedic And Dental Biomaterials:In Vitro And In Vivo Effect On Osteogenesis.
Funder
National Health and Medical Research Council
Funding Amount
$273,428.00
Summary
In 1992, the orthopaedics industry fitted some 300,000 prosthetic devices, artificial hips, knees, giving this industry a global market of $2.1 billion with a projected market growth exceeding 10% per annum. In (1994-5) 5,717 prosthetic hips and 4,593 knees were surgically implanted in NSW of which 14% of hips and 9.5% of knees were revisions. Considerable health funding is allocated to joint replacement for the nation, although successful, outcomes are finite. Importantly, and aside from costs, ....In 1992, the orthopaedics industry fitted some 300,000 prosthetic devices, artificial hips, knees, giving this industry a global market of $2.1 billion with a projected market growth exceeding 10% per annum. In (1994-5) 5,717 prosthetic hips and 4,593 knees were surgically implanted in NSW of which 14% of hips and 9.5% of knees were revisions. Considerable health funding is allocated to joint replacement for the nation, although successful, outcomes are finite. Importantly, and aside from costs, patients morbidity is high. The major cause of long-term failure of these prosthetic replacements is aseptic loosening, the result of bone loss at the bone-device interface. Novel approaches to development of more efficient implant materials would ultimately lead to major contributions to the mobility and and quality of life for these patients. Considerable effort has been devoted to alter surface characteristics of orthopaedic implants to improve the interlocking of device and skeleton. We were the first to demonstrate that surface chemical modification of biomaterials using selected ions resulted in an enhanced bone formation. This proposal is aimed at chemically modifying the surfaces of commonly used orthopaedic and dental materials, to improve the biocompatibility of new devices and the surface coatings for existing prostheses. Furthermore, this application will build on the in vitro data showing that particular peptides specifically bind osteoblasts and therefore have the potential to provide a surface on a prosthesis that is conducive to bone formation. To date, we have coupled these peptides to metallic surfaces and will proceed to study the osteoblastic phenotype and subsequent osteogenesis. Development of these novel biocompatible surfaces is anticipated to reduce patient morbidity and result in significant health care savings.Read moreRead less
A Randomised Controlled Trial Of Personalised Goal-directed Activity To Treat Agitation In Dementia
Funder
National Health and Medical Research Council
Funding Amount
$310,077.00
Summary
We will test by means of a randomised controlled trial the effectiveness of personalised, goal-directed activities in reducing agitated behaviour in aged care residents with dementia. Evidence suggests that treatments work best when adapted to people's interest, skills and backgrounds. Our activities require no special equipment and there is no need to exclude people with limited language skills. The study will be controlled to ensure that benefits are not due just to social interaction.
Sydney Multisite Intervention Of LaughterBosses And ElderClowns (SMILE): An RCT Of Humour Therapy In Residential Care
Funder
National Health and Medical Research Council
Funding Amount
$852,237.00
Summary
Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) is a trial of humour therapy. About 400 residents from 36 hostels and nursing homes will be randomly assigned to receive the SMILE treatment or usual care. ElderClowns will visit weekly, and staff volunteers will be trained to be LaughterBosses and bring humour to daily care routines. SMILE will evaluate whether humour therapy improves resident quality-of-life and mood, and reduces staff burnout and turnover.
Insight And Cognitive Decline In Older Adults With Mild Cognitive Impairment
Funder
National Health and Medical Research Council
Funding Amount
$399,600.00
Summary
Australia's population is aging rapidly and so is the frequency of age-related disorders. Dementia is one of the most frequent mental health disorders and one of the leading causes of years of life lost due to disability in Australia. Therefore it is important to be able to identify older adults at high risk of developing dementia in order to be able to introduce preventative strategies. One important risk factor for cognitive decline is the presence of mild cognitive impairment (MCI) in older a ....Australia's population is aging rapidly and so is the frequency of age-related disorders. Dementia is one of the most frequent mental health disorders and one of the leading causes of years of life lost due to disability in Australia. Therefore it is important to be able to identify older adults at high risk of developing dementia in order to be able to introduce preventative strategies. One important risk factor for cognitive decline is the presence of mild cognitive impairment (MCI) in older adults who complain about memory problems. However many subjects with MCI do not develop dementia and it remains a challenge to identify those with pre-dementia amongst those with MCI. The purpose of this study is to investigate whether reduced awareness of cognitive impairment is a better predictor of cognitive decline and dementia than having memory complaints . To investigate the association of reduced awareness and cognitive decline, 80 participants with MCI and 80 healthy controls will be followed over a period of 24 months. Awareness will be measured and compared to information on cognitive and functional impairment given by the participant and an informant. Additionally, information from neuroimaging and laboratory studies will be collected to determine it's interaction with reduced awareness.Read moreRead less
A Randomised Clinical Trial Of Physical Activity For The Treatment Of Older Adults With Mild Cognitive Impairment
Funder
National Health and Medical Research Council
Funding Amount
$280,250.00
Summary
Australia's population is aging rapidly and so is the frequency of age-related diseases. Dementia and depression are the most frequent mental health disorders of older people. They are also the leading causes of years of life lost due to disability in Australia. The results of recent studies have shown that memory difficulties and dementia are associated with potentially modifiable risk factors, such as physical activity. The purpose of this study is to investigate whether a physical activity pr ....Australia's population is aging rapidly and so is the frequency of age-related diseases. Dementia and depression are the most frequent mental health disorders of older people. They are also the leading causes of years of life lost due to disability in Australia. The results of recent studies have shown that memory difficulties and dementia are associated with potentially modifiable risk factors, such as physical activity. The purpose of this study is to investigate whether a physical activity program for older adults decreases cognitive decline and conversion to dementia in a population at risk: mild cognitive impairment (MCI). 168 subjects with MCI will be randomised (by chance, like the flip of a coin) to either the intervention program of physical activity or usual care - their cognitive (such as memory) performance will be compared at the end of 24 months.Read moreRead less