We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other co ....We will conduct a survey of respiratory symptoms, lung function, smoking status, occupational exposures, and other risk factors among 3200 people aged 40 years and over living in five Australian communities: Melbourne, Sydney, Tasmania, Busselton (WA), and the Kimberley region (WA). In the Kimberley we will survey 400 Aboriginal people and 400 non-Aboriginal people. We will use a survey methodology that has been developed by an international expert panel and has been implemented in many other countries (in North and South America, Asia, and Europe). This study will provide the first nationally-representative information on the burden of chronic obstructive pulmonary disease (COPD) and the opportunities for health gain by improving the management of this illness. In Australia, COPD is a relatively silent and under-recognised disease but nevertheless is the third most important contributor to the burden of disease and the third leading cause of hospital admission as well as being the underlying cause of 4.2% of all deaths. The information we will collect is needed to form a basis for prevention and disease management interventions to reduce the burden of COPD, particularly among population sub-groups who are disproportionately affected, either due to greater exposure to risk factors (mainly tobacco smoking and occupation), greater susceptibility, under-recognition and under-diagnosis, or inadequate disease management. Importantly, the study will serve to raise awareness about the hazards of smoking for all Australians. By identifying target groups, prevalent exposures and management deficiencies, it will lead the way towards policy-relevant randomised controlled trials testing community-based interventions to prevent COPD and-or manage it more effectively. The information collected will help advance knowledge of the prevalence, burden and treatment of COPD that will be relevant to communities throughout the world.Read moreRead less
Studies On The Effects Of Endogenous And Exogenous Opioids In Modulating Exercise-induced Dyspnoea In People With Moderate / Severe Chronic Obstructive Pulmonary Disease (COPD). Two Double-blind Randomised, Placebo Controlled Trials.
Funder
National Health and Medical Research Council
Funding Amount
$197,086.00
Summary
There is evidence that morphine-like chemicals made by the body itself help reduce breathlessness. It is not clear whether this response is because of the effects of these morphine-like chemicals on the brain, in the lung or both. This study will help understand where these chemicals act to reduce breathlessness in people with emphysema during exercise. Subsequently, it will also help to understand whether small, regular doses of morphine safely further reduce breathlessness during exercise.
An Integrated Health-sector Strategy To Combat COPD And Asthma In Vietnam: A Pragmatic Stepped Intervention Cluster Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,894,349.00
Summary
Chronic lung diseases are a major challenge for resource limited settings. In Vietnam, where smoking rates in males are around 50%, there is an urgent need for better strategies to prevent and treat chronic obstructive pulmonary disease (COPD) and asthma. We will perform a study of a low-cost integrated intervention including a health-system based smoking cessation program and the targeted use of proven therapy for COPD and asthma - inhaled corticosteroids - to reduce the burden of lung disease.
Translating Respiratory And Environmental Epidemiology Into Improved Lung Health
Funder
National Health and Medical Research Council
Funding Amount
$319,714.00
Summary
Chronic respiratory disease, tuberculosis and the effects of air pollution are important health problems globally. Evaluating current approaches to dealing with these problems and developing new approaches requires good data. Over the next five years I will lead a number of studies addressing these issues, in Australia and internationally, in order to provided the strongest possible evidence to underpin policy.
FUNCTIONAL IMAGING OF THE BRAINSTEM AND CORTICAL SITES OF BLOOD PRESSURE CONTROL IN HUMAN SUBJECTS IN HEALTH AND DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$398,498.00
Summary
Disturbances in cardiovascular control underpin many diseases yet little is known about how the brain controls the heart and blood vessels. This project uses brain imaging (fMRI) and concurrent nerve recording in awake human subjects to increase our understanding of how normal blood pressure is maintained and how different disease states influence this control.
Lung disease is a major cause of death and disability world-wide. Tuberculosis was responsible for 1.4 million deaths in 2011. Asthma and chronic obstructive pulmonary disease (COPD) have been high priority diseases in Australia for many years. It was estimated that there were over 3 million deaths attributable to particulate air pollution in 2010. In this Fellowship I will undertake a series of projects designed to improve our understanding of these diseases and their causes.
A Cluster Randomised Controlled Trial Of Nurse And General Practitioner Partnership For Care Of COPD
Funder
National Health and Medical Research Council
Funding Amount
$449,377.00
Summary
Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD w ....Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD were published in 2003 but these need to be implemented in the community. General practice is well placed to have a key role in early intervention and evidence based management of COPD. There is evidence that specialised nurses working in collaboration with GPs can improve the care the chronic illnesses including COPD. Care Plans with input from health professionals from a range of disciplines have been recommended for COPD but there are barriers to implementing these in general practice. This project brings together nurse assistance and care planning in a model of care designed to deliver best practice management of COPD in the community. The aim of this research is to evaluate the impact of anurse and GP partnership for care of COPD. We will examine the effect on quality of care and health outcomes at 6 and 12 months follow up. Our hypothesis is that the use of a nurse to work as a team with the patient and GP to develop and implement a care plan based on clinical practice guidelines will improve the quality of care received and have a beneficial effect on the patients' respiratory and overall health. This research will be of major significance for improving COPD care in the community and will have far reaching implications for both policy and practice. It will also define a new role for nurses and GPs working in partnership.Read moreRead less