Optimisation Of Salmonella Genotyping And Epidemiological Data Analysis For Detection And Investigation Of Outbreaks
Funder
National Health and Medical Research Council
Funding Amount
$508,051.00
Summary
Bacteria known as salmonella are the most important causes of food-borne diarrhoeal disease. They occasionally cause potentially fatal septicaemia, especially in young children and people with underlying disease. We estimate that more than 80,000 cases of salmonella infection occur in Australia, each year, at a cost to the community of $37 million. Salmonella are divided into more than 2000 different types, but one - called Typhimurium - causes about 40% of infections and a few others cause most ....Bacteria known as salmonella are the most important causes of food-borne diarrhoeal disease. They occasionally cause potentially fatal septicaemia, especially in young children and people with underlying disease. We estimate that more than 80,000 cases of salmonella infection occur in Australia, each year, at a cost to the community of $37 million. Salmonella are divided into more than 2000 different types, but one - called Typhimurium - causes about 40% of infections and a few others cause most of the rest. This means that is difficult to distinguish cases of salmonella infection that have originated from one source (an outbreak) from cases that have originated from another. Without this information, is it hard to track the source, which is usually inadequately cooked meat or chicken another food that has been contaminated with salmonella after preparation. There are several existing methods for fingerprinting salmonella, but they are quite slow or do not distinguish different strains well enough to identify outbreaks quickly. This means that sources of contaminated food are often not identified in time to prevent more cases occurring. We aim to develop a faster and more discriminatory system for fingerprinting salmonella, based on novel technology that can identify many small genetic sequences that occur in different combinations in different strains. As well, we will develop electronic scanning tools that will link the fingerprints of the salmonella strains with information about the people infected with them, such as the types of food and places where they have eaten, to identify patterns or clusters that indicate a common source. The more rapidly this can be done the sooner the source of contaminated food can be found and eliminated and additional cases can be prevented. This has important implications for public health - it will increase food safety and reduce illness and economic loss.Read moreRead less
Genome-wide Expression Analysis In Advanced Gastric Cancer
Funder
National Health and Medical Research Council
Funding Amount
$326,761.00
Summary
Gastric cancer is the fourth ranked cancer by mortality in Australia. Therapy of gastric cancer is unsatisfactory for two reasons; firstly, how normal stomach cells become cancerous is not well defined. We know long-term infection with the bacteria Helicobacter can lead to these cancers, as can severe acid reflux. The cancers produced by these very different agents look remarkably similar, but must be arising through different pathways. Research to date has not yielded great insight. Secondly, e ....Gastric cancer is the fourth ranked cancer by mortality in Australia. Therapy of gastric cancer is unsatisfactory for two reasons; firstly, how normal stomach cells become cancerous is not well defined. We know long-term infection with the bacteria Helicobacter can lead to these cancers, as can severe acid reflux. The cancers produced by these very different agents look remarkably similar, but must be arising through different pathways. Research to date has not yielded great insight. Secondly, existing therapy, especially chemotherapy, tends to provide a Oone size fits all? solution. Whatever the cause, removal at surgery is the best option for treatment. After this, patients are often treated with chemotherapy. Although improvements in patient comfort have been made, very few patients are cured as a result of this treatment. We need more information with which to match the right patient with the right therapy. We will perform high-throughput analysis of comprehensive arrays of human genes that are affected in gastric cancer. Biopsies from cancerous and normal tissue will be obtained when patients have surgery. This tissue will have the RNA (the Omessage? from each gene) labelled with chemical tags and then applied to DNA Omicrochips?. Each microchip contains about 5000 gene targets; the RNA binds the matching DNA and produces a light reaction. We can read the light output from these 5000 (or more) signals, and perform complex statistical analysis on the results. This will result in several specific Ogene expression profiles? which we will analyse to see which profiles match each situation. Profiles matching reflux-induced cancer and Helicobacter-induced cancer can be compared. This will suggest what unique processes are occurring in the cancer cells. Profiles of patients responding well to therapy may allow the use of Otailor-made? therapy. In the future, insight into cancer pathways should also allow the design of new and more successful therapies.Read moreRead less
A Randomised Control Trial Of A Group-Based Intervention For Substance Abuse In Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,250.00
Summary
The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages ....The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages of their illness, and within a number of different treatment settings. The intervention will be informed by an enhanced understanding of the motivations for substance use in people with psychotic illnesses The specific aims are to: Refine, implement and evaluate, using a controlled experimental design, a novel group-based intervention for reducing substance abuse comorbidity in people with psychotic disorders; Determine reasons for substance use by these individuals, to inform the intervention procedures; Pilot the intervention in a series of different treatment settings, including early episode and rehabilitation programs, and non-government organisations dealing with people with psychotic disorders, to ensure generalisability, adaptability, and acceptability; Augment case managers' knowledge and skills in dealing with comorbid drug and alcohol use Enhance detection, motivation to change, ongoing monitoring and relapse prevention of substance misuse in clients with psychotic disorders. It will also be possible, once the treatment intervention is finalised and evaluated, to expand its use to patients with non-psychotic mental illnesses.Read moreRead less
Gabapentin In The Treatment Of Idiopathic Chronic Cough: A Randomised Double-blind Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$331,229.00
Summary
Better treatment approaches are needed to address the significant quality of life impairment associated with chronic cough. We propose to conduct a double-blind, placebo controlled study comparing the efficacy (and safety) of oral gabapentin therapy on cough reflex severity and cough-specific quality of life in people with idiopathic cough. The advantages are a strong design, use of objective assessment techniques, and investigation of a new treatment modality for cough.
Randomised Trial Of Homocysteine Lowering Treatment Of Depression In Later Life (B-VITAge)
Funder
National Health and Medical Research Council
Funding Amount
$775,530.00
Summary
The causes of depression in later life are varied and complex, but available evidence suggests that cardiovascular disease plays an important role. High homocysteine (a robust risk factor for myocardial infarction and strokes) accounts for about 20% of all cases of depression in older age. We have previously shown that treatment with vitamins B12, B6 and folate reduces homocysteine. We propose to run a trial to test if lowering homocysteine decreases the severity and prevalence of depression.
Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious ....Knee osteoarthritis (OA) affects about 30% of Australians over the age of 65, but also at younger ages. It causes joint pain and stiffness, especially on exercise. The cause is unknown but it results in loss of joint cartilage. There are few treatments available to stop the progression, which can finally result in need for an artificial joint. Most treatments such as paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) reduce pain but have no effect on cartilage. NSAIDs can have serious side effects such as stomach ulcers and increased cardiovascular events (such as heart attacks). Fish oil has possible benefits in OA as it decreases pain and inflammation in rheumatoid arthritis (RA, another type of arthritis with joint inflammation and swelling), less use of NSAID in patients with RA, and in laboratory experiments may reduce cartilage breakdown in OA. It is likely that fish oil will have few side effects and decrease blood cholesterol. Many people with OA are already taking fish oil, however, there is no studies to know if it is effective in OA. The aim of this proposal is to study the effect of fish oil on pain and progression of knee OA, by doing a randomised clinical trial. Participants with knee OA will be given either high dose fish oil or similar oil with low levels of fish oil. The study will run for 2 years and during that time, we will measure pain and blood levels of fatty acids (part of the fish oil) and cholesterol. At the beginning and end of the study, magnetic resonance imaging (MRI) of the knee, a knee xray, and bone density testing will be done. The outcomes of the study will be to determine if fish oil affects pain and function (measured by questionnaires) and progression of OA (measured by cartilage changes on MRI). If fish oil is shown to reduce pain and disability and cartilage loss in OA, it will provide Australians with OA an alternative treatment that is low in side effects with positive effects on cardiovascular disease.Read moreRead less
The AMAZES Study: Asthma And Macrolides: The AZithromycin Efficacy And Safety Study
Funder
National Health and Medical Research Council
Funding Amount
$3,157,566.00
Summary
Asthma is a health priority for Australia where better and new treatment approaches are needed. This project tests the benefit of a common antibiotic for use in asthma. We propose to conduct a large-scale, multicentre, double-blind, placebo controlled study comparing the efficacy (and safety) of the addition of oral low dose azithromycin to maintenance asthma therapy on the incidence of asthma exacerbations and clinical asthma status in participants with asthma.