STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less
Functional Contribution Of Fetal Microchimeric Cells In Transgenic Models Of Maternal Tissue Repair In And After Pregnancy
Funder
National Health and Medical Research Council
Funding Amount
$542,462.00
Summary
Fetal stem cells cross into the mother during pregnancy and persist lifelong in her tissues. To determine whether helpful or harmful, we will study how these cells contribute to healing both after acute injury and in chronic genetic models like brittle-bone disease and muscular dystrophy. This research will inform long-term consequences of pregnancy, important for women's health and longevity, and help develop a promising form of stem cell therapy.
Using Conversational Computer Technology To Improve Diabetes Management: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$708,606.00
Summary
The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for a ....The diabetes epidemic is a growing challenge for the Australian health care system with over 1 million Australians living with diabetes. The impact on individuals' lives and the whole of Australian society is very substantial indeed. There is very good evidence that this impact would be reduced by developing new approaches to manage the disease and facilitate improved self-management. Recent developments in information and communications technologies offer some promising new ways and tools for achieving this. This research will evaluate a computer-controlled, interactive telephone system for improving the management and self-management of Type 2 diabetes in addition to routine care. Patients with Type 2 diabetes will be recruited from Brisbane and each patient will be randomly assigned to receive either this new program or just their usual care from their doctor or Diabetes Clinic. The first group will call the system weekly for six months using a regular phone or a mobile phone if they wish. During the call, they will answer questions by speaking into the phone, listen to feedback and strategies for improving management of their diabetes and then discuss their next targets and behavioural actions. They will receive systematic and tailored advice on blood glucose testing, nutrition and physical activity, as well as medication taking and foot care. The system individualises conversations according to the user s answers and responses over all the interactive sessions. The trial will formally evaluate the clinical impact on blood glucose control and the adoption and maintenance of the targeted health habits, as well as the intervention s cost-effectiveness and users satisfaction with the system. This project s significance lies in the excellent potential of using this new technology to provide a 'low cost' but effective program to help people better manage Type 2 diabetes.Read moreRead less