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Equitable Access To Stuttering Treatments: Developing Distance And Self Managed Treatment Models
Funder
National Health and Medical Research Council
Funding Amount
$4,321,062.00
Summary
The development of normal verbal communication is of the utmost importance to human health. Stuttering is a prevalent disorder that severely interferes with communication. It can be disfiguring and typically causes speech related social anxiety. Social phobia is present in around half of adults affected. It prevents attainment of occupational potential and children who stutter are typically teased and bullied at school. For the past decade NHMRC Project funding has enabled the present team to co ....The development of normal verbal communication is of the utmost importance to human health. Stuttering is a prevalent disorder that severely interferes with communication. It can be disfiguring and typically causes speech related social anxiety. Social phobia is present in around half of adults affected. It prevents attainment of occupational potential and children who stutter are typically teased and bullied at school. For the past decade NHMRC Project funding has enabled the present team to conduct world class basic research and clinical trials in stuttering. Significant gains have resulted from that research, in particular the development of treatments across the age groups that have a significant evidence base. However, it is becoming increasingly clear that there are serious barriers to the implementation of these evidence based treatments, and innovative treatment developments are needed to address this. In particular, speech pathology services for rural and remotely located patients and their families are incompletely funded, and even in urban settings workplace restrictions have resulted in speech pathologists delivering incomplete and piecemeal treatments. The program of research will develop the following innovative treatment models to solve this problem: �Distance intervention models for the delivery of speech pathology services to rural patients and their families and others who are isolated from treatment services. �Self-managed treatment models for children and adults who stutter, including procedures to minimise the ubiquitous problem of relapse in adults. It is widely understood that social anxiety is a significant problem for many stutterers and research is urgently needed to establish the extent of social anxiety in stutterers across the age groups and its negative effects on treatment effectiveness. Thus, a further aim of this program of research is to: �Identify those patients for whom social anxiety is likely to constitute a barrier to successful treatment. �Develop supplementary interventions to meet the needs of those socially anxious patients. The cause of stuttering is unknown. Understanding the mechanisms underpinning effective behavioural treatments would contribute to understanding causal factors in stuttering. Thus, this program of research also aims to: �Establish why behavioural treatments work, thereby generating new knowledge about causal factors.Read moreRead less
New Evidence To Guide Decisions About The Prevention And Treatment Of Common Cardiovascular Diseases.
Funder
National Health and Medical Research Council
Funding Amount
$7,309,675.00
Summary
The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large ....The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large numbers of premature deaths and serious disabling outcomes. This Program of research seeks to provide new information that will give patients, doctors and policy makers innovative options for the treatment and prevention of heart attack and stroke. The Program will incorporate two main elements: observational studies and randomised controlled trials. The observational studies will establish the precise importance of each of the main causes of cardiovascular diseases (such as diabetes, blood pressure, smoking and cholesterol) at different ages, in different ethnic groups and in different geographic regions. Furthermore, these studies will also define the relative importance of established and novel risk factors for cardiovascular disease, providing important new information about how resources for prevention should be directed. The large-scale trials will provide evidence about the effectiveness and safety of a range of new cardiovascular disease prevention and treatment strategies. The work will build on the team�s very successful approach of evaluating the effects of established interventions in high-risk groups for whom those particular treatments are not currently indicated.The Program will also include studies that address the critical issue of translating health research findings into practice _ in terms of health policy, clinical practice and consumer behaviour. A particular focus involves the application and evaluation of novel Internet technologies for promoting best practice. The methodologies used by the team will ensure that the evidence generated by the Program is as precise and reliable as possible, in order to provide a sound base to guide decisions about changes in health care policy and practice. The research findings will have direct relevance to the healthcare needs of millions of Australians within the next five years, and the impact of the work will be assured by the development of implementation and dissemination plans for each major component of the Program.Read moreRead less
Antibodies are made by B-cells and are essential for a functional immune system. B cells circulate in the body, and, when they encounter an invader, they mature into antibody-producing cells (ASC). A small proportion of the cells become “memory” cells with the potential to become ASC should the same infection occur in the future. This is the basis of vaccination. This program aims to understand how a B cell changes into an ASC. We aim eventually to be able to improve vaccines and understand dise ....Antibodies are made by B-cells and are essential for a functional immune system. B cells circulate in the body, and, when they encounter an invader, they mature into antibody-producing cells (ASC). A small proportion of the cells become “memory” cells with the potential to become ASC should the same infection occur in the future. This is the basis of vaccination. This program aims to understand how a B cell changes into an ASC. We aim eventually to be able to improve vaccines and understand diseases such as allergy, lupus, arthritis and leukaemia to develop novel therapies.Read moreRead less
This Program Grant investigates a number of important reproductive problems that affect the fertility of men, prostate cancer and the way the mother nurtures and protects the baby during pregnancy. The successful development of sperm requires the proper function of a number of biological processes. This grant investigates the way in which sperm are produced, the genes that are needed to control their development, and the way sperm propel themselves and fertilize the egg. The research also invest ....This Program Grant investigates a number of important reproductive problems that affect the fertility of men, prostate cancer and the way the mother nurtures and protects the baby during pregnancy. The successful development of sperm requires the proper function of a number of biological processes. This grant investigates the way in which sperm are produced, the genes that are needed to control their development, and the way sperm propel themselves and fertilize the egg. The research also investigates how sperm are protected during their development from infection and immunological rejection, achieved in part by a special environment within the tubes in the testis where they grow. It appears that the general mechanisms that the body uses to combat infections are modified within the testis and the way in which this occurs may provide clues that could be applied to prevent the rejection of transplanted organs in general. Some of the substances that control these processes appear to play an important role in the body�s defense against infection. The grant also investigates the processes that are involved in the development of prostate cancer. These changes can occur over many years and the grant will study some substances that appear to be involved. The work will provide new knowledge that may assist in new tests to identify whether a cancer is slow or fast growing, thereby helping each man to decide the most sensible form of treatment. The grant will investigate how a group of proteins, that also are involved in the control of processes discussed above, assist the mother in protecting her baby during pregnancy. The outcomes will assist in the management of disturbances of pregnancy that may put the fetus at risk of survival.Read moreRead less
MOLECULAR AND CELLULAR PATHOGENESIS OF HUMAN LIVER DISEASE
Funder
National Health and Medical Research Council
Funding Amount
$4,928,323.00
Summary
n humans, chronic liver diseases cause cirrhosis of the liver in some but not all individuals. This leads to protracted ill-health, complications (fluid retention in the abdomen, confusion, bloodstream infections, kidney failure, liver cancer) resulting in hospitalisation, liver transplantation and premature death. In Australia, cirrhosis is an important cause of death and of years of potential life lost, while liver cancer has recently doubled and is predicted to treble by 2020. The common caus ....n humans, chronic liver diseases cause cirrhosis of the liver in some but not all individuals. This leads to protracted ill-health, complications (fluid retention in the abdomen, confusion, bloodstream infections, kidney failure, liver cancer) resulting in hospitalisation, liver transplantation and premature death. In Australia, cirrhosis is an important cause of death and of years of potential life lost, while liver cancer has recently doubled and is predicted to treble by 2020. The common causes are hepatitis C, fatty liver disorders, alcohol and hepatitis B; when 2 of these are present together, there is a higher risk of cirrhosis. This program aims to unravel the pathological processes which cause cirrhosis at the molecular and cellular levels, in order to understand why some people are at higher risk. These processes could result from genetic predisposition, other constitutional factors (age, gender) or from lifestyle factors (overnutrition, inactivity, alcohol). The 3 chief investigators from Westmead s Millennium Institute and the Centenary Institute of Royal Prince Alfred Hospital are international experts in hepatitis C, non-alcoholic steatohepatitis (NASH) and other fatty liver disorders, autoimmune hepatitis, liver transplantation, and scarring processes that lead to cirrhosis of the liver. The new knowledge that will result from these studies will be used to help prevent people developing severe forms of chronic liver disease, and for treating cirrhosis if it has already occurred.Read moreRead less
Regulation Of Bone Resorption And Formation In Health And Disease
Funder
National Health and Medical Research Council
Funding Amount
$5,596,183.00
Summary
Bone is continually being formed and broken down, and these two processes are critical forthe maintenance of a normal skeleton. These processes are dependent upon communication between the bone building and degrading cells, and the hormones growth factors and cytokines that are present in the circulation or produced in bone. The tightly regulated processes of bone formation and degradation need to remain equal, and are essential for the achievement and maintenance of skeletal strength and form. ....Bone is continually being formed and broken down, and these two processes are critical forthe maintenance of a normal skeleton. These processes are dependent upon communication between the bone building and degrading cells, and the hormones growth factors and cytokines that are present in the circulation or produced in bone. The tightly regulated processes of bone formation and degradation need to remain equal, and are essential for the achievement and maintenance of skeletal strength and form. Osteoporosis results from an excess of bone breakdown over formation, and our Program aims to identify the factors that regulate these processes, and develop new therapies that can modify them. We will also determine what it is about bone cell properties that make some cancers, especially those of breast and prostate, particularly prone to spread to bone.Read moreRead less
To understand the genetic basis of two of the most important cancers in women, breast and ovarian cancer. The team has already identified one gene that confers a very high risk of breast cancer and may account for a large proportion of 'familial' breast cancer. Their aim is to identify additional predisposition genes and to determine their normal function in the cell, as well as the way in which they contribute to the development of cancer
Determinants Of Child Health And Development: Populations, Partnerships, Pathways And Prevention
Funder
National Health and Medical Research Council
Funding Amount
$8,214,333.00
Summary
There are considerable challenges to the study of complex health and developmental problems in children and young people. Despite increasing prosperity in Australia, many of these problems are not abating and some appear to be increasing. These include low birthweight, behavioural and mental health problems, autism, obesity and, in Indigenous children, infections. This Program proposes investigating these problems with a view to prevention, thus meeting the national research priority of Promotin ....There are considerable challenges to the study of complex health and developmental problems in children and young people. Despite increasing prosperity in Australia, many of these problems are not abating and some appear to be increasing. These include low birthweight, behavioural and mental health problems, autism, obesity and, in Indigenous children, infections. This Program proposes investigating these problems with a view to prevention, thus meeting the national research priority of Promoting and Maintaining Good Health, particularly _a healthy start to life� and _preventive health care�. The Program is unique in that it brings together a multi-disciplinary team of researchers of international repute to investigate these complex issues. The research team comprises epidemiologists, clinicians, developmental psychologists, biostatisticians, sociologists and other social scientists. This team has a proven track record in producing research outcomes that have translated into innovative health policy and practice in areas as diverse as: - the use of folic acid in spina bifida prevention - understanding cerebral palsies - suicide prevention and mental health in children and young people - Aboriginal child health and development - intellectual disabilities including Rett syndrome and autism - in vitro fertilisation and birth defects. The factors influencing how children develop into young adults include genetic inheritance, nutrition and growth, and family, socioeconomic and environmental conditions. This work demands new ways of measuring and analysing these factors in populations of children and their families. Western Australia is one of only three sites in the world to have comprehensive linked health data on the whole of its population of children and their families. This Program comprises five overlapping themes of research planned around these unique population databases. The five themes are: - social, economic and psychological influences on child health and development - many paths to poor health are linked to social disadvantage. Examining these issues may explain why some childhood conditions are worsening or not improving - pathways to wellbeing, resilience and developmental disorders, including intellectual disability, autism, birth defects and cerebral palsy - nutrition and growth, particularly as it relates to low birthweight, childhood obesity and mental health - infectious disease, its causes and its influence on lifelong health problems and disabilities - Aboriginal health _ whilst spanning each of the research themes above, it presents its own unique challenges and requires it�s own unique solutions. This Program will investigate how children develop into young adults and will examine the influence of their families, nutrition and growth and socioeconomic and environmental conditions. It will develop new ways of measuring and analysRead moreRead less
Interactions Between Adaptable Pathogens, Drugs And The Human Host
Funder
National Health and Medical Research Council
Funding Amount
$5,727,327.00
Summary
The Centre for Clinical Immunology and Biomedical Statistics (CCIBS) represents a collaboration between Royal Perth Hospital and Murdoch University that has brought together internationally recognised expertise in clinical immunology, experimental biology and innovation in biostatistics and computing. These resources have been applied to a broad range of research issues within the broad framework of HIV and hepatitis C disease and treatment. CCIBS has become a leading centre of research excellen ....The Centre for Clinical Immunology and Biomedical Statistics (CCIBS) represents a collaboration between Royal Perth Hospital and Murdoch University that has brought together internationally recognised expertise in clinical immunology, experimental biology and innovation in biostatistics and computing. These resources have been applied to a broad range of research issues within the broad framework of HIV and hepatitis C disease and treatment. CCIBS has become a leading centre of research excellence internationally, establishing a reputation for innovative approaches to host-viral interactions that are built on a long tradition of research into the population genetics of both human and viral genomes, combined with a willingness to negotiate complex computation and statistical challenges in order to faithfully reflect dynamic biological processes at a population level. An early recognition that large and integrated repositories of genetic and clinical data are fundamental to the research success in the genomic era has also led to the creation of the single most comprehensive repository of HIV genetic sequencing data in the world. The contributions that CCIBS has made to several distinct areas of research, including understanding viral adaptation to host immune responses, the development of genetic testing to predict drug hypersensitivity reactions, and causes of antiretroviral drug-associated toxicities, have been published in prestigious journals including Science, Nature, Nature Immunology, The Lancet, Proceedings of National Academy of Sciences, and The American Journal of Human Genetics, and have also resulted in numerous international collaborations that recognise the unique attributes that CCIBS has been able to bring to the global research effort aimed at understanding fundamental aspects of HIV and hepatitis C biology and treatment.Read moreRead less
Insult, Injury And Recovery In Brain Disease: From Molecules To Therapeutic Outcome
Funder
National Health and Medical Research Council
Funding Amount
$8,215,611.00
Summary
When nerve cells are damaged, destroyed or injured, through disease or trauma, common pathological processes are set in train. Even though there are many factors that might trigger disease, these inevitably lead to common processes that end in cell death or initiate protective processes. One theme involves the factors that surround these responses to nerve injury and stress, and the consequent protective and regenerative responses that ensue. Another theme, closely integrates with the first, is ....When nerve cells are damaged, destroyed or injured, through disease or trauma, common pathological processes are set in train. Even though there are many factors that might trigger disease, these inevitably lead to common processes that end in cell death or initiate protective processes. One theme involves the factors that surround these responses to nerve injury and stress, and the consequent protective and regenerative responses that ensue. Another theme, closely integrates with the first, is to exploit basic biological mechanisms with the aim of identifying and developing therapeutic targets for the management of a wider range of neurological conditions.Read moreRead less