Improving Care Of The Dying With Chronic Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$130,000.00
Summary
Chronic heart failure is increasing in prevalence and is primarily a condition of ageing. Although chronic heart failure has worse outcomes than many cancers, patients are often denied the benefits of palliative care with its emphasis on symptom management, spirituality, emotional health and focus on family issues. This project seeks to assess the state of knowledge in Australia related to palliative care in chronic heart failure. Guidelines and care maps appropriate to Australian conditions wil ....Chronic heart failure is increasing in prevalence and is primarily a condition of ageing. Although chronic heart failure has worse outcomes than many cancers, patients are often denied the benefits of palliative care with its emphasis on symptom management, spirituality, emotional health and focus on family issues. This project seeks to assess the state of knowledge in Australia related to palliative care in chronic heart failure. Guidelines and care maps appropriate to Australian conditions will be developed and their usefulness assessed in improving care of patients and their families.Read moreRead less
Gaining Two-way Understanding Of Recovery From Chronic And Recurring Mental Disorders In FNQ Indigenous Communities.
Funder
National Health and Medical Research Council
Funding Amount
$110,519.00
Summary
Little is known about the rates of chronic and recurring mental illness in the Indigenous population, particularly in remote Indigenous communities. This research aims to document the extent of the problem and explore the factors that place individuals at risk of poorer mental health outcomes as well as those factors that promote resiliency and recovery in the face of such risk. In addition, the concept of recovery in mental illness will be expanded to include Indigenous views.
Using Single Patient Trials To Determine The Effectiveness Of Psychostimulants In Fatigue In Advanced Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$162,563.00
Summary
The lack of good evidence in palliative care (PC) is widely acknowledged but research in PC is difficult. Methodological barriers include: difficulties in recruitment, high rates of attrition, problems with maintaining distinct and sustainable intervention strategies, poorly chosen outcomes and opposition to randomization. Organizational barriers include: lack of research infrastructure, few trained clinical researchers, prioritisation of clinical responsibilities and funding difficulties. The h ....The lack of good evidence in palliative care (PC) is widely acknowledged but research in PC is difficult. Methodological barriers include: difficulties in recruitment, high rates of attrition, problems with maintaining distinct and sustainable intervention strategies, poorly chosen outcomes and opposition to randomization. Organizational barriers include: lack of research infrastructure, few trained clinical researchers, prioritisation of clinical responsibilities and funding difficulties. The hierarchy of evidence rates RCTs as the gold standard. An alternative is the n-of-1 trial: a randomized, double-blind cross-over comparison of active drug with placebo or another drug. The patient is in effect their own control. N-of-1 trials provide an objective means of testing the effectiveness of medicines in individual patients, providing evidence stronger than RCT evidence for the efficacy of that drug in that particular individual. If multiple n-of-1 trials are conducted, the resultant data amounts to RCT evidence for that treatment in a population. We propose n-of-1 trials as a workable option for researching the benefit of drugs and other therapies in PC patients. If successful, this model could be accepted internationally as the gold standard for research in this difficult population group. This would be a world first and of great national and international significance. In advanced cancer, the prevalence of fatigue is very high at 60-90% and can be related to the treatment or the disease itself. The impact of fatigue on function (physical, mental, social and spiritual) and hence quality of life (QOL) is very significant for many palliative patients as well as their families-carers. The role of pyschostimulants in the management of fatigue in patients with advanced cancer and life limiting disease needs to be defined. We will conduct n-of-1 trials of psychostimulants (i.e. methylphenidate) for fatigue in a group of 40 patients, recruited from 5 sites around Australia through a national clinical trial network recently set up for palliative care research. Managing fatigue with treatment supported by the best possible evidence for individual patients and producing any improvement in fatigue will improve patients� functional status, and will greatly improve QOL for patients and carers.Read moreRead less
Prevention And Management Of Chronic Disease In Primary Health Care
Funder
National Health and Medical Research Council
Funding Amount
$898,008.00
Summary
Over the past 10 years, Mark Harris has developed and led an innovate program of research on better ways to prevent and manage chronic disease in primary health care. This has included research on early intervention to assess and reduce the risk factors for these conditions involving innovative approaches to patient education; team based care; information and decision support systems. This research is now being extended to focus on disadvantaged groups and communities.
Depressive Illness And The Heart: Identifying The Relation Between Affective Disorders And Coronary Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$503,625.00
Summary
Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial inf ....Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial infarction (MI), which materially increases mortality. The mechanism of increased cardiac risk attributable to depressive illness is at present uncertain but activation of the sympathetic nervous system, exaggerated platelet reactivity and-or altered baroreflex function are likely to be of prime importance. Preliminary data from our laboratory indicates that whole body and cardiac sympathetic nervous activity and cardiac baroreflex sensitivity are modified following antidepressant therapy. Identifying the underlying neurochemical mechanisms responsible for alterations in affective behaviour, and quantifying cardiac and whole body sympathetic activity directly and indirectly, and testing whether therapeutic and behavioural interventions can influence brain neurotransmitter turnover and modify cardiac sympathetic tone, platelet reactivity, and baroreflex function in a fashion likely to reduce cardiac risk, will be an important step forward in alleviating the burden of depressive illness on the community.Read moreRead less
Centre Of Research Excellence - REduce The Burden Of Antimicrobial ReSistance Through OPtimal, PersONalised Dosing (RESPOND)
Funder
National Health and Medical Research Council
Funding Amount
$2,500,000.00
Summary
Each year more than 17 million people die from infectious diseases. Many of these deaths are due to the poor use of antimicrobial drugs and an increase in infections caused by antimicrobial-resistant 'superbugs'. CRE RESPOND will enable an optimal treatment of infection by empowering clinicians with an evidence-based, patient-centred approach to guide antimicrobial dosing. We will generate new knowledge, educate healthcare workers, and build research capacity through our network of collaborators
Developmental Influences On Brain Structure And Connectivity: Implications For Emerging Borderline Personality Disorder
Funder
National Health and Medical Research Council
Funding Amount
$147,611.00
Summary
Borderline personality disorder (BPD) is a severe, debilitating mental illness that has usual onset in adolescence. Research has highlighted the importance of adolescent brain development, particularly the maturation of brain connections, in onset of mental illness. Brain mapping techniques will be applied to gain a better understanding of BPD onset and progression within an approach that integrates neurobiology and psychosocial context. This is critical for understanding development of BPD.