An Implementation Trial Of A Telephone-based Care Management Program For Patients Following Myocardial Infarction
Funder
National Health and Medical Research Council
Funding Amount
$641,656.00
Summary
We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such progra ....We are trialling the implementation of an innovative telephone-delivered program for managing people who have had a heart attack. Cardiac rehabilitation programs are generally based in hospitals in Australia and people have to be able to attend the programs when they are offered. Even though such programs have been shown to be very effective in improving outcomes after a heart attack, at least 85% of Australians after a heart attack are either unable to access and-or unable to attend such programs due to transport and many other barriers. So, there is an urgent need to identify new, effective, and affordable ways of delivering cardiac rehabilitation programs to people after a heart attack. The proposed telephone-delivered program will be particularly appropriate for disadvantaged people, such as those living in rural and remote areas as well as Indigenous Australians, who do not currently have access to hospital-based cardiac rehabilitation programs. People who have had a heart attack will be recruited from three of Brisbane's largest public teaching hospitals, and will then be randomly assigned to the telephone-delivered cardiac rehabilitation program (Care Management Intervention group) or to a control or Usual Care group. The Care Management Intervention group will receive regular telephone calls from a highly qualified 'Care Manager' based at the renowned National Heart Foundation of Australia telephone support service, 'Heartline'. The Care Manager will help people to manage their heart condition and prevent the reoccurrence of further heart problems. People will also be encouraged to make necessary lifestyle and behavioural changes with the assistance of the Care Manager and some Heart Foundation educational and interactive resources to record their progress. We expect that the program or Care Management Intervention group will have better health outcomes than the control or Usual Care group at 6 and 12 months follow up.Read moreRead less
The Role Of Linked Cytokines In T Helper Cell Differentiation
Funder
National Health and Medical Research Council
Funding Amount
$390,504.00
Summary
An important class of T cells known as T Follicular Helper cells (TFH) orchestrate the immune response so that we can produce antibodies to fight infection. The novel finding that our Lab made last year is that the molecule interleukin 21 (IL-21) is a growth factor for TFH. The findings we have made thus far could be used in a number of ways. For eg, IL-21could be used to expand numbers of TFH, using them to boost vaccination or natural defences against viruses, bacteria and tumour cells.
Improving Asthma Control: General Practice Strategies To Optimise Medication Adherence
Funder
National Health and Medical Research Council
Funding Amount
$460,820.00
Summary
Asthma is a major health problem for Australia. Many patients have frequent symptoms and need urgent health care because they do not use a preventer inhaler regularly. This may be intentional e.g. fear of side-effects, and-or unintentional e.g. forgetting. This real-life study will test two simple strategies for GPs to improve their patients' use of preventer medications, to improve asthma control. Innovative technology will allow GPs to tailor the approach to each patient during a normal visit.
The Australia And New Zealand Fontan Registry: A Growing Population Of Young Adults With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$129,103.00
Summary
The Fontan procedure is an operation performed for all children with heart defects who cannot be repaired with 2 pumping chambers like a normal heart. It is expected that after 2 or 3 decades, these patients will either die or need a heart transplantation. We want to establish a registry to evaluate the number and status of this increasing patient population. This study may foresee and even prevent a sudden burden on the health system caused by their needs.
Regulation Of Growth Hormone Action By Oestrogen And Selective Oestrogen Receptor Modulators
Funder
National Health and Medical Research Council
Funding Amount
$474,750.00
Summary
Growth hormone (GH) is essential for body growth and development. In adult life, it plays a key role in regulating the ratio of body fat to muscle, thus influencing health. Disruption of GH action decreases muscle mass and increases body fat. These changes lead to reduced muscle strength and fitness, and increase the risk of diabetes, hypertension and cardiovascular mortality. Our laboratory has reported that oestrogens taken orally blunt GH action and cause unfavourable changes in body fat and ....Growth hormone (GH) is essential for body growth and development. In adult life, it plays a key role in regulating the ratio of body fat to muscle, thus influencing health. Disruption of GH action decreases muscle mass and increases body fat. These changes lead to reduced muscle strength and fitness, and increase the risk of diabetes, hypertension and cardiovascular mortality. Our laboratory has reported that oestrogens taken orally blunt GH action and cause unfavourable changes in body fat and muscle. How this happens is not known. As oral oestrogens are widely used in our society, it is important to understand the basis of their impact on GH action. SERMs, or selective oestrogen receptor modulators, are a group of drugs used in the treatment of breast cancer and osteoporosis. These substances mimic oestrogen action in some tissues, and block oestrogen action in others. Whether SERMs interfere with GH action as oestrogens do have not been studied, but such knowledge would have therapeutic significance because of their widespread and long-term use. GH action is mediated by a protein, called the GH receptor, located on the surface of target tissues. We propose that oestrogens and SERMs alter the production and function of this protein to control GH action. Thereby, this project is designed to test, in cultured cells of human origin, how oestrogens and SERMs modulate abundance of the GH receptor and its ability to mediate GH action. This work is anticipated to gain novel insights into the interaction of GH with oestrogens and SERMs. This information may also be useful for the design of new drugs devoid of adverse effects on GH action, and hence would have potentially significant implications in women s health and disease.Read moreRead less
A Randomised Control Trial Of Treatments For Children With Different Types Of Reading Difficulty
Funder
National Health and Medical Research Council
Funding Amount
$752,319.00
Summary
This randomise control trial will test treatments for children with different types of reading difficulty. The outcomes will reveal how struggling readers should be supported in classrooms and by the Reading Assistance Voucher programme. This will reduce the number of struggling readers who attempt suicide, drop out of school, or abuse drugs to try and escape their sense of failure. This will suport the Government's efforts to ensure that Australians have A Healthy Start to Life.
Peripheral Nerve Grafts, Neurotrophic Factors, And Ex Vivo Gene Therapy In Visual System Repair
Funder
National Health and Medical Research Council
Funding Amount
$240,990.00
Summary
Worldwide, hundreds of thousands of people are victims of severe brain and spinal cord injuries, often as a result of motor vehicle accidents or sporting mishaps. Thousands more are added to this population each year. Because there is only limited intrinsic potential for the regeneration of axons in the adult mammalian central nervous system (CNS), traumatic injury almost always results in long-lasting functional impairments (mental and-or physical). The personal, social and economic costs for t ....Worldwide, hundreds of thousands of people are victims of severe brain and spinal cord injuries, often as a result of motor vehicle accidents or sporting mishaps. Thousands more are added to this population each year. Because there is only limited intrinsic potential for the regeneration of axons in the adult mammalian central nervous system (CNS), traumatic injury almost always results in long-lasting functional impairments (mental and-or physical). The personal, social and economic costs for the long-term clinical care and maintenance of functionally impaired patients are enormous. The proposed study aims to develop new and unique surgical and molecular approaches to CNS repair, using the rodent visual system as the experimental model. Pieces of peripheral nerve (PN) will be cellularly and genetically manipulated to produce increased levels of growth promoting factors. The modified PN tissue will then be transplanted into the injured CNS. It is expected that the increased levels of neurotrophic factors will promote and guide the regeneration of increased numbers of nerve fibres through the bridges and back into appropriate parts of the brain. A major goal is to determine if it is possible to harvest adult peripheral glia (Schwann cells) from the PN of a host, expand and engineer these cells ex vivo, and then graft these cells back into the same host to promote the repair of injured fibre tracts. Such an approach would be of considerable benefit in the surgical repair of CNS injuries in humans. It is thus intended that our experimental studies will lead to the development of new therapeutic strategies for the treatment of human brain and spinal cord injuries, resulting in improved functional outcomes and better quality of life after neurotrauma.Read moreRead less
To Determine The Means By Which Plasminogen Activators Modulate Integrity Of The Blood Brain Barrier
Funder
National Health and Medical Research Council
Funding Amount
$523,084.00
Summary
Tissue-type plasminogen activator (t-PA) is used clinically to remove blood clots. However, t-PA can also cause brain injury and influence the blood brain barrier (BBB) which has implications for the treatment of patients with ischaemic stroke. This project will use in vitro and in vivo models to understand the mechanism by which t-PA modulates the BBB. A novel tPA variant will also be created that ultimately may be of benefit for patients with ischaemic stroke.
Physiological And Neurophysiological Assessment Of Lip And Tongue Function For Speech In Multiple Sclerosis
Funder
National Health and Medical Research Council
Funding Amount
$356,250.00
Summary
Speech difficulties are commonly experienced by people with multiple sclerosis (MS) and can have a devastating, restrictive effect on social interactions, work and education opportunities, ultimately reducing quality of life. Research has shown that a major factor underlying impaired speech in MS is disturbed functioning of the structures that articulate speech, particularly the tongue and lips. In order to effectively treat these speech disturbances, it is imperative that the nature and severit ....Speech difficulties are commonly experienced by people with multiple sclerosis (MS) and can have a devastating, restrictive effect on social interactions, work and education opportunities, ultimately reducing quality of life. Research has shown that a major factor underlying impaired speech in MS is disturbed functioning of the structures that articulate speech, particularly the tongue and lips. In order to effectively treat these speech disturbances, it is imperative that the nature and severity of the tongue and lip impairments be identified, so that specific treatment methods can be employed to directly target those impairments. The present project will use state-of-the-art technology to track and record movements of the tongue and lips during speech and to investigate how well the neural command pathways leading from the brain to the lip and tongue muscles are functioning in persons with MS. The results of the study will direct the development of more specific and effective speech therapy procedures that will empower persons with MS with intelligible speech.Read moreRead less
Mediterranean Diet And Mortality: Analysis Of Longitudinal Dietary Patterns Using Newly Developed Statistical Methods
Funder
National Health and Medical Research Council
Funding Amount
$340,547.00
Summary
Assessment of the effect of changes in diet of health has not undergone rigourous analytical assessment in the scientific literature. This proposal focusses on patterns of change over time in a Mediterranean diet in 41,000 persons in the Melbourne Collaborative Cohort Study. It will assess the benefits of adoption and maintenance of this diet over an extended period, as well as determining how the benefits of the diet depend on a person's age at its adoption, and how the benefits of the diet int ....Assessment of the effect of changes in diet of health has not undergone rigourous analytical assessment in the scientific literature. This proposal focusses on patterns of change over time in a Mediterranean diet in 41,000 persons in the Melbourne Collaborative Cohort Study. It will assess the benefits of adoption and maintenance of this diet over an extended period, as well as determining how the benefits of the diet depend on a person's age at its adoption, and how the benefits of the diet interplay with other potential lifestyle changes.Read moreRead less