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Systematic Practice-based Asthma Care In The Australian Setting
Funder
National Health and Medical Research Council
Funding Amount
$563,625.00
Summary
Asthma is an illness which increasingly is affecting the health and quality of life of millions of Australians. Much effort has been focused in recent years on ways of improving the management of those people who suffer from moderate and severe asthma. A recent government initiative has been to promote the use of the 3+ Visit Plan, which encourages a more proactive, systematic approach to assessing and treating asthma in general practice. There is currently no evidence about exactly how practice ....Asthma is an illness which increasingly is affecting the health and quality of life of millions of Australians. Much effort has been focused in recent years on ways of improving the management of those people who suffer from moderate and severe asthma. A recent government initiative has been to promote the use of the 3+ Visit Plan, which encourages a more proactive, systematic approach to assessing and treating asthma in general practice. There is currently no evidence about exactly how practices can best be organized to provide this systematic care, in a way which improves the process of care and the health outcomes for patients. This study aims to evaluate the effectiveness of changing aspects of practice organization and structure, such as setting up registers of asthma patients, providing recalls or reminders to patients to come in for regular review, having the GPs provide education and self-management skills to patients, focusing on the contributions which practice staff can make to the process, and initiating quality assurance measures such as audit and feedback to the GPs about their quality of care. We anticipate that these changes will provide positive benefits for the patients, but will also investigate what it costs the practices, patients and government to bring these changes about, within the perspective of efficiency and cost-effectiveness. The evidence generated by this study will provide an excellent base for providing advice to policy makers, as well as contributing to the development of best-practice models of care for asthma patients in general practice.Read moreRead less
Integrating Health Technology Assessment And Service Delivery And Organisation To Maximise Health Gains
Funder
National Health and Medical Research Council
Funding Amount
$258,538.00
Summary
The public heath care system in Australia faces ever greater issues around demand (e.g. aging population) and supply (e.g. expensive new interventions). It is becoming ever more important to ensure that the money we spend on health is used efficiently. This study is a unique application that aims to improve the efficiency of the health service by assessing how scarce services can be best organised to maximise health benefits.
An Investigation Of The Relationship Between The Pharmaceutical Industry, Medical Profession And Medical Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$186,449.00
Summary
In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on t ....In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on the relationship between the medical profession and the pharmaceutical industry. To date most debate has taken the form of personal observations or professional opinion , and there has been little objective research into medical industry interactions. This project aims to examine the relationship between the pharmaceutical industry, the medical profession and the medical practitioners. Specifically, the aim of this project is to establish whether this relationship as it currently exists, and as stated in guidelines from professional bodies, is appropriate in terms of justifiable ethical standards, empirical research and social perspectives. The results of this research will enable assessment of current guidelines and the development of further guidelines and regular process where appropriate.Read moreRead less
Investigation Of Tobacco Industry Efforts To Counteract Tobacco Control In Australia, 1970-2000
Funder
National Health and Medical Research Council
Funding Amount
$333,225.00
Summary
Tobacco use continues to be both the most important preventable cause of premature death and a key determinant of health inequity in Australia. Tobacco is a legally sold product which addicts many of its consumers, mostly as adolescents, and then kills half of them when used as intended. Comprehensive policy change, product regulation and litigation is required to put a halt to the tobacco industry's decades of avoidance, delay and disruption of tobacco control. In an interview for the Wall Stre ....Tobacco use continues to be both the most important preventable cause of premature death and a key determinant of health inequity in Australia. Tobacco is a legally sold product which addicts many of its consumers, mostly as adolescents, and then kills half of them when used as intended. Comprehensive policy change, product regulation and litigation is required to put a halt to the tobacco industry's decades of avoidance, delay and disruption of tobacco control. In an interview for the Wall Street Journal in 1995, Stan Glantz, from the University of California at San Francisco, equated the tobacco industry with other disease vectors: If you want to do something about malaria, you have to study mosquitoes and if you want to do something about lung cancer, you have to study the tobacco industry. Regulatory changes can only be justified by specific local evidence of both the private plans and knowledge of the tobacco industry to attack tobacco control and their public statements and actions designed to mislead consumers and effectively prevent or delay tobacco control. This study will document the public actions and statements of the tobacco industry in Australia between 1970 and 2000. It will draw on interviews with and personal records of tobacco control experts and former state and federal health ministers; as well as tobacco retail trade publications; print media reports; material obtained via Freedom of Information from State and Federal Health Departments; Federal Cabinet papers released under the 30 year rule (ie papers are available from prior 1972); and radio and television reports. It will complement a parallel study of the tobacco industry's internal documents. The outcome will be provision of strategically vital evidence to support effective tobacco control advocacy, policy formation, regulation and litigation in Australia, in the face of continuing industry countermeasures.Read moreRead less
Role Of DNA Methylation And Non-coding RNA In Human Centromere Function
Funder
National Health and Medical Research Council
Funding Amount
$499,000.00
Summary
A chromosome is a grouping of coiled strands of DNA, containing many genes. Every human cell has 23 pairs of chromosomes, which together comprise the genome. Both gain and loss of any of these chromosomes will lead to severe medical problems including birth defects and cancer development. Thus, the understanding of the mechanisms underlying the exact passage of these chromosomes from a parental cell to two new cells during cell division, and how the information is copied from from one cell gener ....A chromosome is a grouping of coiled strands of DNA, containing many genes. Every human cell has 23 pairs of chromosomes, which together comprise the genome. Both gain and loss of any of these chromosomes will lead to severe medical problems including birth defects and cancer development. Thus, the understanding of the mechanisms underlying the exact passage of these chromosomes from a parental cell to two new cells during cell division, and how the information is copied from from one cell generation to another, is an important area of research, however, much remains to be learnt about the mechanisms. Our laboratory was the first to discover a key component of the chromosome that is involved in the regulation of the cell division process, ensuring the accurate segregation of chromosomes. This structure, known as a neocentromere, is an ideal model system to study important aspects of chromosome segregation. The present project proposes to study the properties of this neocentromere in detail. The outcome will contribute to our knowledge on the processes underlying cell and chromosome division, which will ultimately have a direct impact on our understanding of the causes for some of the most common clinical conditions that affect human health.Read moreRead less
Identifying Target Molecules Regulated By Nuclear Retention In Cancer And Development
Funder
National Health and Medical Research Council
Funding Amount
$267,173.00
Summary
Human DNA contains approximately 30000 genes; only twice as many as worms and flies, ten times as many as bacteria, and fewer than rice. Humans, however have considerably more complexity than these lower organisms. What are the factors responsible for the additional complexity? In the simplest scenario, one gene is transcribed to produce one message (mRNA), which is the blueprint for producing one protein. We now know that there are numerous mechanisms that potentially allow many different prote ....Human DNA contains approximately 30000 genes; only twice as many as worms and flies, ten times as many as bacteria, and fewer than rice. Humans, however have considerably more complexity than these lower organisms. What are the factors responsible for the additional complexity? In the simplest scenario, one gene is transcribed to produce one message (mRNA), which is the blueprint for producing one protein. We now know that there are numerous mechanisms that potentially allow many different proteins to be made from one gene. Also, it is the decisions about which gene will be made ( expressed ) into protein where and when in development, that is critical for our complexity. The control of gene expression is thus fundamental to all cellular processes and many diseases such as cancer and metabolic disorders are associated with some aspect of aberrant gene expression. The production of mRNA from DNA occurs in the human cell nucleus. The nucleus is not simply a bag of DNA, in fact, many important nuclear factors are organised into sub-nuclear bodies . Recently we discovered a novel sub-nuclear body, the paraspeckle and have been identifying its components and their function. Paraspeckles are involved in a previously undiscovered mechanism of the control of gene expression. Here, certain mRNA molecules are trapped in the nucleus until a signal is received from elsewhere in the cell, which causes the mRNA to be released and protein to be made. This Rapid Release Nuclear Retention mechanism effectively allows the quick production of specific proteins to be made on demand. In this project we propose to use cutting edge molecular and cell biology techniques to identify the special mRNA molecules that are trapped in paraspeckles in cancer cells. This will increase our understanding about the molecular details of this process, ultimately leading to potential uses in gene therapy, and should result in the discovery of important targets for cancer treatment.Read moreRead less
Deconstructing DTCA: Towards A Differentiated Policy Response To Direct-to-Consumer Advertising In Australia.
Funder
National Health and Medical Research Council
Funding Amount
$190,760.00
Summary
Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culmina ....Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culminate in a national workshop which will develop a differentiated set of recommendations for responding to different types and modes of DTCA. This is likely to lead to better health policy and to resources that may assist consumers and health professionals deal with DTCA.Read moreRead less
Development And Validation Of An Australian Diabetes Health Policy Simulation Model
Funder
National Health and Medical Research Council
Funding Amount
$400,396.00
Summary
Diabetes imposes a heavy personal, societal and financial burden on Australia and this is predicted to increase over time. The aim of this project is to develop a computer simulation model that can be used to inform clinicians and policy makers in efficient allocation of resources to improve the quality of diabetes care.