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
This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of t ....This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-off; how benefits weigh up against harms. This research is relevant to all partners in healthcare, (consumers, clinicians and policy-makers), who currently are being tested or using tests without being fully informed about the accuracy and effects of these tests.Read moreRead less
Advances In Clinical Trials Research And Evidence Based Decision Making
Funder
National Health and Medical Research Council
Funding Amount
$6,712,859.00
Summary
The NHMRC Clinical Trials Centre at the University of Sydney aims to use clinical trials and methodological research in trials to improve health in Australia and internationally It is a member of many international collaborative trials groups, especially in heart disease and cancer. A particular area of interest is patient preferences and decision making, particularly in cancer. The Clinical Trial Centre is active in using data from its own and other clinical trials in combined analyses to arriv ....The NHMRC Clinical Trials Centre at the University of Sydney aims to use clinical trials and methodological research in trials to improve health in Australia and internationally It is a member of many international collaborative trials groups, especially in heart disease and cancer. A particular area of interest is patient preferences and decision making, particularly in cancer. The Clinical Trial Centre is active in using data from its own and other clinical trials in combined analyses to arrive at better evidence.Read moreRead less
Health Outcomes Monitoring And Evaluation: Learning About Activity, Nutrition, Diet And Social Factors
Funder
National Health and Medical Research Council
Funding Amount
$7,486,989.00
Summary
Diabetes, Heart and Kidney disease occur in epidemic proportions among Indigenous Australians. Of particular concerns is the early age of onset of conditions that are to disease of older adulthood in the broader Australian community. While these chronic diseases are known to cause premature death and suffering in Aboriginal and Torres Strait Islander communities, there are gaps in our knowledge. For example, we know very little about how these conditionsdevelop over time in different populations ....Diabetes, Heart and Kidney disease occur in epidemic proportions among Indigenous Australians. Of particular concerns is the early age of onset of conditions that are to disease of older adulthood in the broader Australian community. While these chronic diseases are known to cause premature death and suffering in Aboriginal and Torres Strait Islander communities, there are gaps in our knowledge. For example, we know very little about how these conditionsdevelop over time in different populations. Probably the greatest knowledge gap is the area of effective intervention - both to prevent to prevent diabetes, kidney and heart disease in young people, and to treat existing cases effectivly. The main goal of this program is to bring together a multi skilled team of researchers to better understand the development of these chronic disease across the lifespan ( including differences between different populations), and to guuide the development of diet, lifestyle, and clinical interventions. Such interventions need to be simple, effective, acceptable to Indigenous people and able to be sustained over the long term. All interventions will be rigorously evaluated. The results will inform policies in ares such as quality and affordability of the food supply in remote communnities; infrastructure to promote physical activity; and provision of high quality primary health care focussing on early intervention and care of people at risk of chronic disease.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