Hepatitis C Treatment-as-prevention In The Prison Setting
Funder
National Health and Medical Research Council
Funding Amount
$314,644.00
Summary
The burden of hepatitis C virus (HCV) infection in Australia is rising with prison settings being a major reservoir of HCV infection. This study evaluates the feasibility of a rapid scale-up of a new highly effective, short and tolerable HCV therapy and its impact on HCV transmission in the prison setting. This is the first HCV treatment-as-prevention study in prisons having strong potentials to inform public health policy nationally and internationally.
Brain Angiotensin: Generation, Localisation And Physiological Function
Funder
National Health and Medical Research Council
Funding Amount
$209,250.00
Summary
The renin angiotensin system is one of the major homonal systems of the body that regulate the cardiovascular system and bodily salt and water balance. Drugs that inhibit the function of this system by reducing the blood level of the hormone angiotensin II or blocking the receptors at which it acts are in the forefront of treatment of high blood pressure and heart failure. It has been proposed that a separate brain renin angiotensin system exists that is not influenced by angiotensin II in the b ....The renin angiotensin system is one of the major homonal systems of the body that regulate the cardiovascular system and bodily salt and water balance. Drugs that inhibit the function of this system by reducing the blood level of the hormone angiotensin II or blocking the receptors at which it acts are in the forefront of treatment of high blood pressure and heart failure. It has been proposed that a separate brain renin angiotensin system exists that is not influenced by angiotensin II in the blood stream because of the blood-brain barrier. Strains of mice in which the genes that code for two components of this system - angiotensin converting enzyme (the enzyme responsible for generating angiotensin II) and angiotensinogen (the protein which gives rise to angiotensin II) provide excellent tools to elucidate this system in the brain. By studying these mice we will be able to determine whether angiotensin converting enzyme is necessary in the brain for foreming angiotensin II, and we will be able to determine the sites in the brain where authentic angiotensin peptides exist. We will also determine whether angiotensin II transmits information between neurons in the brain that play a role in control of the cardiovascular system and body fluid balance.Read moreRead less
The Mechanism Of Action Of IVIg In Inflammatory Neuropathy
Funder
National Health and Medical Research Council
Funding Amount
$452,141.00
Summary
Intravenous immunoglobulin (IVIg) is the major therapy used for the inflammatory neuropathies GBS, CIDP and for multifocal neuropathy. The cost of IVIg for these neuropathies in Australia is approximately 60 million dollars per year. As new indications for IVIg continue to be developed the resource becomes more valuable. We plan to explore the mechanism of action of IVIg with the aim of saving this precious resource and providing significant financial savings to the health service.
Linking Of Physiological Models Of Iv Anaesthetic Disposition With Models Of The Cardio- And Cerebro-vascular Systems
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
On average, nearly 1 in 10 Australians are anaesthetised each year. Most cases include an injection of either thiopentone or propofol directly into a vein. These drugs quickly produce the desired loss of consciousness, but can also produce significant undesirable effects on the circulatory system. To date, anaesthetists have relied on their accumulated experience to choose doses of these drugs that achieve an appropriate balance between their desirable and undesirable effects. However, the scien ....On average, nearly 1 in 10 Australians are anaesthetised each year. Most cases include an injection of either thiopentone or propofol directly into a vein. These drugs quickly produce the desired loss of consciousness, but can also produce significant undesirable effects on the circulatory system. To date, anaesthetists have relied on their accumulated experience to choose doses of these drugs that achieve an appropriate balance between their desirable and undesirable effects. However, the scientific basis of this process was poorly understood. Consequently, we conducted experiments in sheep in which we showed that the level of unconsciousness produced by these drugs depended on their concentration in the brain. Each sheep was unharmed and could be studied repeatedly. We established the important factors that influenced this brain concentration, and developed a unique computer model of the processes governing the desirable effects of thiopentone and propofol. However, understanding of what influences the undesirable effects of these drugs is less well developed. In this project, we propose a series of experiments in which we inject the thiopentone and propofol in special sites within the sheep so that we achieve low concentrations in some parts of the body, but high concentrations in others, while also measuring their undesirable effects. This will show which sites in the body high concentrations of drug should be avoided to minimise these undesirable effects. Another series of studies will be used to extend our computer model so that it can predict these undesirable effects. This extended model will allow anaesthetists to visualise and understand the fundamental factors influencing both the desirable and undesirable effects of thiopentone and propofol. This in turn will lead to dose strategies that help the anaesthetist maximise the desirable effects, while minimising the undesirable, in individual patients.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
HCV Treatment Among Male Inmates In NSW: Determining Social Capital Indicators For Accessing Treatment And Improvements In QALYs Post-treatment
Funder
National Health and Medical Research Council
Funding Amount
$69,060.00
Summary
The HCV treatment among male inmates in NSW study will focus on identifying and measuring the social capital of inmates in custody with hepatitis C virus (HCV) in NSW correctional centres. A comparison of the social capital experienced by Aboriginal and non-Aboriginal men will be conducted. A cost-utility analysis of HCV treatment will also be conducted. Changes in social capital and quality-adjusted life years following treatment will be measured to identify any gains achieved following complet ....The HCV treatment among male inmates in NSW study will focus on identifying and measuring the social capital of inmates in custody with hepatitis C virus (HCV) in NSW correctional centres. A comparison of the social capital experienced by Aboriginal and non-Aboriginal men will be conducted. A cost-utility analysis of HCV treatment will also be conducted. Changes in social capital and quality-adjusted life years following treatment will be measured to identify any gains achieved following completion of treatment.Read moreRead less
Health Outcomes And Service Utilisation In A Cohort Of People Who Inject Drugs, Sex Workers And At-risk Youth - A Record Linkage Study
Funder
National Health and Medical Research Council
Funding Amount
$458,333.00
Summary
People who inject drugs and sex workers endure poorer health and a disproportionate burden of disease than the general population. Improving health in these marginalised populations remains a challenge. To identify demographic, behavioural and clinical factors that predict health outcomes we will undertake a retrospective record linkage study in a cohort of 40000 primary care clinic attendees from a socially disadvantaged urban population with high prevalence of injecting drug use and sex work.