Determining The Synergistic Effects Of Complementary Medicines On Pro-inflammatory Cytokines,
Funder
National Health and Medical Research Council
Funding Amount
$290,412.00
Summary
Diseases like influenza, commonly called ‘the flu’, produce symptoms such as fever, headaches, lethargy and lack of appetite. What most people don’t realise is that it is not the influenza virus that produces these symptoms, but the body’s immune response to the influenza virus. This immune response comes about because the influenza virus stimulates cells to produce molecules called cytokines, and cytokines have many effects in the body, including causing fever and a lack of appetite. In severe ....Diseases like influenza, commonly called ‘the flu’, produce symptoms such as fever, headaches, lethargy and lack of appetite. What most people don’t realise is that it is not the influenza virus that produces these symptoms, but the body’s immune response to the influenza virus. This immune response comes about because the influenza virus stimulates cells to produce molecules called cytokines, and cytokines have many effects in the body, including causing fever and a lack of appetite. In severe infections like those caused by the influenza virus responsible for the pandemic of 1918, and during “bird ‘flu” (H5N1) infections, people die because the immune response becomes overwhelming. Cytokines produced during these sorts of responses are actually very harmful, even though in small amounts they help to kill the virus and cure the infection. Researchers working in this field have likened these severe responses to a “cytokine storm”. This project focusses on finding alternative therapies such as those used in Chinese medicine to prevent a cytokine storm happening, so that if an influenza pandemic occurs these treatments could be quickly made available to everyone. Examples are the Chinese herbs Angelica sinensis and Salvia miltiorrhiza. Recent laboratory studies in New York have shown that both of these herbs have potent cytokine effects, decreasing levels of an inflammatory cytokine known to be associated with death in both malaria and sepsis. Our study aims to closely examine the effects of these Chinese herbs, as well as other commercially available herbal extracts, and traditional combinations of herbs, to find synergies between them that could be used to treat severe influenza infections.Read moreRead less
Clinical And Physiological Evaluation Of Chinese Herbal Medicine For Constipation Predominant Irritable Bowel Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$592,705.00
Summary
This innovative study examines the effectiveness, safety and mechanisms of action of a complex Chinese herbal medicine (CHM) for irritable bowel syndrome (IBS). IBS is the most common chronic medical disorder of the digestive tract with 10% prevalence in the Australian population. Characterised by abdominal pain and altered bowel habits, it significantly affects quality of life and has major socioeconomic implications. IBS is increasingly recognized as a complex multi-factorial condition with ps ....This innovative study examines the effectiveness, safety and mechanisms of action of a complex Chinese herbal medicine (CHM) for irritable bowel syndrome (IBS). IBS is the most common chronic medical disorder of the digestive tract with 10% prevalence in the Australian population. Characterised by abdominal pain and altered bowel habits, it significantly affects quality of life and has major socioeconomic implications. IBS is increasingly recognized as a complex multi-factorial condition with psychogenic, hormonal and immune components. It is poorly addressed by current pharmaceutical treatments. Medical treatment of IBS remains unsatisfactory, with incomplete benefits offered by a single drug approach. The multi-factorial nature of IBS renders it an ideal candidate for evaluation with a more complex mix of low dose agents offered by herbal medicine. Specifically, CHMs by their complex chemical nature have substantial potential in the treatment of IBS because of their range of physiological effects on both bowel function and the central nervous systems We will perform a clinical trial of 8 weeks to determine the effectiveness of a chemically standardised CHM preparation in 160 patients with constipation predominant IBS patients compared to an identical placebo (sham). This project builds on our previous studies that demonstrated an effectiveness of CHM for IBS superior to current interventions. We’ve validated methods to ensure chemical standardisation of herbal medicines; validated approaches to psychosocial assessment of cognitive and behavioural changes in IBS patients; and have validated physiological, mechanistic evaluation of the lower bowel in response to treatment. The significance of the current proposal lies in its ability to provide a standardised, multi-component CHM (8 herbs) for the comprehensive clinical evaluation of the efficacy and safety of this type of therapy for IBS, and to provide insight into the relevant mechanisms of action. This project draws together the unique skills and previous studies from the Centre for Complementary Medicine Research (UWS), and the Gastrointestinal Investigation Unit of RNSH, USYD. This innovative project is medically important because it addresses a common gastrointestinal disorder with high socioeconomic implications for which conventional western medicine has failed to produce a cure or adequate palliative treatment.Read moreRead less
Preventing Obesity Among Socioeconomically Disadvantaged Women And Children
Funder
National Health and Medical Research Council
Funding Amount
$2,072,674.00
Summary
The research will investigate the causes of the increased risk of obesity among socioeconomically disadvantaged women and children. It will also focus on women and children who appear �resilient� to obesity and will explore the possibility of applying the lessons learned to other women and children, in order to help support them in adopting and maintaining obesity-protective behaviours. The research aims to provide evidence to inform policies and programs that should be put into place to prevent ....The research will investigate the causes of the increased risk of obesity among socioeconomically disadvantaged women and children. It will also focus on women and children who appear �resilient� to obesity and will explore the possibility of applying the lessons learned to other women and children, in order to help support them in adopting and maintaining obesity-protective behaviours. The research aims to provide evidence to inform policies and programs that should be put into place to prevent obesity among socioeconomically disadvantaged groups.Read moreRead less
Primary Care: What Is Their Approach To Patients With Advanced Cancer And Those Who Require Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
It is recommended that 50-60% of all cancer patients receive radiotherapy at some time in their disease. However, only 38% of all cancer patients receive radiotherapy in Australia. Advanced cancer patients may be missing out on radiotherapy because they are not referred for palliative radiotherapy. The specific aims of this study are to: Explore the primary care approach to patients with advanced cancer and particularly those who require radiotherapy; Define factors that influence how Australian ....It is recommended that 50-60% of all cancer patients receive radiotherapy at some time in their disease. However, only 38% of all cancer patients receive radiotherapy in Australia. Advanced cancer patients may be missing out on radiotherapy because they are not referred for palliative radiotherapy. The specific aims of this study are to: Explore the primary care approach to patients with advanced cancer and particularly those who require radiotherapy; Define factors that influence how Australian GPs respond to symptoms of advanced cancer; Map the patients’ perspective on current referral practice for palliative care. This project will be comprised of three stages: simulated consultations with GPs, survey of GPs and patient interviews. These methods will enable researchers to develop an understanding of the primary care approach to patients with advanced cancer and those who require radiotherapy and how patients with advanced disease are referred for treatment.Read moreRead less
Body Composition Changes In Cardiac Cachexia: Pathophysiology, Quantification And Approaches To Therapy
Funder
National Health and Medical Research Council
Funding Amount
$120,000.00
Summary
Cachexia is weight loss and weakness caused by disease, or as a side effect of illness. Congestive heart failure is a common cardiovascular condition that is accompanied by high mortality (up to 50% over 2 years) and considerable suffering. People with congestive heart failure often develop cachexia. This project will explore the mechanisms responsible for the development of cachexia using an animal model of cardiac cachexia that the researchers have developed. It will be complemented by an exam ....Cachexia is weight loss and weakness caused by disease, or as a side effect of illness. Congestive heart failure is a common cardiovascular condition that is accompanied by high mortality (up to 50% over 2 years) and considerable suffering. People with congestive heart failure often develop cachexia. This project will explore the mechanisms responsible for the development of cachexia using an animal model of cardiac cachexia that the researchers have developed. It will be complemented by an examination of the effects of exercise on measures of cachexia in patients with congestive heart failure. The researchers believe that this study will supply valuable new information about the development of cachexia and lead to new therapies for this syndrome.Read moreRead less
Gene Based Treatment Strategies For Diabetic Retinopathy
Funder
National Health and Medical Research Council
Funding Amount
$2,630,000.00
Summary
Diabetic retinopathy is the leading cause of blindness in the working population of developed countries and it is an increasing problem in the developing world. Present therapy involves extensive laser destruction of the light-detecting part of he retina. In addition, it is not only effective when administered at an appropriate stage in the disease process. Consequently, there is an urgent need for the development of better, prophylactic, easily administrable and cheaper therapies. This project ....Diabetic retinopathy is the leading cause of blindness in the working population of developed countries and it is an increasing problem in the developing world. Present therapy involves extensive laser destruction of the light-detecting part of he retina. In addition, it is not only effective when administered at an appropriate stage in the disease process. Consequently, there is an urgent need for the development of better, prophylactic, easily administrable and cheaper therapies. This project aims to develop a potentially permanent solution to alleviate diabetes-related blindness in the world. The project combines several very recent scientific advances into one strategy to combat diabetic retinopathy at a molecular level. Vision is our most important sensory organ that cannot be replaced. Thus, human trials can only be conducted following extensive animal safety and efficacy trials. To date the development of new therapies has been seriously hampered by the lack of appropriate, easy to reproduce animal models for different stages of diabetic retinopathy. In addition, it aims to identify new therapeutic agents from molecules that are naturally produced by the retina while fighting the disease. Finally, tested and evaluated in the animal models. The most successful therapeutic candidates will then be further developed for human trials.If successful, our approach will potentially have a major impact on the treatment of diabetic retinopathy and possibly on all diabetic vascular diseases. A single injection might only be necessary to prevent the development of diabetic retinopathy, which would represent a significant weapon in the management of patients. In addition, successful application of secretion gene therapy in the eye might open up the possibility to introduce the same concept for the treatment of larger organs undergoing microvascular changes as a result of diabetes.Read moreRead less
In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states ....In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.Read moreRead less
A Comprehensive Regulatory Strategy For Obesity Prevention In Australia
Funder
National Health and Medical Research Council
Funding Amount
$810,696.00
Summary
This research aims to develop regulatory approaches to obesity prevention and the reduction of socio-economic inequalities in obesity prevalence. Laws related to the provision, marketing, and labelling of food, urban planning, transportation, taxes and subsidies and so on will be comprehensively analysed and prioritised, and options proposed for legislative reform. The evidence-base and the implementation pathways will be developed contemporaneously and will be widely promoted to governments. A ....This research aims to develop regulatory approaches to obesity prevention and the reduction of socio-economic inequalities in obesity prevalence. Laws related to the provision, marketing, and labelling of food, urban planning, transportation, taxes and subsidies and so on will be comprehensively analysed and prioritised, and options proposed for legislative reform. The evidence-base and the implementation pathways will be developed contemporaneously and will be widely promoted to governments. A significant portion of time will be devoted to working closely with those within the bureaucracy who administer the law and legislators who together make the relevant policy decisions so that they may gain an understanding of the rationale behind each recommendation.Read moreRead less
Needs Based Access To Specialist Palliative Care Services: Development And Evaluation Of A Consumer Toolkit
Funder
National Health and Medical Research Council
Funding Amount
$286,572.00
Summary
The study will test the cost-effectiveness of two models of supportive care coordination for advanced cancer against _usual care�: a Telephone Caseworker model and an Oncologist-GP model. Both models are aimed at improving patients� and their informal caregivers� health and psychosocial status; are patient-centred, evidence based and readily transferable across health care settings. The Telephone Caseworker model has the additional advantage of reaching people isolated through geography, physica ....The study will test the cost-effectiveness of two models of supportive care coordination for advanced cancer against _usual care�: a Telephone Caseworker model and an Oncologist-GP model. Both models are aimed at improving patients� and their informal caregivers� health and psychosocial status; are patient-centred, evidence based and readily transferable across health care settings. The Telephone Caseworker model has the additional advantage of reaching people isolated through geography, physical disability or age.Read moreRead less