Reducing The Burden Of Joint Replacement: An Innovative Biofeedback Device For Post-Surgical Rehabilitation.
Funder
National Health and Medical Research Council
Funding Amount
$169,500.00
Summary
This project aims to develop a robust wearable device capable of providing immediate audible feedback with respect to knee motion for enhanced post-knee replacement surgery rehabilitation, suitable for use by older people both independently and supervised at home or in the clinic. As there is a current unmet need for such wearable biofeedback devices, this project will lead to intellectual property generation, strengthened partnerships between the involved parties and identification of an indust ....This project aims to develop a robust wearable device capable of providing immediate audible feedback with respect to knee motion for enhanced post-knee replacement surgery rehabilitation, suitable for use by older people both independently and supervised at home or in the clinic. As there is a current unmet need for such wearable biofeedback devices, this project will lead to intellectual property generation, strengthened partnerships between the involved parties and identification of an industry partner to commercialise the technology.Read moreRead less
Characterisation Of The Morning Surge Of Blood Pressure As A Risk Factor For Cardiovascular Disease.
Funder
National Health and Medical Research Council
Funding Amount
$399,450.00
Summary
Cardiovascular events occur more frequently in the early morning transition between the asleep and awake state. This parallels the period where the rise in blood pressure and heart rate is at its greatest and hence may be a potential risk marker for cardiovascular events. We have developed a new mathematical way of measuring the morning surge in blood pressure and heart rate in patients using ambulatory monitoring which has been patented. The main aim of the grant is to determine if morning bloo ....Cardiovascular events occur more frequently in the early morning transition between the asleep and awake state. This parallels the period where the rise in blood pressure and heart rate is at its greatest and hence may be a potential risk marker for cardiovascular events. We have developed a new mathematical way of measuring the morning surge in blood pressure and heart rate in patients using ambulatory monitoring which has been patented. The main aim of the grant is to determine if morning blood pressure surge is a risk factor and to determine the underlying mechanisms. Using both clinical and experimental studies we aim to a) characterise the rate of morning rise in hypertension and normotension b) determine whether subjects with an exaggerated morning surge in blood pressure also have an over responsive nervous system, c) determine whether the rate of rise in blood pressure is a risk factor and d) determine in stroke prone animals whether preventing the waking blood pressure surge is beneficial. This will be achieved via a novel analysis method of continuous BP recording over the 24hr period. These studies are important since identification of new risk markers or predictors of sudden cardiac death, stroke and myocardial infarction is a national health priority. Understanding the mechanisms that are responsible for the increased risk of a cardiovascular event in the morning is the first step to devising appropriate treatment and risk management. Our study will shed light on both the mechanism and the therapy aspects.Read moreRead less
IMMUNE-MEDIATED INFLAMMATION IN DORSAL ROOT GANGLIA AFTER PERIPHERAL NERVE INJURY AND IN SENSORY NEUROPATHIES
Funder
National Health and Medical Research Council
Funding Amount
$378,300.00
Summary
Damage to the nervous system can occur because of accidental or iatrogenic trauma, toxins, infection, metabolic disorders, and even normal ageing. The consequences can outweigh the direct effects of the injury. Almost all injury to the nervous system results in loss of nerve cells and consequently modified sensation and movement. Nerve damage may also be followed by sensory disturbances, ranging from tingling, numbness and abnormal temperature sensations to spontaneous pain, allodynia (painful s ....Damage to the nervous system can occur because of accidental or iatrogenic trauma, toxins, infection, metabolic disorders, and even normal ageing. The consequences can outweigh the direct effects of the injury. Almost all injury to the nervous system results in loss of nerve cells and consequently modified sensation and movement. Nerve damage may also be followed by sensory disturbances, ranging from tingling, numbness and abnormal temperature sensations to spontaneous pain, allodynia (painful sensations from light touch) or hyperalgesia (increased sensitivity to a damaging stimulus). Some of these symptoms are encountered in older people as they lose sensory neurones. The problems are chronic and most are intractable to drugs. This project will clarify how immune-mediated inflammation of dorsal root (sensory) ganglia (DRGs) contributes to these sequelae. Even the simplest form of neural damage following peripheral nerve injury can produce changes in regions of the nervous system far from the parts directly involved in the injury. Our recent work has described for the first time the involvement of the immune system in triggering changes in DRGs following transection of a distant peripheral nerve in rats. T-cell activation leads to invasion of macrophages and production of proinflammatory cytokines. These substances can activate sensory neurones and may be responsible for progressive neuronal death. Thus we have established a simple system in which we can evaluate the influx of T-cells and macrophages of different kinds into DRGs after injury and other insults. We intend to use this to define the sequence of cellular events involved in recruitment of immune cells and compare it with other experimental interventions known to produce a neuroimmune response in this system. This will identify whether the DRG is a special site for neuroimmune interactions and so should be a target for therapy.Read moreRead less
LONG TERM FUNCTIONAL ABILITY AND COSTS OF STROKE SUBTYPES.
Funder
National Health and Medical Research Council
Funding Amount
$270,604.00
Summary
Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on o ....Stroke is the third most common cause of death in Australia, and is more common in the older age groups. Because the population most at risk of developing stroke is growing faster than the rest of the population, it is likely that there will be a large increase in the number of strokes occurring in coming years. At 1 year after stroke about one-third of patients have died, a third remain severely disabled and a third recover with minimal disability. In Australia, there is little information on outcome beyond 1 year. It is thought that at 5 years after stroke about 55% of patients will die, and a further 10% will have another nonfatal stroke. Stroke is estimated to cost the community in excess of $1 billion a year. Little is known about the long-term costs of stroke to survivors and their relatives. These costs are likely to be substantial, and are likely to include costs related to hospitalisations, outpatient visits, general practitioner visits, medications, aids and community services. It is also likely that substantial informal care is provided by relatives and friends (e.g. assistance with shopping and personal care). The aim of this study is to assess the long-term outcome of patients with stroke. These will include measures of survival, stroke recurrence, and ability to perform usual daily activities. In addition, we aim to determine the long-term use of health care and community resources and the costs incurred by patients, their carers, and the community. Information on survival patterns, stroke recurrence and disability will provide information of great value for health service planning. Such information will also be useful to patients, their families, and medical staff who treat these patients. Information on the costs of stroke will provide the only information about the patterns of long-term health care and community resource use among stroke patients in Australia. This information will be useful for health service planning.Read moreRead less
Regeneration And Repair In The Rodent Visual System: An In Vivo Gene Therapy And Neural Transplantation Study
Funder
National Health and Medical Research Council
Funding Amount
$426,000.00
Summary
In the adult human central nervous system (CNS), traumatic injury, stroke, or loss of nerve cells due to degenerative disease all result in long-term and severe functional impairments. The personal, social and economic costs associated with these neurological problems are massive. In the proposed work, gene therapy and transplant techniques will be used to develop new cooperative strategies for neural repair. The aims are to protect and-or replace damaged nerve cells (neurons) and promote the lo ....In the adult human central nervous system (CNS), traumatic injury, stroke, or loss of nerve cells due to degenerative disease all result in long-term and severe functional impairments. The personal, social and economic costs associated with these neurological problems are massive. In the proposed work, gene therapy and transplant techniques will be used to develop new cooperative strategies for neural repair. The aims are to protect and-or replace damaged nerve cells (neurons) and promote the long-distance regrowth of their processes (axons). The ultimate goal is to improve the treatment of human CNS injury and disease, leading to better functional recovery. We will use the visual system as our experimental CNS model. Viruses are novel tools that can be used for the introduction of foreign genes into cells. We will use modifed, non-harmful viral vectors to genetically alter retinal neurons. We will incorporate extra copies of known neuroprotective and-or growth-promting genes into retinal cells and analyze whether these genetically engineered neurons possess a greater ability to survive and regenerate their axons after injury. We will combine this approach with the transplantation of peripheral nerve bridges which are known to boost the regrowth of CNS axons. We will also test the effects of viral transfer of genes into retinal neurons in transgenic mice that have already been given an 'extra dose' of a neuroprotective gene. We will determine if different genes cooperate together to produce a synergistic therapeutic effect after CNS injury. The above studies focus on regeneration in what are essentially acute injury models. We are also interested in the restoration of circuitry in chronic situations, where the damage occured some time previously and neurons have already been lost. We will therefore graft neural precursor cells into the rat eye in an attempt to replace endogenous retinal neurons that are dying or have been lost due to injury.Read moreRead less
Expression And Role Of Integrins During Lens Development And Cataractogenesis
Funder
National Health and Medical Research Council
Funding Amount
$336,760.00
Summary
Cataract is the leading cause of blindness in the world. Numerous risk factors for cataract have been identified, but little is known about the cellular and molecular mechanisms that underlie this debilitating disease. Development of adequate treatments or, eventually, a cure for cataract will require a better understanding of the basic molecular mechanisms that regulate normal lens development and the formation of cataract. The research outlined in this application builds upon our previous rese ....Cataract is the leading cause of blindness in the world. Numerous risk factors for cataract have been identified, but little is known about the cellular and molecular mechanisms that underlie this debilitating disease. Development of adequate treatments or, eventually, a cure for cataract will require a better understanding of the basic molecular mechanisms that regulate normal lens development and the formation of cataract. The research outlined in this application builds upon our previous research, which has identified molecules (growth factors) that are involved in either the regulation of normal lens development and growth (FGF and TGF-beta) or the induction of cataractous changes in the lens epithelium (TGF-beta). The studies are directed at identifying members of an important family of cell adhesion molecules, the integrins, in the lens and examining the role that these molecules play in controlling lens structure and function. These cell surface glycoproteins function in adhesion of cells to each other and to extracellular matrix, and transmit signals in response to changes in the extracellular environment. Such responses include cell proliferation, migration and differentiation. In this regard they often act in concert with growth factor receptors (eg. FGF and TGF-beta). After defining where and when integrins are expressed in the developing lens we will investigate their function in mediating various lens cell responses by using genetic manipulations to alter the expression of integrins or their intracellular signaling mediators in lenses of transgenic mice. In addition, a lens explant culture system will be used to investigate the roles integrins play during lens development and during formation of anterior subcapsular cataract by TGF-beta. These studies will provide important insights into the molecular mechanisms that control cellular events in normal and abnormal lens development.Read moreRead less
RCT Of Polypill Versus Usual Care Among Aboriginal And Torres Strait Islander People With High Cardiovascular Risk
Funder
National Health and Medical Research Council
Funding Amount
$1,855,205.00
Summary
Cardiovascular disease is a major contributor to the lower life expectancy of Aboriginal compared to non Aboriginal people. Guidelines recommend people at high risk of cardiovascular disease shoul be on a combination of blood thinning, blood pressure lowering and cholesterol lowering medications. There is a large gap between actual practice and these guidelines. We will test a combined polypill strategy aiming to simplify treatment and reduce costs to close this gap.
I am a neuroscientist interested in injury to the nervous system with emphasis on promoting functional recovery and clinical translation. Injury models are neurotrauma, the long-term effects of maternal drug administration on offspring and diabetic retino