STudy Of Risk Assessment To Reduce Complications In Patients Following Noncardiac SurgerY (STRATIFY)
Funder
National Health and Medical Research Council
Funding Amount
$436,000.00
Summary
Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduce ....Cardiac problems account for many complications in patients undergoing major non-cardiac surgery, and even apparently minor cardiac damage is a marker of high risk for subsequent adverse events. Unfortunately, while money and effort is expended on identifying patients at risk, the appropriate response to this risk is quite unclear. The performance of bypass surgery or balloon angioplasty in order to treat the underlying coronary disease of at-risk patients is used in other situations, and reduces longterm risk. However, in many patients undergoing major noncardiac surgery, this approach may be inappropriately aggressive, as these patients are often elderly, have other diseases that make heart operations more difficult and risky than usual, and in any case may have a reduced life expectancy from the disease necessitating the operation. As the most critical issue is to ensure that patients undergo their surgery uneventfully, an alternative is the use of intensive medical therapy to protect the heart. This multicentre study, based at Brisbane hospitals that perform large numbers of major operations, will follow up patients for complications, and outcome (including quality of life) will be assessed six months after the operation. We will address two important questions about the efficacy and cost of risk reduction strategies. First, in patients at higher levels of risk and with a positive stress test, could a combination of medical therapy designed to protect the heart be as effective as current approaches, which include the performance of bypass surgery or coronary balloon angioplasty? Second, in patients identified as being at some risk - but low risk - are drugs sufficiently effective to avoid the need for further testing to quantify risk? As the population continues to age, the numbers of at risk patients undergoing major surgery will increase, and answers to these questions will provide important information to guide their management.Read moreRead less
Investigating The Relationship Between Depression, Anxiety And Nausea And Vomiting During Pregnancy: Causation Or Shared Liability?
Funder
National Health and Medical Research Council
Funding Amount
$600,874.00
Summary
Recent studies showing women who experience severe Nausea and vomiting during pregnancy (NVP) have higher rates of Anxiety and Depression prior to pregnancy have revived earlier hypotheses that NVP may have a psychogenic component. We hypothesize that Anxiety and Depression do not play a causal role in NVP but rather, the relationship is due to shared risk from genetic effects that influence both traits. We will test this hypothesis using genetic and epidemiological approaches.
A Cluster RCT Of A Novel Psychological Intervention To Reduce Depression Among At-risk Older Adults Transitioning To Residential Aged Care
Funder
National Health and Medical Research Council
Funding Amount
$893,152.00
Summary
Depression is common in aged care facilities, with many older adults finding the transition extremely difficult. We have developed a simple intervention to help new residents, including those with dementia, to adjust to life in aged care. This program focuses on key aspects of psychological wellbeing, and is designed for widespread use in aged care. We will evaluate the intervention to determine if it is superior to current care approaches in reducing depression and improving quality of life.
Preventing Anxiety, Depression And Substance Use In Adolescents.
Funder
National Health and Medical Research Council
Funding Amount
$1,709,988.00
Summary
Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders. Yet we have few models of well-implemented prevention programs for these common disorders. The current proposal addresses this gap by evaluating an innovative internet-based approach to preventing mental health and substance use problems in Australian adolescents.
Mental illnesses are the largest single cause of disability and costs the economy $56.7 billion per year. Depression and anxiety in those with dementia lead to poorer outcomes with reduced quality of life, poor functional status and worsening cognition, despite under-treatment. I will develop an integrated network in Australia to maximise treatment outcomes for depression and anxiety in dementia.
Organizational Change And Treatment Of Depression And Dementia In Aged Care Facilities
Funder
National Health and Medical Research Council
Funding Amount
$567,052.00
Summary
Mental health disorders are common in aged care settings. However, these problems are not well managed. This situation results in distress for residents and family members, as well as high levels of burnout and turnover among staff. This project will address the organizational barriers with the aim of better managing and treating depression and behavioural problems associated with dementia.
Macrophages are white blood cells that provide front line defence against infection by initiating inflammatory responses by ingesting or phagocytosing microbes and by releasing soluble messengers (cytokines) to recruit other immune cells. These defensive functions require extensive trafficking of proteins within the macrophages. Protein trafficking is orchestrated in part by a family of membrane fusion proteins called SNAREs. By defining the relevant SNAREs, we have recently discovered a much ac ....Macrophages are white blood cells that provide front line defence against infection by initiating inflammatory responses by ingesting or phagocytosing microbes and by releasing soluble messengers (cytokines) to recruit other immune cells. These defensive functions require extensive trafficking of proteins within the macrophages. Protein trafficking is orchestrated in part by a family of membrane fusion proteins called SNAREs. By defining the relevant SNAREs, we have recently discovered a much acclaimed and novel pathway that allows efficient, combined cytokine secretion and phagocytosis in macrophages. Our studies proposed here will now expand on this discovery by comparing the phagocytic process, in terms of SNARE-mediated membrane and cytokine trafficking, for a wide range of microbes, highlighting differences that could provide new avenues for drug development. Moreover, since our strategy of using SNAREs to investigate and map trafficking pathways has proven so successful, we will now launch a major large-scale initiative to study ALL SNARE-mediated trafficking pathways in macrophages using a discovery pipeline of assays, including live cell imaging, we have developed. This will provide valuable information on many SNAREs including those associated with disease, and will elucidate trafficking pathways governing all macrophage actions in immunity, including cytokine secretion and antigen presentation. All of these pathways are highly relevant to current drug targets being used clinically or studied in inflammatory disease and for the development of vaccines.Read moreRead less
Detection And Management Of Depression In General Practice Patients With Chronic Manifestations Of Ischaemic Heart Disea
Funder
National Health and Medical Research Council
Funding Amount
$499,797.00
Summary
This research will investigate the impact of ischemic heart disease on the prevalence and severity of patients with depression. This will be done via a 12 month general practice based program of 1) systematic screening for depression 2) informing general practitioners of best-practice guidelines for management of depression in these patients, and 3) providing the treating general practitioner with patient-specific, psychiatric advice.
Indigenous Mental Health Model Of Care: RCT Based On A Trans-diagnostic CBT Program Co-designed With Community
Funder
National Health and Medical Research Council
Funding Amount
$996,217.00
Summary
We propose to develop an Indigenous Model of Mental Health Care (IMMHC) that encompasses psychological therapy and cultural healing practices developed in consultation with local, participating Indigenous communities, that will for the first time treat highly prevalent mood and anxiety disorders in Indigenous Australians.
Reducing Childbirth Related Fear And Preference For Caesarean Section: A RCT Of A Midwife-led Psycho-education Intervention (APRIME)
Funder
National Health and Medical Research Council
Funding Amount
$487,116.00
Summary
In 2008 34% of mothers had a caesarean section in Queensland. Women who are fearful are more likely to want and have a surgical delivery. We will recruit and train midwives to provide counselling and education about birth choices to fearful women during pregnancy. Our program (APRIME) enables women to work through fearful elements of childbirth, review their expectations/ experiences and develop a realistic plan. We predict that women receiving APRIME will report less fear and prefer a normal bi ....In 2008 34% of mothers had a caesarean section in Queensland. Women who are fearful are more likely to want and have a surgical delivery. We will recruit and train midwives to provide counselling and education about birth choices to fearful women during pregnancy. Our program (APRIME) enables women to work through fearful elements of childbirth, review their expectations/ experiences and develop a realistic plan. We predict that women receiving APRIME will report less fear and prefer a normal birth.Read moreRead less