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  • Funded Activity

    Enterovirus 71 In The Asia-Pacific Region: Reverse Genetic Approaches To Virus Surveillance And Vaccine Development.

    Funder
    National Health and Medical Research Council
    Funding Amount
    $690,833.00
    Summary
    In this research the team will use advanced biotechnological techniques to study the distribution and virulence markers of an important emerging infectious disease, enterovirus 71 encephalitis, in the Asia-Pacific region. The knowledge and technical advances derived from this study will be shared with neighbouring countries in order to conduct sensitive surveillance for this infection throughout the region. The study's other major aim is to use cutting-edge biotechnological techniques to develop .... In this research the team will use advanced biotechnological techniques to study the distribution and virulence markers of an important emerging infectious disease, enterovirus 71 encephalitis, in the Asia-Pacific region. The knowledge and technical advances derived from this study will be shared with neighbouring countries in order to conduct sensitive surveillance for this infection throughout the region. The study's other major aim is to use cutting-edge biotechnological techniques to develop a genetically defined, live attenuated vaccine strain. Candidate vaccine strains will be tested for their effectiveness in both cell culture-based and animal models.
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    A Study To Pilot A Clinical Trial To Test Dignity Psychotherapy For The Frail Aged

    Funder
    National Health and Medical Research Council
    Funding Amount
    $25,000.00
    Summary
    One of the greatest challenges today is to preserve the dignity of the frail elderly. Our study will test and perfect a strategy to trial a new approach for this population, Dignity Psychotherapy. The approach will document aspects of the senior's life that they regard as meaningful, want remembered, or of which they are proud. Among the terminally ill, the approach has had positive outcomes. Benefits for elders may include that the approach forms a foundation for holistic care.
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    Funded Activity

    Person-centred Environment And Care For Residents With Dementia: A Cost-effective Way Of Improving Quality Of Life And Q

    Funder
    National Health and Medical Research Council
    Funding Amount
    $1,548,805.00
    Summary
    Improving the quality of life (QOL) and quality of care for persons with dementia are important areas of Australian health research. A growing body of evidence shows that QOL in dementia can be improved by relatively simple and inexpensive modifications to nursing care practices and the physical environment. Most studies in these areas are observational, few have utilized a randomized control group design, and none has included economic evaluation. This study will address these deficiencies. Thi .... Improving the quality of life (QOL) and quality of care for persons with dementia are important areas of Australian health research. A growing body of evidence shows that QOL in dementia can be improved by relatively simple and inexpensive modifications to nursing care practices and the physical environment. Most studies in these areas are observational, few have utilized a randomized control group design, and none has included economic evaluation. This study will address these deficiencies. This is the first time that a randomized controlled trial of Person-Centred Care (PCC) and Person-Centred Environment Design (PCD) will be undertaken. The study will be conducted in 40 residential aged care services in New South Wales, to determine the efficacy and cost effectiveness of implementing PCC and PCD separately, and in combination, in improving resident quality of life and quality of care.
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    Can The Needs Caregivers Of Patients With Advanced Cancer Be Met Using A GP Caregive Needs Toolkit?

    Funder
    National Health and Medical Research Council
    Funding Amount
    $584,815.00
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    Funded Activity

    Measuring Changes In Fluids, Fat, Muscle Mass, Proteins & Other Body Components Non-invasively Through Course Of Illness

    Funder
    National Health and Medical Research Council
    Funding Amount
    $120,000.00
    Summary
    The course of non-cancer related disease is difficult to assess clinically making it hard for clinicians to accurately predict the end of life course of illness for patients. No matter what the end of life disease is, death will involve multi-system organ failure and changes in body composition. These changes, including fluid distribution, muscle mass and type and fat mass as well as measures of body mass index, basal metabolic rate and arm muscle circumference can be accurately followed with no .... The course of non-cancer related disease is difficult to assess clinically making it hard for clinicians to accurately predict the end of life course of illness for patients. No matter what the end of life disease is, death will involve multi-system organ failure and changes in body composition. These changes, including fluid distribution, muscle mass and type and fat mass as well as measures of body mass index, basal metabolic rate and arm muscle circumference can be accurately followed with non-invasive multi-frequency bio-impedance. This information will provide a basis to either confirm the clinical diagnosis or lead to recommendations for change.
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    Improving Quality Of Life Of People With Dementia Living In Residential Care Facilities A Randomised Trail Of Educat Int

    Funder
    National Health and Medical Research Council
    Funding Amount
    $777,409.00
    Summary
    The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to .... The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.
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    Funded Activity

    Genetic Factors For Osteoporosis

    Funder
    National Health and Medical Research Council
    Funding Amount
    $810,661.00
    Summary
    Osteoporosis is a common condition in which bone strength is reduced due to reduced amount and quality of bone. Reduced bone strength means an increased risk of fracture. Osteoporotic fractures occur in 1 in 2 women and 1 in 3 men in their lifetime, and the likelihood of suffering osteoporotic fracture increases with age. Most of the risk of developing osteoporosis is genetic, but few of the genes involved have been identified. Our goal is to identify those genes. We will complete recruitment an .... Osteoporosis is a common condition in which bone strength is reduced due to reduced amount and quality of bone. Reduced bone strength means an increased risk of fracture. Osteoporotic fractures occur in 1 in 2 women and 1 in 3 men in their lifetime, and the likelihood of suffering osteoporotic fracture increases with age. Most of the risk of developing osteoporosis is genetic, but few of the genes involved have been identified. Our goal is to identify those genes. We will complete recruitment and assessment of a cohort of 1500 postmenopausal women with either low or high bone mineral density from pre-existing population cohorts in Australia. A genomewide association study will then be performed on these cases. Associated genes in different datasets will then be investigated further in our cohort, and high-density SNP mapping performed to identify true associated variants. These studies should identify most genetic variants associated with BMD variation and low trauma fracture in the general community, allowing development of diagnostic-disease predictive genetic tests, and informing development of novel therapeutic agents for osteoporosis.
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    Funded Activity

    Using N-of-1 Trials To Determine Effectiveness Of Paracetamol In Advanced Cancer Patients On Opioids

    Funder
    National Health and Medical Research Council
    Funding Amount
    $49,996.00
    Summary
    In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and produci .... In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and producing any improvement in pain will improve patients’ functional status, and will greatly improve QOL for patients and carers. N-of-1 trials are randomized, double-blind cross-over comparisons of active drug with placebo or another drug. The patient is their own control. N-of-1 trials provide objective means of testing effectiveness of medicines in individuals, providing evidence stronger than randomised controlled trial evidence for the efficacy of that drug in that individual. We will pilot N-of-1 trials of paracetamol for pain in 10 patients. If feasible, this will be a new method of obtaining strong evidence in a difficult to research population: palliative care patients.
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    Funded Activity

    Confirming The Burden Of Disease Associated With Dementia Using New Empirically Driven Australian Based Disability Rati

    Funder
    National Health and Medical Research Council
    Funding Amount
    $138,084.00
    Summary
    The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden e .... The amount of burden the population experiences as a result of individual diseases influences health policy. The Australian Burden of Disease project quantifies the relative burden associated with each disease. New estimates are to be released this year will outline the magnitude of burden associated with dementia now and estimate that for the year 2023. Although the projections use the best data available, three improvements to the methodology would improve the accuracy of the dementia burden estimates. First, the dementia calculations currently use a “disability weight” metric derived from a Dutch study. This is problematic in that the weights do not reflect an Australian experience of dementia, nor do they reflect the preferences of people closely affected by the disease (e.g. carers). Second, the dementia estimates do not include cases of mild cognitive impairment (considered a precursor state of dementia). Hence the dementia estimates may not estimate the full impact of dementia in Australia. Finally, there is no evidence that the method used by the Burden of Disease study to account for the impact of disease comorbidity adequately deals with the comorbidity associated with dementia. Consequently, there is need to develop a new and comprehensive set of disability weights for dementia that are Australian-based, include all stages of dementia severity and account for comorbidity. The proposed project aims to develop a new set of empirically derived Australian-based disability weights for dementia. The project will entail three studies. The first study will generate empirically based case vignettes that describe a range of dementia case scenarios. These descriptions will then be used in rating exercises (Study 2) to develop new disability weights. The second study involves Australian health practitioners, carers and lay persons reading case vignettes and completing health valuation rating exercises to generate new disability weights for dementia. The third study uses the new disability weights to re-calculate the burden of disease estimates for dementia. The new estimates will be compared to those reported by the 2007 Australian Burden of Disease project. In knowing the accuracy of the estimates, policy makers can use the burden data for dementia with confidence when engaging in service planning for the future.
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    Funded Activity

    Identifying EHealth Literacy And Readability Issues For Palliative Care Consumers

    Funder
    National Health and Medical Research Council
    Funding Amount
    $29,375.00
    Summary
    Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individ .... Access and use of health information can affect a patient’s health experience and potentially their health outcomes. Increasingly health information is being provided and sought through the internet and online resources. Palliative care patients and their carers have specific information needs relating to the nature and progress of their disease, their symptoms and their current and pending quality of life. However, their ability to find and use information relies on many factors such as individual skills and experiences and how information is presented and made available. eHealth literacy is a measure of the mix of skills required by consumers to successfully access and understand palliative care information. Readability is one aspect of eHealth literacy and readability scales can be used to identify how effective websites are in providing appropriate written information for palliative care consumers. This research will help assess eHealth literacy levels and hence potential intervention needs of palliative care patients and carers as well as determining whether the readability requirement of palliative care websites and information is too high.
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