Inhaled Mannitol For The Treatment Of Mucociliary Dysfunction- Its Effect And Mechanisms On The Clearance Of Mucus
Funder
National Health and Medical Research Council
Funding Amount
$324,100.00
Summary
Excessive secretion of mucus is a problem in asthma and bronchiectasis. Mucus is secreted from submucosal glands and goblet cells as a result of inflammation present in the airways. Excessive mucus is not easily transported by the cilia (hair like structures) in the airways and accumulation leads to productive cough and to recurrent infections. Cough is a secondary mechanism to clear mucus when the mucociliary system fails. Cough generates high airflow rates that can move mucus. However, patient ....Excessive secretion of mucus is a problem in asthma and bronchiectasis. Mucus is secreted from submucosal glands and goblet cells as a result of inflammation present in the airways. Excessive mucus is not easily transported by the cilia (hair like structures) in the airways and accumulation leads to productive cough and to recurrent infections. Cough is a secondary mechanism to clear mucus when the mucociliary system fails. Cough generates high airflow rates that can move mucus. However, patients with moderately to severely obstructed airways cannot generate high airflow rates. In addition, cough becomes very inefficient in moving mucus if it is sticky and viscous. As the cilia cannot transport large quantities of mucus the best approach is to alter the properties of mucus that would facilitate cough clearance. Increased hydration of mucus could change its surface and rheological properties. Increased hydration can be achieved by the osmotic movement of water into the airway lumen in response to inhaling an aerosol of salt or sugar. We have evidence using radioactive aerosols, that mannitol, a sugar, increases clearance of mucus acutely in patients with excessive secretions. We also have new evidence that mannitol taken daily over two weeks increases the health status in patients with bronchiectasis. Further we now have preliminary data demonstrating that mannitol changes the surface properties of mucus. We aim to study the properties of mucus in relation to its clearance in vivo in humans. This has not been done before. If we can demonstrate that changes in clearance in response to mannitol relate to the changes in mucus then we will be able to easily evaluate current treatments and doses for patients with excessive secretions and to identify new treatments. Mannitol is a potential treatment for diseases with excessive secretions and understanding of how it works will hopefully lead to better outcomes for patients.Read moreRead less
This project will characterise the biological and functional properties of a novel human pro-inflammatory S100 protein. The protein is a natural component of the innate immune system and is regulated in cells by mediators of inflammation and infection. Our preliminary experiments indicate that this protein can activate mast cells. These cells reside in almost all body tissue and are located close to blood vessels and nerves. This location makes them prime targets to trigger vascular and inflamma ....This project will characterise the biological and functional properties of a novel human pro-inflammatory S100 protein. The protein is a natural component of the innate immune system and is regulated in cells by mediators of inflammation and infection. Our preliminary experiments indicate that this protein can activate mast cells. These cells reside in almost all body tissue and are located close to blood vessels and nerves. This location makes them prime targets to trigger vascular and inflammatory events. They are known to be important in allergy and infection and have a proposed role in chronic inflammatory processes. Although the mechanisms of mast cell activation contributing to acute responses in allergic reactions are well accepted, ways in which they are activated in asthma and other chronic inflammatory disease are virtually unknown. We will use lung biopsies from patients with asthma to detect patterns of expression of the protein and determine its effects on lung mast cells. A murine model will be used to define the characteristics of inflammation induced by the S100 protein and the role of mast cells in this process. Structural studies will define the parts of the protein necessary for mast cell activation. We will attempt to identify its receptor on mast cells to enable future studies to define how the protein triggers the cells to produce mediators such as histamine and those causing blood vessel changes. This knowledge could lead to design of novel drugs that could regulate this process. Results from this project will provide new knowledge of chronic inflammatory processes and could result in designing novel strategies to regulate these. Studies are relevant to infectious diseases and many other conditions with a chronic inflammatory basis, including asthma, rheumatoid arthritis, cardiovascular disease, cystic fibrosis and infection.Read moreRead less
A Multilevel Study Of Socioeconomic Position And Physical Activity: Environmental And Individual-level Determinants
Funder
National Health and Medical Research Council
Funding Amount
$429,000.00
Summary
Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited ....Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited, and very little research has investigated this issue. This study will investigate why socioeconomic groups differ in their physical activity, by examining the influence of neighbourhood and individual-level factors. Neighbourhood factors include people's access to recreational facilities such as swimming pools, tennis courts, golf clubs, gyms, local parks, walking and bicycle paths; prices for entry to recreational facilities and opening hours; physical characteristics of the neighbourhood including public transport, presence of footpaths and street lighting, speed limits on local streets, availability of local services such as shops and schools, and; aesthetic characteristics, such as the presence and size of parks and green spaces, and traffic density. Individual factors include personal enjoyment, knowledge, confidence, type of occupation and hours worked, family responsibilities, age, health status, and whether other family member or friends engage in physical activity. A major aim of the study is to determine whether environmental or individual factors are more important in influencing participation in physical activity. The study will produce new knowledge to inform future public health strategies directed at increasing physical activity among socioeconomically disadvantaged groups, and these will have the potential to reduce socioeconomic health inequalities, as well as contribute to an overall reduction of the disease burden attributable to chronic conditions.Read moreRead less
A Longitudinal Multilevel Study Of Change In Physical Activity In Mid-age And Factors Associated With Change
Funder
National Health and Medical Research Council
Funding Amount
$742,678.00
Summary
This project will examine patterns of change in physical activity for men and women aged 40-64 years between 2007-2011; determines the relative contribution of sociodemographic, psychological, social, environmental factors to any observed changes. Knowledge produced by this study will be crucial for the development of strategies to increase physical activity in mid-aged adults, and to prevent high levels of inactivity-related chronic health problems among this group as they move into old age.
Are The Energy Expenditures Of Household And Garden Chores Of Sufficient Intensity To Confer Health Benefits?
Funder
National Health and Medical Research Council
Funding Amount
$322,110.00
Summary
Participation in regular moderate to vigorous intensity physical activity reduces risk for cardiovascular disease, non-insulin dependent diabetes, osteoporosis and some cancers. Recent epidemiological recommendations are that 30 minutes of moderate intensity physical activity (e.g. brisk walking at 4.8-6.4 km-hr) on most days is sufficient to confer these significant health benefits. However, many Australians spend substantial amounts of time engaged in household chores and gardening - yardwork ....Participation in regular moderate to vigorous intensity physical activity reduces risk for cardiovascular disease, non-insulin dependent diabetes, osteoporosis and some cancers. Recent epidemiological recommendations are that 30 minutes of moderate intensity physical activity (e.g. brisk walking at 4.8-6.4 km-hr) on most days is sufficient to confer these significant health benefits. However, many Australians spend substantial amounts of time engaged in household chores and gardening - yardwork activities but it is unknown whether the intensities of these activities are sufficient to confer the aforementioned health benefits. The aims of this study are therefore to: 1. Measure directly the energy cost of self-paced common household chores and gardening - yard activities. 2. Provide data that are required to estimate accurately the prevalence of 'adequate' levels of physical activity among adults. 3. Identify indirect methods (such as heart rate, motion and breathing frequency) which, in combination, are suitable for use in large scale surveys of activity levels. The outcomes of this study will be: 1. A greatly improved understanding of whether energy expenditure associated with self-paced household chores and gardening - yard activities is adequate to confer health benefits. 2. Our results will be used in key public health interventions which are aimed at modifying the physical activity levels of Australians. 3. If the public health message encourages some of the ~30% of sedentary Australians to undertake regular moderate intensity physical activity then this will: reduce the cost of the health care system, substantially reduce the premature loss of life and decrease morbidity and disability. 4. Our results will help public health epidemiologists to monitor the percentage of Australians who are adequately physically active.Read moreRead less
Measurement And Prediction Of The Energy Expenditure Of Older Australian Women During Household And Garden Tasks.
Funder
National Health and Medical Research Council
Funding Amount
$209,000.00
Summary
Participation in regular moderate to vigorous intensity physical activity reduces risk for cardiovascular disease, non-insulin dependent diabetes, osteoporosis and some cancers. Recent epidemiological recommendations are that at least 30 minutes of moderate intensity physical activity (eg. brisk walking at 4.8-6.4 km-hr) on most days is sufficient to confer these significant health benefits. Many older Australians spend substantial amounts of time engaged in household and garden chores but it is ....Participation in regular moderate to vigorous intensity physical activity reduces risk for cardiovascular disease, non-insulin dependent diabetes, osteoporosis and some cancers. Recent epidemiological recommendations are that at least 30 minutes of moderate intensity physical activity (eg. brisk walking at 4.8-6.4 km-hr) on most days is sufficient to confer these significant health benefits. Many older Australians spend substantial amounts of time engaged in household and garden chores but it is unknown whether the intensities of these activities are sufficient to confer the aforementioned health benefits. The aims of this study are therefore to: 1. measure directly the energy cost of self-paced common household and garden activities 2. provide data that are required to estimate accurately the prevalence of 'adequate' levels of physical activity among older adults 3. identify indirect methods (such as heart rate, motion and breathing frequency) which, in combination, are suitable for estimating energy expenditure in large scale surveys. The outcomes of this study will be: 1. A greatly improved understanding of whether for older Australians (55-65 years) energy expenditure of self-paced household and garden activities is adequate to confer health benefits. 2. Our results will be used in key public health interventions which are aimed at modifying the physical activity levels of Australians. 3. If the public health message encourages some of the ~45% of insufficiently active older Australians to undertake regular moderate intensity physical activity then this will reduce the cost of the health care system, substantially reduce the premature loss of life and decrease morbidity and disability. 4. Our results will help public health epidemiologists to monitor the percentage of Australians who are adequately physically active.Read moreRead less
Comparison Of Health And Development Of Young Adults Born With And Without Assisted Conception.
Funder
National Health and Medical Research Council
Funding Amount
$473,674.00
Summary
Since 1983, a large number of children have been conceived with IVF and use of this technology is increasing. Few studies have examined the longer term health and development of these young people as they progress into adulthood. The proposed study will investigate outcomes for IVF conceived young adults as compared to their spontaneously conceived peers. The study will provide new information on the long term safety of IVF.
Testing A Home Based Rehabilitation Program For Survivors Of A Critical Illness: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$447,602.00
Summary
The aim of this study is to evaluate whether a home-based, individually tailored physical rehabilitation program can improve the physical and psychological recovery for survivors of a critical illness. Surviving a critical illness results in physical de-conditioning and emotional sequelae. Many observational studies have demonstrated a delayed recovery, often beyond a six-month period. At present there is a lack of specific service provision for the recovering intensive care patient, and prelimi ....The aim of this study is to evaluate whether a home-based, individually tailored physical rehabilitation program can improve the physical and psychological recovery for survivors of a critical illness. Surviving a critical illness results in physical de-conditioning and emotional sequelae. Many observational studies have demonstrated a delayed recovery, often beyond a six-month period. At present there is a lack of specific service provision for the recovering intensive care patient, and preliminary work by us indicates a need for an outreach follow-up service for ICU survivors that does not require individuals to attend an outpatient clinic. The 8-week program includes prescribed training of lower limb exercises, walking, and upper limb exercises, with the goal of improved physical strength and endurance at study end-point of 26 weeks. The standardised leg and arm exercises will be adjusted according to participant progress, using a specifically designed rehabilitation manual. Physical function, endurance and psychological well-being between the usual care and this program will be compared. Importantly, the project addresses outcomes that are clinically meaningful for the patients. It is designed to evaluate whether physical rehabilitation for people recovering from a critical illness improves physical and psychological recovery, which contribute to how people function and they feel. There appears to be little research in this area, so the innovative aspects of the study are an important consideration. The project addresses one of the National Research Priorities using an exercise-based rehabilitation program. It also provides an important innovation: successful implementation and positive findings from this home-based rehabilitation program will provide a model of care that existing primary care or community services can adopt so that all survivors of a critical illness will have the opportunity to improve their physical and psychological recovery.Read moreRead less