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Novel Strategies For The Early Identification Provention And Treatment Of The Microvascular Complications Of Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$4,715,000.00
Summary
Despite recent advances, approximately one third of subjects with type 1 diabetes develop kidney disease and similar proportion develop vision-threatening eye disease. Indeed, in many instances eye and kidney disease occur in the same individual. The central aim of this proposed Special Program is the exploration of mechanisms that lead to the development and progression of these devastating complications of type 1 diabetes with a particular focus on novel strategies, directly applicable to man, ....Despite recent advances, approximately one third of subjects with type 1 diabetes develop kidney disease and similar proportion develop vision-threatening eye disease. Indeed, in many instances eye and kidney disease occur in the same individual. The central aim of this proposed Special Program is the exploration of mechanisms that lead to the development and progression of these devastating complications of type 1 diabetes with a particular focus on novel strategies, directly applicable to man, for their prevention and treatment. Participants in Special Program include both established diabetes researchers and investigators from other areas of academia (blood vessel biology and applied genetics). Strong interrelationships between the various investigators and their departments already exist and will be further consolidated with continued collaboration, sharing a combination of models, novel interventions and complex genetic techniques that would not be possible outside of a large collaborative framework. In addition to academic collaboration, interactions with industry-based drug discovery programs is also an important component in developing new treatment strategies for diabetic kidney and eye disease. The Special Program will thus consist of a range of studies of direct relevance to diabetic kidney and diabetic eye disease in humans. It is expected that these studies will lead to new strategies for the prevention, treatment and even the reversal of long term complications of diabetes.Read moreRead less
Molecular Analysis Of Pathways In Diabetes (MAPDB) Study
Funder
National Health and Medical Research Council
Funding Amount
$3,348,000.00
Summary
The sequence of human genome provides a complete part-list of the genes and proteins that make our bodies. A most unknown subset of these parts work together in molecular pathways that underpin susceptibility and resistance to Type 1 diabetes and its complications. The MAPDB study will link patients, families, doctors, genome experts, immunologists, physiologists, statisticians and data base programmers together to illuminate these molecular pathways. In particular, the study will reveal genes a ....The sequence of human genome provides a complete part-list of the genes and proteins that make our bodies. A most unknown subset of these parts work together in molecular pathways that underpin susceptibility and resistance to Type 1 diabetes and its complications. The MAPDB study will link patients, families, doctors, genome experts, immunologists, physiologists, statisticians and data base programmers together to illuminate these molecular pathways. In particular, the study will reveal genes and pathways that medicate protection from diabetes and its complications - either by inhibiting T cell responses to pancreatic beta cells, protecting or regenerating beta cells in the face of metabolic or immunologic stress, or protecting eyes and kidneys from the damaging effects of high blood glucose. By identifying genes and proteins with these functions, the study will enable new treatments to be developed aimed at augmenting these protective pathways, to prevent diabetes starting in children at risk, and to preserve beta cell mass, protect transplanted stem cells or beta cells, and prevent eye and kidney damage in people already affected by Type 1 diabetes. Genes and proteins that are needed for T cell attack on beta cells will also be revealed. This information will enable new treatments to be developed that block these processes, to prevent diabetes from starting, to preserve beta cell mass and to prevent destruction of transplanted stem cells or beta cells. The MAPDB study will also identify different versions-alleles- of many of the genes in the pathways described above. Particular combinations of these gene alleles will be defines that can identify people at high risk of developing Type 1 diabetes, risk of cell or islet transplantation rejection, or at most risk for eye-kidney complications. Different gene combinations may be found that allow different kinds of Type 1 diabetes to distinguished. By creating ways to identify and distinguish people's individual risk, the study will yield diagnostic tests to enable new treatments and clinical trials to be targeted.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
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.Read moreRead less
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.
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.Read moreRead less
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.Read moreRead less
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.Read moreRead less
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.Read moreRead less