Characterization Of Neutralizing Antibody Responses In HCV Infected Individuals.
Funder
National Health and Medical Research Council
Funding Amount
$478,076.00
Summary
Hepatitis C virus is a major human pathogen infecting 200 million people world-wide. Currently, there is no vaccine to prevent infection and treatment regimes are only partially effective. IInitial HCV infection is frequently asymptomatic and 30% of people spontaneously clear the virus. The remaining 70% of people develop a life-long chronic infection that causes progressive liver disease, cirrhosis and in some cases liver cancer. The reason why some people are able to clear virus has been attri ....Hepatitis C virus is a major human pathogen infecting 200 million people world-wide. Currently, there is no vaccine to prevent infection and treatment regimes are only partially effective. IInitial HCV infection is frequently asymptomatic and 30% of people spontaneously clear the virus. The remaining 70% of people develop a life-long chronic infection that causes progressive liver disease, cirrhosis and in some cases liver cancer. The reason why some people are able to clear virus has been attributed to the development of a strong cellular immune response and antibody is belived to play a monir role in achieving viral clearance. However, measurememnt of antibody responses in HCV infected pateints is routinely performed using conventional diagnostic tests that do not measure antibody that can help neutralize and clear virus. We have developed an assay that accurately measures the level of NAb in patient sera. We have found that chronically infected patients have broadly reactive neutralizing antibodies but that patients who clear virus, naturally or through treatment do not have broadly reactive neutralizing antibodies. Possibly explaining this phenomenon is that early during infection, antibody is frequently specific only to the infecting virus therefore to detect neutralizing antibodies, homologous viral sequences must be examined. In addition, we have found evidence that HCV can evade neutralzing antibodies through masking of sites to which antibodies bind. We propose to explore whether acutely infected patients develop NAb to autologous viral sequences, and how do these viral sequences and the antibody titre change throughout the course of infection and treatment. We also plan to determine the mechanism of neutralization resistance through the use of mutagenesis of resistant HCV glycoproteins. These studies are aimed at gaining a thorough understanding of the true role of antibody in HCV infection and its influence on viral evolution.Read moreRead less
Molecular Genetics And Evolution Of Antibiotic Resistant Staphylococci
Funder
National Health and Medical Research Council
Funding Amount
$437,545.00
Summary
Potentially life-threatening infections caused by Staphylococcus aureus bacteria, commonly known as Golden Staph, often arise as complications in patients within hospitals. These infections compromise the health of the patient and jeopardise their recovery from the condition for which they were initially admitted, which significantly increases healthcare costs. Hospital-acquired infections caused by Golden Staph are a major problem in Australia and globally. The problem is largely due to the pre ....Potentially life-threatening infections caused by Staphylococcus aureus bacteria, commonly known as Golden Staph, often arise as complications in patients within hospitals. These infections compromise the health of the patient and jeopardise their recovery from the condition for which they were initially admitted, which significantly increases healthcare costs. Hospital-acquired infections caused by Golden Staph are a major problem in Australia and globally. The problem is largely due to the presence in hospitals of strains that have become resistant to most clinically-useful antibiotics and are therefore very difficult to eradicate. This research project will reveal detailed information about strains of Golden Staph that are currently prevalent in hospitals in Australia, USA, Europe, and South East Asia. It will also provide important insights into the mechanisms that enable this organism to become resistant so readily, and identify factors that promote the development of resistant strains. The results of this research project will lead to improved methods for the characterisation of clinical strains and the monitoring of antibiotic resistance. The findings will also be of relevance to other types of antibiotic resistant bacteria. Most importantly, the application of knowledge arising from these studies has potential to minimise the emergence of strains that are even more resistant, thereby extending the effectiveness of existing and future antibiotics. The design and implementation of strategies to limit the proliferation of resistant bacteria are essential if we are to avoid a scenario similar to that prior to the introduction of antibiotics, when serious infectious diseases were often untreatable.Read moreRead less
The Impact Of Insurance On Use Of Dental Services And Oral Health
Funder
National Health and Medical Research Council
Funding Amount
$203,616.00
Summary
Dental problems are very common in the Australian population, and health expenditure on dental services is large. This project addresses the impact of dental insurance on use of dental services and oral health outcomes to investigate the effect of insurance on dental visit patterns and mix of dental services provided, and examine how the cost of dental care is related to outcomes such as tooth loss and quality of life.
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
This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professiona ....This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professionals in relatively small rural hospitals. Patients and rural doctors often have little choice but to manage urgent cases locally and in some cases experienced and skilled local teams are able to offer a wider range of services, including a limited number of elective procedures. Despite underlying assumptions that the quality of the services cannot match that of specialist care in larger hospitals, there is no agreement on what constitutes quality of rural procedural care and little evidence that the quality is different. This issue is important as substantial government funds are spent on recruiting, training and retaining a qualified rural medical workforce, and yet fewer rural doctors are providing these services and fewer rural hospitals have the facilities to support those rural doctors still providing the services. Further, measuring the quality of care is a complex issue on which different stakeholders may have different views. This study proposes a multi-perspective approach to assessing the quality of care through a number of case studies provided by rural doctors.Read moreRead less